Innocensia Kambewe 26 May 2022

What is social anxiety?

Social anxiety is a type of anxiety disorder that is common but often misunderstood  (1). It is different from shyness. Shy people want to interact with others but are too nervous about doing so. Shyness is common, especially in children, but it isn’t a psychiatric condition unless it causes significant distress and problems functioning at school or work for at least six months. On the other hand, social anxiety can be paralyzing, making it hard for the person to join in any activity at all. Social anxiety disorder is different from having a very low opinion of oneself (self-esteem), feeling inferior to others (low self-confidence), or feeling awkward around others (shyness). In these examples, there isn’t a marked fear of being watched and judged by others that causes avoidance of social situations or certain places (3). People with social anxiety disorder have an intense fear of being judged by others, or being embarrassed or humiliated by their own actions. They avoid social situations, and they are afraid of acting in ways that might be embarrassing or humiliating. These fears are so intense that they can interfere with the person’s normal routine and limit their ability to work or participate in social activities (1).

 Social anxiety is the third most common mental health disorder, affecting about 15 million American adults aged 18 and older in any given year according to the Anxiety and Depression Association of America (ADAA). It is especially common among adolescents and people in their early 20s (2). The exact cause of social anxiety disorder is unknown. However, research suggests that both environmental and genetic factors play a role (2).

Causes of Social Anxiety

Social anxiety is a specific phobia or fear of social situations. The fear is so strong that it can interfere with daily life, including work and school.

Social anxiety disorder has several possible causes, including:

  • Genetics: Social anxiety disorder appears to have a genetic component, although it's not clear to what extent. Studies suggest that genetics may account for anywhere from 30 to 50 percent of the risk of developing the disorder.
  • Brain chemistry: Brain chemicals such as serotonin affect mood and behavior. Low levels of serotonin have been linked with depression and other mental health problems, including social anxiety disorder. Abnormalities in certain brain areas known as "limbic structures" also may play a role in causing social anxiety disorder. These structures include the amygdala (which processes emotional information), hippocampus (which processes memory), and hypothalamus (which controls body temperature).

What are the symptoms of social anxiety?

Social anxiety disorder is a mental condition marked by an intense fear of social situations. A person with the disorder will go to great lengths to avoid being in a situation where he or she might be scrutinized by others. The fear of being judged causes significant distress and interferes with daily life. Together with this, social anxiety comes with other emotional symptoms like (3);

  • Fear of embarrassing or humiliating yourself
  • Intense fear of interacting with strangers
  • Fear that others are noticing that you look anxious
  • Fear of physical symptoms showing which may cause you embarrassment
  • Avoiding being the center of attention
  • Anticipation of a feared activity or event
  • Avoiding any social situations
  • Analyzing and identifying flaws in your performance and interactions after a social situation
  • Expectation of the worst possible consequences from any experience, negative or not.

In addition to the emotional toll that social anxiety disorder can take on a person, it can also cause physical symptoms such as (3):

  • Increased heart rate,
  • Trembling
  • Blushing
  • Sweating
  • Upset stomach or nausea
  • Trouble catching your breath
  • Dizziness or lightheadedness
  • Feeling that your mind has gone blank
  • Muscle tension

In severe cases, it may even prompt some people to avoid everyday situations such as grocery shopping or even riding in an elevator.

What is the treatment for social anxiety?

Social anxiety disorder is typically treated with psychotherapy (also known as "talk therapy"), although medication may also be prescribed to help ease symptoms (4).

It is also important that one does not ignore any symptoms they may have of the disorder, as the longer one waits, the more the effect social anxiety has on your daily life. It can also lead to depression, other anxiety disorders, and even agoraphobia (4).

It is safe to say that almost everyone has experienced anxiety at one point or another, whether it is in the classroom, at work, or while meeting new people. While some anxiety is considered normal, it can become a disorder when certain fears and anxieties are persistent and unreasonable.

The bottom line is that while an appointment with your doctor or therapist may be the best way to get a true diagnosis, there are some signs and tools online that you can look for in order to assess if you have Social Anxiety Disorder or not.

To search for the best Psychiatry doctors worldwide, please use the Mya Care search engine.

To search for the best doctors and healthcare providers worldwide, please use the Mya Care search engine.

About the Author:
Innocensia is a public health specialist, medical writer and researcher based in South Africa. One of her greatest passions is helping others gain more knowledge on health and medical issues in the world. This is why she spends a lot of her time writing public health and medical articles to increase health awareness.


  1. Leary MR, Kowalski RM. Social anxiety. Guilford Press; 1997 Jul 4.
  2. Morrison AS, Heimberg RG. Social anxiety and social anxiety disorder. Annual review of clinical psychology. 2013 Mar 28;9:249-74.
  3. Langer JK, Tonge NA, Piccirillo M, Rodebaugh TL, Thompson RJ, Gotlib IH. Symptoms of social anxiety disorder and major depressive disorder: A network perspective. Journal of affective disorders. 2019 Jan 15;243:531-8.
  4. Cheng X, Yang Y. The Causes of Social Anxiety Disorder in the Different Developmental Stages. In2021 International Conference on Public Art and Human Development (ICPAHD 2021) 2022 Jan 28 (pp. 329-334). Atlantis Press.