Social Phobia: Reasons, Diagnosis and Treatment

Does starting conversations with strangers seem like a heavy burden?

Does going to social gatherings never appeal to you?

Do you have trouble maintaining eye contact with others?

Do you avoid eating in front of other people?

And do you find it hard to get to know people in new places?

Ever heard about social anxiety disorder?

Don’t worry, it is not deadly, you will live.

But what is social anxiety disorder in the first place?

Social Anxiety Disorder


As per the National Institute of Mental Health, social anxiety disorder or social phobia is a mental health condition of persisting fear of social interactions in which one is exposed to unfamiliar people.

This fear of social interaction is chronic and can cause a person to act in an awkward manner in front of others.

People with social phobia have unpleasant social encounters.

They don’t find the capacity, mental state nor motivation to be around others who present a potential threat to their emotional safety or well-being.

However, to them, all strangers are a possible threat.

Even though, they are urged to be around new people at different times in their lives, yet, no matter how many times they face their fears it never fades or goes away.

On the contrary, it persists and adds to their anxiety.

People with social anxiety disorder suffer a fear of rejection, labeling, negative evaluation, and social stumbling.

They fear just being watched or called upon by others.

That is why they avoid any situation that could expose them to any of their fears.

They might willingly not attend their best friend’s wedding, their birthday party celebration, their friends gathering or their promotion party.

Not only that, but they also avoid the routes that lead to the celebration in the first place.

They would do anything to avoid giving a public speech, deliver a presentation in front of others, or talk their mind in front of strangers.

However, when having to face uncomfortable situations they would start suffering from physical symptoms.

Symptoms like short breathing, fast heartbeats, stomach butterflies and muscle tension.

People with social phobia are very self-conscious.

They shy away from social situations that involve performance, observation or interaction.

Sadly, many people suffer from social anxiety disorder.

Around 15 million adults are victims of social phobia.

The percentage is the same among both men and women, however, sometimes a bit higher among females.

Why Do People Suffer from Social Phobia?


Our emotional brains also called the limbic system is where the story begins.

Our emotional brain contains our amygdala, the part responsible for the expression of fear and defense mechanism.

The amygdala is the part of the brain that stores memories of emotional events, especially fear.

It is the reason why we respond the way we respond to external stimuli, especially those that we fear.

It is there to protect us against the threats of the world.

The amygdala works through two routes, a short one and a longer one.

The short one comes from the thalamus, the one that receives information from sensory stimuli and prepares for a reaction.

The other longer route comes from the prefrontal cortex, the area responsible for decision making.

The communication between the amygdala and the prefrontal cortex is what makes a person eventually takes an action against a threat.

It is the process of our survival.

However, sometimes an increased activity in the amygdala can lead to anxiety.

Our emotional brain also contains the hippocampus, the part of the brain that encodes threatening events into our amygdala.

There is the hypothalamus as well which controls the release of stress hormones.

The hippocampus controls the hypothalamus response.

The amygdala communicates with the hippocampus as well as the hypothalamus, together they form a network that frames anxiety.

So when a person faces an external threat and the experience is fired with negative emotions, it gets stored in the amygdala and stays with you.

What happens later is that every time a threatening situation happens, the painful memory is fired and it gets strengthened.

What started out as a random situation could turn into anxiety.

But is our brain activity the only reason we might suffer from anxiety?


Fortunately, no.

There are other reasons why we suffer social phobia.

Genetics could be one of them.

Although this field of study is relatively undeveloped, yet, results show that anxiety could be the work of genes.

To be more specific, it could be the work of FAAH (Fatty Acid Amide Hydrolase).

Our brains have a neurotransmitter called anandamide.

This neurotransmitter is responsible for us feeling happy, comfortable and at ease.

The level of anandamide in our brain is regulated by the work of FAAH.

FAAH deactivated the anandamide by converting it into other acids.

However, FAAH variant gene in people results in less FAAH, which means that anandamide could last longer.

More anandamide means more comfort and easiness to forget negative experiences.

And hence less subjectivity to anxiety disorder.

Those who have less gene variation react more intense to feelings of fear and discomfort than normal people.

The good news though, hereditary anxiety disorder is not to be blamed for developing a social anxiety disorder.

The most it could do it make you prone to it, however, anxiety disorder needs a trigger to develop and still could be reversed.

Family and Social Phobia

family and phobia

Could social phobia extend its roots to our childhood?
Of course, it does.

Most social anxiety disorder starts as early as teen aging.

When a four-year-old is shy, doesn’t talk to strangers and clings to his mother all the time, it is normal.

However, when a ten-year-old does that, then it’s a warning signal.

Same for kids who isolate themselves from others at school and don’t have many friends.

They also don’t engage in class nor express themselves publicly.

Although these kids might be very talkative at home or in the environments in which they feel safe, yet, such behavior should be spotted.

The thing is parents usually overlook their children’s problem.

Part of it is denial, other is because of their closeness and not noticing change and part because they don’t label them as problems.

In addition, it is very tricky to fairly rate someone anxiousness, because it’s he alone can do so precisely.

Many parents when asked to rate their children anxiousness, they rated lower than how their children actually did.

Another important factor as well is that the parents themselves could be shy and hence pass on their shyness to their children and nothing seem to be a problem.

Fact is, detecting a social anxiety disorder at an early age and dealing with it is much easier than diagnosing it at an older age.

