Most everyone occasionally experiences some degree of anxiety in social settings, such as with public speaking, job interviews, meeting new people, or talking with a physically attractive person. However, when levels of anxiety become excessive across many interpersonal contexts, this often signifies more than just ordinary nervousness or shyness, but a problem involving intense social fears that can adversely impact quality of life. This is the face of social anxiety disorder (SA)—a common, disabling, and alarmingly under-recognized mental health problem.
Once deemed the “neglected anxiety disorder” because its symptoms are easily mistaken for those of shyness, SA is no longer disregarded, at least from a research standpoint. Recent epidemiological studies estimate that lifetime prevalence of SA is approximately 12% in the United States, making it the third most common psychological disorder in the country behind depression and alcohol dependence. Unfortunately, despite both its prevalence and the surge in empirical research in the last two decades, SA remains overlooked at the societal level.
SA is marked by irrational fears of being negatively judged or rejected by others as well as hypersensitivity to criticism, embarrassment, and scrutiny. As a result, individuals with SA tend to become distressed over the prospect of entering social or performance situations and worry about acting in ways that will be embarrassing or awkward. In turn, they will usually avoid such events or else endure them with intense anxiety and distress. Paradoxically, socially anxious individuals may desperately desire to participate in social interactions but find their inability to do so beyond their control.
In the absence of treatment, SA typically follows a chronic course with full remissions rarely occurring. Aside from hindering the ability to form and maintain interpersonal relationships, the disorder may interfere significantly with educational attainment, career entry and advancement, and financial independence, as well as pose a risk for other psychological disorders. Lamentably, socially anxious individuals are often reluctant to seek treatment due largely to unawareness of available treatment resources.
Indeed, a child or adult who appears quiet or reserved could very well be shy, introverted and prefer to be solitary, or merely merit a matter of brushing up on social skills. Then again, it could suggest a more serious condition that, fortunately, is as easily treated as it is overlooked. As with any mental or physical condition, bolstering awareness is key. And when symptoms of SA are recognized, relief should not be far behind.
Related resources on SA (also known as Social Phobia)
National Institute of Mental Health
Anxiety Disorders Association of America
Association for Behavioral and Cognitive Therapies