Running head: SOCIAL ANXIETY DISORDER 1
Social Anxiety Disorder
Emily Stevens
Salt Lake Community College
SOCIAL ANXIETY DISORDER 2
Definition of Social Anxiety Disorder
The current definition and criterion of social anxiety disorder in the Diagnostic and Statistical
Manual of the American Psychiatric Association (DSM-5) according to the Social Anxiety
Institute is described as the following:
A. A persistent fear of one or more social or performance situations in which a person is
exposed to unfamiliar people or to possible scrutiny by others. The individual fears that
he or she will act in a way that will be embarrassing and humiliating.
B. Exposure to the feared situation almost invariably provokes anxiety, which may take the
form of a situationally-bound or situationally predisposed Panic Attack.
C. The person recognizes that this fear is unreasonable or excessive.
D. The feared situations are avoided or else are endured with intense anxiety and distress.
E. The avoidance, anxious anticipation, or distress in the feared social or performance
situation(s) interferes significantly with the person’s normal routine, occupational
(academic) functioning, or social activities or relationships, or there is marked distress
about having the phobia.
F. The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months.
G. The fear of avoidance is not due to direct physiological effects of a substance (e.g., drugs,
medications) or a general medical condition not better accounted for by another mental
disorder…[ CITATION Tho19 \l 1033 ]
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As mentioned above, the anxiety must be persistent and last six months or more. That is quite
a lot of time to spend worrying excessively over social situations and being humiliated. Now
let’s take a look at some of the symptoms and causes of social anxiety disorder.
Symptoms of Social Anxiety Disorder
According to the website verywellmind.com, the symptoms of social anxiety disorder fall
into three different areas: physical symptoms, cognitive symptoms, and behavioral symptoms.
Some common physical symptoms include: blushing, sweating, shaking, chest tightness or pain,
a trembling voice, shortness of breath, limp in throat, blurred vision, headaches, dry mouth,
paresthesias –tingling sensation, heart pounding and racing, and feelings of detachment from
oneself.
Common cognitive symptoms, according to the same website (verywellmind.com),
include: having a negative bias, having negative thoughts, and having negative beliefs. The
website defines “negative bias” as “having a tendency to discount positive social encounters and
magnify the social abilities of others.” A situation to demonstrate negative bias is basically how
it doesn’t matter if the individual had a great time on their date because all they’ll be able to
think about is how much better their date seemed to be at ordering their food. The website
defines “negative thoughts” as “automatic negative evaluations about yourself in social or
performance-related situations. For example, on the first day of class, the instructor asks
everyone to introduce themselves. An individual with SAD may think things like, “Everyone
else looks so much more relaxed,” or “What if everyone notices how red my face is?” Someone
with negative beliefs would think things like, “I’ll never be able to answer a question without
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stuttering,” or “I’ll never be able to order something without practicing how I’m going to say it
six times in my head,” which shows ones belief in ones adequacy in social situations.
Besides having physical and cognitive symptoms, people with SAD tend to make choices
based on fear and avoidance, like dropping a class to avoid a presentation. Three common
behavior symptoms are avoidance (things done/not done to reduce anxiety), safety behaviors
(actions taken to control social situations), and escape (leaving a feared social situation).
Causes of Social Anxiety Disorder
Social anxiety disorder can be caused by many factors including genetic predisposition,
childhood experiences, and unusual brain functioning. According to bridgestorecovery.com,
“People with a parent who have suffered from social anxiety disorder have a 30-40 percent
greater likelihood of developing the condition themselves.” Unfortunately, it’s impossible to
determine how much of the social anxiety association is based on genetics or parenting, which
can be naturally affected by the disorder. Genetically, both shortages and excesses of serotonin, a
chemical that can help stabilize moods, have been linked to social anxiety symptoms. People
with SAD struggle to produce serotonin consistently. Parenting style can also affect social
anxiety disorder. “If parents are over controlling… [or] quick to criticize…, a child’s self-image
and impression of the world can be shaped by words and actions associated with these
characteristics. Symptoms of SAD tend to show up in late childhood or early adolescence.
The amygdala is responsible for physiological changes associated the “fight-or-flight
response”. The amygdala is what triggers the physical symptoms of social anxiety disorder. If an
individual who does not have social anxiety disorder were to experience a sudden jolt of anxiety,
their prefrontal cortex would calm their reaction by rationalizing it. If no threat is present, it
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sends signals to the amygdala to defuse the response. But in people suffering from SAD, the
prefrontal cortex amplifies the amygdale instead of calming it [ CITATION Bri191 \l 1033 ].
Traumatic experiences can be shocking to kids when they discover that caregivers are
capable of hurtful behavior. Life events that are traumatic or very stressful can influence the
development of SAD. Examples of stressful life events known to have an effect on the
development of social anxiety disorder, according the website bridgestorecovery.com, include:
physical, sexual, or emotional abuse, bullying by peers, family conflicts (such as domestic
violence and divorce), and death of a parent.
Treatments for Social Anxiety Disorder
Verywellmind.com says, “Treatments for social anxiety disorder…depend on the severity
of your emotional and physical symptoms and how well you function daily. The length of
treatment also varies. … Both medication and therapy have been shown effective in treating
social anxiety disorder.” In order to get a treatment, a diagnosis should be made by a mental
health specialist.
The National Institute of Mental Health website says, “A type of psychotherapy called
cognitive behavioral therapy (CBT) is especially useful for treating social anxiety disorder.”
CBT teaches a person different ways in reacting to situations and can also help a person learn
and practice social skills. There are three types of medications generally used to help treat SAD.
Anti-anxiety medications begin working right away to reduce anxiety however they are usually
not taken for long periods of time. Antidepressants while mainly used to treat depression are also
useful in helping treat some symptoms of SAD. Antidepressants may take several weeks to start
working and may cause side effects such as headaches or difficulty sleeping [ CITATION Nat19 \l
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1033 ]. Beta-blockers can help reduce some of the physical symptoms anxiety and are commonly
used for “performance anxiety”.
Psychotherapy and medication can both take some time to work. In the meantime or if
you’re not interested in medication, a healthy lifestyle can also help with social anxiety. Besides
talking to family and friends who you trust, get plenty of sleep, eat a healthy diet, and exercise.
”Although treatment is available and effective…, it’s estimated that only 25% of
people…ever receive treatment” [ CITATION ver \l 1033 ] . Social anxiety disorder is not
uncommon but without treatment can last for many years or a lifetime and keep a person from
reaching their full potential.
References
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Association, A. P. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5.
Health, N. I. (n.d.). Social Anxiety Disorder: More Than Just Shyness. Retrieved 2019, from
https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-
shyness/index.shtml
Recovery, B. t. (n.d.). Causes of Social Anxiety. Retrieved 2019, from https://www.bridgestorecovery.com/social-
anxiety/causes-social-anxiety/
Recovery, B. t. (n.d.). Causes of Social Anxiety. Retrieved 2019, from https://www.bridgestorecovery.com/social-
anxiety/causes-social-anxiety/
Thomas A. Richards, P. (2019). Retrieved November 25, 2019, from DSM-5 Definition of Social Anxiety Disorder:
https://socialanxietyinstitute.org/dsm-definition-social-anxiety-disorder
verywellmind. (n.d.). Living With Social Anxiety Disorder. Retrieved from
https://www.verywellmind.com/coping-with-social-anxiety-disorder-3024836
