AARP Eye Center
We've all been there: a bout of serious nerves while mingling at a cocktail party or butterflies before a big presentation at work. But social anxiety disorder isn't just garden-variety shyness. For people who suffer from the condition, social interactions aren't just uncomfortable — they can be excruciating, filling people with pure dread.
"Social anxiety disorder is a diagnosis [that] has several criteria,” says Larry Cohen, LICSW, cofounder of the National Social Anxiety Center, with regional clinics throughout the U.S. “The main one is a fear of judgment, criticism or embarrassment — of being evaluated negatively by other people.”
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It's surprisingly common: An estimated 12 percent of U.S. adults will experience social anxiety disorder at some point in their lives, according to the National Institute of Mental Health, though it typically first develops in childhood or adolescence. It's the third most frequently diagnosed mental health disorder, behind depression and alcoholism.
Social anxiety can range from mild to severe. At its most severe, it can take the form of full-on panic so debilitating and ongoing that some people are afraid to be out in public in ordinary settings — grocery shopping, for instance, or even just walking down the street — because they're fearful of being observed and judged. Says Ellen Hendriksen, Ph.D., a Boston-based clinical psychologist and author of How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety: “It gets in the way of living the life one wants to live."
It can also come with some uncomfortable physical symptoms: racing heart, muscle tension, blushing and sweating, or feelings of nausea or dizziness.
Those with moderate social anxiety — the most common kind — tend to avoid social situations, where they may feel awkward and nervous. That can result in fewer friendships, fewer and less satisfying romantic relationships, and an inhibited career. “People with social anxiety disorder also have a much higher incidence of depression, because their lives are so inhibited and isolated,” says Cohen.
People suffering from a milder form of social anxiety disorder may interact with others, but in a kind of “please don't pay attention to me” way. “They may be quiet, polite and as pleasing as possible,” says Aziz Gazipura, a Portland, Oregon-based clinical psychologist, founder of the Center for Social Confidence and author of The Solution to Social Anxiety: Break Free From the Shyness That Holds You Back. “They basically try to become invisible in plain sight.”