Social Anxiety Disorder (SAD), formerly known as social phobia, is a mental health condition that affects 12.1% of the adult population in the United States and millions of people worldwide, manifesting in different ways and to varying degrees.
SAD is mainly characterized by an intense, persistent fear of being watched and judged by others. This fear can significantly impact daily activities, leading to considerable distress and impairment. Unlike typical nervousness that everyone might feel in social situations, SAD involves a fear that is out of proportion to the actual threat posed by the social or performance situation.
If this sounds like you, you are not alone. Keep reading to learn more about SAD and how certain types of mental health treatment can help you manage your condition and regain control of your life.
What are the Symptoms of Social Anxiety Disorder?
The symptoms of SAD can vary from person to person and can be divided into emotional, physical, and behavioral categories.
Emotionally, individuals with SAD experience intense fear and deep, persistent worry about social situations where they might be judged or scrutinized. This fear is accompanied by excessive worry about upcoming social events, often for weeks or even months beforehand. They harbor an overwhelming fear of being embarrassed or humiliated in front of others and tend to engage in negative self-talk, assuming the worst about themselves.
Physically, those with SAD frequently blush and sweat excessively, particularly in social or performance situations. Trembling, rapid heart rate, and feeling nauseous or sick are common. Shortness of breath and feeling like one is choking can also occur.
Behaviorally, avoidance is a key characteristic, as individuals with SAD often steer clear of social situations to prevent anxiety. This avoidance can manifest in skipping classes, declining job offers, or avoiding interactions with colleagues and peers. Some might resort to safety behaviors, such as avoiding eye contact, speaking softly, or holding objects to prevent trembling. Additionally, substance use may become a coping mechanism, with individuals turning to alcohol or drugs to handle social situations.
Social Anxiety Disorder can significantly impair an individual’s ability to function in both educational and occupational settings. In educational settings, students with SAD may avoid participating in class discussions or group activities, leading to lower engagement and poorer academic performance. Frequent absenteeism due to anxiety about attending classes or interacting with peers is common. This anxiety affects concentration, making it difficult to complete assignments and perform well on exams. Additionally, forming and maintaining friendships is challenging, often leading to isolation and further anxiety.
In occupational settings, employees with SAD may struggle with tasks involving public speaking, team collaboration, or client interactions, affecting their performance and career progression. High levels of anxiety can lead to frequent sick leaves or tardiness, while difficulties in forming professional relationships can result in a lack of support and networking opportunities. Furthermore, there may be a reluctance to apply for promotions or new positions that require greater social interaction or visibility.
Can Social Disorder Anxiety Co-occur With Other Mental Health Issues?
Social Anxiety Disorder often coexists with other mental health conditions, which can make diagnosis and treatment more challenging. Depression is common among individuals with SAD, as the isolation and negative self-perception associated with SAD can contribute to the development of major depressive disorder. Generalized Anxiety Disorder (GAD), characterized by persistent and excessive worry about various aspects of life, frequently co-occurs with SAD.
Some individuals with SAD may use alcohol or drugs to self-medicate and alleviate their anxiety, leading to an increased risk of substance dependency issues. Panic disorder, involving sudden, intense episodes of fear and physical symptoms, can also occur in those with SAD. Additionally, the fear of social judgment and scrutiny in SAD can overlap with obsessive thoughts and compulsions related to social interactions, characteristic of obsessive-compulsive disorder (OCD).
Is Social Anxiety the Same as Being an Introvert?
While social anxiety syndrome and introversion may appear similar on the surface, they are distinct concepts with different underlying causes and manifestations. Understanding these differences can help clarify why introversion is not synonymous with social anxiety and why an extrovert can indeed suffer from social anxiety.
Introversion is a personality trait characterized by a preference for solitary activities or small group interactions over large social gatherings. Introverts typically find social interactions draining and require time alone to recharge. Key features of introversion include:
- Enjoying solitary activities such as reading, writing, or spending time in nature.
- Deep conversations with close friends over small talk are preferred.
- Feeling exhausted after prolonged social interaction, even if it’s enjoyable.
- Being reflective and introspective, often thinking deeply about various topics.
Introversion is not inherently linked to anxiety or fear of social situations. Instead, it is about where a person derives their energy. Introverts can be socially skilled and enjoy social interactions but may need more downtime afterward.
Social anxiety syndrome, on the other hand, is not a personality trait – it is a mental health condition characterized by an intense, persistent fear of being judged, embarrassed, or humiliated in social situations. This fear often leads to avoidance of social interactions and can significantly impair daily functioning. Social anxiety syndrome goes beyond the discomfort that introverts might feel in social settings. It involves a pervasive fear that can disrupt personal, academic, or professional life.
As explained above, social anxiety syndrome is characterized by an intense fear of social situations. Individuals with this condition worry excessively about being judged, embarrassed, or rejected by others. This overwhelming fear often leads them to avoid social interactions altogether or endure these occasions with significant distress that can manifest as physical symptoms such as sweating, trembling, nausea, or a rapid heart rate. This fear and the accompanying physical symptoms can make it difficult to perform everyday tasks, such as eating in public, speaking in meetings, or attending social gatherings.
In other words, introverts may find social interactions draining but do not necessarily fear them. Their discomfort arises from the energy expenditure required to engage socially. In contrast, individuals with social anxiety experience discomfort due to a fear of judgment, embarrassment, or negative evaluation by others.
Another difference is in the nature of social interactions. Introverts can enjoy social interactions, particularly with close friends or in small, familiar settings. Their preference for solitude is mainly about recharging energy. On the other hand, social interactions are often a source of intense, debilitating fear and distress for those with social anxiety. These individuals may avoid social situations altogether to prevent the anxiety associated with them, which often affects various aspects of life, including work, school, and relationships, and usually requires professional help.
Can an Extrovert Suffer from Social Anxiety?
Yes, an extrovert can suffer from social anxiety. Extroversion is characterized by a preference for social interactions and external stimulation. Extroverts generally feel energized by being around people and thrive in social environments. However, social anxiety is about the fear of negative evaluation and judgment in social situations, which can affect anyone, regardless of their personality type.
An extrovert with social anxiety may desire social interaction and enjoy being around people but simultaneously fear being judged or embarrassed. This conflict can create significant distress. For example, an extrovert might look forward to a party but feel anxious about making a good impression or being judged by others.
In short, introversion (or extroversion) and social anxiety syndrome are distinct concepts. While introverts may prefer solitude, they do not necessarily fear social interactions. In contrast, individuals with social anxiety experience significant distress in social situations, regardless of their personality type.
Can Web-Based Therapy Benefit Social Anxiety Disorder?
In recent years, web-based therapy has emerged as a promising treatment option for Social Anxiety Disorder. This approach leverages the accessibility and convenience of the Internet to deliver therapeutic interventions.
Benefits of Virtual Therapy
Web-based therapy offers numerous benefits. It provides access to therapy for individuals who may not have the means or ability to attend in-person sessions, particularly benefiting those living in remote areas. The online format can help reduce the stigma associated with seeking help, providing a sense of anonymity that encourages more people to seek treatment. It also allows individuals to get help from the comfort of their homes and potentially reduce their worries about encountering any social situations that may make it challenging for them to continue showing up for in-person appointments. Additionally, it allows individuals to access therapy at their own pace and at times that suit their schedules, making it easier to integrate into daily life. Often more affordable than traditional face-to-face therapy, web-based therapy may also reduce financial barriers to treatment.
Virtual Therapy Options
There are various types of web-based therapy available. Online Cognitive Behavioral Therapy (CBT) programs help individuals identify and challenge negative thought patterns and behaviors associated with SAD. These programs often include modules, exercises, and interactive content. Some web-based therapies provide structured self-help materials with periodic support from a therapist via email or chat. Video conferencing platforms are used to conduct real-time therapy sessions, replicating the traditional face-to-face therapy experience. Additionally, online forums and support groups allow individuals to share their experiences and gain support from others facing similar challenges.
Numerous studies have demonstrated the effectiveness of web-based therapy for treating Social Anxiety Disorder. A recent study found that participants who received internet-delivered CBT showed significant reductions in social anxiety symptoms, comparable to those who received face-to-face CBT. A meta-analysis by Andrews et al. (2018) reviewed multiple studies and concluded that internet-based interventions for anxiety disorders, including SAD, were effective and provided lasting benefits. Research by Hedman et al. (2011) demonstrated that web-based guided self-help CBT led to significant improvements in social anxiety symptoms, with results maintained at a one-year follow-up.
Virtual vs. In-Person Therapy
Research indicates that web-based CBT can be as effective as traditional face-to-face CBT in reducing symptoms of SAD. Many individuals who undergo web-based therapy report sustained improvement in their symptoms over time. By overcoming geographical, logistical, and social barriers, web-based therapy increases the likelihood of individuals seeking and receiving treatment.
Is Web-Based Therapy Right for You?
Social anxiety disorder is a debilitating mental health condition that can severely impact an individual’s personal, academic, and professional life. Traditional therapies have proven effective, but barriers such as accessibility, cost, and stigma may often prevent individuals from seeking help.
Web-based therapy offers a viable solution to these challenges, providing accessible, flexible, and cost-effective treatment options. The efficacy of online interventions, particularly cognitive behavioral therapy, has been well-documented, showing comparable outcomes to traditional methods.
Virtual Therapy Options at Plus by APN
At Plus by APN, you can find a team of skilled mental health professionals and a variety of cutting-edge treatments to help patients with SAD and any other mental health disorders tackle their symptoms and achieve immediate and long-term remission. From convenient web-based therapy to in-person innovative treatments such as ketamine-assisted therapy, you can count on APN’s team of mental health professionals for the help you need and the customized, integrative treatment approach you deserve. If you would like to learn more about our virtual and in-person treatment options for conditions such as Social Anxiety Disorder, call us at 855.934.1178 or submit our confidential contact form today.
References
- Andrews G, Basu A, Cuijpers P, Craske MG, McEvoy P, English CL, Newby JM. Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. J Anxiety Disord. 2018 Apr;55:70-78. doi: 10.1016/j.janxdis.2018.01.001. Epub 2018 Feb 1. PMID: 29422409.
- Carlbring P, Gunnarsdóttir M, Hedensjö L, Andersson G, Ekselius L, Furmark T. Treatment of social phobia: randomised trial of internet-delivered cognitive-behavioural therapy with telephone support. Br J Psychiatry. 2007 Feb;190:123-8. doi: 10.1192/bjp.bp.105.020107. PMID: 17267928.
- Hedman E, Andersson G, Ljótsson B, Andersson E, Rück C, Mörtberg E, Lindefors N. Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: a randomized controlled non-inferiority trial. PLoS One. 2011 Mar 25;6(3):e18001. doi: 10.1371/journal.pone.0018001. PMID: 21483704; PMCID: PMC3070741.
- “NIMH Website Maintenance.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/topics/anxiety-disorders. Accessed 21 July 2024.
- “Social Anxiety Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/statistics/social-anxiety-disorder. Accessed 21 July 2024.
- “Struggling at Work Due to Social Anxiety.” Andrew Kukes Foundation for Social Anxiety, 23 May 2013, akfsa.org/research/struggling-at-work-due-to-anxiety/.
