Coping with Social Anxiety Disorder (SAD)

By Rhea Josyula, StandOut Connect Intern
March 20, 2024

How many of us feel ‘butterflies’ in our stomach before a big presentation or a party where we will meet new people? Our world today is filled with stressful events including job interviews, traffic, and more. It is perfectly normal to feel nervous in such situations. However, when these feelings of anxiety feel excessive or overwhelming and interfere with everyday activities and social interactions, it could be a sign of a deeper issue known as Social Anxiety Disorder (SAD).

This disorder can significantly affect a person’s daily routines, relationships, and overall well-being. This disorder can significantly affect a person’s daily routines, relationships, and overall well-being.

Approximately7% of American adults, a staggering 15 million people, have been diagnosed with Social Anxiety Disorder. Unfortunately, this disorder is more prevalent among teenagers, with more than 75% of individuals with this disorder experiencing their first symptoms during childhood or early adolescence. However, these statistics only scratch the surface of the extent of the problem. About 36% of individuals who have reported struggling with this disorder admitted that they experienced symptoms for a decade or more before seeking help. Sadly, many individuals hesitate to disclose their problem or seek help, often due to associated stigma or simply, a lack of awareness about this disorder.

The COVID - 19 pandemic further exaggerated the prevalence of social anxiety disorder. During this period, when in person socializing was not feasible, people became accustomed to virtual socializing over platforms like Zoom and social media. Post pandemic, people, especially children who grew up in the pandemic, have begun to struggle in their in-person relationships and interactions after becoming used to the safety of virtual interactions.

This disorder is a growing cause of concern in our society, with its prevalence post COVID increasing. Hence, raising awareness on the topic including diagnosis and intervention methodologies is critical.


1.     Social anxiety can be characterized by symptoms like increased heart rate, sweating, and difficulty breathing in situations involving social interactions

2.    Social anxiety can be understood as a faulty activation of our flight/flight response

3.     Rates of social anxiety have increased in recent years after events like the COVID-19pandemic

4.     Social anxiety is treatable with psychotherapy and cognitive behavioral therapy as well as interventions like deep breathing

Recognizing the Signs of Social Anxiety Disorder

When figuring out if someone has Social Anxiety Disorder, it's important to tell the difference between regular worries and signs of a bigger problem. While a certain degree of unease is normal, heightened levels of fear and anxiety surrounding social interactions can serve as red flags for potential SAD diagnosis.

Symptoms of this disorder in response to social encounters may include:

●     Blushing

●     Increased heart rate

●     Trembling

●     Sweating

●     Upset stomach

●     Nausea

●     Difficulty catching your breath

●     Dizziness or lightheadedness

●     Muscle tension

Everyday experiences that may evoke social anxiety may encompass:

●     Interacting with unfamiliar individuals

●     Attending social gatherings

●     Work or school environments

●     Initiating conversations

●     Making eye contact

●     Dating

●     Entering crowded rooms

●     Returning items to stores

●     Eating in public

●     Using public restrooms


Identifying Social Anxiety Disorder

Social Anxiety Disorder is an anxiety disorder characterized by intense fear and anxiety in social situations, often stemming from the fear of judgment or humiliation by others. People suffering from this disorder may experience symptoms like increased heart rate, sweating, and fear of judgment or humiliation by others. While it is natural for individuals to worry about social acceptance, extreme anxiety towards social interactions is a common symptom of SAD. This excessive anxiety can be debilitating, resulting in poor quality of daily life with stressful interactions or avoidance of social situations that causes discomfort.

Several factors can contribute to the development of Social Anxiety Disorder. People who are inherently more introverted or have experienced trauma at some point in their life are more likely to develop this disorder. Additionally, individuals with a family history of SAD are more likely to develop this disorder.

For a formal diagnosis of Social Anxiety Disorder, the symptoms must persist for at least six months, significantly affecting the individual's ability to function in social settings. Early recognition and intervention are crucial in managing this disorder and improving the quality of life for those affected.


Understanding the Rise of Social Anxiety Disorder

A significant factor contributing to the surge in Social Anxiety Disorder is the influence of social media. Our over reliance on the virtual methods of social connectivity offered by social media has eroded our comfort with face-to-face interactions. causing us to become more socially anxious every year. This is especially prevalent in younger generations, who have increasingly early and liberal access to social media. This shift to virtual interaction during the developmental stages of life is likely to have a profound impact on developing their social functioning skills and abilities. Eventually, the growing prevalence of social anxiety disorder in children and adolescents seems to be a natural consequence.

