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The Third Most Common Anxiety Disorder: Social Anxiety

Abs and I have interviewed lots of people dealing with many different phobias and anxieties. One of the most prevalent and painful is Social Anxiety Disorder (SAD).  When someone suffers from social anxiety disorder (SAD), she feels constantly judged in social situations and often believes that she just does not fit in. She may chastise herself for making a comment in a group or at a work meeting, even if nobody else gave it a second thought. She may feel that people are thinking about her physical appearance or intelligence, even when there are no indications that this is the case. As you can imagine, this heightened sense of being evaluated and judged in social situations makes one reluctant to put herself out there.


The onset of SAD is often around thirteen years old, that wonderful age when just about everyone is feeling (and looking and acting) awkward. It is the beginning of adolescence, the developmental stage when we are already obsessed with how we are perceived by our peers. Parents may think that their children are just being moody teenagers when they rather stay in their rooms than socialize. And while sometimes this is the case, often the parents are unknowingly watching the beginning of social anxiety disorder.


Many people believe that social anxiety disorder is the same as introversion, but this not the case. Introverts get energy and satisfaction from time alone—in fact, they often prefer it. SAD sufferers, however, abstain from social situations because of the anxiety they experience with other people. And this is not the sufferer’s preference; many anxiety sisters we’ve met have told us that the worst part of SAD is the loneliness and isolation which results from avoiding social anxiety.


Like other anxiety disorders, SAD has biological origins. Human beings are fundamentally social animals; our ancestors needed to band together in order to survive. So being accepted by the group is a really important thing to most people. The fear of being ostracized from the group or being negatively viewed by our peers can be paralyzing.


Interestingly, SAD also has cultural underpinnings. In collectivist societies like those found in Asia, India, China and Latin America, there are low rates of social anxiety disorder.  However, in individualist Western cultures such as the United States, SAD is quite prevalent. This makes sense because “we” cultures discourage individualism whereas “I” cultures promote it.


The silver lining behind SAD is that it can be effectively treated. Cognitive behavioral therapy (CBT), mindfulness, and medication are all options.  We will discuss these choices more in our next blog on social anxiety disorder.


Have you struggled with SAD? What helps? What makes it worse? If you feel up to it, please share (anonymously is okay) your experiences with our community.


  • Ray
    March 14, 2017

    What can I do to get better? I always just thought I was very shy, but I do avoid new social situations and parties. What can I do to help myself.

  • Mags
    March 15, 2017

    Hi Ray,
    Thank you for writing. We plan to write quite a bit about social anxiety disorder, and include what anxiety sisters and brothers can do to get better.

    A few quick ideas: social anxiety disorder seems to respond well to medications like SSRI’s (e.g., prozac). Cognitive behavioral therapy (which helps you question your thoughts and assumptions that lead to anxious feelings) is also quite helpful.

    Like with any other anxiety disorder, try to be mindful not to avoid situations because they are uncomfortable. Instead go into these situations with a plan. If you are uncomfortable at a party, give yourself a few minutes in the bathroom to do some TLC –talk to yourself (have a mantra like “I am okay”), loosen all constraints (dress comfortably), cool off (put some cold water on your face). I know this can be a real struggle, and if it is impacting your life you may need to get some help like medication or therapy. Also feel free to share ideas on the forums with other people with social anxiety disorder.


  • Rachelle
    January 30, 2019

    I went to several therapists and Dr.s growing up and they couldn’t figure out what was wrong with me. I picked up a book at the library with the word shy in its title, it was all about SAD. It felt like someone was looking into my soul. Medication turned out to be the biggest help to me, but before I grew the nerve to goto, the Dr. I had to learn to cope on my own. Self pep talks help, repeating phrases over and over like a mantra. Music is a big help, its calming or you can use it to block out people, like if you’re afraid to use public restrooms. I make someone go with me just about everywhere if they’re free. Having a book, cell phone, or something to distract yourself with helps. Fidget cubes, or fidgeting in general. I have found, the build up is worse than the event. So just get through the wait period, and the actual event will be short.

  • Emily Kite
    February 16, 2019

    I’ve had severe anxiety for years…. but it went away.. and then it came back.. out of nowhere…. I don’t know what I did differently in those years it went away… I did go through a very traumatic event …. and that’s all I can put my finger on..the few that new me before this somewhat new anxiety took hold have made the comment that I’m not the same person I was when I returned ( from my traumatizing event) they don’t know the scope of it.. I don’t talk about it… I’m just guessing maybe I have a little PTSD ( I’m saying that because I am an over analytical person and very intelligent) and I’m constantly analyzing myself…I ised to drive anywhere anytime.. go to concerts… go to social events.. but now… I am almost house bound… I go to work… because I have to.. and every day is a struggle…. my husband doesn’t understand… he didn’t know me before my traumatizing event… the doctor put me on medicine but I don’t take it like I’m supposed to because I have a phobia of medication….I needed to go to Home Depot today and made it half way there and turned back and came home… it’s 10 min away… and my husband is sick…but I just couldn’t bare the thought of going by myself… he went with me but I could see the look of disappointment in his eyes… and thatbkills me… I felt like a failure… I bought us concert tickets for his birthday.. one I wanted to attend.. but when it got to it I just said I couldn’t take off work ( I already had the vacation days approved) but work is now within my normal routine..: anything outside of a normal routine through a me into a tizzy… so he went with someone else…. right now… I’m doing so good to manage work and home… I call In so much because I’m physically ill…. I throw up everyday… multiple times… is there any help on a medication phobia… I know it would help… but it makes me have a panic attack thinking about taking it…. I feel like I may need therapy … I know I do.. but my small town is very limited on that kind of stuff.. and I also have a driving phobia so I can’t go far to get the help I need… my world is shrinking and the only place I feel comfortable is at home… and that’s not who I am… so it’s a tricky situation and it’s making me very depressed…. because I want help but don’t know where to find it…. in the current state I’m in


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