It’s Saturday night, and your best friend’s throwing a big birthday bash complete with a taco truck, mariachi band, and 300 of her closest friends. Should be a blast, right? Unfortunately, that’s not the case if you have social anxiety disorder — one of several forms of anxiety disorders recognized by mental health professionals.

For someone with social anxiety disorder, commonplace situations such as starting a conversation, attending a party, or going on a date could trigger a cascade of unpleasant physical, emotional, and behavioral reactions.

If this sounds like you, you’re not alone. Social anxiety disorder — formerly referred to as social phobia — was recently named the third most prevalent psychological disorder in the country after depression and alcoholism. According to the Anxiety and Depression Association of America (ADAA), approximately 15 million American adults have social anxiety disorder. Symptoms of this disorder may start around the age of 13.

Situations That May Prompt Social Anxiety

People with social anxiety disorder experience significant emotional discomfort in common social situations such as:

  • Interacting with new people
  • Attending parties or social gatherings
  • Entering rooms
  • Going to work or school
  • Starting conversations
  • Eating in front of others
  • Making eye contact
  • Being the center of attention
  • Returning items to a store
  • Being watched while doing something
  • Using a public restroom
  • Meeting people in authority
Ethan Zohn Campaign

Symptoms of social anxiety disorder

Social anxiety disorder is not a matter of being shy or introverted. The following symptoms are severe enough to interfere with everyday life. People may experience all, or some of the below:

  • Intense, persistent fear of being watched and judged by others
  • Feel anxious in anticipation of a feared activity or event
  • Avoid situations where they might be the center of attention
  • Worry about embarrassing or humiliating themselves and offending others
  • Feel discomfort being around new people and have trouble making conversation, even if they wish they could
  • Blush, sweat, tremble, feel a rapid heart rate, have a shaky voice, or feel their “mind going blank” in social situations.
  • Analyze their “performance” after a social engagement and anticipate the worst possible consequences for their behavior

What causes social anxiety disorder?

Most people with social anxiety disorder experience a generalized form, and will be affected across a broad range of situations. But some people demonstrate a specific social anxiety, such as the fear of speaking in front of groups or the fear of eating in front of others.

There is no one cause responsible for social anxiety disorder, which most likely arises from a complex interaction of both biological and environmental factors.

  • Family: Anxiety disorders tend to run in families. This may be due to inherited genetics or learned, modeled behavior. Children with overprotective and controlling parents are also more likely to develop social anxiety disorder.
  • Brain functioning: An overactive amygdala, responsible for the fear response, may be responsible for increased anxiety in social situations.
  • Negative experiences: Social anxiety disorder can be linked to a history of abuse, bullying, or teasing. Health conditions that draw attention to personal appearance can also lead to social anxiety.
  • Temperament: Shy, timid, or withdrawn children are more likely to develop social anxiety disorder in adolescence and adulthood.
  • New social or work demands: While social anxiety disorder symptoms tend to develop during adolescence, adults faced with meeting new people, public speaking, or performative work demands may experience symptoms for the first time.

Consequences of social anxiety disorder

Living with untreated or undiagnosed social anxiety disorder can severely and negatively impact your life, including your relationships with others and your self-confidence. Avoiding social situations can lead to low self-esteem, social isolation, depression, and an oversensitivity to criticism.

Social anxiety disorder can also prove to be a cruel self-fulfilling prophecy. As you avoid social interactions, you don’t get to practice your social skills or grow comfortably in new situations or with new people. In fact, your social skills may atrophy, leading to increased self-consciousness about being awkward.