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What are the Symptoms of Social Anxiety Disorder?

Overview of the Symptoms of SAD

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Social anxiety disorder symptoms include cognitive, physical, and behavioral difficulties. If you suffer with social anxiety, you may wonder whether your symptoms are severe enough for you to be diagnosed with social anxiety disorder (SAD). Only a trained mental health professional can provide a diagnosis, however reading about the symptoms of the disorder will help you learn whether what you are feeling is typical of those with SAD.

Situational Triggers

People with SAD fear being embarrassed or humiliated in front of others. You may be afraid of one or many different types of social situations.

Below are some situations that trigger anxiety in those with SAD.

Regardless of which specific situations trigger your social anxiety, the symptoms that you experience will fall into one of three broad categories: cognitive symptoms (what you think), physical symptoms (what you feel), and behavioral symptoms (what you do).

Cognitive Symptoms

The cognitive symptoms of SAD are the dysfunctional thought patterns that accompany the disorder. People with SAD are plagued with negative thoughts and self-doubt when it comes to social situations. If these negative thought patterns are allowed to continue without treatment, they may erode your self-esteem over time. Below are some common issues that you may experience.

  • Negative bias: You tend to discount positive social encounters and magnify the social abilities of others.
     
  • Negative thoughts: Negative thoughts are automatic negative evaluations about yourself in a social situation. Imagine starting a new job or the first day of a new class. The instructor or manager asks everyone to introduce themselves to the group. Someone with social phobia may start to have thoughts such as:
    • “Everyone else looks so much more relaxed.”
    • “What if I say something dumb?”
    • “What if everyone notices my voice shaking?”

    Your thoughts start to rapidly spiral out of control to the point that you don't hear anything anyone else has said. When it comes your turn, you say as little as possible and hope that no one noticed your anxiety. Negative thoughts often occur so automatically that you are not even aware of them.

  • Negative beliefs: You have strongly held beliefs about your inadequacy in social situations.

Physical Symptoms

The physical symptoms of SAD are real and extremely distressing. Some of the most common symptoms are:

  • blushing
  • sweating
  • shaking
  • muscle tension
  • chills
  • chest tightness
  • chest pain
  • trembling voice
  • shortness of breath
  • lump in throat
  • blurred vision
  • ringing in the ears
  • headaches
  • dry mouth
  • dizziness
  • nausea
  • diarrhea
  • parathesias (tingling)
  • heart racing (tachycardia)
  • heart pounding (palpitations)
  • disorientation (depersonalization/derealization)

In some people, the symptoms may become so severe that they escalate into a panic attack. How does this differ from panic disorder?

People with SAD know that their panic attacks are provoked by fears of the potential consequences of social situations. On the other hand, those with panic disorder may worry that the attacks reflect a physical problem, in addition to worrying about the risk of having future attacks.

Behavioral Symptoms

People with SAD tend to make choices based on fear and avoidance rather than preferences, desires or ambitions. If you have SAD, this problem may be familiar. You may have dropped a class to avoid doing a presentation or turned down a job promotion because it meant increased social and performance demands.

People with generalized SAD are particularly at risk of having poor quality of life. They may have few or no friends, no romantic relationships, drop out of school or quit their jobs, and may use alcohol to tolerate anxiety.

Below are some common behavioral symptoms:

  • Avoidance: Those things that you do or don't do to reduce anxiety about being in social situations.
     
  • Safety behaviors: Actions that you take to control or limit your experience of social situations.
     
  • Escape: Leaving or escaping from a feared situation.

Although the symptoms of SAD can greatly affect your quality of life, the good news is that they respond well to treatment. The physical symptoms are well-suited to exposure therapy or medication and the cognitive and behavioral symptoms are prime candidates for psychotherapy such as cognitive-behavioral therapy (CBT).

Source:

Hope DA, Heimberg RG, Turk C. (2010). Managing Social Anxiety: A Cognitive-Behavioral Therapy Approach Workbook (2nd Ed.). New York: Oxford University Press.

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