What is social anxiety disorder?

Social anxiety disorder is also known as social phobia. It is an excessive fear and avoidance of social situations. This happens over and over. A person with social anxiety may fear things like being:

• judged
• criticised
• humiliated

It’s normal to feel shy or nervous when in situations that are new or challenging, like formal situations, meeting new people or giving a speech.

But social anxiety disorder happens in ordinary everyday situations, such as:

• eating in public
• being watched while doing something

You may feel that you will humiliate or embarrass yourself in these everyday situations.

What are the symptoms of social anxiety disorder?

Symptoms of social anxiety disorder can be both psychological and physical.

Psychological symptoms of social anxiety disorder include:

• feeling anxious in social situations
• feeling self-conscious around other people
• replaying social situations repeatedly in your mind after they have occurred

Physical symptoms of social anxiety disorder include:

• a fast, pounding heartbeat
• sweating
• dizziness
• trembling
• upset stomach, nausea and diarrhoea
• blushing or stammering when speaking
• chest pain

These common physical symptoms can be stressful for someone with social anxiety disorder. You may worry that someone will notice and judge you when you have these symptoms. This can cause further embarrassment.

Safety behaviours

If you have social anxiety disorder, you may have ‘safety behaviours’, which might include:

• always using headphones when catching public transport
• only attending social events if there is alcohol available
• avoiding speaking in social situations
• These safety behaviours can make you feel more comfortable and help you cope in social situations. However, they do not help you to overcome your social anxiety. They can prevent you from recovering.

What causes social anxiety disorder?

Many factors can contribute to social anxiety disorder. These include:

• genetic factors — social anxiety disorder can run in families
• temperament — shy or excessively timid children or adolescents are more at risk
• being bullied, embarrassed or poorly treated

Social anxiety disorder is common in Australia and often starts in childhood.

When should I see my doctor?

If you think you may have social anxiety disorder, seek help from your doctor or a mental health professional. They can diagnose you and give you advice on treatments and coping strategies. Your doctor can refer you for further help if needed.

It can be difficult to interact with a medical professional. You could ask a friend or family member for support. They can:

• help book an appointment for you
• go with you to the appointment

There are also many online resources for coping with anxiety. These may be a good option if you are not ready to seek professional help. These include peer support groups and helplines where you can chat to other people who feel the same way.

If you need to talk to someone about your mental health, call Beyond Blue on 1300 22 4636.

How is social anxiety disorder diagnosed?

A mental health professional can diagnose social anxiety disorder.

You can be diagnosed with social anxiety disorder if you have had typical symptoms that have caused significant distress for at least 6 months.

How is social anxiety disorder treated?

There are different treatment options for social anxiety disorder.

Therapy

Social anxiety disorder can be treated with psychological therapies (talking therapies). This therapy can help you understand what is going on and help to change how you think. This can help you manage your anxiety.

Cognitive behaviour therapy (CBT) is a type of psychological therapy. In CBT, you work with a psychologist or doctor to identify thinking patterns that are not helpful to you. It usually takes between 8 and 12 sessions.

A psychologist can also:

• help you relax and teach you breathing techniques to manage anxiety
• teach you about your anxiety symptoms and why they happen

Medicines

While psychological therapies are the most effective treatment, medicines may also be given for severe social anxiety.

The medicines most often used to treat social anxiety disorder are antidepressants — specifically SSRIs (selective serotonin reuptake inhibitors).

Medicines are not used in children with social anxiety who are under 6 years old.

Living with social anxiety disorder

If you have social anxiety disorder, fear of being humiliated or judged can cause you to avoid or limit social situations. This can:

• impact your personal relationships
• prevent you from participating in everyday social events
• lead to loneliness
• lead to reduced success at school or work

There are ways you can manage your social anxiety and aid your recovery. You can:

• Write down things that cause you anxiety, so you can discuss them with a mental health professional.
• Set yourself small goals to help you overcome things you are anxious about.
• Practice a healthy lifestyle by eating well, doing exercise and sleeping well.
• Avoid smoking, drugs and alcohol.
• Try mindfulness.

Complications of social anxiety disorder

If you have social anxiety disorder, you may be at higher risk of:

• suffering from depression
• having a problem with alcohol or drug use

People may use these substances to help with anxiety, but then become reliant on them.

Resources and support

To find online resources to help with anxiety and overcoming social phobia, you can visit:

• Beyond Blue — Anxiety management strategies
• MindSpot
• MyCompass (Black Dog Institute)
• ReachOut

For advice and to get connected to local mental health services, you can call Head to Health on 1800 595 212. Check the operating times.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.