Social Anxiety Disorder: More Than Just Being an Introvert!

Social Anxiety Disorder (SAD) / Social Phobia


Social Anxiety Disorder


Significant and enduring fear of social or performance circumstances where shame or embarrassment might occur is the hallmark of a social anxiety disorder (SAD), often known as social phobia. Even though some social situations may cause some worry, people with social anxiety disorder frequently feel significant distress, self-consciousness, and fear of being judged.

People with the disorder experience persistent distress during social contact, and others choose to completely avoid them, which can occasionally result in isolation and withdrawal. SAD sufferers, like those with many other anxiety disorders, may be aware that their anxiety is frequently unjustified or illogical and discover themselves caught in the vicious cycle of anxiety and apprehension about social rejection or embarrassment. Sufferers may have severe physical symptoms such as nausea, shaking, sweating, or blushing even in "normal," everyday social circumstances.


Signs and Symptoms


The fear, worry, and avoidance that characterize social anxiety disorder are distinct from normal nervousness because they affect relationships, daily activities, work, school, and other activities. The onset of social anxiety disorder often occurs between the ages of early and mid-teens; however, it can also happen in younger children or adults.

Signs and symptoms of social anxiety disorder may include: 

  • Fear of situations in which you may be judged negatively
  • Worry about embarrassing or humiliating yourself
  • Intense fear of interacting or talking with strangers
  • Fear that others will notice that you look anxious
  • Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling or having a shaky voice
  • Avoidance doing things or speaking to people out of fear of embarrassment
  • Avoidance of situations where you might be the center of attention
  • Anxiety in anticipation of a feared activity or event
  • Intense fear or anxiety during social situations
  • Analysis of your performance and identification of flaws in your interactions after a social situation
  • The expectation of the worst possible consequences from a negative experience during a social situation


Other Physical Symptoms:


  • Blushing
  • Fast heartbeat
  • Trembling
  • Sweating
  • Upset stomach or nausea
  • Trouble catching your breath
  • Dizziness or lightheadedness
  • Feeling that your mind has gone blank
  • Muscle tension


When you have a social anxiety disorder, it may be difficult to deal with routine, everyday situations, such as:


  • Interacting with unfamiliar people or strangers
  • Attending parties or social gatherings
  • Going to work or school
  • Starting conversations
  • Making eye contact
  • Dating
  • Entering a room in which people are already seated
  • Returning items to a store
  • Eating in front of others
  • Using a public restroom




Social anxiety disorder most likely results from a complex mix of biological and environmental factors, similar to many other mental health diseases. Potential reasons include:


  1. Inherited qualities: 

There is a familial tendency for anxiety problems. It is unclear, though, how much of this may be inherited and how much is the result of learned behavior.


  1. Brain Structure: 

The amygdala may be involved in regulating the fear response. People with an overactive amygdala can experience a more intense fear reaction, which would make them more anxious in social circumstances.


  1. Environment:

Some people may experience severe anxiety after being in an uncomfortable or embarrassing social situation, suggesting that social anxiety disorder may be a learned behavior. Additionally, there may be a link between social anxiety disorder and parents who are either more controlling or overprotective of their kids or who exhibit anxious behavior in social circumstances.




Social anxiety disorder can take over your life if it is not treated. Anxiety can prevent one from enjoying life, relationships, job, or school. This condition may result in:


  • Low self-esteem
  • Trouble being assertive
  • Negative self-talk
  • Hypersensitivity to criticism
  • Poor social skills
  • Isolation and difficult social relationships
  • Low academic and employment achievement
  • Substance abuse, such as drinking too much alcohol
  • Suicide or suicide attempts




Although it is impossible to foretell what will lead someone to acquire an anxiety disorder, there are activities you can do to lessen the severity of symptoms if you experience anxiety:


  • Get assistance as soon as possible: Waiting to get treatment for anxiety, like many other mental health issues, might make it more difficult.
  • Decide on your priorities: By carefully balancing your time and energy, you can lessen tension. Make sure to spend time engaging in activities you enjoy.
  • Getting Psychotherapy: A form of psychotherapy (or talk therapy) known as cognitive behavioral therapy (CBT) is particularly effective in treating social anxiety disorder. CBT can help you overcome some of your anxiety and fears by teaching you alternate ways of thinking, acting, and reacting.
  • Attending Support Groups: Even though social situations can be upsetting for those who struggle with social anxiety, joining a support group where everyone has the same struggles as you can provide you the opportunity to get objective feedback and gain empathy. Additionally, by observing how others handle their social anxiety, you may discover some new strategies to try.


Treatment (Medication):


If the physician diagnoses that you suffer from a social anxiety disorder, they might suggest one of the following types of drugs:

  • Anti-Anxiety Medications
  • Antidepressants (drugs that change the balance of mood-changing chemicals in your brain)
  • Beta-blockers (drugs that block adrenaline from affecting you)

Anti-anxiety drugs are typically prescribed for short-term use because they can create tolerance. They do, however, start functioning immediately and can greatly reduce some of the symptoms of anxiety.

On the other hand, antidepressants take several weeks to fully kick in. Additionally, many of them have negative side effects like nausea, weight gain, or constipation.

Finally, beta-blockers can help with the physical signs of anxiety such as tremors, perspiration, and a fast heartbeat. This is so that they can prevent the effects of adrenaline, which is what you experience when you're anxious, on you.


Dr. Roshni Gautam

Danphe Care