Social anxiety disorder is characterized by an intense fear of social situations. It can be linked to public performances or involve any social interaction.
Social anxiety can exist on a spectrum. Some people may experience mild distress, while others experience severe symptoms that affect many aspects of their life.
Regardless of your exact symptoms, consider speaking with someone who can help. Talk therapy, medication, and self-help strategies can empower you to live your best life.
Humans are social creatures. Yet many of us struggle with social interactions. Social anxiety disorder (SAD) is the most common anxiety disorder [1] in the U.S., and it can take a significant toll on how people experience life. While it may seem like there are multiple types of social anxiety, experts believe it's one condition that impacts people’s lives in different ways.
If you find social situations or public interactions difficult, consider speaking with someone who can help. Therapy is a chance to make sense of your symptoms and find the right strategies to prioritize your mental and emotional well-being.
What are the types of social anxiety disorder?
The way experts view social anxiety has evolved over the years. The Diagnostic and Statistical Manual of Mental Disorders (DSM) currently lists social anxiety disorder and a “performance-only” subtype. This marks a change from previous versions which included “generalized” social anxiety disorder but not the performance type.
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Social anxiety disorder
Social anxiety disorder is characterized by an intense fear of being embarrassed or judged by others. For someone with social anxiety disorder, regular activities like eating in public or having a conversation can be triggering.
To be diagnosed with social anxiety disorder [2], your anxiety should be disproportionate to the event that’s causing it. In many cases, it’s intense enough that you avoid social situations altogether. For example, let’s say your friend invites you to dinner to meet her new partner. While you’d like to support her, you skip the meal because the idea of introducing yourself and making small talk feels overwhelming.
According to the DSM, symptoms must last six or more months and be severe enough to significantly impact your daily life. These symptoms can’t be caused by substance misuse or another health condition.
Performance social anxiety disorder
“Performance-only” social anxiety disorder is the only subtype of social anxiety that’s included in the DSM. With performance anxiety, your symptoms are limited to speaking or performing in public. You may feel comfortable in most social situations but be triggered by situations where you feel judged or evaluated by others in public.
Some other situations that might cause performance social anxiety disorder include:
Leading a meeting at work
Playing a team sport
Making a toast at dinner
Range of social anxiety disorder symptoms
Approximately 15 million U.S. adults experience social anxiety [3], and it can affect everyone differently. Research suggests that social anxiety disorder symptoms exist on a scale, ranging from mild, moderate, to extreme [4].
With mild social anxiety disorder, symptoms are typically uncomfortable but manageable. You know certain situations make you anxious but you’re usually able to manage that distress. For example, let’s say you struggle with meeting new groups of people. You may feel awkward and self-conscious, but you’re still able to attend social gatherings.
People with moderate social anxiety feel emotional distress in various social situations. You may find that you actively avoid situations that make you feel uncomfortable, like going to dinner or speaking up at work. You may also have a habit of overthinking your interactions.
On the opposite end of the spectrum, severe social anxiety disorder can significantly impact your daily life. You feel anxious in any type of social situation, and experience intense physical reactions like panic attacks.
Unofficial categories for social anxiety
While there’s only one subtype of social anxiety disorder, some experts believe that the disorder should be broken into additional categories.
One theory supports the idea of five types of social anxiety [5]:
Interpersonal anxiety
Formal speaking anxiety
Stranger-authority anxiety
Eating and drinking while being observed
Anxiety of doing something while observed
Regardless of your exact symptoms, know that you deserve access to the right care for your needs. The way experts classify social anxiety disorder may continue to evolve, so don’t hesitate to seek support.
Treatment for social anxiety disorders
Living with social anxiety affects more than your social life. Unmanaged anxiety can impact your confidence, career, and friendships. It can even interfere with your ability to manage basic tasks, like ordering food at a restaurant or going for a run with a friend.
It's common for people with social anxiety to go years before getting help. However, treatment can make a meaningful difference in how symptoms impact your life. For many people, this involves talk therapy, medication, or a combination of the two.
Cognitive behavioral therapy (CBT) is a first-choice treatment because it focuses on the link between your thoughts, feelings, and behaviors. With the support of your therapist, you can explore how those factors contribute to your symptoms. Other effective therapy approaches for social anxiety include exposure therapy, acceptance and commitment therapy (ACT), and group sessions.
Another option is to explore self-help strategies. This won't replace therapy, but it can help you manage the way symptoms impact your life.
Start with:
Keeping a journal: Journaling is a powerful tool for learning more about your thoughts and behavior patterns. It’s a safe way to express your feelings and better understand what triggers your anxiety.
Practicing mindfulness: Mindfulness means focusing on the present moment without judgment. The next time you start to feel anxious, challenge yourself to notice it, accept it, and then return to the current moment.
Working on your social skills: Look for ways to feel more confident heading into social situations. For example, you might practice giving and accepting compliments. Active listening is another skill that can help you focus less on yourself and more on others.
With performance-only anxiety, the internal monologue usually shows up in specific situations, like giving a presentation or speaking in a meeting. The person may think, ‘What if I mess this up?’ or ‘Everyone will notice if I make a mistake.’ With broader social anxiety, that critical voice tends to follow them into most interactions.
Brandy Chalmers, LPC
Clinical reviewer
Find care with Rula
Social anxiety affects different people in different ways. Symptoms can be triggered by public performances, like giving a speech, or extend to most types of social interactions.
Regardless of your symptoms, know that you deserve to enjoy all that life has to offer. If social anxiety is impacting your quality of life, consider seeing a mental health professional.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
References
- Social Anxiety Disorder https://www.ncbi.nlm.nih.gov/books/NBK555890/
- DSM-5 Definition of Social Anxiety Disorder https://socialanxietyinstitute.org/dsm-definition-social-anxiety-disorder
- What is Social Anxiety Disorder? https://adaa.org/understanding-anxiety/social-anxiety-disorder
- Social Anxiety Disorder: Associated Conditions and Therapeutic Approaches https://www.researchgate.net/publication/366413003_Social_Anxiety_Disorder_Associated_Conditions_and_Therapeutic_Approaches
- Putative clinical subtypes of social phobia: a factor-analytical study https://pubmed.ncbi.nlm.nih.gov/11722303/
Alex Bachert
Alex Bachert is a freelance copywriter and mental health advocate. Since earning her masters degree in public health, she has focused her career on creating informative content that empowers people to prioritize their health and well-being. Alex has partnered with organizations like Ro, WellTheory, and Firsthand, and her work has been recognized by the Digital Health Association.
When she’s not writing about mental health, Alex is usually playing pickleball, meeting with her local board of health, or enjoying time with her three kids.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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