Social Anxiety Disorder

Discover how proven counselling can help you break free from the prison of social anxiety and step into a life of confidence and connection.

For those with social anxiety disorder, getting coffee, going to work, or attending a party can trigger panic attacks and unbearable distress.

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    Imagine the sheer terror that grips you at a simple social interaction. This is a daunting reality for many Canadians grappling with social anxiety disorder.

    Social anxiety disorder, often called social phobia, is a common mental health issue in Canada. It manifests as an acute fear of social situations, leading to avoidance behaviours, intense anxiety and distress that can drastically disrupt a person’s daily life.

    Based on data from the Canadian Community Health Survey, it’s estimated that about 8% of Canadians will eventually encounter symptoms of social anxiety disorder.

    Living with social anxiety disorder can turn your world upside down. It can make it tough to form and maintain relationships, create stress at work, and generally make life much harder than needed. But here’s the good news – this condition doesn’t have to be a life sentence. There are treatments available that can help.

    A woman with social anxiety disorder, dreading having to present at her work in front of people, her palms are sweaty and her heart beats against her chest

    Symptoms of Social Anxiety Disorder

    Social anxiety disorder manifests in various ways, and its symptoms can be broadly categorized into emotional, behavioural, and physical.

    Emotional Symptoms

    Emotional symptoms are often the most noticeable signs of social anxiety disorder. They include:

    1. Excessive self-consciousness: Individuals may feel overwhelmingly observed and judged in everyday social situations.
    2. Intense worry: This can occur for days or even weeks before an upcoming social situation.
    3. Extreme fear of embarrassment or humiliation: This fear often stems from the belief that others will notice their nervousness.
    4. Dread of situations where they may be the center of attention: Social events, presentations, or even casual conversations can trigger this fear.
    5. Fear of physical symptoms that may cause embarrassment: These include blushing, sweating, trembling, or having a shaky voice.
    6. Fear of meeting new people: Interacting with strangers can be daunting.

    Behavioural Symptoms

    Behavioural symptoms are actions or habits that individuals with a social anxiety disorder may exhibit. These include:

    1. Avoidance of social situations: To the degree that limits their activities or disrupts their life.
    2. Escaping from social situations: They may leave events early or find reasons to excuse themselves.
    3. Needing a companion to endure a social situation: They may rely on a friend or family member to accompany them.
    4. Excessive preparation for social situations: They may rehearse or excessively worry about what they say or do.
    5. Limited eye contact: They may struggle to maintain eye contact during conversations.
    6. Quiet or withdrawn behaviour in social settings: They may prefer to stay on the sidelines during social events.

    Physical Symptoms

    Physical symptoms are the bodily reactions that occur in response to social anxiety. These include:

    1. Blushing, sweating, or trembling: These are common reactions to feeling anxious.
    2. Nausea or upset stomach: Anxiety can often manifest as gastrointestinal discomfort.
    3. Difficulty speaking: This can include a shaky voice or a hard time-making conversation.
    4. Rapid heart rate: Anxiety can cause physical reactions like an increased heart rate.
    5. Shortness of breath: They may feel unable to catch their breath during anxiety-inducing situations.
    6. Dizziness or faintness: Severe anxiety can sometimes lead to feeling lightheaded or faint.

    Everyone’s experience with social anxiety is unique, and symptoms can vary in intensity and frequency.

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    Avoiding Social Situations

    People with social anxiety often avoid social situations because they fear being judged, embarrassed, or humiliated. Here are some common social situations they might avoid:

    1. Public speaking or performing in front of others
    2. Attending parties or social gatherings
    3. Participating in group work or team activities
    4. Going to restaurants or shopping malls
    5. Using public restrooms
    6. Attending meetings or classes
    7. Going on dates or meeting new people
    8. Making phone calls in public
    9. Eating or drinking in front of others
    10. Asking for help or information.

    Causes of Social Anxiety Disorder

    Social Anxiety Disorder (SAD) is a complex condition shaped by a mix of our genes, the environment we grow up in, and our mental and emotional experiences. It’s not the result of a single cause, but rather an interplay of these elements:

    1. Genetic Factors: Genetics significantly contribute to the development of SAD. Research indicates that having a first-degree relative with this disorder increases the likelihood of an individual developing it, pointing towards a hereditary component. However, the exact genes involved remain under investigation.
    2. Environmental Factors: Experiences early in life, such as bullying, rejection, or humiliation, can contribute to the onset of SAD. These traumatic events can lead to negative self-perceptions and beliefs about others, fueling social anxiety.
    3. Psychological Factors: Cognitive theories propose that individuals with SAD often perceive social situations as threatening and overestimate the negative outcomes of social interactions. This perception can lead to avoidance of social situations, fostering social anxiety.

    It’s crucial to note that these risk factors interact in complex ways, and the precise combination leading to SAD can vary among individuals. Therefore, understanding and treating SAD necessitates a comprehensive approach considering an individual’s unique genetic makeup, life experiences, and psychological traits.

    Social and Occupational Impacts of Social Anxiety Disorder

    Challenges in Forming Connections and Maintaining Relationships

    • Individuals with SAD often struggle to form and maintain relationships. Their fear of being judged or embarrassed can lead to avoidance of social situations, making it hard to meet new people or maintain existing relationships.
    • They may struggle with expressing their feelings or communicating effectively, leading to misunderstandings and conflicts.
    • The fear of rejection can also lead to isolation and loneliness, exacerbating their anxiety.

    Job Stress and Performance Difficulties

    • Social anxiety can lead to significant stress and performance issues in the workplace. Individuals may avoid jobs that require social interaction or public speaking, limiting their career opportunities.
    • They may struggle with teamwork or collaboration tasks and have difficulty speaking up in meetings or voicing their ideas.
    • The constant worry about being judged or criticized can decrease productivity and job satisfaction.

    Academic Challenges and Impact on Education

    • Students may avoid participating in class discussions or giving presentations, affecting their grades and learning.
    • They may also avoid social events or extracurricular activities, missing out on important aspects of the educational experience.
    • The stress and worry associated with social anxiety can also lead to difficulties concentrating or retaining information, further impacting academic performance.

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    Therapy Treatment for Social Anxiety Disorders

    • Cognitive-behavioural Therapy (CBT): This is the most well-established and highly recommended therapy for SAD. CBT involves identifying and challenging negative thought patterns and behaviours and developing healthier, more effective ones. Techniques such as cognitive restructuring, exposure exercises, and social skills training are often used.
    • Mindfulness-Based Therapies: Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are about helping people live in the here and now without passing judgment on their experiences.This can help reduce worry and rumination, common issues in SAD.
    • Acceptance and Commitment Therapy (ACT): ACT is a form of CBT that involves accepting uncomfortable feelings rather than avoiding them, identifying personal values, and acting in line with them. This can help individuals with SAD to engage more fully in social situations, despite their anxiety.
    • Interpersonal Therapy (IPT): While not as commonly used for SAD as CBT, IPT can help address interpersonal issues that often accompany this disorder, such as difficulties in forming and maintaining relationships.
    • Group Therapy: This can be particularly beneficial for individuals with SAD, as it provides a safe and supportive environment to practice social skills and receive feedback from others.
    • Psychodynamic Therapy: This approach involves exploring unconscious conflicts and past experiences that may contribute to current anxiety.

    Real-World Examples

    CBT Therapy

    Consider Alex, who has Social Anxiety Disorder (SAD) and fears public speaking. In Cognitive-Behavioral Therapy (CBT), Alex would:

    1. Identify fear-triggering thoughts, like “Everyone will laugh if I make a mistake.”
    2. Challenge these thoughts with his therapist, realizing that past experiences don’t support this fear.
    3. Gradually face his fear through exposure therapy, starting with speaking to small, supportive groups.
    4. Learn coping strategies like deep breathing and mindfulness to manage anxiety.
    5. Improve social skills and build confidence.

    Alex learns to manage his fear through CBT, enabling him to handle previously avoided situations.

    ACT Therapy

    Meet Bella, who struggles with SAD and avoids social gatherings due to fear of judgment. In ACT, Bella would:

    1. Identify Values: Bella identifies her values, such as building strong friendships and contributing to her community.
    2. Recognize Thoughts: Bella learns to recognize her anxious thoughts as just thoughts, not facts. For example, she might think, “People will judge me,” but she learns to see this as a thought, not a reality.
    3. Acceptance: Bella learns to accept her feelings of anxiety as a normal human response, rather than trying to eliminate or avoid them.
    4. Mindfulness: Bella practices mindfulness exercises to stay present during social interactions rather than getting lost in her anxious thoughts.
    5. Commitment: Despite her anxiety, Bella commits to taking action aligned with her values, such as attending a social event.
    6. Behavioural Changes: Bella’s avoidance behaviour over time decreases as she continues engaging in social situations that align with her values, even when anxious.

    Through ACT, Bella learns to accept her social phobia and live according to her values.

    Self-help Strategies for Managing Symptoms

    • Educating oneself about anxiety and its impacts
    • Practicing controlled breathing techniques
    • Engaging in mindfulness practices and meditation
    • Regular physical activity and maintaining a nutritious diet
    • Participating in calming physical activities like yoga or tai chi
    • Establishing a consistent sleep schedule to ensure adequate rest
    • Recognizing personal anxiety triggers and knowing when to seek professional help
    • Limiting intake of caffeine and other substances that can heighten anxiety

    Key Takeaways

    1. Social anxiety disorder, or social phobia, is a common mental health issue in Canada, affecting about 8% of Canadians at some point.
    2. The disorder is characterized by an acute fear of social situations, leading to avoidance behaviours and distress that can drastically disrupt a person’s daily life.
    3. The symptoms of social anxiety disorder can be categorized into emotional, behavioural, and physical symptoms.
    4. The causes of social anxiety disorder are multifaceted, influenced by genetic, environmental, and psychological factors.
    5. The disorder can have significant social and occupational impacts, affecting relationships, work performance, and academic achievements.
    6. Several therapy treatments are available for social anxiety disorders, including cognitive-behavioural therapy (CBT), mindfulness-based therapies, acceptance and commitment therapy (ACT), interpersonal therapy (IPT), group therapy, and psychodynamic therapy.


    • Fear of situations in which you may be judged
    • Worrying about embarrassing or humiliating yourself
    • Intense fear of interacting or talking with strangers
    • Fear that others will notice that you look anxious
    • Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling or having a shaky voice

    The root cause of social anxiety disorder is not fully understood. It's believed to arise from a combination of genetic factors, environmental influences, and an imbalance of neurotransmitters in the brain. It's also linked to having an overactive amygdala, the part of the brain that controls fear response.

    The severity of social anxiety disorder can vary significantly between individuals. For some, it may cause mild distress or inconvenience; for others, it can be extremely debilitating and interfere with daily functioning.

    While social anxiety disorder is a chronic condition that can persist for many years or a lifetime, it's important to note that it can be effectively managed with the right treatment. Cognitive-behavioural therapy (CBT) is particularly effective in treating social anxiety disorder and can provide coping skills and strategies for social anxiety. Medications can also be used if necessary. While it may not completely "cure" the condition, treatment can significantly reduce symptoms and improve quality of life.

    No matter what you are struggling with, we are here for you.

    No matter what you are struggling with, we are here for you.

    Pareen Sehat MC, RCC

    Pareen Sehat MC, RCC

    Pareen’s career began in Behaviour Therapy, this is where she developed a passion for Cognitive Behavioural Therapy approaches. Following a Bachelor of Arts with a major in Psychology she pursued a Master of Counselling. Pareen is a Registered Clinical Counsellor (RCC) with the BC Association of Clinical Counsellors. She specializes in CBT and Lifespan Integrations approaches to anxiety and trauma. She has been published on major online publications such as - Yahoo, MSN, AskMen, PsychCentral, Best Life Online, and more.