Symptoms of Social Anxiety Disorder
By Dr. Randi Fredricks, Ph.D.
Social phobia, also called social anxiety disorder, affects about 15 million American adults.
It is the third most prevalent psychiatric disorder, following substance abuse and depression.
Women and men are equally likely to develop social phobia. Social anxiety is a common comorbid problem in those
with eating disorders.
The DSM-IV describes social phobia as an intense, irrational and persistent fear of being scrutinized or
negatively evaluated by others.19 In patients with this disorder, feared social or performance situations typically
provoke an immediate anxious reaction ranging from fear to panic.
Social phobia can be limited to only one type of situation, such as a fear of speaking in public, or it may be so
broad that a person experiences symptoms almost anytime they are around other people. Social phobia can become so
debilitating that it prevents people from going to work or school. In one study, nearly one half of those with
social phobia were unable to complete high school.18 Many people with this problem have a hard time making
friends and even associating with family.
The symptoms of social phobia can include fear of the following:
Public speaking or performing
Making "small talk"
Small group discussion
Asking questions in groups
Being introduced
Meeting or talking with strangers
Being assertive
Being watched doing something (such as eating or writing)
Attending social gatherings
Using the telephone
Using public restrooms
Interacting with "important" people
Indirect evaluation (such as test taking or a job review)
Physical symptoms often accompany the intense anxiety of social phobia and include blushing, trembling, nausea,
profuse sweating, and difficulty talking. People with social phobia are generally aware that their feelings are
irrational. But even if they manage to confront an experience they fear, they usually feel very anxious
beforehand and intensely uncomfortable throughout. Afterward, anxious feelings tend to linger as they worry
about what people are thinking about them.
In one study of patients with social anxiety, about half reported that their disorder began in response to a
specific embarrassing experience, while the others reported that it had been with them for as long as they
could remember.
Social phobia often co-occurs with other anxiety disorders or depression,19 and increases a person's risk of
depression fourfold.
Substance-related disorders frequently develop in individuals who attempt to "self-medicate" their social phobia
by drinking or using drugs. Approximately one half of patients with social phobia have comorbid mental, drug
or alcohol problems. Studies have shown that at least 16% of patients who present with social phobia have
alcohol abuse problems. Longitudinal data indicates that social phobia precedes approximately 70% of these
comorbid conditions, suggesting that these conditions arise in response to the social phobia.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
Fredricks, R. (2008). Healing & wholeness: Complementary and alternative therapies for mental health. Bloomington,IN: Authorhouse.
San Jose Therapy Counseling Psychotherapy psychotherapist therapist
