It's normal to feel nervous in some social situations. For example, going on a date or giving a presentation may cause that feeling of butterflies in your stomach. But in social anxiety disorder, also called social phobia, everyday interactions cause significant anxiety, fear, self-consciousness and embarrassment because you fear being scrutinized or judged by others.
In social anxiety disorder, fear and anxiety lead to avoidance that can disrupt your life. Severe stress can affect your daily routine, work, school or other activities.
Social anxiety disorder is a chronic mental health condition, but learning coping skills in psychotherapy and taking medications can help you gain confidence and improve your ability to interact with others.
Social anxiety disorder care at Mayo Clinic
Feelings of shyness or discomfort in certain situations aren't necessarily signs of social anxiety disorder, particularly in children. Comfort levels in social situations vary, depending on personality traits and life experiences. Some people are naturally reserved and others are more outgoing.
In contrast to everyday nervousness, social anxiety disorder includes fear, anxiety and avoidance that interfere with daily routine, work, school or other activities. Social anxiety disorder typically begins in the early to mid-teens, though it can sometimes start in younger children or in adults.
Signs and symptoms of social anxiety disorder can include persistent:
For children, anxiety about interacting with adults or peers may be shown by crying, having temper tantrums, clinging to parents or refusing to speak in social situations.
Performance type of social anxiety disorder is when you experience intense fear and anxiety only during speaking or performing in public, but not in other types of social situations.
Physical signs and symptoms can sometimes accompany social anxiety disorder and may include:
Common, everyday experiences that may be hard to endure when you have social anxiety disorder include, for example:
Social anxiety disorder symptoms can change over time. They may flare up if you're facing a lot of stress or demands. Although avoiding situations that produce anxiety may make you feel better in the short term, your anxiety is likely to continue over the long term if you don't get treatment.
See your doctor or mental health professional if you fear and avoid normal social situations because they cause embarrassment, worry or panic.
Like many other mental health conditions, social anxiety disorder likely arises from a complex interaction of biological and environmental factors. Possible causes include
Your doctor will want to determine whether other conditions may be causing your anxiety or if you have social anxiety disorder along with another physical or mental health disorder.
Your doctor may determine a diagnosis based on:
DSM-5 criteria for social anxiety disorder include:
Left untreated, social anxiety disorder can run your life. Anxieties can interfere with work, school, relationships or enjoyment of life. Social anxiety disorder can cause:
Other anxiety disorders and certain other mental health disorders, particularly major depressive disorder and substance abuse problems, often occur with social anxiety disorder.
There's no way to predict what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you're anxious:
Although social anxiety disorder generally requires help from a medical expert or qualified psychotherapist, you can try some of these techniques to handle situations that are likely to trigger your symptoms:
First, consider your fears to identify what situations cause the most anxiety. Then gradually practice these activities until they cause you less anxiety. Begin with small steps by setting daily or weekly goals in situations that aren't overwhelming. The more you practice, the less anxious you'll feel.
Consider practicing these situations:
At first, being social when you're feeling anxious is challenging. As difficult or painful as it may seem initially, don't avoid situations that trigger your symptoms. By regularly facing these kinds of situations, you'll continue to build and reinforce your coping skills.
These strategies can help you begin to face situations that make you nervous:
Avoid using alcohol to calm your nerves. It may seem like it helps temporarily, but in the long run it can make you feel more anxious.
These coping methods may help ease your anxiety:
Over time, these coping methods can help control your symptoms and prevent a relapse. Remind yourself that you can get through anxious moments, that your anxiety is short-lived and that the negative consequences you worry about so much rarely come to pass.
Several factors can increase the risk of developing social anxiety disorder, including: