What are the causes of social anxiety? Read on to find out.
Do you frequently feel worried, tense and uncomfortable around other people? Social anxiety is a common form of anxiety that involves feelings of fear and worry in situations that may involve performing in front of a crowd or facing scrutiny from others.
Social anxiety disorder is a common issue. In fact, the National Comorbidity Survey Replication (NCS-R) suggests that an estimated 7 percent of U.S. adults suffer from social anxiety disorder on an annual basis.
Like other anxiety disorders, we don’t know precisely what causes social anxiety disorder to develop. However, experts have identified several risk factors, including specific genes you may inherit from your parents.
Below, we’ll explain what social anxiety disorder is, as well as how it differs from the feelings of mild anxiety many people feel in crowded, busy places.
We’ll also cover the potential causes of social anxiety disorder and this mental health condition is most likely to develop in your life.
Finally, we’ll discuss effective treatments for social anxiety disorder, from behavioral therapy and lifestyle changes to medications you can use to manage your symptoms and make real progress toward feeling better.
Social anxiety disorder, or social phobia, is a common anxiety disorder involving symptoms of anxiety that occur before and during social events.
If you have social anxiety disorder, you might worry excessively about being judged, evaluated or gossiped about by others, including in situations like talking to people at a party, going on a date or taking part in a job interview.
For many with social anxiety, even simple interactions with others — such as talking to an employee in a retail store, using a public restroom or being asked for directions — can result in a burst of intense fear and other anxiety symptoms.
The exact symptoms of social anxiety disorder can vary from person to person. However, many individuals affected by this disorder report common symptoms, including:
A rapid heart rate in social situations
Speaking in a soft voice when around other people
Sweaty palms and a general increase in sweating in social settings
Struggling to make eye contact, talk or spend time around new people
Blushing, trembling, muscle tension and other physical anxiety symptoms
An overly rigid, unnatural body posture
Experiencing a “blank mind” in social settings
Worrying about being judged by others
Feeling nauseous or physically sick
These symptoms may result in changes to your behavior, such as deliberately avoiding events, meetings and other situations that involve being in front of other people. For some, the symptoms of social anxiety can get in the way of work, school and maintaining relationships.
Our guide to social phobia and social anxiety goes into greater detail about these symptoms, along with other common issues you may notice if you’re prone to social anxiety.
What are the main causes of social anxiety? It’s normal to feel anxious in response to stressful or potentially embarrassing situations, such as talking in front of a crowd or going on a date with someone you’re interested in. Often, these feelings work as a natural response to stressful events.
While some anxiety is a normal part of life, experts aren’t completely aware of why some people develop feelings of severe or persistent fear related to socializing.
Like many other anxiety disorders, the evidence available today suggests that a variety of factors — from your genes to your upbringing and personal background — all play a part in the development of social anxiety dis
We’ve listed these factors and explained how each may affect your social fears and feelings of anxiety below.
Experts think genetic factors play a major role in many mental health conditions, and social anxiety is no exception.
Several parts of your brain are involved in producing feelings of worry, fear and anxiety, including in social situations. Experts believe your genes may influence how these parts of your brain function, potentially causing increased anxiety levels.
Interestingly, research also suggests that some of these genes may be involved in certain other psychiatric disorders.
For example, social anxiety disorder frequently occurs in people who also develop other mental health issues, including other types of anxiety disorders, affective disorders, nicotine dependence and substance use disorders.
This association could be caused solely by genetic factors, environmental factors or a combination of both.
Research suggests that an insecure attachment style — a pattern of behavior in and around your relationships defined by uncertainty and a lack of trust — might play a role in social anxiety disorder.
For example, an article published in the journal PLoS One noted that insecure attachment might be linked with stronger social anxiety symptoms. Other research has also found that insecure attachment is a significant predictor of depression and anxious symptoms.
Our guide to anxious attachment in adults goes into more detail about the potential effects your attachment style can have on your mental well-being.
It isn’t completely clear if abuse during childhood causes social anxiety. However, research has found that people who experience emotional maltreatment, neglect or other forms of abuse as children are more likely to display severe social anxiety symptoms.
In a study published in the journal Depression and Anxiety in 2012, researchers assessed the symptoms of 156 people seeking treatment for social anxiety disorder.
They found that people who faced maltreatment as children, particularly emotional abuse and neglect, displayed more severe symptoms than their peers. Physical abuse was also linked to reduced quality of life.
That said, other types of childhood abuse, such as sexual abuse, did not appear to be linked to social anxiety.
Anxiety disorders are partly environmental, meaning they may develop as a result of behaviors or situations you’ve been exposed to in life.
