Social Anxiety Disorder
Social anxiety disorder centres on a persistent fear of being scrutinised, embarrassed, rejected or judged negatively in social or performance situations.
More than ordinary shyness
A person may fear conversations, meeting unfamiliar people, eating in front of others, speaking in a group, dating or being observed. Attention can turn inward: “Am I blushing?”, “Do I sound foolish?”, “Can they see I am anxious?” The anticipation and post-event replay may be as distressing as the situation itself.
Shyness is not a disorder. The distinction depends on persistence, disproportionate fear, avoidance and meaningful interference with study, work, relationships or opportunities.
Common patterns
- Strong anxiety before or during situations involving possible scrutiny.
- Avoiding events, calls, meetings or speaking, or enduring them with marked distress.
- Physical symptoms such as blushing, trembling, sweating, nausea or a blank mind.
- Using “safety behaviours”, such as rehearsing every sentence, avoiding eye contact or relying on alcohol.
Assessment and treatment
A professional considers the situations involved, duration, developmental and cultural context, functional impact, and whether panic, depression, autism, trauma, body-image concerns, substances or a medical condition may better explain the experience.
Individual CBT designed for social anxiety is a well-supported treatment. Work may involve attention training, examining predictions and self-images, behavioural experiments and gradual exposure. Medication can also be considered by a doctor. The plan should be collaborative and tailored, not a demand to “just be more confident”.