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class="hl-title-area"> <h1>Social Anxiety Disorder</h1> <p class="attribution" id="byline"> Written by Valencia Higuera | Published on <meta content="2012-07-02" itemprop="datePublished"/>July 2, 2012<br/>Medically Reviewed by <a href="http://www.healthline.com/health/medical-board">George Krucik, MD</a> </p> <div class="hl-widget-sharebar c"></div> <div class="sharebarContainer"><a class="link-sharebar" href="#overlaySharebar" id="sharebarLink" rel="#overlaySharebar"></a></div> </header> <nav class="hl-tab-navigation"> <div class="hl-arrow-tabnav hl-left-arrow-tabnav hl-icon-left-arrow"></div> <div class="hl-lpipe-tabnav"></div> <div class="hl-tabs-tabnav"> <ul> <li><a href="#Overview"> Overview</a></li> <li><a href="#Causes"> Causes</a></li> <li><a href="#Symptoms"> Symptoms</a></li> <li><a href="#Diagnosis"> Diagnosis</a></li> <li><a href="#Treatment"> Treatment</a></li> <li><a href="#Outlook"> Outlook</a></li> </ul></div> <div class="hl-rpipe-tabnav"></div> <div class="hl-arrow-tabnav hl-right-arrow-tabnav hl-icon-right-arrow"></div> </nav> <div class="grid648"> <div class="container-article" itemscope="" itemtype="http://schema.org/Article"> <article class="hl-article-toc"> <h2 class="content_head" id="TOC_TITLE_HDR_1"><a name="Overview"></a>What Is Social Anxiety Disorder? </h2><div class="content_body" id="TOC_TITLE_1"> <p><strong>Social anxiety disorder</strong>, also called social phobia, is a type of anxiety disorder that causes extreme fear in social settings. People with this disorder have trouble talking to people, meeting new people, and attending social gatherings. They fear being judged or scrutinized by others. They may understand that their fears are irrational or unreasonable, but feel powerless to overcome them. </p> <p>Social anxiety is different from shyness. Shyness is usually short-term and doesn’t disrupt one’s life. Social anxiety is persistent and debilitating. It can affect one’s ability to: </p> <ul> <li>work</li> <li>attend school</li> <li>develop close relationships with people outside of his or her family</li> </ul> <p>Approximately 15 million American adults have social anxiety disorder. According to the Anxiety and Depression Association of America (ADAA), symptoms of this disorder may start around the age of 13 (ADAA, 2012).</p> </div> <h2 class="content_head" id="TOC_TITLE_HDR_2"><a name="Causes"></a>What Causes Social Anxiety Disorder? </h2> <div class="content_body" id="TOC_TITLE_2"> <p>The exact cause of social phobia is unknown. However, doctors believe it’s a combination of environmental factors and genetics. Negative experiences also may contribute to this disorder, including:</p> <ul> <li>bullying</li> <li>family conflict</li> <li>sexual abuse</li> </ul> <p>Physical abnormalities such as a serotonin imbalance may contribute. <strong>Serotonin</strong> is a chemical in the <A id="hllink108" class="hllink hllink-auto" href="http://www.healthline.com/human-body-maps/brain">brain</A> that helps regulate mood. An overactive <strong>amygdala</strong> (a structure in the brain that controls fear response and feelings or thoughts of anxiety) may also cause these disorders.</p> <p>Anxiety disorders can run in families. However, doctors aren’t sure if they’re actually linked to genetic factors (<a href="http://www.mayoclinic.com/health/social-anxiety-disorder/DS00595/DSECTION=causes">Mayo Clinic</a>, 2011). Learning to react to situations in the same way as other people in your family may cause you to develop a social phobia. </p> </div> <h2 class="content_head" id="TOC_TITLE_HDR_3"><a name="Symptoms"></a>Symptoms of Social Anxiety Disorder </h2> <div class="content_body" id="TOC_TITLE_3"> <p>Social interaction may cause the following physical symptoms:</p> <ul> <li>blushing </li> <li>nausea </li> <li>excessive sweating </li> <li>trembling or shaking </li> <li>difficulty speaking </li> <li>dizziness or <A id="hllink156" class="hllink hllink-auto" href="http://www.healthline.com/health/lightheadedness">lightheadedness</A> </li> <li>rapid heart rate </li> </ul> <p>Psychological symptoms may include:</p> <ul> <li>worrying intensely about social situations</li> <li>worrying for days or weeks before an event</li> <li>avoiding social situations or trying to blend into the background if you must attend</li> <li>worrying about embarrassing yourself in a social situation</li> <li>worrying