Social Anxiety Disorder (Cleveland Clinic)

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What is social anxiety disorder?
Social anxiety disorder, also called social phobia, is an anxiety disorder in which a person has an excessive and unreasonable fear of social situations. Anxiety (intense nervousness) and self-consciousness arise from a fear of being closely watched, judged and criticized by others.

A person with social anxiety disorder is afraid that he or she will make mistakes and be embarrassed or humiliated in front of others. The fear might be made worse by a lack of social skills or experience in social situations. The anxiety can build into a panic attack. As a result of the fear, the person endures certain social situations in extreme distress or might avoid them altogether. In addition, people with social anxiety disorder often suffer "anticipatory" anxiety--the fear of a situation before it even happens--for days or weeks before the event. In many cases, the person is aware that the fear is unreasonable, yet is unable to overcome it.

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 be harmful by interfering with the person's normal daily routine, including school, work, social activities and relationships.

People with social anxiety disorder might 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 center 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 might be linked with other mental disorders, such as panic disorder, obsessive-compulsive disorder and depression. In fact, many people with social anxiety disorder 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 recognize their feeling as a sign of illness. Symptoms of social anxiety disorder 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 diarrhea

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

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Last Updated: 8/29/2007

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