Social Anxiety Disorder: What & Why You Need to Know

fear of public speaking

Your wife wants you to go with her to another work party. Man, the one six months ago was a train wreck. You didn’t know a soul and felt like judging eyes were all over you. And it made you so anxious you had to bail. Maybe it’s time to talk about social anxiety disorder? 

Unfortunately, like with so many anxiety disorders, individuals with SAD often choose to leave things as they are and somehow drag themselves through life. If that’s you…

Would you believe me if I told you social anxiety disorder (social phobia) is the third most prevalent emotional/mental disorder? The top two? Depression and alcohol dependence.

Here’s another interesting tidbit. Half of those diagnosed with social anxiety disorder (SAD – not to be confused with seasonal affective disorder) developed it by the age of 11. And 80% had been diagnosed by the age of 20.

Given the stats, and potential for significant life-interruption, having a “need-to-know” article on SAD available on Chipur is a necessity. The “why” of it all is simple. Identifying misery is crucial to a sufferer. I mean, what could be worse than struggling through an unknown – unnamed – hell? And, of course, relief doesn’t happen in the absence of knowledge.

What Is Social Anxiety Disorder?

Well, I suppose the best way to begin painting a picture of SAD is to summarize the highlights of the American Psychiatric Association’s DSM-5 diagnostic criteria.

SAD is about a persistent fear of one or more social or performance situations in which the individual will be exposed to unfamiliar people or possible scrutiny by others. If that happens the individual becomes afraid their behavior or anxiety symptoms will be embarrassing or humiliating.

what is social anxiety disorder

“I really don’t feel like facing anybody.”

Given the stakes are that high, there’s a pretty good chance that exposure to a feared situation will result in intense anxiety. Panic attacks are often experienced.

Frustrating thing is, the individual knows the fear doesn’t make sense and is over-the-top. Still, the feared situations are avoided or endured with great anxiety and clenching of teeth.

Ultimately, the avoidance, anticipatory anxiety, distress, etc. cause significant routine or life interruption.

Continuing within the emotional realm, many SAD sufferers have been labeled as shy, quiet, withdrawn, inhibited, nervous, aloof, and unfriendly. But the paradox is, most enduring SAD are just the opposite. And it’s their disorder that causes the misrepresentation and misperception.

It may help to know some common triggers…

  • Being introduced to others
  • Being the center of attention
  • Being teased or criticized
  • Being watched or observed while doing something
  • Any form of public speaking
  • Interacting with people of authority
  • Writing, talking, making phone calls in public
  • Going eye-to-eye with someone

And here are some common physical presentations…

  • Racing heartbeat
  • Excessive sweating
  • Blushing
  • Dry mouth and throat
  • Trembling and muscle twitches.

Finally, it’s important to understand that the manifestations of SAD make it look a lot like panic disorder and/or agoraphobia. But there are key differences, so don’t be fooled. Oh, and to make things all the more confusing they can coexist. Yikes!

What Are We Going to Do About SAD?

I’m here to tell you SAD is a treatable disorder and great outcomes can occur. But before one is likely to pursue diagnosis and treatment, there has to be insight into the fact that a problem exists and it’s time for the suffering to end.

Unfortunately, like with so many anxiety disorders, individuals with SAD often choose to leave things as they are and somehow drag themselves through life. If that’s you, I encourage you to reconsider and tell your story to a professional. I believe you’ll be glad you did.


Social anxiety specific cognitive behavioral therapy (CBT) is the primo treatment choice for SAD. Individual and group work are valuable. Of course, group work may not be desirable to a SAD sufferer, but isn’t exposure, learning, and knowing you’ll make it out in one piece what it’s all about?


As with treatment for any emotional/mental situation, meds can be of assistance when it comes to managing SAD. But experience tells me meds are never the entire answer, so don’t expect much if you’re thinking of sidestepping therapy.

I’m sure it’s no surprise that antidepressants are the drugs of choice for the treatment of SAD. FDA approval has been given to sertraline (Zoloft), paroxetine (Paxil), and venlafaxine (Effexor XR).

Other drugs used off-label for the treatment of SAD include other serotonin/norepinephrine/dopamine managing antidepressants, tricyclic and monoamine oxidase inhibitor (MAOI) antidepressants, atypical antipsychotics, anticonvulsants, beta-blockers, light-dose benzodiazepines, and buspirone (Buspar).

But, again, meds with therapy is always the most effective angle.

That’ll Do It

So there you have a quick need-to-know on SAD. I’m glad to have it on Chipur.

No doubt about it, social anxiety disorder can be double-hard. And that’s why it’s so important to pursue diagnosis and treatment if you believe you’re SAD. I mean, why would anyone want to suffer needlessly?

And if you’ve been, or are being, treated, continue to use the skills you’ve learned. Don’t let up.

Hey, shout-out to the Social Anxiety Association for reference material.

BTW, if you’re looking for some pleasant and meaningful reading material, check-out my eBook, Feelings & Rhymes Through Treacherous Times.

Speaking of reading material, there are those hundreds of Chipur articles.