that other people will notice you are <A id="hllink176" class="hllink hllink-auto" href="http://www.healthline.com/health/stress">stressed</A> or <A id="hllink178" class="hllink hllink-auto" href="http://www.healthline.com/human-body-maps/nervous-system/male">nervous</A></li> <li>needing a drink to face a social situation</li> <li>missing school or work because of anxiety</li> </ul> <p>It is normal to sometimes feel anxious. However, when you have social phobia, you have a constant fear of being judged by others or humiliated in front of them. You may avoid all social situations, including: </p> <ul> <li>asking a question</li> <li>conducting a job interview</li> <li>shopping</li> <li>using public restrooms</li> <li>talking on the phone</li> <li>eating in public</li> </ul> <p>Symptoms of social anxiety may not occur in all situations. You can have limited or selective anxiety. For example, symptoms may only occur when you’re eating in front of people or talking to strangers. Symptoms can occur in all social settings if you have a broad or extreme case. </p> </div> <h2 class="content_head" id="TOC_TITLE_HDR_4"><a name="Diagnosis"></a>Diagnosing Social Anxiety Disorder </h2> <div class="content_body" id="TOC_TITLE_4"> <p>There is no medical test to check for social anxiety disorder. Your doctor will diagnose social phobia from a description of your symptoms. He or she can also diagnose social phobia after examining certain behavioral patterns. </p> <p>During your appointment, your doctor will ask you to explain your symptoms. He or she will also ask you to talk about situations that cause your symptoms. The criteria for social anxiety disorder includes:</p> <ul> <li>a constant fear of social situations due to fear of humiliation or embarrassment </li> <li>feeling anxious or panicky before a social interaction </li> <li>a realization that your fears are unreasonable </li> <li>anxiety that disrupts daily living </li> </ul> </div> <h2 class="content_head" id="TOC_TITLE_HDR_5"><a name="Treatment"></a>Treatment for Social Anxiety Disorder </h2> <div class="content_body" id="TOC_TITLE_5"> <p>Several types of treatment are available for social anxiety disorder. Treatment results differ from person to person. Some people only need one type of treatment. However, others may require more than one. Your doctor may start with self-help treatments and therapy before suggesting medication.</p> <p>Treatment options for social anxiety disorder include:</p> <ul> <li><strong>cognitive-behavioral therapy</strong>: learning how to control anxiety through relaxation and breathing and learning to replace negative thoughts with positive ones </li> <li><strong>exposure therapy</strong>: learning how to gradually face social situations, rather than avoiding them </li> <li><strong>group therapy</strong>: learning social skills and techniques to help you interact with people in social settings. Participating in group therapy with others who have the same fears may make you feel less alone. It will give you a chance to practice your new skills through role playing </li> </ul> <p>At-home treatments include:</p> <ul> <li><strong>avoiding caffeine</strong>: foods such as coffee, chocolate, and soda are stimulants and may increase anxiety </li> <li><strong>getting plenty of sleep</strong> (at least eight hours per night): lack of sleep can increase anxiety and worsen symptoms of social phobia </li> </ul> <p>Your doctor may prescribe medications that treat anxiety and depression if your condition doesn’t improve with therapy and lifestyle changes. These medications do not cure social anxiety disorder. However, they can improve your symptoms and help you function in daily life. Symptoms may take up to three months to improve with medication.</p> <p>Medications approved by the Food and Drug Administration (FDA) to treat social anxiety disorder include Paxil, Zoloft, and Effexor. Your doctor may start you with a low dose of medication and gradually increase your prescription to avoid side effects. </p> <p>Common side effects of these medication include:</p> <ul> <li>insomnia (sleeplessness)</li> <li>weight gain</li> <li>upset stomach</li> <li>lack of sexual desire</li> </ul> <p>Talk to your doctor about the benefits and risks to decide which treatment is right for you. </p> </div> <h2 class="content_head" id="TOC_TITLE_HDR_6"><a name="Outlook"></a>Outlook for Social Anxiety Disorder </h2> <div class="content_body" id="TOC_TITLE_6"> <p>About 36 percent of people with social anxiety have symptoms for at least 10 years before speaking with a doctor (ADAA, 2012).