Social Anxiety Disorder (also known as Social Phobia) is a condition in which people experience significant and sometimes paralyzing symptoms of anxiety in social situations, based on core deep fears related to evaluation and judgement by others. This anxiety and fear not only impedes an individual’s social life but also interferes with everyday activities, school, and professional life.
About 75% of SAD sufferers experience symptoms by age 13. SAD is influenced by the onset of puberty and associated hormones and physical changes, as well as the evolving and increasingly complex social networks and changes in the maturing teen brain.
Individuals with SAD are often socially inhibited and shy as young children and report a specific socially-humiliating experience prior to onset resulting in the avoidance of such experiences in the future.
The disorder is divided into the following two categories:
Generalized- symptoms are present in most social situations, and
Non-Generalized- symptoms are present in a select few social situations.
Children with this disorder may exhibit behaviors and traits such as crying, tantrums, clinging to familiar people, extreme shyness, refusing to speak in front of their class, and fear or timidity in unfamiliar settings and with unfamiliar people. Children diagnosed with SAD experience anxiety with their peers as well as with adults, but they do have the capacity to form social relationships with familiar people. SAD is harder to diagnose in children because they do not have the ability to describe the nature of their anxiety as effectively as adults. The disorder may therefore go unrecognized even though the child shows symptoms of the disorder. In children, Social Phobia may be intertwined with Separation Anxiety.
SAD typically emerges during adolescence in teens who have a history of a social inhibition. Females have 50% higher likelihood to be impacted than males. The lifetime prevalence of Social Anxiety Disorder is 13.6% in ages 18-29 and 6.9% for 17-18 demographic with 30% of annual cases classified as severe.
This hypersensitivity also results in fear of others making both direct and indirect judgments. They may have extreme test anxiety or refuse to participate in class which compromises academic performance and may lead to avoidance of or dropping out of school.
It is more difficult for those with Social Phobia to develop intimate relationships. Research shows that left untreated, they are less likely to marry, less likely to have fulfilling friendships, and more likely to live with members of their biological family. Severe cases may experience suicidal thoughts, or development of substance abuse or other disorders.
Physical symptoms can be visible or non-visible; acute or pervasive:
Cognitive symptoms range from interpretations, predictions, memories and often include the following “cognitive distortions:”
Behavioral symptoms are actions done or avoided to prevent, decrease or reduce the symptoms of anxiety Check order
Emotional symptoms the following are the most common feelings for sufferers of social anxiety Check the order of items
In the 17-18 year old demographic, the lifetime prevalence of Social Phobia is 6.9%. In the 18-29 year old age demographic, the lifetime prevalence of Social Phobia is 13.6%. About 30% of annual cases of Social Phobia are classified as severe. Social Phobia typically emerges during adolescence in teens with a history of social inhibition. Females are 50% more likely to be impacted than males.
The evidenced-based treatment for Social Anxiety Disorder is Cognitive Behavioral Therapy (CBT), more specifically Exposure and Response Prevention (ERP). ERP involves the gradual exposure and habituation to triggering anxiety-inducing events (a feared object, situation, or place) to help people learn new ways of coping with their anxiety. It is called “response prevention” because the goal is to modify the habitual unhelpful response/thoughts and replace them with healthier behaviors and thoughts. ERP is an intensive practice of repeated exposures to the trigger.
Anxiety and Depression Association of America, ADAA:
Henderson, L., Gilbert, P., & Zimbardo, P. (2014). Shyness, social anxiety, and social phobia. Social Anxiety: Clinical, Developmental, and Social Perspectives, 95.
Mayo-Wilson, E., Dias, S., Mavranezouli, I., Kew, K., Clark, D. M., Ades, A. E., & Pilling, S. (2014). Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. The Lancet Psychiatry, 1(5), 368-376.
National Institute of Mental Health (NIMH):
An organization with the National Institute of health dedicated to mental health research: