Living with social anxiety, also known as social phobia, is emotionally painful and can be debilitating. Social anxiety disorder, unaffectionately known as SAD, is characterized by an intense fear of common everyday social interactions in which the person anticipates that they will be emotionally or physically judged, embarrassed, scrutinized negatively, or rejected.

According to The Diagnostic and Statistical Manual of Mental Disorders (DSM) social anxiety sufferers present with an extreme fear of simple social situations such as having a conversation or meeting with unfamiliar people, being observed eating and drinking in front of people, or talking in front of a group. These activities which may be a bit uncomfortable for some are downright frightening to a person with social anxiety.

Symptoms can be crippling, preventing the person from being productive. Physical symptoms include a racing heart, sweating cracking voice, tightening in the chest, dizziness, headache, stomach pains, and loss of appetite.

Social anxiety is a growing problem. As our social world gets bigger through social media platforms, the number of people with social anxiety will continue to increase. According to the Anxiety and Depression Association of America, 15 million Americans suffer from the disorder; however, only 5% of sufferers seek treatment.

In addition to physical symptoms, social anxiety sufferers are constantly hypervigilant and fearful about the possibility of being the center of attention. The fear triggers the flight or fight response, so when a person is not able to avoid the feared social interaction, they may behave aggressively. Social anxiety may cause a person’s world to get smaller as they are increasingly limited in what they can do, even employment opportunities. Some professions would be too triggering because of the possibility of having to perform in front of others.

Nicole Artz writes that social anxiety is often mistaken for shyness. The primary difference is that a shy person may be admittedly uncomfortable in certain situations, however, a person with social anxiety feels anxiety in all social settings and also experience shame regarding their condition.

People with social anxiety will attempt to mask or medicate their condition with substance abuse. According to the Recovery Village, substance use disorder and social anxiety often co-occur. Too often the substance use disorder gets addressed without uncovering the underlying social anxiety. This may result in reoccurring attempts to address substance abuse.

Addressing social anxiety early in life will result in better outcomes. The disorder may begin in childhood. Arlin Cunic writes that low self-esteem may perpetuate and exacerbate social anxiety. When children do not feel that they are adequate, they may fear others will uncover their inadequacies. Conversely, having social anxiety may confirm a person’s low self-worth.

According to the DSM-V, children with social anxiety dread social situations with their peers. They experience extreme fear of being the center of attention, especially when called on in class. They may not want to eat in the cafeteria, due to fear of being watched and kids with social anxiety are very fearful of being late and having to walk into a class already in session. Being asked to read aloud in class could send a child with social anxiety running out of the classroom or causing so much of a disruption that they are expelled from school.

Kids display different symptoms when suffering from social anxiety. They may cry and throw temper tantrums at the threat of going into social settings. Parents often mistake these behaviors for acting out.

Norris’ (2022) self-regulation workbook is a resource for kids with social anxiety. Treating social anxiety often begins with telling someone who can be trusted. People with social anxiety need an advocate who may be able to provide support in social settings. Norris tells us that cognitive behavioral interventions help to uncover the faulty thinking patterns that lead to low-self esteem and social anxiety.

The Anxiety and Depression Association of America offers a good informational brochure on social anxiety. Remember, people do the best they can with the resources they have. When parents understand and can identify the symptoms of social anxiety, they become the best resource and advocate for their children.


Anxiety and Depression Association of America (ADAA) Social Anxiety Brochure

Artz, Nicole. LMFT. Shyness vs. Social Disorder: Understanding the difference. Choosing Therapy.

National Library of Medicine. DSM -IV to DSM-5 Social Phobia/Social Anxiety Disorder Comparison.

Norris (2022). Self-regulation skills workbook for kids (8-12): Mindfulness, positive thinking, and self-regulatung. Kangaroo Publications

The Recovery Village. Social anxiety and substance abuse. The Link Between Social Anxiety Disorder & Substance Abuse | Learn More

• Lisa Hill, Ph.D., is an associate professor in criminal justice at California State University, East Bay and a licensed marriage and family therapist. She also worked for county and federal probation departments for three decades and wrote a book based on that experience. She and her husband live in Tracy and have four children. Contact her at

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