Although the link isn’t crystal-clear, some research suggests there’s a connection between certain parenting styles, such as being excessively protective or controlling, and your risk of an anxiety disorder, such as social anxiety as an adolescent or adult.
For instance, in one study conducted in China, researchers found that maternal overprotection was associated with increased social anxiety in adolescents.
A different study published in the Journal of Anxiety Disorders also found a link between some parenting behaviors, such as maternal overprotection and reduced paternal emotional warmth, and an elevated risk of social anxiety in adolescents.
In other words, certain parenting practices, such as being overprotective and cold, may play a role in the development of social anxiety disorder. However, it’s unclear how strong this role is or how specific parenting practices might be affected by other factors that cause anxiety.
At what age does social anxiety start? Social anxiety disorder tends to develop earlier than other anxiety disorders. Many people first experience symptoms during their early-to-mid teens, and most with the condition will have developed it by age 20.
Lots of folks with social anxiety are able to point to a specific event from their teens or 20s as the first moment they identified symptoms. Others report always feeling uncomfortable or more worried than their peers in situations that require social functioning.
Social anxiety usually develops early in life, but like other anxiety disorders, it can happen at any age. A small percentage of individuals develop social anxiety disorder late in life, sometimes after several decades of being able to maintain a normal social life without significant worry.
Like other mental disorders, social anxiety disorder can take a serious toll on your well-being and overall quality of life.
The good news is that social anxiety is almost always treatable, typically with a mix of therapy, changes to your habits and, if appropriate, medication.
Can you self-treat social anxiety? If you’re worried you might have social anxiety disorder, it’s important to connect with a mental health professional about your symptoms. You can access help by talking to your primary care provider about a mental health referral or meeting with a psychiatrist in your area.
You can also get support from home using our online psychiatry service, which lets you easily connect with a licensed provider for a private consultation and evaluation.
Since social anxiety can vary in severity, there’s no one-size-fits-all form of treatment that’s effective for everyone. Instead, your mental health provider will usually suggest one or several treatment options based on your symptoms and needs.
These may include a form of cognitive behavioral therapy (CBT), changes you can make to your habits when in anxiety-inducing situations or medication you can take as needed or on a regular schedule to reduce feelings of anxiety.
Social anxiety disorder symptoms often get better with therapy, including cognitive behavioral therapy. This type of therapy involves identifying approaches to thinking and behaving that can contribute to anxiety, then replacing them with healthier behaviors and reactions.
Another form of therapy often used to treat social anxiety disorder is exposure therapy, which involves directly confronting your fears in a safe, controlled environment.
Your mental health provider may suggest taking part in therapy on its own or in combination with changes to your habits and potentially the use of medication.
Many people with social anxiety experience improvements by making simple changes to their habits and daily life. Your healthcare provider may suggest:
Talking to trusted friends and family members about how you feel
Practicing stress management techniques, such as mindfulness
Reading about social anxiety, its symptoms and how you can treat it
Eating a balanced, healthy diet and keeping yourself physically active
Taking part in a local support group or anonymous online support group
Our guide to calming anxiety goes into more detail about techniques you can use to gain more control over your anxiety symptoms, including in social situations.
If you have social anxiety disorder, your healthcare provider may suggest taking medication to reduce the severity of your symptoms. Medication for anxiety is often prescribed for use while also taking part in talk therapy and making lifestyle changes.
Several types of medication are used to treat social anxiety, including antidepressants, beta-blockers and fast-acting anti-anxiety medications.
Since anxiety can vary in type and severity, your healthcare provider will carefully select the most appropriate medication based on your symptoms and needs.
Some prescription medications for anxiety, such as antidepressants, can take several weeks to start working effectively. Make sure to closely follow your mental health provider’s instructions and use your medication exactly as directed.
We offer several medications for anxiety and depression online, following a consultation with a licensed provider who’ll determine if a prescription is appropriate.
Currently, experts have yet to identify any precise reasons for social anxiety. But studies suggest that genetic factors, attachment style and upbringing as a child all likely play a role in the development of social anxiety disorder.
If you think you have social anxiety disorder, it’s important to talk with a mental health provider about your symptoms and the impact they have on your psychological well-being.
Social anxiety disorder is almost always treatable, and getting help is a great first step toward learning how to control your symptoms and reduce the impact that anxiety has on your life.
You can access help for social anxiety from home by taking part in a mental health consultation or contacting your healthcare provider to schedule an appointment.
You can also learn more about how to treat social anxiety disorder, generalized anxiety disorder (GAD), panic disorder and other common forms of anxiety with our full guide to anxiety disorder treatments.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
Start your mental wellness journey today.