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Social anxiety can hit all of us from time to time. Whether it’s casual conversation with that cute classmate you were afraid to ask out or you need to communicate with that intimidating coworker, there are some understandable, commonly experienced cases in which a little social anxiety is just human. But you may wonder if there’s a difference between social anxiety and something more intense — specifically, is there a measurable difference when you compare social phobia vs. social anxiety?
You might have heard these terms used interchangeably, which is common for terms across the mental health world. It’s also sort of frustrating when people crave specifics to better understand their issues.
But you could assume that social anxiety might be a milder form of a more serious “phobia,” and you might not be entirely incorrect in thinking that.
The medical community has waffled on the question of how different anxiety and phobias are.
But we’re here to clear up some misconceptions and help you get a better understanding of all forms of social anxiety, so you can seek the right treatments for your mental health condition.
The easiest place to start is with all the stuff these two terms have in common.
Social anxiety and social phobia are, for all intents and purposes, the same thing.
Kind of anticlimactic, right? Social phobia was differentiated from agoraphobia — the fear of crowded or open spaces — in the 1960s, and over the years it’s been rebranded as social anxiety disorder, also known as SAD.
By the way, social anxiety disorder and social phobia really just describe a condition in which your intense fear of social interactions — and the judgment or scrutiny of others that may result from it — causes your quality of life to decrease.
Practically speaking, that could mean that you avoid applying for better jobs because of an irrational fear that it could lead to embarrassment. Or you don’t use public restrooms because they feel like performance situations, or you don’t hang out with your friends because they might decide you’re not cool enough.
Everyone feels this uncertainty about social interactions from time to time, but when it becomes a pattern with consequences, that’s when it becomes a disorder or phobia.
It’s perhaps fair to say that social anxiety — no disorder attached — may be different (and less severe) than social phobia or social disorder, but that has more to do with the definition of a disorder. For instance, there’s a difference between being anxious and having an anxiety disorder. It stands to reason, therefore, that once can be socially anxious but not have social anxiety disorder.
But if we want to get historic in our consideration here, the idea of social “phobia” is archaic, because it defines the root problem — you’re afraid of being judged by other people — as a phobia, rather than as a specific form of anxiety.
A phobia can be an overblown but intense fear of something dangerous, like spiders. Ultimately, you don’t encounter spiders every day, but they are dangerous in certain circumstances. That danger can lead to you developing a phobia of all spiders, not just the dangerous ones. But you can’t be bitten by a venomous coworker (we’re pretty sure, anyway), which means that your fear isn’t necessarily based on an actual danger.
Okay, that’s the murky side, for the sake of argument. But generally speaking, if you hear a medical professional or other healthcare provider talking about social phobia, they mean social anxiety disorder.
Besides, social anxiety is generally a better term, because the symptoms of social anxiety disorder are pretty similar to symptoms of anxiety generally. Typically, symptoms of anxiety might include:
Rapid heart rate
Feeling restless or wound-up
Problems controlling feelings of worry
That fits closely with social anxiety disorder’s typical persistent fear of judgment, self-consciousness in everyday activities and its telltale avoidance of parties or work events.
You can think of treatment for social anxiety as a two-pronged approach — treating the anxiety and also treating the specific phobia or fear of social situations. Luckily, there are effective treatments available for both.
Treatment might employ therapy like cognitive behavioral therapy or CBT, which is a method for training people to be more aware of the negative and anxious thoughts that cause their disorders, and learn to respond to and refute them.
In the case of social anxiety disorder or panic disorder, that may mean learning to coach yourself against assumptions about the worst case scenario, and visualize success and positive outcomes instead.
CBT might be paired with antidepressants approved by the FDA for the treatment of SAD.
Antidepressants like selective serotonin reuptake inhibitors (SSRIs) — including fluoxetine (Prozac®), escitalopram (Lexapro®) —and selective norepinephrine reuptake inhibitors (SNRIs) — like venlafaxine (Effexor®) and duloxetine (Cymbalta®) — have been incredibly successful in treating anxiety disorders, including social anxiety disorder.
They don’t always work for everyone, but they do work for many people.
Experts do have one caveat: combination treatments haven’t been proven more effective for social anxiety than a single treatment of either medication or therapy. Research shows that medication starts working more quickly, but therapy’s effects last longer.
Your healthcare provider will be able to help you make decisions about the best course of action for your needs.
Another thing that might work for you in treating this condition is something called exposure therapy. As you may have guessed, this is a controlled exposure to social situations to help you conquer your anxieties. Talk to a mental health professional about whether this can be effective for your needs. You may also ask them about joining a social anxiety forum or health anxiety forum, as these online support groups can offer tips and comfort from people facing the same challenges.
Treating social anxiety is a problem that requires action, and some of those actions may be very difficult. You may have to face your fears, and do so regularly until your exposure begins to train your brain to see social situations with less fear.
Failing to treat any type of anxiety disorder can lead to problems — you increase your risk of substance abuse, medical conditions related to heart health and generally you might see less joy in your daily life.
One action that can be taken with relative ease, however, is the first action anyone can take: asking for help.
Getting help from a mental healthcare professional or other healthcare provider is the first step in any situation, because with expert help you’ll be more adequately prepared and equipped to deal with anxiety in any form.
If you’re ready to take that first step now, consider our online therapy options for quick, simple access to mental health professionals who can help you in the comfort of your own non-social home.
So take that first step from your bedroom or living room now. We’ll get you outside in due time.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.
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