Anxiety in Social Situations

It's normal to occasionally be anxious when meeting new people or entering social situations, but how do you know if your worries are more than just typical anxiety? Read on for the first in a series of posts explaining Social Anxiety Disorder- what it is, and how to treat it.

Social Anxiety Disorder: An Overview

Social Anxiety Disorder (SAD) is defined as an intense anxiety centred around social situations where negatively evaluation by others may occur. People meeting the diagnostic criteria for SAD actively and passively avoid situations that trigger their fears and engage in safety behaviours that maintain the disorder. SAD prevents individuals achieving goals that are meaningful to them, impairing social, occupational, relational and financial functioning. SAD is the fourth most common adult psychological disorder and is usually chronic in nature, with sufferers presenting for clinical help an average of 15 years after onset. 50% of individuals never seek treatment.

Diagnostic Criteria

The diagnostic criteria as defined in the DSM-5 specifies that those presenting with symptoms consistent with a diagnosis of SAD will exhibit a marked fear of social situations in which the individual is exposed to possible scrutiny by others. The individual also fears that they will act in a way or show anxiety symptoms that will lead negatively evaluation by others. The fear of offending others may often the predominant fear of individuals from collectivist cultures. The social situations almost always provoke fear and anxiety, although the degree or type of anxiety may vary. This excludes those who feel anxious only occasionally. These social situations are avoided or endured with strong fear or anxiety. The social anxiety is out of proportion with the real threat posed within the individual’s sociocultural context. The fear is ongoing and typically lasts more than six months, although flexibility is allowed for clinical judgement as to the systemic or transient nature of fears. The anxiety causes clinical and substantial distress or impairment in occupational, or other critical areas of functioning, and is not due to the physiological effects of a medication or other substance, or another medical condition. The anxiety is not better explained by the symptoms of another disorder. If another medical condition is present, the anxiety is clearly unrelated or excessive. There is also an option to specify if the anxiety is limited to performance situations only. This subtype usually relates to those for whom performance is a large part of their work e.g. athletes, actors, or dancers.