What Triggers Social Anxiety Disorder?

There are many theories as to what triggers anxiety.

Depending on the school of psychology that explains this theory the explanation differs.

According to psychoanalysis school, which Freud is its father and founder, anxiety is a battle between the id, ego, and superego.

For Freud and his school, a person is a combination of id, ego, and superego.

Anxiety here is a signal that the person is at high risk and the ego as well as the superego sends signals to the individual to act upon it to protect oneself.

As per the cognitive school, the school which studies the mental processes and their relation to our behavior.

In this school, anxiety is a result of a person’s irrational thought pattern that regards everything as a threat and magnifies its impact and consequences.

For the behaviorist, the school which regards that behaviors are acquired through conditioning from our surroundings, anxiety is a learned response as a result of exposure to a trigger.

For them anxiety happens as a result of loud parents, shouting at school, being laughed at during a presentation, panicking at public speaking, or a similar situation of distress.

Regardless of which theory makes more sound to you, the real problem is when our brains become programmed to look out for potential threat and stay alert all the time.

Fear, failure, frustration, confrontation as well as self-exposure are characteristics of life.

We can’t live with them, yet, we can’t live without them.

So, unless we find a way to deal with such challenges life would be a nightmare.

But to deal with something you have to be prepared of it.

Symptoms of social anxiety disorder


Many people have lived in anxiety for so long that they don’t even recognize it.

However, for others, it is temporary as per the situation they are into.

But the symptoms of anxiety remain the same for everyone:

1- Feeling watched all the time and over self-consciousness

When you avoid doing things in front of others and feel watched all the time, then there might be something wrong

2- Taking feedback defensively and avoiding confrontation

If all feedback is associated with you with a false feeling of judgment and labeling and hence you avoid confrontation at all costs, then you need to dig for more warning signs.

3- Avoiding social gatherings at all costs

If social gatherings seem like a very unpleasant experience that you try to avoid at all cost, no matter how important, then something is possibly wrong out here.

4- Panic attacks accompanying your public exposure

If every time you are giving a public speech, delivering a presentation or obliged to give your opinion in a meeting panic attacks come along, then social phobia is probably hiding around one of the corners.

5- Feeling embarrassed in front about others is horrifying

We all stumble upon that carpet or make ourselves a material of a good laugh every once in a while.

But, if such situations never pass easy with you and you keep feeling bad for the rest of the weak, then something an intense trigger has been fired in your brain.

6- Avoiding eye contact at all costs

If looking in someone else’s eye gives you butterflies and makes you stumble over your words, then you need to go easy on yourself and investigate the matter further.

7- Being alone and avoiding engaging with others

If you shut yourself out of people and try to convince yourself that you are better off when you are actually unhappy, then there is an underlying reason that requires your attention.

8- Exaggerated physical symptoms in social situations

If you suffer a dry mouth, a lump throat, trembling voice, chest tightness, muscle tension and sweating in most of your social interactions then you to need to see a therapist, not a physician.

9- Magnifying bad experience and negative bias

If you always see the dark side of your social interactions and fail to see its potential and good side, and all you are left with is the negative experience, then there is a good chance your suffering social phobia.

Social Phobia Versus Introversion

Although introverts might also avoid social gatherings there is a huge difference between introversion and social phobia.

Introverts do enjoy their own company, while social phobic only uses it as a sanctuary to hide from people.

Introverts don’t hold negative grudges against social interaction and could actually reach out to it sometimes.

Social phobic, on the other hand, preserve only negative experiences of social interaction.

Introverts are very good thinkers, in fact, they could amaze everyone with their organized train of thoughts and logical arguments.

They don’t speak much but when they do they present themselves well.

For them, social interactions might be exhausting but not dreadful.

Yet, if social phobic could choose, they would choose to not only speak but also hide.

Social Phobia Treatment

Although some cases would need expert help and therapeutic intervention, not all cases would.

It could take up to ten years for people to be aware of their social anxiety disorder and hence seek help.

First, you need to pay attention to your social behavior.

If you find anything alarming, then watch out for its severity.

If it is severe enough to disturb and degrade the quality of your life, then you need to seek an expert’s help.

Nevertheless, if your symptoms are mild then you can follow these simple steps:

First, talk to yourself to understand what exactly is worrying you about the situation.

Try to find out the root cause behind your discomfort.

Is it criticism, judgment, labeling, evaluation, and so on

Second, dig deeper for similar feelings and check what similar situations triggered these feelings.

Third, try to catch the thought pattern.

Meaning, if a certain type of personalities make you feel threatened because they are similar to the personality of the people who hurt you before (the trigger) be aware of that.

Then be conscious of the associated thoughts and train of reactions that follow.

For example, If on dealing with such people, you start feeling threatened and start perceiving all their actions as harmful even though they are not, be aware of that.

Fourth, try to break the loop by talking to yourself to calm it down.

Working on your self-esteem and self-confidence could also help.

So next time you are about to freak out, take a deep breath, analyze the situation and take it easy.


Social phobia is not so easy to detect, as it could take sometime.

It could show its signs since early childhood, so parents need to be very observant of their children.

Although, social phobia could be genetics, genes are not the only responsible for it.

People suffering from social anxiety disorder have many symptoms in common.

Once spotted they could be easily treated.

It all starts in your mind and in your mind it ends.

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