Social anxiety disorder is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as at parties and other social events.
People with social anxiety disorder fear and avoid situations in which they may be judged by others. It may begin in adolescence and may have to do with overprotective parents or limited social opportunities. Males and females are affected equally with this disorder.
People with social phobia are at high risk for alcohol or other drug use. This is because they may come to rely on alcohol or drugs to relax in social situations.
People with social anxiety become very anxious and self-conscious in everyday social situations. They have an intense, persistent, and chronic fear of being watched and judged by others, and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends.
Social anxiety can be limited to one situation (such as talking to people, eating or drinking, or writing on a blackboard in front of others). Or, it may be so broad that the person experiences anxiety around almost everyone other than family members.
Physical symptoms that often occur include:
Social anxiety disorder is different from shyness. Shy people are able to participate in social functions. Social anxiety disorder affects the ability to function in work and relationships.
Some of the most common fears of people with this disorder include:
The health care provider will look at your history of social anxiety and will get a description of the behavior from you, your family, and friends.
The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of the phobia.
Anti-anxiety and antidepressant medications are sometimes used to help relieve the symptoms. See: Panic Disorder for more information about medications.
Behavioral treatment may have long-lasting benefits:
Lifestyle changes may help reduce how often the attacks occur.
The outcome is often good with treatment. Antidepressant medications can also be effective.
Call your health care provider or mental health professional if fear is affecting your work and relationships with others.
Phobia - social
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, Va: American Psychiatric Publishing. 2013.
Stein MB, Stein DJ. Social anxiety disorder. Lancet. 2008;371:1115-1125.
Taylor CT, Pollack MH, LeBeau RT, Simon NM. Anxiety disorders: Panic, social anxiety, and generalized anxiety. In: Stern TA, Rosenbaum JF, Fava M, et al, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Elsevier Mosby; 2008:chap 32.
Updated by: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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