22nd February 2024

Background

Social anxiety disorder, also known as social phobia, is associated with a constant fear of being humiliated, judged, or embarrassed. It often occurs in a social setting or where some sort of performance is required. It can include meeting or talking to new people, social gatherings, eating in public, giving a presentation or anything involving being in public. Whilst these situations can induce anxiety in the average person, in individuals with social anxiety disorder this fear is often out of proportion and they will worry excessively before, during and after these situations. This can be due to a previous experience or fear of potential outcomes from a scenario. They can worry about saying or doing the wrong thing, coming across negatively, or humiliating themselves. It is also common in children and young adults and may present with crying, freezing, or having tantrums when in social situations.  It is associated with distress and anxiety, which leads to avoidance of social settings, which can impact the individual’s ability to go to work, school and socialise. It is also associated with somatic symptoms such as tachycardia, palpitations, sweating, shaking, nausea, and panic attacks. Due to the debilitating nature of social anxiety disorder, there is substantial comorbidity between this and depression, substance misuse, panic disorder, GAD and PTSD.  The average age of onset is believed to be 13 years. Most sufferers don’t seek treatment, and if they do, they may wait decades after onset to do so. Social anxiety disorder is often undiagnosed in primary care settings due to poor recognition or awareness. Often, individuals will be diagnosed with depression, anxiety or panic disorders without the underlying social anxiety disorder being identified or addressed. 

 Risk factors include female gender, a family history, shyness in childhood and being behaviourally inhibited.