Learning about Mental Health: Social Anxiety Disorder

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According to Anxiety UK, one-tenth of the population of the United Kingdom is likely to experience a ‘disabling anxiety disorder’ during their lifetime, and one in six young people will experience some form anxiety. Social anxiety is the inability to interact with other people or to take any action for fear of being judged. While it is normal to feel nervous when stepping out of one’s comfort zone, social anxiety disorder (SAD) is more intense. Extreme feelings of fear and anxiety, known as phobias, can lead to social isolation, which affects school, work, or other activities. Some everyday situations that can be difficult to face due to social anxiety disorder include: making eye contact, attending social functions or any sort of gathering with a sizeable crowd, starting conversations, going to school, or going to work.


When experiencing social anxiety disorder, the following physical symptoms may occur: sweating, blushing, dizziness, nausea, increased heart rate, feeling frozen in place, blank mind, and trembling. Emotional and behavioural symptoms of social anxiety disorder include:

  • Fear of judgment
  • Fear of embarrassment
  • Avoiding situations where one might be the centre of attention
  • Inability to interact with strangers
  • Fear of displaying physical symptoms of anxiety
  • Anxiety over an upcoming event

It is important to remember that feeling shy and uncomfortable in certain situations is normal. In addition, some people are naturally reserved, while some people are more outgoing. However, regardless of whether or not an individual is normally reserved, action should be taken if any of the above symptoms manifest.

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Spotlight Effect

The spotlight effect occurs when people overestimate how much others notice their appearance or behaviour. For example, when you step into your office with a small coffee stain on your outfit, you worry about others noticing the stain, when, in reality, only a few people may notice. This is a fairly normal phenomenon, but it is heightened in people with SAD.

Many individuals with SAD focus on how they react to uncomfortable situations, which can lead to even more problems. An individual may experience increased heart rate as a result of nervousness upon stepping into a social gathering. This individual starts to believe that people notice how nervous they are, which causes more anxiety, and symptoms will continue until the individual is removed from the environment.

Some people experience performance anxiety, where symptoms are displayed only when the individual is required to speak or perform in public. For some, it is a case of simple stage fright. For others, it may lead to full-blown panic attacks. Many try to avoid their social anxiety symptoms by staying in their comfort zone, avoiding interaction with the outside world or maintaining a very limited or non-existent social circle. This may work in the short term, but society thrives on social interaction, and you cannot stay locked away forever.

Risk Factors for SAD

Mental health illnesses are hardly ever straightforward in terms of their roots. There is a complicated mix of environmental and biological components at play. Therefore, experts usually compile risk factors that may lead to the development of mental disorders. Some risks factors that could lead to the development of SAD include:

Family history – Social anxiety disorder tends to run in families, indicating that genetics could be at play. It could also add credence to SAD as a learned behaviour, as children of socially anxious parents may learn to be reserved, and display these traits in front of their own children.

Brain defects – Another biological cause of SAD is a part of the brain called the amygdala, which plays a role in controlling the body’s response to fear. When the amygdala is overactive, it may lead to increased anxiety. Cases of SAD attributed to defects in the amygdala are often treated with prescribed medication.

Negative experiences – SAD may also develop after a particularly unpleasant social interaction. This experience may have led to embarrassment, causing the individual to withdraw and develop the disorder. Other situations such as family conflict, abuse and trauma can also lead to SAD.

Early childhood – Children whose parents are extremely controlling or overprotective are also at risk of developing the disorder. Additionally, children who have been bullied, ridiculed, or humiliated tend to withdraw from social interactions, which could lead to SAD if not addressed.

Appearance – People who have noticeable conditions such as physical defects and stammering may feel self-conscious and withdraw from society for fear of being ridiculed or judged for their condition.

Substance abuse – The abuse of alcohol and drugs, such as cocaine, amphetamine, and caffeine may cause anxiety in the user. This is known as substance-induced anxiety disorder. Prescription drugs and legal substances such as antihistamines and analgesics can also induce anxiety, in which case it is a medication-induced anxiety disorder.

When to Seek Help

Men are less likely to address their mental health issues than women. Many men mistakenly believe that admitting to having social anxiety disorder will damage their ego and cause further embarrassment. It is imperative that you seek professional help if you notice any of the warning signs of SAD in yourself or a loved one. Recognising the symptoms is the first step towards treatment. Seeking help is the second. Social anxiety disorder can be treated through psychotherapy, and, in some cases, a combination of therapy and medication. If left untreated, SAD may lead to a variety of complications, including depression, alcohol and substance abuse, and, in some extreme cases, suicide attempts. For individuals who have developed SAD due to drug or alcohol abuse, it is important to receive treatment for the substance abuse, during which anxiety issues will be addressed. Usually, treatment for substance abuse is holistic, meaning that the professionals are well-equipped to handle your anxiety problems. Medical prescriptions for social anxiety disorder are often closely monitored, as the abuse of some prescription drugs will lead to further issues.

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