Social anxiety

Social anxiety is anxiety (emotional discomfort, fear, apprehension, or worry) about social situations, interactions with others, and being evaluated or scrutinized by other people. It can occur at different times of life, and for different reasons. Developmental social anxiety occurs early in childhood as a normal part of the development of social functioning, and is a stage that most children grow out of, but problem or chronic social anxiety may persist (perhaps unnoticed) until adolescence or may surface in adulthood. People vary in how often they experience social anxiety and in which kinds of situations. Overcoming social anxiety depends on the person and the situation. In some cases it can be relatively easy—just a matter of time passing for many individuals, and yet for some people social anxiety can become a very difficult, painful and even disabling problem that is chronic in nature. The reasons are unknown. Social anxiety can be related to shyness or anxiety disorders or other emotional or temperamental factors, but its exact nature is still the subject of research and theory and the causes may vary depending on the individual. Recovery from chronic social anxiety is possible in many cases, but usually only with some kind of therapy or sustained self-help or support group work.

A psychopathological (chronic and disabling) form of social anxiety is called social phobia or social anxiety disorder, and is a chronic problem that can result in a reduced quality of life. Overcoming social anxiety of this type can be very difficult without getting assistance from therapists, psychologists or support groups. Social anxiety can also be self-integrated and persistent for people who suffer from obsessive-compulsive disorder, which can also make the social anxiety harder to overcome, especially if ignored.

Some use the terms social anxiety and social phobia interchangeably.

Child development
Social anxiety first occurs in infancy and is said to be a normal and necessary emotion for effective social functioning and developmental growth. Cognitive advances and increased pressures in late childhood and early adolescence result in repeated social anxiety. Adolescents have identified their most common anxieties as focused on relationships with peers to whom they are attracted, peer rejection, public speaking, blushing, self-consciousness, and past behavior. Most adolescents progress through their fears and meet the developmental demands placed on them.

Ordinary adult form
Common adult forms of social anxiety include shyness, performance anxiety, public speaking anxiety, stage fright, timidness, etc. All of these may also assume clinical forms, i.e., become anxiety disorders (see below).

The term social anxiety is also commonly used in reference to experiences such as embarrassment and shame. However some psychologists draw distinctions among various types of social discomfort, with the criterion for anxiety being anticipation. For example, the anticipation of an embarrassment is a form of social anxiety, while embarrassment itself is not.

Criteria that distinguish between clinical and nonclinical forms of social anxiety include the intensity and level of behavioral and psychosomatic disruption (discomfort) in addition to the anticipatory nature of the fear. Social anxieties may also be classified according to the broadness of triggering social situations. For example, fear of eating in public has a very narrow situational scope (eating in public), while shyness may have a wide scope (a person may be shy of doing many things in various circumstances). The clinical (disorder) forms are also divided into general social phobia (i.e., social anxiety disorder) and specific social phobia.

Social anxiety as a disorder
Extreme, persistent and disabling social anxiety may be diagnosed as social anxiety disorder. The experience is commonly described as having physiological components (e.g., sweating, blushing), cognitive/perceptual components (e.g., belief that one may be judged negatively or looking for signs of disapproval), and behavioral components (e.g. avoiding a situation).

The essence of social anxiety has been said to be an irrational or unreasonable expectation of negative evaluation by others. One theory is that social anxiety occurs when there is motivation to make a desired impression along with doubt about having the ability to do so. Although the "official" clinical name for the disorder, as listed in the DSM and ICD, is Social Phobia or Social Anxiety Disorder, support groups for people who have the disorder (whether through clinical diagnosis or self-diagnosis) often refer to it as simply "social anxiety" or even "SA".

Criteria in the DSM and ICD attempt to distinguish clinical versus nonclinical forms of social anxiety, including by intensity and levels of behavioral and psychosomatic disruption: The validity of the "disorder" diagnosis has been challenged, however, on scientific and political grounds; people satisfying DSM social phobia criteria may simply be temperamentally high in social anxiety rather than suffering from a disorder, although such problems in living in society may still deserve attention as a matter of social justice.

Clinicians and researchers continue to struggle with definitional problems regarding the constructs of shyness, social anxiety, and social anxiety disorder. Each shares similarities, yet each has been used to define distinct aspects of psychological life as it relates to interpersonal functioning and how easy or difficult different cases of social anxiety are to overcome. A continuum describes some of the distinctions yet there is no absolute consensus yet as to where one disorder begins and another ends, although it is widely agreed that there are differences.

Social anxiety disorder may sometimes be symptomatic of an underlying medical disorder, such as hypothyroidism.