A diagnosis of social anxiety disorder (SAD) requires that a number of specific criteria are met. Mental health professionals use a handbook called the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) when making diagnoses. A mental health professional will ask questions to determine whether you meet each of the following criteria when making a diagnosis:
- You have significant and persistent fear of social or performance situations in which embarrassment, rejection, or scrutiny are possible.
- You almost always experience the physical symptoms of anxiety when in the feared social situation(s).
- You recognize that the fear is unreasonable but are unable to do anything about it.
- You either avoid the feared situations or endure them with intense anxiety or distress.
In order to be diagnosed with SAD, the fear and avoidance must be so severe that they significantly interfere with your daily functioning, school, work, or relationships or you are in significant distress about having the phobia.
A mental health professional will also rule out possible alternative causes of symptoms such as drug or medication use, or a medical condition, before making a diagnosis of SAD.
Finally, the fear must not be only about the symptoms of a medical condition or another mental disorder. For example, the fear is not just of shaking in Parkinson's disease or panic attacks in panic disorder.
In cases where you fear only one or a few social situations (such as public speaking), the diagnosis is specific SAD. In contrast, if you are afraid of and avoid most social situations, you would be diagnosed with generalized SAD.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.