Social anxiety disorder affects your emotions and behavior. It can also cause significant physical symptoms.
Emotional and behavioral social anxiety disorder signs and symptoms include:
- Intense fear of interacting with strangers
- Fear of situations in which you may be judged
- Worrying about embarrassing or humiliating yourself
- Fear that others will notice that you look anxious
- Anxiety that disrupts your daily routine, work, school or other activities
- Avoiding doing things or speaking to people out of fear of embarrassment
- Avoiding situations where you might be the center of attention
- Difficulty making eye contact
- Difficulty talking
Physical social anxiety disorder signs and symptoms include:
- Trembling or shaking
- Fast heartbeat
- Upset stomach
- Shaky voice
- Muscle tension
- Cold, clammy hands
Worrying about having symptoms
When you have social anxiety disorder, you realize that your anxiety or fear is out of proportion to the situation. Yet you're so worried about developing social anxiety disorder symptoms that you avoid situations that may trigger them. This type of worrying creates a vicious cycle that can make symptoms worse.
When to see a doctor
See your doctor or mental health provider if you fear and avoid normal social situations because they cause embarrassment, worry or panic. If this type of anxiety disrupts your life, causes severe stress and affects your daily activities, you may have social anxiety disorder or another mental health condition that requires treatment to get better.
Feelings of shyness or discomfort in certain situations aren't necessarily signs of social anxiety disorder, particularly in children. Comfort levels in social situations vary from individual to individual due to personality traits and life experiences. Some people are naturally reserved and others are more outgoing. What sets social anxiety disorder apart from everyday nervousness is that its symptoms are much more severe, causing you to avoid normal social situations.
Common, everyday experiences that may be difficult to endure when you have social anxiety disorder include:
- Using a public restroom or telephone
- Returning items to a store
- Interacting with strangers
- Writing in front of others
- Making eye contact
- Entering a room in which people are already seated
- Ordering food in a restaurant
- Being introduced to strangers
- Initiating conversations
Social anxiety disorder symptoms can change over time. They may flare up if you're facing a lot of stress or demands. Or if you completely avoid situations that would usually make you anxious, you may not have symptoms. Although avoidance may allow you to feel better in the short term, your anxiety is likely to persist over the long term if you don't get treatment.
- Social phobia (social anxiety disorder). In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 11, 2011.
- Schneier FR. Social anxiety disorder: Epidemiology, clinical manifestations, and diagnosis. http://www.uptodate.com/home/index.html. Accessed June 17, 2011.
- Hollander E, et al. Social phobia (social anxiety disorder). In: Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://www.psychiatryonline.com. Accessed June 11, 2011.
- Phobic disorders. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec15/ch196/ch196e.html. Accessed June 17, 2011.
- Hofmann SG. Psychotherapy for social anxiety disorder. http://www.uptodate.com/home/index.html. Accessed June 17, 2011.
- Bruce TJ, et al. Pharmacotherapy for social anxiety disorder. http://www.uptodate.com/home/index.html. Accessed June 17, 2011.
- Lee RA. Anxiety disorders. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/154207005-3/0/1494/57.html?tocnode=54111716&fromURL=57.html#4-u1.0-B978-1-4160-2954-0..50014-4_229. Accessed June 10, 2011.
- Lakhan SE, et al. Nutritional and herbal supplements for anxiety and anxiety-related disorders: Systematic review. Nutrition Journal. 2010;9:42. http://www.nutritionj.com/content/9/1/42. Accessed June 17, 2011.