Social phobia: definition, symptoms, causes, treatment


Social phobia, also known as social anxiety disorder, is a common mental health problem. It is a type of anxiety disorder. People affected by it experience fear and anxiety in specific social situations or in all situations, due to the fear of being judged or humiliated. Learn more about social phobia in this overview.

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Social phobia is a mental health problem that causes a person to experience intense and persistent fear and anxiety in specific social situations or in all situations, as well as sometimes daily tasks like eating or drinking in front of others. Anxiety is caused by the fear of being judged or humiliated by others.

Social phobia is mentioned in the most recent edition of the “Diagnostic and Statistical Manual for Mental Disorders” (DSM-5), the book used by mental health professionals to diagnose disorders, as an anxiety disorder. social, and it is classified as a type of anxiety disorder.

People affected by social phobia

By some estimates, social phobia affects up to 12% of the population of the United States at some point in their lives. About 7% of adults are affected in any given year.

Some people may not experience anxiety in social situations, but they do experience it when they need to play or do something in front of a group. This is called performance anxiety, and it can happen when you are giving a speech, dancing, playing an instrument, etc.


People with social anxiety disorder experience physical and mental signs and symptoms when they are in social situations or when they occur in front of others.

Physical signs and symptoms include:

  • Faster heartbeat or rate
  • Shortness of breath
  • Sweat
  • Tremors or tremors
  • Headache
  • Fatigue and sleep disturbances
  • Nausea or diarrhea
  • Frequent urination

Emotional and mental symptoms include:

  • Feeling of apprehension or dread
  • Feeling tense or nervous
  • Agitation
  • Irritability
  • Anticipate the worst
  • Watch for danger signs


If you have these symptoms, it is important to discuss them with a doctor or other healthcare professional. They will perform a physical exam and take a history to determine if this is caused by a physical problem. Once that’s ruled out, they’ll likely refer you to a mental health professional who has more training in diagnosing mental health issues, such as a psychiatrist, psychologist, or therapist.

DSM-5 diagnostic criteria

To diagnose a person with social phobia, they must have the characteristics of DSM-5. The diagnostic criteria for social phobia are:

  • Severe fear or anxiety about at least one social situation
  • Fear of acting in a certain way or showing symptoms of anxiety and being viewed negatively
  • Symptoms of anxiety are almost always caused by social situations
  • Avoid social situations that cause anxiety
  • The feelings are out of proportion to the real threat of the social situation
  • Symptoms are not caused by medications, medications, or any other medical or mental health problem

Symptoms should be persistent and present for at least 6 months and result in impaired ability of the person to function in everyday life. In children, the social setting must also be with peers and not just adults to be classified as social anxiety.

Causes and risk factors

Several parts of the brain are involved in social phobia, and it appears to be affected by both genetic and environmental factors. When it comes to genetics, social phobia sometimes occurs in families, but there is no known reason why some family members have it and others don’t. Temperament risk factors include behavioral inhibition, and environmental factors can sometimes include adversity or childhood abuse.

A person with social phobia is also at increased risk for other mental illnesses, such as depression and substance use disorders. It often starts early in life, with an average age of onset of 13 years, and also lasts a long time.


Social phobia is treated with psychotherapy, also called talk therapy, drugs, or a combination of both. Often psychotherapy is started first, with medication added as needed. Research has shown that although there is usually a more immediate effect of drugs, the effects of therapy last longer.


Typically, the form of therapy used for social phobia is cognitive behavioral therapy (CBT). A person treated with CBT will learn different ways of thinking, reacting, and behaving in situations that cause distress, ideally leading to improvement in anxiety and fear. It can also help them learn and develop better social skills. CBT is often done in individual sessions, but it can also be helpful in groups.

Although not an official form of psychotherapy, people with social phobia sometimes use support groups, which allow them to encourage and learn from each other. It should not replace standard therapy and / or medication, but they are a good adjunct.


The most common drugs used for social phobia that are considered first-line treatment are selective serotonin reuptake inhibitors (SSRIs). This class of drugs is considered an antidepressant, but it is used for many other conditions, including social phobia. The selective serotonin norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor) has also been shown to help with social phobia.

SSRI drugs

Examples of SSRIs are:

  • Prozac (fluoxetine)
  • Celexa (citalopram)
  • Zoloft (sertraline)
  • Paxil (paroxetine)
  • Lexapro (escitalopram)

Occasionally, benzodiazepines may be used, which are anti-anxiety drugs that work quickly to reduce anxiety. However, they can also be addictive and withdrawal, so they are used in situations where symptoms are debilitating and require quick relief.

For performance anxiety in particular, beta blockers, such as Inderal (propranolol), are often used. These are often used for heart disease and blood pressure, but in this case, they are helpful in reducing specific physical symptoms such as rapid heart rate, sweating, and tremors.

A word from Verywell

It is difficult to live with anxiety, especially when it comes to social situations. However, if you have symptoms that resemble social phobia, it is important to discuss them with your doctor or health care provider. They will be able to rule out any physical cause, get more information about your symptoms, and provide you with resources and referrals, allowing you to live your life the way you want to.

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