What is Social Anxiety Disorder?

Social anxiety disorder is one of the most common anxiety disorders, affecting between 7 and 13% of the population. People with social anxiety disorder tend to feel quite nervous or uncomfortable in social situations. They are very concerned that they will do something embarrassing or humiliating, or that others will think badly of them. These individuals are very self-conscious and constantly feel "on stage."

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Recognizing Social Anxiety Disorder - Do I have It?

Sandra's Story
Sandra is a 35-year-old single woman who lives alone. She feels extremely uncomfortable interacting with other people, and worries that others think badly of her. She was extremely anxious as a child and spent most of her time alone because she had trouble making friends. Sandra's main fears are that other people will disagree with her and that she will say something to offend someone. She is very concerned that interacting with other people will lead to some kind of conflict that she will not be able to handle. As a result, she avoids conversations where she might have to give her personal opinions, and she finds it difficult to be assertive. She feels especially anxious around family members and people who live in her apartment building.

Sandra feels anxious for most of the day and finds her social fears quite distressing. She has been unemployed for the past 3 months. She left her job due to extreme anxiety when interacting with co-workers and customers. She would like to develop some friendships, but tends to avoid people because she fears that they won't like her once they get to know her. Recently, she has been using alcohol to try and reduce her anxiety at family functions. She feels that she is starting to become dependent on alcohol and worries that family members will confront her about her drinking.

Sandra wants to have a romantic relationship, as well as close relationships with friends and family, but she feels too tense and nervous to get close to others. She spends much of her time thinking about everything she is missing out on because of her fears. She is worried she will never be able to have a family of her own, and she is finding it harder and harder to be optimistic about her future

Michael's Story
Michael is a 44-year-old married man who lives with his wife and two children. He is worried about being negatively evaluated when he interacts with authority figures at work (for example, talking to his boss, making phone calls to senior executives within the company) or when speaking in front of a group of people (for example, giving presentations during meetings at work). He is afraid that other people will think that he is stupid and incompetent, even though others have told him that they respect and admire his skills and knowledge. He is very concerned that his mind will go blank, that he will not be able to think of anything to say, or that he will use the wrong words. He first noticed a problem when he was unable to participate in classes at university because he felt too self-conscious and anxious.

Michael has turned down numerous promotions at work because they would involve giving more presentations and interacting more often with senior executives. He is considering quitting his job even though he loves the actual work. In addition, he has become increasingly isolated from friends and family, and his wife gets frustrated with his constant need for reassurance that everything will be okay. He feels tense and anxious much of the time, especially when facing a planned meeting with his boss or a scheduled presentation.


What is a Social Situation?

A social situation includes any situation in which you and at least one other person are present. Social situations tend to fall into two main categories: performance situations and interpersonal interactions.

Performance Situations

Interpersonal Interactions
These are situations where people feel they are being observed by others. Examples include:
  • Public speaking (e.g., presenting at a meeting
  • Participating in meetings or classes(e.g. asking or answering questions)
  • Eating in front of others
  • Using public washrooms
  • Writing in front of others (e.g. signing a cheque of filling out a form)
  • Performing in public (e.g. singing or acting on stage, or playing a sport)
  • Entering a room where everyone is already seated
These are situations where people are interacting with others and developing closer relationships. Examples include:
  • Meeting new people
  • Talking to co-workers or friends
  • Inviting others to do things
  • Going to social events (e.g. parties or dinners)
  • Dating
  • Being assertive
  • Expressing opinions
  • Talking on the phone
  • Working in a group (e.g. working on a project with other co-workers)
  • Ordering food at a restaurant
  • Returning something at a store
  • Having a job interview

Note: It is not uncommon for people to fear some social situations and feel quite comfortable in others. For example, some people feel very comfortable speaking or performing in front of large groups of people, but feel anxious making small talk or meeting new people. Other people are comfortable spending time with friends and family, and interacting socially with co-workers, but are very fearful of performance situations, such as participating in business meetings or giving formal speeches. Also, some people fear only a single situation (such as public speaking), while others fear and avoid a wide range of social situations.

What Does Social Anxiety Look Like?

When faced with a feared social situation, people with social anxiety experience the following:

Physical Symptoms(what you feel)

  • Examples: racing heart, upset stomach, shaking, choking sensations, sweating, blushing, trembling, dry mouth, shortness of breath, nausea, dizziness, lightheadedness, blurred vision, urge to urinate, etc.
  • People with social anxiety are often very concerned about visible signs of anxiety, such as blushing or trembling.

Negative Thoughts (what you think)

  • Examples: "I'm going to say something stupid," "I'll get anxious and others will notice," "They won't like me," "Others will think I'm stupid," "I'll offend someone," or "No one will talk to me."
  • People with social anxiety tend to have negative thoughts about themselves (e.g., "I'll have nothing to say"), as well as how others will react to them (e.g., "Others will think I'm weird").
  • People with social anxiety also tend to focus their attention on themselves during social situations. They focus on their performance and how anxious they feel and look.

Avoidance and Safety Behaviors(what you do)

  • Examples: Avoiding (e.g., not going to the party), escaping a scary social situation (e.g., leaving the party early) or engaging in protective behaviours to try and stay safe (e.g., drinking alcohol, staying quiet, and avoiding eye contact).
  • People with social anxiety will often try to avoid or escape social situations. If they do go into social situations, they tend to do things to feel less anxious or to protect themselves from embarrassment or negative evaluation (e.g., if I'm worried about saying something stupid, then I'll try to avoid talking).


When Does Social Anxiety Become a Problem?

It's normal to feel anxious in social situations from time to time. For example, many people feel anxious in job interviews or when having to give a formal speech. Social anxiety can be a problem when it becomes too intense or happens too often. When it does, social anxiety can cause significant distress and affect many aspects of a person's life including:

Work and school

  • Examples: difficulty with job interviews; problems interacting with bosses or co-workers; trouble asking and answering questions in meetings or classes; refusing job promotions; avoiding certain types of jobs or career paths; poor performance at work or school; decreased enjoyment of work or school.

Relationships.

  • Examples: difficulty developing and keeping friendships and romantic relationships; trouble opening up to others; difficulty sharing opinions

Recreational activities/Hobbies.

  • Examples: avoid trying new things; avoid taking classes or lessons; avoid activities that involve interacting with others, such as going skiing or to the gym

Day-to-day activities.

  • Examples: difficulty running errands and completing daily activities, such as going grocery shopping, going out to eat, taking the bus, asking for directions, etc.


Social Anxiety Disorder: The Facts


  • Although social anxiety disorder can start at any age, most people with social anxiety disorder first experienced problems in childhood or adolescence.
  • Social anxiety disorder can develop suddenly after a stressful or humiliating experience or slowly over time.
  • Social anxiety tends to run in families.
  • Men and women are equally likely to develop social anxiety disorder.
  • Social anxiety disorder is associated with a number of other problems including low self-esteem, poor body image, depression, and substance abuse problems.

Home Management Strategies for Social Anxiety Disorder

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