Social anxiety disorder is the intense fear of social situations. People with social anxiety disorder:

  • Avoid interactions with other people
  • Are extremely afraid of being judged negatively by others
  • Feel humiliated, embarrassed, and inadequate more easily than others

Social anxiety may be:

  • Generalized to all social interactions
  • Specific to certain social situations, such as public speaking

It is much more severe than shyness. It can interfere with work, school, or other situations. It also carries physical reactions.

Physical Reactions of Anxiety

Physical reaction anxiety
© 2009 Nucleus Medical Art, Inc.


The exact cause is unknown. Possible causes include:

  • Genetic factors
  • Problems with regulation of chemicals in the brain
  • Past emotional trauma in social situations

Risk Factors

Factors that increase your chance for social anxiety disorder include:



People with social anxiety disorder may have the following symptoms during social interactions:

  • Blushing
  • Excessive sweating
  • Trembling
  • Dry throat and mouth
  • Muscle twitches
  • Intense anxiety]]>
  • Rapid heart beat
  • Fainting feeling

Symptoms may begin in any public situation such as:

  • Being teased or criticized
  • Being the center of attention
  • Meeting new people
  • Interacting with authority figures
  • Interacting with members of the opposite sex
  • Eating, writing, or speaking in public
  • Using public toilets



Your doctor will ask about your fears and symptoms. A physical exam may be done. You may be referred to a mental health professional. They may conduct a psychiatric evaluation.


Treatments include:

Cognitive-behavioral Therapy

With this type of therapy, a therapist may:

  • Help you change phobic and other negative thought patterns and behaviors
  • Teach you to control anxiety symptoms by methods such as:
  • Suggest changes of your social environment to minimize perceived stress:
    • May be helpful in the short term
  • Gradually expose you to feared situations in a controlled environment

A peer support group may also be helpful.


  • Selective serotonin reuptake inhibitors (SSRIs)—relieve symptoms of ]]>anxiety]]> and depression ***
  • Benzodiazepines, anticonvulsants ( ]]>gabapentin]]> , ]]>pregabalin]]> ), and monoamine oxidase inhibitors—relieve anxiety and depression
  • Beta-blockers—stop the physical symptoms of panic and anxiety (used to relieve the performance anxiety that often occurs with social anxiety disorder)

***Please note FDA Public Health Advisory for Antidepressants:

The FDA advises that people taking antidepressants should be closely observed. For some, the medications have been linked to worsening symptoms and suicidal thoughts. These adverse effects are most common in young adults. The effects tend to occur at the beginning of treatment or when there is an increase or decrease in the dose. Although the warning is for all antidepressants, of most concern are the SSRI class such as:

For more information, please visit: http://www.fda.gov/cder/drug/antidepressants/


There are no guidelines for preventing social anxiety disorder. However, early diagnosis and treatment can prevent complications such as:

  • Substance abuse
  • Depression
  • Dysfunctional school, work, social, and family interactions