Gender, too, can play a role in the development of social anxiety. Females are more likely to develop social anxiety disorder relative to males and report a higher number of social fears. Further, the ways in which social anxiety manifests are affected by gender. Women are more likely to experience social anxiety in a professional setting than men, including interacting with authority figures or undergoing interviews. Men, on the other hand, are more likely to have social anxiety around issues such as dating. There is also a difference in comorbidity based on gender, with men more likely to have comorbid externalizing (observable) disorders, while women are more likely to have comorbid internalizing disorders.

However, the clearest linkage to the prevalence of social anxiety disorder is age. On average, younger demographics, such as children and teens, are more likely to meet the benchmark for social anxiety disorder than older adults. Studies indicate that a staggering 90% of new cases of social anxiety disorder manifest by the age of 23, highlighting the critical role of early life stages in shaping social anxiety trajectories.

Exploring the Neuroscience of Social Anxiety Disorder

At the heart of Social Anxiety Disorder lies the amygdala, a pivotal part of the brain responsible for processing fear and emotions. This almond-shaped structure also plays a crucial role in linking emotions to memories and senses, making it a key player in understanding the mechanisms behind SAD.

When faced with a perceived threat, the amygdala activates the body's fight or flight response. This triggers the release of stress hormones like adrenaline and activates the sympathetic nervous system, leading to physiological responses such as dilated pupils and increased heart rate, helping the body react to potential danger.

In individuals with SAD, the amygdala may function abnormally, resulting in a failure to regulate emotions, particularly fear. This dysfunction can manifest as an overactive amygdala, causing systems responsible for fear inhibition to shut down, leading to heightened anxiety in various social situations and daily activities.

Understanding the neurobiological mechanisms including the amygdala can offer insights into the neural processing of SAD, and help with targeted interventions aimed at restoring balance to this crucial brain region.


Strategies to cope with Social Anxiety Disorder

There are several strategies and treatment options available to improve the quality of life after being diagnosed with Social Anxiety Disorder:

1.     Psychotherapy: Psychotherapy involves recognizing feelings and actions that help deal with Social Anxiety Disorder. Exposure-based Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that is commonly used to treat patients with SAD, helping patients work up the confidence to face social situations that cause them anxiety.

2.     Practice Deep Breathing: In stressful situations, the body gets into the ‘fight or flight’mode causing breathing to become shallow and rapid. Under stress, it is common for individuals to experience shallow breathing. Practicing deep breathing techniques, such as the 4-4-6 method—inhaling for 4 counts, holding for 4counts, and exhaling for 6 counts—can infuse the body with oxygen and help the body calm down in stressful situations.

3.     Avoid Substance Use: When social situations get very stressful, some people may turn to alcohol or drugs as coping mechanisms. This, however, creates a harmful cycle, leading to unintended consequences including addiction and worse physical and mental health. Avoiding substance abuse not only protects a person's physical and mental health but also enhances the effectiveness of treatments.

4.     Confront Your Fears: Social situations can be extremely distressing to individuals suffering from Social Anxiety Disorder, and as a result, it is common to avoid such interactions. However, avoiding feared situations may magnify the stress and lead to other problems including relationship stress. Having patients gradually attempt to face their fears will reduce anxiety and give a sense of empowerment and have the opposite effect that avoidance would have.

5.     Seek Medical Help: In extreme cases of Social Anxiety Disorder, coping mechanisms stated above may not suffice and the best plan of action is to seek medical help. Seeking medical intervention offers tailored support, potentially including medication, specialized therapy, and personalized guidance, steering individuals toward a path of healing and empowerment. It is important that we educate ourselves on being able to identify Social Anxiety Disorder and seek the help of a certified professional.

Inconclusion, Social Anxiety Disorder can be identified by nervous behaviors in response to social interactions. However, there are several ways to cope with SAD including therapy, deep breathing exercises, and medical assistance. Even though SAD can get in the way of living the life you want, you are not alone. Many people live with social anxiety and there are effective ways to treat this disorder.



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