Social Anxiety

Social anxiety disorder is characterised by strong and persistent fears about being in social situations – often based on a dread that the individual will humiliate or embarrass themselves.

What is Social anxiety?

For some, social anxiety might mean worrying for several weeks about an upcoming event, for others social anxiety can prevent them attending social situations or even leaving the house.

Relationships can become hard to maintain as people with social anxiety may come across as being aloof or distant. They may lose friendships as they decline opportunities to go out or might cancel at the last minute and friends may feel let down. Often people with social anxiety feel shame about their condition and can’t be honest about how they are feeling – which means they may make ‘excuses’ which others don’t understand or believe.

It is common for people with social anxiety to become withdrawn, isolated and depressed and many will also suffer from depression, obsessive compulsive disorder and generalised anxiety disorder.

Symptoms of social anxiety

Common symptoms of social anxiety include:

• Nausea and stomach complaints
• Sweating
• Trembling and muscle tension
• Difficulty talking to others
• Immense fear of talking in public
• Avoiding public spaces and social situations
• Difficulties making friends and avoiding meeting new people
• Fear of being judged or watched by strangers
• Cancelling plans at last minute
• Panic attacks

Diagnosing social anxiety

In order for a diagnosis to take place, it is important to consider all aspects of an individual’s life. There are 3 key questions that are often used when determining whether an anxiety disorder is social anxiety.

1. Fear of embarrassment causes me to avoid doing things or speaking to people.
2. I avoid activities in which I am the centre of attention.
3. Being embarrassed or looking stupid are among my worst fears.

Social anxiety commonly arises during adolescence, perhaps because this is a time where we are exploring who we are and can be extremely sensitive to how others perceive us.

Often, symptoms of social anxiety will have diminished by adulthood, however it takes people an average of 15 years to seek help for their social anxiety . This delay in seeking treatment can make symptoms worse and may result in a greater risk of depression developing as well.

Anxiety is a normal evolutionary response to stress, fear or danger in certain situations.

Dr Muffazal Rawala

MBBS, MSc, MRCPsych

Consultant Adult Psychiatrist

London

Dr Muffazal Rawala is an experienced NHS Consultant Psychiatrist, currently working for East London NHS Foundation Trust. He has a Medical Degree, a Masters in Transcultural Mental Health, has a postgraduate certificate in Psychopharmacology and is a...