Social Anxiety

What Causes Social Anxiety?

Social anxiety disorder can negatively impact your life in many ways. Read on to learn about the causes, symptoms, and treatment options.

Table of Contents

What Is Social Anxiety Disorder?

Social anxiety disorder, also known as social phobia, is a long-standing and overwhelming fear of social situations. It involves an extreme fear of being judged, negatively evaluated, or rejected in a social or performance situation.

Individuals with social anxiety often worry that they will act in ways that might embarrass or humiliate them. This fear can be so intense that it significantly interferes with their daily routines, job performance, schoolwork, or social relationships.
it’s important to know the signs and symptoms to best deploy plausible treatment opportunities.1
Social Anxiety disorder

Prevalence of Social Anxiety

Social anxiety is a common mental health condition. According to the National Institute of Mental Health, about 12% of U.S. adults experience social anxiety disorder.2

It’s also worth noting that social anxiety disorder affects men and women equally and often starts during youth. In fact, the average age of onset for social anxiety disorder is during the teenage years.

When Does Social Anxiety Become a Problem?

Untreated social anxiety in public becomes a problem when it interferes with a person’s lifestyle, relationships, and well-being. The line between normal shyness and social anxiety disorder can be blurry.

However, a key distinction is that social anxiety disorder significantly disrupts normal life, limiting what you can do, where you can go, and who you can meet. It can prevent you from doing things you enjoy or things that could help you achieve personal or professional goals.

What is Social Anxiety Disorder?

What Are the Signs and Symptoms of Social Anxiety Disorder?

There are several signs and symptoms to look out for when diagnosing social anxiety disorder. These symptoms can be physical, emotional, or behavioral.3

Physical Symptoms

Some physical symptoms to look out for to determine if someone has a social anxiety disorder include:
  • Blushing: A person dealing with social anxiety in public may experience excess blushing or redness of the face. This uncontrollable symptom has to do with discomfort and fearful feelings surrounding social situations.
  • Fast Heartbeat: When experiencing social anxiety, your heartbeat might quicken. This is a part of the body’s natural “fight or flight” response to stressful situations. It can feel as if your heart is racing or pounding
  • Trembling: Trembling or uncontrollable shaking is a common symptom found in people dealing with extreme social anxiety. This might affect your hands, voice, or other parts of your body. The more you focus on it, the more pronounced the trembling can become. It’s a direct result of the heightened state of nervousness or stress that social situations can induce in individuals with social anxiety.
  • Sweating: A person enduring an anxiety attack may experience excess sweating, regardless of body temperature. This sweating is a bodily reaction to the fear and nervousness associated with anxiety disorders.
  • Upset Stomach or Nausea: An upset stomach or nausea is another physical symptom of social anxiety disorders. This happens because anxiety and stress can have a direct impact on gastrointestinal function. You may feel queasy or experience a churning sensation in your stomach during anxiety-inducing social situations. In some extreme cases, you may feel the urge to vomit.

Emotional and Behavioral Symptoms

There are also various emotional and behavioral symptoms to look out for to determine if someone has a social anxiety disorder, such as:

Fear of Situations in Which You May be Judged Negatively

This is a key symptom of social anxiety. This can include a wide range of scenarios, from giving a presentation at work to attending a social event.
You may avoid these situations out of fear of what others may think or say about you. However, often these fears are not founded in reality, and these fears are just the brain’s reaction to the anxiety disorder.

Worry About Embarrassing or Humiliating Yourself

Anxiety can cause the brain to severely overthink, leading to unnecessary fear or worrying in social situations. This fear is not limited to making a big mistake, but can also include smaller, everyday actions, such as tripping over a word during conversation.

Intense Fear of Interacting or Talking with Strangers

Feeling an intense fear of interacting or talking with strangers is a strong indicator of social phobia.
The thought of initiating a conversation, or even just being involved in one, can cause significant stress.

You might find yourself avoiding situations where you have to meet new people, which can limit your social interactions and make you feel isolated.