</p> <p>People with social phobia may rely on drugs and alcohol to cope with anxiety triggered by social interaction. Left untreated, social phobia can lead to other high-risk behaviors, including: </p> <ul> <li>alcohol and <A id="hllink385" class="hllink hllink-auto" href="http://www.healthline.com/health/drug-abuse">drug abuse</A></li> <li>loneliness</li> <li>thoughts of suicide</li> </ul> <p>The outlook for social anxiety is good with treatment. Therapy, lifestyle changes, and medication can help many people cope with their anxiety and function in social situations. </p> <p>Social phobia doesn’t have to control your life. Although it may take weeks or months, psychotherapy and/or medication can help you begin to feel calmer and more confident in social situations. </p> <p>Keep your fears under control by: </p> <ul type="disc"> <li>recognizing the triggers that cause you to start feeling nervous or out of control</li> <li>practicing relaxation and breathing techniques</li> <li>taking your medication as directed </li> </ul> </div></article> <div class="span12 box-share-help-feedback"> <div class="span5"> <div class="box-article-helpful"> <div class="box-helpful-question"> Was this article helpful? <span class="helpful-option-yes">Yes</span> <span class="helpful-option-no">No</span> </div> <div class="box-helpful-confirmation"></div> </div> </div> <div class="span3"> <div class="box-link-feedback"> <span class="icon-email"></span> <a class="link-feedback" href="#feedbackOverlay" id="feedbackLink" rel="#feedbackOverlay">Feedback?</a> </div> <div class="overlay-simple overlay-feedback" id="feedbackOverlay"> <div class="overlay-content"> <div class="box-form-feedback" id="feedbackformdiv"> <form action="/v2/widgetemail" id="feedbackform"> <input name="to" type="hidden" value="hrl"></input> <input id="urlfield" name="urlfield" type="hidden" value=""></input> <h2>Send us your feedback</h2> <p class="box-message">We are unable to respond directly to questions, but your feedback is greatly appreciated, and will be taken into account in our ongoing review of our Health Reference Library.<br/></p> <p> <label>Your Name:</label><br/> <input class="field-name" id="nametext" name="nametext" placeholder="Name Here" type="text"></input> <span class="box-msg-error" id="box-msg-name"><span class="icon-error">✖</span> <span id="errorMsgName">Please enter your name</span></span> </p> <p> <label>Your Email:</label><br/> <input class="field-email-address" id="feedbackemail" name="emailaddress" placeholder="name@example.com" type="email"></input> <span class="box-msg-error" id="box-msg-email"><span class="icon-error">✖</span> <span id="errorMsgEmail">Please enter your email</span></span> </p> <p> <input id="copy" name="copy" type="checkbox"></input> <label>Send me a copy</label> </p> <p class="box-textarea"> <textarea class="field-message" cols="60" id="feedbacktextarea" name="messagetext" rows="4"></textarea> </p> <div class="textarea-char-count" id="charcount">0</div> <p class="box-buttons"> <button class="btn-cancel" name="feedbackcancelbutton" type="button">Cancel</button> <button class="btn-send-msg">Send Message</button> <span class="box-loading"><img alt="" src="/resources/base/images/ajax-loader.gif"/></span> </p> </form> <p class="box-privacy"><span class="icon-lock"></span> Email addresses will not be shared with 3rd parties. See <a href="http://www.healthline.com/health/privacy-policy" target="_blank">privacy policy</a></p> </div> <div class="box-thankyou" id="thankyou"> <h2><span class="icon-green-checkmark"></span> Thank you.</h2> <p>Your message has been sent.</p> </div> <div class="box-submit-error" id="submissionerror"> <h2>We're sorry, an error occurred.</h2> <p>We are unable to collect your feedback at this time. However, your feedback is important to us. Please try again later.