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Social anxiety disorder

A person with social anxiety disorder, or social phobia, has a persistent fear of social situations and embarrassment when meeting or talking to other people.

Social anxiety disorder is very different from being shy and disrupts daily life, relationships, school, university or work.

The condition can even affect a person while they are at home if they need to speak on the phone.

Social anxiety disorder is one of the UK's most common anxiety disorders. It can affect adults and children, and affects more women than it does men.

Social anxiety disorder causes

People with social anxiety disorder suffer from distorted thinking, including false beliefs about social situations and the negative opinions of others. Without treatment, social anxiety disorder can negatively interfere with the person's normal daily routine, including school, work, social activities and relationships.

People with social phobias may be afraid of a specific situation, such as speaking in public. However, most people with social anxiety disorder fear more than one social situation. Other situations that commonly provoke anxiety include:

  • Eating or drinking in front of others.
  • Writing or working in front of others.
  • Being the centre of attention.
  • Interacting with people, including dating or going to parties.
  • Asking questions or giving reports in groups.
  • Using public toilets.
  • Talking on the telephone.

Social anxiety disorder may be linked to other mental illnesses, such as panic disorder, obsessive-compulsive disorder, and depression. In fact, many people with social anxiety disorder initially see the doctor with complaints related to these disorders, not because of social anxiety symptoms.

What are the symptoms of social anxiety disorder?

Many people with social anxiety disorder feel that there is "something wrong", but don't recognise their feeling as a sign of illness. Symptoms of social anxiety disorder can include:

  • Intense anxiety in social situations.
  • Avoidance of social situations.
  • Physical symptoms of anxiety, including confusion, pounding heart, sweating, shaking, blushing, muscle tension, upset stomach and diarrhoea.

Children with this disorder may express their anxiety by crying, clinging to a parent or throwing a tantrum.

What causes social anxiety disorder?

There is no single known cause of social anxiety disorder, but research suggests that biological, psychological, and environmental factors may play a role in its development:

  • Biological: Social anxiety disorder may be related to an imbalance of the neurotransmitter serotonin. Neurotransmitters are special chemical messengers that help move information from nerve cell to nerve cell in the brain. If the neurotransmitters are out of balance, messages cannot get through the brain properly. This can alter the way the brain reacts to stressful situations, leading to anxiety. In addition, social anxiety disorder appears to run in families. This means that the disorder may be passed on in families through genes, the material that contains instructions for the function of each cell in the body.
  • Psychological: The development of social anxiety disorder may stem from an embarrassing or humiliating experience at a social event in the past.
  • Environmental: People with social anxiety disorder may develop their fear from observing the behaviour of others or seeing what happened to someone else as the result of their behaviour (such as being laughed at or made fun of). Further, children who are sheltered or overprotected by their parents may not learn good social skills as part of their normal development.
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