Social Anxiety: A Social Phobia

Social anxiety disorder, also known as social phobia, is a long-term condition ruled by a fear of social situations.

It is usually triggered during a person’s teenage years but can happen anytime.

Social anxiety can be extremely distressing and have a huge impact on a person’s life – sadly, for most, it does not go away without treatment.

In the first part of our two-blog series on Complex Phobias, we will look into what social anxiety is, the symptoms, causes, and how to treat it.

What is social anxiety?

“As many as 1 in 10 adults have some degree of social anxiety disorder.”

But, what is social anxiety? It’s certainly more than shyness!

Social anxiety is a fear that doesn’t disappear and affects the day-to-day life of those suffering, this can include their self-confidence, relationships, work and school life.

Most people will worry about certain social situations but a person with social anxiety will feel panicked before, during and after.

A person suffering from social anxiety may also have other mental health conditions such as depression, anxiety or panic disorder.

Below are some of the key indicators of social anxiety:

A person will worry about common daily activities such as meeting new people, starting conversations, speaking to people on the phone, going to work and going to the shops
They may avoid social situations that include group conversations, eating in front of others or even parties
They will likely find themselves worrying about embarrassing things such as blushing, sweating and appearing that they don’t know what they’re doing
They might find it hard to perform in front of others as they feel watched or judged
They will fear being criticised, may avoid eye contact and likely have low self-esteem
Symptoms such as feeling nauseous, sweating, shaking or having a fast heart rate are common
They will likely have panic attacks relating to social situations

Causes of social anxiety

There isn’t a known cause of social anxiety, but it’s thought to be a combination of the below factors.

As with disorders such as anxiety and depression, physical, biological and genetic factors play a role, issues with the neurotransmitters in a person’s brain may lead to an imbalance in hormones such as serotonin, dopamine and glutamate – they usually help regulate our moods.

It is also thought that environmental factors play a part but alongside biological and genetic factors.

The following are some of the environmental factors that may contribute to social anxiety disorder:

Abuse
Negative interactions with those around you
Controlling parenting styles
An insecure attachment style

Treatment

Living with a social phobia, such as social anxiety, can feel like the end of the world but there are several treatments available:

Cognitive behavioural therapy (CBT) – this is with a therapist and focuses on identifying negative thought patterns to help you change them. This can be one-to-one, within a group setting or with a loved one
Guided self-help – this is when you will work through a CBT-based online course or workbook with support from a therapist
Medication – the three main medications prescribed for social anxiety are selective serotonin reuptake inhibitors (SSRIs), benzodiazepines and beta-blockers.
Support groups – some people may find that joining a support group with people also suffering from social anxiety may be useful. Anxiety UK, Mind and YoungMinds are a good place to start.

It wouldn’t be out of the ordinary for a person to need to try a combination of treatments – everyone is different!

Always reach out

According to the ADAA, “over a third of people with social anxiety don’t seek help until they have had symptoms for at least ten years.”

Without treatment, the symptoms will only get worse. The combination of therapy, medication and lifestyle changes can help a person vastly improve their quality of life.

Speak to your GP if you have any concerns or would like to explore your treatment options further.

Our teams support individuals with a range of mental health diagnoses, including anxiety disorders. We work with individuals to create a tailored support plan, and this can include managing anxiety.

Find out more about our support model.