</p> </div> </div><div class="overlay-footer"> <div class="overlay-close">Close</div> </div> </div> </div> </div> <div class="row12 hl-article-references"> <div class="span8"> <div class="box-article-source "> <p class="references-title">Article Sources:</p> <div class="basesources"> <ul> <li>Social Anxiety Disorder (n.d). Anxiety and Depression Association of America. Retrieved July 1, 2012, from <a href="http://www.adaa.org/understanding-anxiety/social-anxiety-disorder">http://www.adaa.org/understanding-anxiety/social-anxiety-disorder</a> </li> <li>Social Anxiety Disorder. (2011, August 23). Mayo Clinic. Retrieved July 3, 2012, from <a href="http://www.mayoclinic.com/health/social-anxiety-disorder/DS00595/DSECTION=treatments-and-drugs">http://www.mayoclinic.com/health/social-anxiety-disorder/DS00595/DSECTION=treatments-and-drugs</a> </li> <li>Social Phobia (2012, March 7). National Center for Biotechnology Information. Retrieved July 1, 2012, from <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001953">http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001953</a> </li> </ul></div> <div class="morebox"> <div id="moresources" style="display:none"> <ul class="morelist"></ul> </div> <a href="#" id="showmoresources">Show all</a> </div> </div><!-- end of article source block --> </div><!-- article source span --> <div class="span4"> <div class="box-hrl-logo-src"> <div class="hrl-logo"></div> </div> </div><!-- hrl logo span --> </div><!-- row12 --> <div class="toc-content-promotion"> <!--hl-linking-ignore-start--> <div class="overlay-content-promotion"> <div class="content-promotion-header"> <div class="triangle"></div> <div class="content-promotion-title"> <p class="content-promotion-title-text">Recommended for You</p> </div> <div class="content-promotion-close"><a class="link-close-overlay-content-promotion" href="#"></a></div> </div> <div class="content-promotion-stories"> <!-- Fontest02: true --> <div class="content-promotion-story click-link" data="/health-slideshow/best-anxiety-blogs"> <div class="content-promotion-title">The Best Anxiety Health Blogs of the Year</div> <div class="content-promotion-image"> <a href="http://www.healthline.com/health-slideshow/best-anxiety-blogs" title="The Best Anxiety Health Blogs of the Year"><img alt="The Best Anxiety Health Blogs of the Year" src="/hlcmsresource/images/slideshow/Anxiety-Best-Blogs/194x105_Best_Anxiety_Blogs_2014.jpg"/></a> </div> <div class="content-promotion-text"> <div class="content-promotion-disclaimer">See our picks for the best anxiety blogs of 2014. 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var breakpointsToHideAd = []; var breakpointsToHideAdByPageType = []; breakpointsToHideAdByPageType = ['768','600','480','320']; isAdOnPageLoad = AppResponsiveAds.getShowAdOnPageLoad("MR1",breakpointsToHideAd,breakpointsToHideAdByPageType); var cfgDfpManager = { isAdOnPageLoad: isAdOnPageLoad, adshost : 'http://ads.healthline.com', adSize: '300x250', dfpAdSite : 'hn.us.hl.lc.x.x.rfs', btk1 : '', btk2 : '', kw : 'anxiety,social_anxiety_disorder,2792032', k1 : 'anxiety', k2 : 'mentalhealth', k3 : 'health', pos : 'mr1', ugc : 'false', ac : '', uac : '', akh : 'Social Anxiety Disorder', aks : '5000', env : '', msiteID : '', adTagPageUrl : encodeURIComponent('/health/anxiety/social-phobia'), yeildex : 'true', targetsrc : 'www.google.com' }; var mr1timeout = setTimeout(function() { AppDfpmanager.mr1IframeInit(cfgDfpManager); }, 300); }); </script> <script> require(["jquery","base/dfpmanager","base/responsive-ads","matchmedia"],function($,AppDfpmanager,AppResponsiveAds){ $(function() { // determine if mr2 ad is shown on page load var isAdOnPageLoad = true; 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var breakpointsToHideAd = []; var breakpointsToHideAdByPageType = []; breakpointsToHideAd = ['600','480','320']; var isAdOnPageLoad = AppResponsiveAds.getShowAdOnPageLoad("PB",breakpointsToHideAd,breakpointsToHideAdByPageType); var cfgDfpManager = { isAdOnPageLoad: isAdOnPageLoad, adshost : 'http://ads.healthline.com', logged_in : 'false', dfpAdSite : 'hn.us.hl.lc.x.x.rfs', btk1 : '', btk2 : '', kw : 'anxiety,social_anxiety_disorder,2792032', k1 : 'anxiety', k2 : 'mentalhealth', k3 : 'health', pos : 'lb', ugc : 'false', ac : '', uac : '', akh : '', aks : '5000', env : '', msiteID : '', adTagPageUrl : encodeURIComponent('/health/anxiety/social-phobia'), partner : 'healthline', pg_dart_site : 'hn.us.hl.lc.x.x.rfs', pg_dart_zone : 'anxiety', pg_k2 : 'mentalhealth', pHLID : '2792032', HLID : '2792032', visit_type : 'HCviewer', yeildex : 'true', targetsrc : 'www.google.com' }; var pbtimeout = setTimeout(function() { AppDfpmanager.pbIframeInit(cfgDfpManager); }, 300); }); // dom ready }); </script> <script> var HL_adBlankMonitor = function(cfg) { if(cfg.adBlankCodes.length > 0) { for(var i = 0; 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