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Mental Health Information Centre - Southern Africa

Social anxiety disorder

What is social anxiety disorder?

Social anxiety disorder (or social phobia) is characterised by fears of embarrassment or humiliation in a social or performance situation. While public-speaking is the most common fear amongst the general public, amongst people with social anxiety disorder it is of one or other social interaction. Most frequently these interactions include:

  • fear of eating or drinking in front of others
  • fear of writing, signing, or working in front of others
  • fear of being the centre of attention
  • fear of going to parties or dating
  • fear of using a public toilet

When the person is faced with a feared social situation, they may experience intense anxiety, including a full-blown panic attack. They may also experience marked anticipatory anxiety prior to the social situation. Symptoms also frequently involve blushing and stuttering.

Social anxiety disorder and shyness

Social anxiety disorder is not simply shyness. People with social anxiety disorder often avoid the social situation they fear, and if faced with it will experience intense distress. In order to be diagnosed with this disorder, the symptoms must cause significant distress or must interfere with important areas of functioning (such as work or family).

Who gets social anxiety disorder?

Social anxiety disorder has been estimated to be present in 3-13% of the population. More women than men suffer from this disorder, and it is found throughout the world. Social anxiety disorder typically begins during adolescence or early adulthood.

What causes social anxiety disorder?

Certain systems in the brain are known to be involved.

  • Hereditary, or genetic, factors.
  • Environmental factors, such as not learning how to cope in certain social interactions during childhood.

What to do and where to go for help?

Certain specific medications are effective. However, the combination of medication and psychotherapy (talk therapy) has been shown to be a particularly powerful approach in managing social anxiety disorder. Cognitive-behavioural therapy (CBT) is the mainstay of psychotherapy for the treatment of social anxiety disorder.

Further resources

MRC Anxiety Disorders Research Unit

Tel: +27 21 938 9161

Internet: www.mrc.ac.za/anxiety/anxiety.htm

 SA Depression & Anxiety Group

Tel: (011) 783 1474/6

Internet: www.sadag.co.za

Download pdf for more information: Anxiety disorders 

Books about Social Anxiety Disorder (Social Phobia)

Dying of Embarrassment: Help for Social Anxiety & Phobia. B.G. Markway, C.N. Carmin, C.A. Pollard and T. Flynn. Oakland, New Harbinger Publications, Inc., 1996.

The Hidden Face of Shyness: Understanding & Overcoming Social Phobia. F. Schneier and L. Welkowitz. New York, Avon Books, 1996.

Social Phobia: From Shyness to Stage Fright. J.R. Marshall. New York, Basic Books, 1994.

Mental Health Topics

In partnership with:

University of Stellenbosch
South African Medical Research Council
University of Cape Town