Social Anxiety Disorder
Facts to Know:
- Social anxiety disorder is very common, affecting 5-10% of people over the course of their lives.
- Social anxiety disorder causes significant distress in social situations due to fear of embarrassment, rejection, or negative evaluation from others.
- Social anxiety disorder can be treated effectively with therapy and/or medication.
What is social anxiety disorder?
Social anxiety disorder is an anxiety disorder characterized by significant distress and/or avoidance of social situations due to fear of embarrassment, rejection, or negative evaluation from others. It is a common psychiatric diagnosis, affecting around 5-10% of people over the lifespan. It is more commonly seen in females than males. The typical age of onset for social anxiety ranges between late childhood to early adolescence. While the exact cause of social anxiety disorder is not known, genetics and environmental factors likely both play a role. People with a family member with social anxiety disorder are more likely to develop the condition, and children may learn socially anxious behaviors from caregivers. Once social anxiety disorder develops, the condition often continues unless the person receives treatment.
Psychologically, individuals with social anxiety disorder often have a distorted assumption that they will be judged negatively or feel embarrassed when engaged in a particular social situation. They tend to be hypersensitive to social cues that suggest negative evaluation or judgement and tend to overestimate the bodily sensations of anxiety (i.e., blushing, sweating, or shaky voice) that they may exhibit in social situations. Neurobiological research has shown that social situations cause heightened activity level in the amygdala, the part of the brain responsible for our fear response, in individuals with social anxiety disorder.
- Excessive distress and/or avoidance of social situations in which the individual expects to be negatively evaluated, rejected or embarrassed.
- Distress when encountering social situations that results in bodily symptoms such as sweating, palpitations, hyperventilating, shaking, sweatiness, blushing, or freezing.
- The distress or avoidance of social situations results in impairment in life functioning, such as difficulty meeting demands in school or work or withdrawal from social or extra-curricular activities.
A diagnosis of social anxiety disorder is best made by a mental health professional. An evaluation involves a thorough interview that the individual’s subjective experience, symptoms, environmental factors, family history, and the individual’s level of functioning. Standardized questionnaires may also be used to aide in diagnosis. For evaluations involving young children, clinicians may also want to observe how the child interacts in different social situations.
Cognitive behavioral therapy (CBT) has been shown through research to be an effective treatment for social anxiety disorder. In CBT, individuals learn to identify the physiological cues, distorted thought processes, and maladaptive behavioral habits that surround their social anxiety. They then develop coping skills to help regulate their anxiety in social situations, such as body relaxation techniques and thinking more realistically about what will likely happen to them in social situations. Finally, individuals in CBT engage in exposure with response prevention, which involves slowly facing specific anxiety-provoking social situations and employing the skills learned until the anxiety response decreases and eventually goes away. CBT for social anxiety is especially effective in group formats since it allows individuals to confront social fears in treatment in front of peers. Our therapists and psychiatrists are trained in individual and group CBT treatments for social anxiety.
In cases of moderate to severe social anxiety disorder, medications may be an important component of treatment. In fact, research suggests that the most effective treatment for social anxiety disorder is the combination of serotonin reuptake inhibitors and CBT. Here at ColumbiaDoctors, our psychiatrists combine a thorough evaluation of each individual’s concerns with the latest research to design a customized treatment plan.
How Can I Receive Treatment for Social Anxiety Disorder at Columbia?
At ColumbiaDoctors, we provide the full array of treatments for social anxiety disorder.
Search our providers for a therapist or psychiatrist with expertise in social anxiety disorder.
To make an appointment, please call 212-305-6001 or submit our online form.
Article written by: