Social Anxiety Disorder in Adults

Social Anxiety Disorder in Adults

Summary: It is normal for a person to be shy on certain occasions, but when their shyness prevents them from speaking at school, at work or elsewhere, the person may suffer from a social anxiety disorder. Fortunately, many strategies can be used to overcome social anxiety.


It can be an adult who never has a date because he is too shy to talk to someone of the opposite sex. It can be a quiet employee who is not appreciated by his colleagues and who is poorly paid by his employer. It may be one of your friends who is so funny, but who suffers from loneliness because he is too shy to approach strangers.


It happens to everyone to be shy from time to time. For example, many people feel nervous before making a presentation or meeting an employer for the first time. A slight shyness does not hurt, on the contrary, it prevents doing things that could be embarrassing or cause problems. But if you are so shy that it causes you problems at school, at work or in your interpersonal relationships, then you may be suffering from a social anxiety disorder…

 Social anxiety (or social phobia or social anxiety disorder) is a disorder that makes people who suffer from it very nervous in a social situation, especially in the presence of people or unknown situations, or when they are afraid of to be judged.

These people are afraid to show their anxiety or make a mistake that will embarrass them.

This anxiety can be so severe that it leads them to avoid a range of situations, and they may end up shutting themselves up and becoming unable to function to their full potential.

Why it’s important to treat social anxiety

Because of their response to avoid social situations, people with the risk of having a low quality of life, and being unable to work or just being underpaid at work. Ultimately, in the absence of treatment, social anxiety can lead to other problems, such as alcohol or other drug abuse, depression, and other mental disorders.

How widespread is it?

People who have a social phobia have generally been shy all their life, but the phobia usually becomes apparent in adolescence, when social life intensifies.

It affects people of all ages and some 8% of Canadians have symptoms at some point in their lives (Statistics Canada, 2002).

Signs and symptoms of social anxiety

Symptoms are felt before or during a social situation:

  • Flushing, sweating, feeling hot
  • nausea
  • tremors
  • Difficulty speaking or making eye contact

Types of social anxiety

The DSM-IV (a manual of mental disorders for professionals) distinguishes two main types of social anxiety disorders:

a) Generalized social anxiety disorder:

The person tends to avoid (or withstand) a wide variety of social situations: engaging in conversation with anyone except relatives, talking to strangers, talking on the phone, expressing a personal opinion, approaching someone in a position of authority ( eg, a teacher or employer).

b) Non-generalized social anxiety disorder:

The person has difficulties mainly in situations where they may be observed and judged by others, such as speaking in public, in class or at a meeting; give a performance in front of the public; eat or drink in the presence of others; use public toilets when other people are present; to make a mistake in front of witnesses.

What are the causes of social anxiety?

Many factors contribute to social anxiety.

  • Genetics: In case of family history, the risk is higher.
  • Life experiences can also lead to social fear of being humiliated or embarrassed. For Example:

a) Trauma, or bad experiences like having been harassed about her appearance.

b) To have grown up with social anxiety, or in an environment where the opinion of others is highly valued.

Do I have a social anxiety disorder?

Are you very much and persistently afraid of social situations or situations where you may be observed and judged by others? Situations that could lead to embarrassment or rejection?

Do you avoid these situations, or do you support them with anxiety (eg, showing anxiety symptoms)?

Are your fears unreasonable or complicating your life?

If you answer yes to one of these screening questions, then you should consult a health professional.

If you think you have a social anxiety disorder

Consult a health professional. Your doctor, for example, can check if you have a medical condition that contributes to your anxiety, such as hormonal problems. He can then refer you to specialized mental health services, or refer you to a mental health professional. ex. a psychologist.

Beware; social anxiety could make you think that your worries are unfounded, that it’s just shyness and that you will not be taken seriously. It’s your social anxiety that speaks. Ask for help, you deserve it.

How is social anxiety treated?

The bad news is that you may have a social anxiety disorder. The good news is that there are many effective social anxiety disorder treatment.

1. Cognitive Behavioral Therapy (CBT)

CBT is a type of psychotherapy provided by a psychologist, psychiatrist or other qualified professional who assists people with social anxiety through various cognitive and behavioral techniques. Social gatherings generate fears, which arouse feelings of social anxiety and incite avoidance behaviors. By changing one’s thoughts or behaviors, one can overcome one’s social anxiety.

The TCC uses the following techniques:

a) Transformation of worried thoughts into more useful thoughts (cognitive restructuring)

Fears associated with social anxiety include:

Fears about others: “Everyone will laugh at me. Or again, “Everyone is watching me. “

Fears relating to oneself: “I am going to ridicule myself. Or again, “I am going to humiliate myself. “

These thoughts need to be replaced by other more useful thoughts, such as:

“No one will laugh, and even if someone laughs, it does not matter. Everything will be forgotten the next day anyway! Or “Nobody looks at me, after all, I’m not a star! “.

“I will not ridicule myself, after all, I will not do anything worse than the others! “I will not feel a humiliation, I have experienced worse! “

b) Exposure:

Exposing yourself gradually and repeatedly to the disturbing situation until you are no longer afraid of it. For example, a person who is afraid to speak in front of a teacher can start by talking to him or her after class, individually, and then progress to being able to talk to him or her during classes in the presence of others. The exhibition follows the established “hierarchy” of behaviors, a step-by-step approach that begins with the most affluent behaviors and progresses toward more demanding behaviors.

 c) Role play: Exercises to apply new ways of responding to disturbing situations. For example, an anxious adult about what he should say when meeting new people can replicate the situation in therapy.

d) Social Skills Training: Learning Effective Steps and Rules in Social Interactions. People are generally expected to learn social skills naturally, or on their own. The school does not usually teach how to talk to others, make friends, or learn social skills. But because people with social anxiety tend to avoid social situations, they have few opportunities to learn to practice their social skills. Therefore, it is useful to be specifically familiar with social skills and interpersonal communication skills.

e) Problem Solving: This approach is about identifying the problems that cause stress and how to manage them. This involves learning how to systematically solve problems that arise using the brainstorming technique, evaluating the advantages and disadvantages of various solutions, and defining the steps leading to the best solution. The person must learn to use this process whenever they have a problem.

 Social anxiety tends to encourage people who suffer from it to avoid problems (and problematic situations), so one of the main goals of cognitive-behavioral therapy (or any therapy) is to help people with diabetes gradually. to confront their problems (and problematic situations).

2. Drugs

Medications prescribed by a physician (family doctor, pediatrician or psychiatrist) are generally used only in cases where social anxiety is not alleviated by other types of counseling or therapy, or when anxiety is so intense that it precludes the use of counseling or therapy. The data demonstrates that when used correctly, medication is safe and effective (Bridge, JAMA, April 18, 2007). Recent data show that a combination of drugs and psychotherapy seems more effective than the use of drugs alone or psychotherapy (Walkup et al., 2008).