Afraid That Others Will Notice Your Anxiety

You may believe that your nervousness is visibly apparent and that people will judge you for it. This can create a cycle of anxiety, where you’re anxious about feeling anxious, amplifying the overall intensity of the situation.
Social Anxiety

What Causes Social Anxiety Disorder?

Three different factors can cause social anxiety disorder: inherited traits, brain structure, and environment. One or all these factors can play a significant role in developing this type of anxiety disorder.

Inherited Traits

A person can be genetically predisposed to mental health disorder.s If you have relatives who have been diagnosed with an anxiety disorder, you have an increased risk of receiving the same diagnosis.

Brain Structure

One area, known as the amygdala, is involved in controlling fear response. In people with social anxiety, the amygdala may be more reactive to fear and anxiety, causing them to feel more anxious in social situations.


If you’ve had negative social experiences, especially ones that induce trauma, you might be more likely to develop anxiety in social settings. This could include being bullied, teased, or simply feeling left out.

Also, being raised in a family that’s more protective or controlling can make you feel less confident in social situations, leading to anxiety.

Risk Factors of Social Anxiety Disorder

Risk factors are anything that can increase a person’s risk of developing a disease or disorder. Here are some risk factors for social anxiety disorder:

Family History

A person with a family history that includes anxiety disorders is likely to be more at risk of developing these disorders. This is because they are more likely to have a brain structure prone to anxiety disorders if it is in their genetic makeup.

Negative Experiences

Frequent negative experiences can increase a person’s risk of developing an anxiety disorder, even if a person is not predisposed to mental illness. Sometimes, even a single embarrassing incident can be enough to cause social anxiety.


Temperament can play a significant role in social anxiety. If you’re naturally shy, introverted, or frequently find yourself uncomfortable in new situations, you might be at a higher risk of developing this type of anxiety.

New Social or Work Demands

Sudden life changes can cause stress or panic responses. This could include starting a new job, moving to a new city, or entering a new school.
These situations often require you to meet new people and adapt to new social norms, which can be stressful and increase the likelihood of social anxiety.

Chronic Medical Conditions

If you have a condition that makes you stand out or requires special care, such as a physical disability or a skin condition, it could make you more self-conscious and more likely to develop social anxiety.

Complications With Social Anxiety Disorder

If left untreated, several complications can arise with social anxiety disorder. Here are some examples of the negative impact that social phobia can have on a person’s life:

Low Self-Esteem

If you have anxiety, you might find yourself frequently worrying about what others think of you. These constant worries can make you view yourself in a negative light and lower your self-esteem.

Trouble Being Assertive

When you’re worried about other people’s reactions or judgments, it can be hard to express your own needs and desires confidently. This can impact your ability to stand up for yourself in various situations, from personal relationships to the workplace.

Negative Self-Talk

Anxiety often encourages negative self-talk, which is a cycle of unkind or discouraging thoughts about oneself. You might tell yourself things like “I’m not good enough” or “people don’t like me.” This continuous negative self-talk can make anxiety worse and lead to a distorted view of oneself.

Hypersensitivity to Criticism

Hypersensitivity to criticism is typical amongst people dealing with untreated social anxiety disorders. This means that even mild feedback or offhand comments can feel deeply hurtful or embarrassing.
This hypersensitivity can make social situations seem even more daunting and can increase the fear of making mistakes or being judged.

Poor Social Skills

When you’re anxious in social situations, it can be hard to pay attention to others and respond appropriately.
This can make you seem distant or uninterested, even when you’re actually eager to connect. Over time, these challenges can limit your opportunities to practice and develop your social skills.

How Can I Support Myself and Others With a Social Anxiety Disorder?

Social anxiety disorder can be challenging to manage without any guidance or support. It’s important to address the root of any underlying issues and the potential treatment options.
Awareness and de-stigmatization are the most critical aspects of ensuring support for those with anxiety disorders. Here are some social anxiety tips to support yourself or others after a diagnosis:

Educate Yourself

Educating yourself about the symptoms and treatment of social anxiety disorder is an excellent way to show support for yourself or a loved one who was recently diagnosed. You can also educate yourself on social anxiety coping skills to learn how to overcome the disorder better.


Communicating how you’re feeling can help avoid misunderstandings surrounding issues stemming from social phobia.
Whether you’re the person who was diagnosed or you wish to support someone who was diagnosed, using communication can help facilitate overcoming social anxiety for everybody involved.

When to Get Professional Help

This type of anxiety can sometimes improve on its own. However, if anxiety in social situations starts to interfere with your daily life, such as work, school, or relationships, it’s time to seek professional help.
If you are supporting someone with anxiety, you might suggest seeking help if you notice they’re avoiding social situations, showing signs of distress, or if their behavior is impacting their life.
In such cases, a professional can provide a thorough evaluation and guide you to the appropriate treatment. Remember, it’s never too late to seek help, and doing so can be a significant first step towards managing social anxiety.

Supporting those With Social Anxiety

Social Anxiety Disorder Treatment

There are two common types of disorder treatment: medication and therapy.4


Social anxiety can cause an imbalance in brain chemicals associated with mood and fear. Medication works by restoring the balance of these chemicals, helping to reduce feelings of anxiety and fear. Several different medications are available for people dealing with social anxiety disorder. 

Individuals may be prescribed:
  • SSRIs: Selective serotonin reuptake inhibitors (SSRIs) are the most frequently used drug for overcoming social anxiety. They help by increasing the levels of serotonin in your brain, which can improve mood and reduce anxiety.
  • Upset Benzodiazepines: Benzodiazepines can also provide quick relief from acute symptoms of anxiety. They help to calm the body and mind by slowing down the nervous system.

Side Effects of Medication

Common side effects of SSRIs may include nausea, headache, and difficulty sleeping, while benzodiazepines can lead to drowsiness and potential dependence over time.
Always consult with a healthcare provider before starting a new medication and discuss any potential risks or side effects. The goal is to find a medication that provides the most benefit with the least amount of side effects, ensuring that you can manage your social anxiety effectively.


Therapy provides a safe environment for you to explore, understand, and manage your social anxiety. It gives you the tools to challenge and change the thought patterns that lead to anxiety. By working on these thought patterns, you can begin to change how you react to situations that cause anxiety.

Types of Therapy Used for Social Anxiety Disorder

There are several types of therapy used for social anxiety. The most common is cognitive-behavioral therapy (CBT). This therapy helps you understand and change thought patterns leading to anxiety.
Other therapies include exposure therapy, where you gradually face social situations, or acceptance and commitment therapy (ACT), which teaches you to accept anxiety and not let it control you.

A Closer Look at ACT

Social Anxiety

Reach Out to J. Flowers Health Institute for Specialized Social Anxiety Support

Navigating anxiety can be a challenging journey, but you don’t have to face it alone. At J. Flowers Health Institute, we understand that the path to overcoming social anxiety begins with a comprehensive understanding of the condition and its root causes.

Our Approach to Anxiety in Social Settings

At J. Flowers Health Institute, we employ a comprehensive and personalized approach to diagnosing and treating anxiety. Our “Living MRI” is designed to look beyond the surface symptoms and delve into the root cause of your condition.
Our diagnostic evaluation may include:
  • Medical evaluation
  • Psychological diagnostic testing
  • Psychiatric evaluation
  • Neuropsychological testing
  • Lifestyle assessment
  • Specialty physicians consult
  • Spiritual consult and assessment
  • Nutritional and fitness evaluations
  • Comprehensive report and action plan
We then use this information to devise an action plan tailored to your specific condition and circumstances. By doing so, we address not only your symptoms but also the root cause of your anxiety.

Alleviating Social Anxiety with J. Flowers Health Institute

We believe that understanding your unique context is essential in devising an effective treatment plan. This means taking the time to understand you – your history, your experiences, your lifestyle, and your goals.
At J. Flowers Health Institute, our board-certified experts are dedicated to providing the highest level of individualized care. Whether you are struggling with social anxiety or any other mental health condition, we are committed to helping you navigate your journey towards wellness.

Reach Out and Begin Healing

Let us help you overcome your mental health symptoms and begin to enjoy life again. Contact us today.