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What Causes Social Anxiety?

Social anxiety impacts many people in America – this article talks about some causes and treatment options for the disorder.

What is Social Anxiety Disorder (SAD)?

The National Institute of Mental Health recorded that 7% of American adults had severe social anxiety within the past year. The report also estimated that social anxiety is more prevalent in women than in men.1

SAD is also called social phobia. The condition is associated with extreme anxiety or fear in social settings. People might be terrified of meeting others, of other people judging them, or of embarrassing themselves. In everyday social situations, they might be self-conscious or become extremely worried about being the center of attention when out in public. These are just a few signs of social anxiety people might experience.

Social anxiety poses physical, behavioral, and emotional symptoms to those that experience it. Physical symptoms of social anxiety can cause:

  • Increased heartbeat
  • Racing thoughts
  • Nausea
  • Trouble breathing
  • Sweating
  • Muscle Tension
  • An “out-of-body” sensation

Social anxiety can worsen when someone doesn’t know what steps to take or who to talk to. Luckily, treatment is available to help those with social anxiety start to overcome their fears.

Causes of Social Anxiety Disorder

Though the root cause of social anxiety is not fully known, its causes may stem from environmental causes, inherited traits, and changes in brain structure.

Inherited traits mean that social anxiety disorder can be passed down a family’s genes, though researchers do not know how much is due to genetics or learned behavior after being born. Someone may develop severe social anxiety later on in life, or sometimes people will develop it at the same time as when a relative developed the condition.

Another cause of social anxiety could be due to our brain structure. The amygdala, a part of the brain that controls the response to fear, could explain why some develop social anxiety whereas others don’t. Individuals with an overactive amygdala exhibit a heightened fear response, increasing anxiety in social situations.

Our environment can also be a determining factor in developing social anxiety. Someone can develop SAD after an embarrassing or unpleasant social situation. Another instance might be when parents display anxious behavior and are overprotective or controlling of their children, leading them to develop an increased fear in social situations.

How Can Social Anxiety Affect Your Life?

When the condition worsens, people may have severe symptoms that lead them to isolate themselves from other people, oftentimes making healing even harder. The excessive fear of rejection and humiliation limits a person’s school, work, and relationships, and often is associated with social anxiety and panic attacks.

Most people often have concerns about embarrassment and acceptance. However, the extreme dread and anxiety that accompanies SAD are overwhelming. Due to this overwhelming feeling, people find it hard to function in their daily life and intensely avoid anxiety-inducing situations. SAD puts people at an elevated risk for major depressive disorder.

Social Anxiety Effects

Other ways that social anxiety can affect your life include:

  • Low self-esteem
  • Negative thoughts
  • Sensitivity to criticism
  • Poor social skills that don’t improve
  • Overworking the sympathetic nervous system, which leads to health problems
  • Added stress can pose health problems for the cardiovascular system
  • Limiting a person’s quality of life from being scared to try new things
  • Can negatively affect relationships

Tips for Overcoming Social Anxiety

Just because social anxiety may seem debilitating doesn’t mean that there aren’t ways to overcome it. Therapy and medication are some options, but there are some things people can try first if they are nervous about going to therapy.

Slowly and gradually increasing the social interactions can be a great way to try to minimize the fear in those situations. People can also take time to relax and partake in calming exercises such as yoga, light outdoor exercise, or soothing breathing practices. If someone is too worried about taking a yoga class, getting out into nature can also help the mind relax after a stressful day. Alongside these ideas, eating a balanced diet and getting enough sleep can put your body more at ease throughout the day, helping with physical symptoms of social anxiety. 

Emotionally and mentally, learning how to reframe one’s thoughts in fearful situations can also help with social anxiety. Speaking with trusted friends or family can help alleviate some of the phobia as well.2

Social Anxiety

Treatment for Social Anxiety Disorder

Overcoming social anxiety is a process, and both medication and psychotherapy may take some time. While medications work, a healthy lifestyle speeds up the process. A medical professional may also combine medication, psychotherapy, and support groups to treat the condition.

Medication-Assisted Treatment

Medication-assisted treatment for SAD involves antidepressants, like serotonin-norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs). Beta-blockers and anti-anxiety medications like benzodiazepines also can help.

Beta-blockers help control physical symptoms like sweating, rapid heart rate, and tremors. They are mainly used to treat “performance anxiety,” which is a type of social anxiety.

Benzodiazepines are powerful anti-anxiety sedative medications that reduce anxious feelings. These medications are effective for rapidly decreasing anxiety symptoms. However, people may build a tolerance to the drugs and become dependent on them. Before taking benzodiazepines, make sure a healthcare professional is consulted.3

Social Anxiety Therapy

Both mild and severe social anxiety is normally treated through psychotherapy or talk therapy. While there is no shortage of therapeutic methods, there are two common types of psychotherapy to treat patients with social anxiety.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) teaches the different approaches to thinking, reacting, and behaving to situations to help reduce anxiety and fear. CBT allows people to practice social skills that are important for treating social anxiety. When social anxiety might cause someone to avoid certain activities, CBT can slowly introduce exposure therapy, which helps patients gradually face their fears. To work, exposure therapy may add in relaxation exercises depending on the patient’s needs. CBT may be done in a group or individually

Acceptance and Commitment Therapy

Similarly, Acceptance and Commitment Therapy (ACT) uses goal setting and mindfulness approaches to reduce anxiety and discomfort.

Different therapies work depending on the needs of a patient. It is essential for patients to ask for a medical professional’s advice on what form of therapy might benefit them best.  

Support Groups

Support groups include many different people who can give unbiased, honest feedback about someone’s situation or anxieties. This way, people can learn that their thoughts about rejection and judgment might be distorted or untrue. People can also learn how others approach and overcome their social phobia and perhaps implement some of those practices in their own life.

Support groups are available both online and in person. It’s important to note that those in support groups might not be medical professionals and do not give licensed advice. Cautiously use any advice given by a colleague in these groups.3


While finding the right recovery option to fit your specific needs and expectations may seem difficult, consistently seeking wellness is key. Developing healthy habits can greatly improve your social anxiety, and the body and mind will learn to adapt to new patterns. It is important to set goals - even if they are mundane and seemingly “simple” to accomplish - to boost confidence and overall mental stability over time.4

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