Are There Other Types of Social Anxiety?

“Social anxiety” is a term that’s thrown around an awful lot. But what does it actually mean to have social anxiety? 

Read on to learn more about the different types of social anxiety, its signs and symptoms, and what you can do to treat it.

Types of Social Anxiety Disorder

Social anxiety disorder (SAD), also known as social phobia, is a marked fear or anxiety of social situations where there is the potential for scrutiny by others. The person fears he or she will act in a way or show symptoms that will be humiliating or lead to rejection. The individual either avoids these situations or endures them with great distress.

Social anxiety disorder can be divided into two types - generalized and non-generalized.

Generalized Social Anxiety Disorder

Generalized social anxiety disorder is characterized by a fear of most, if not all, social situations in which they feel they will act in a way that might be judged, scrutinized, or negatively evaluated by others.

“Social anxiety can include fear that people are looking at you, talking about you, overly concerned with your behavior, etc.” explains Amy Marschall, PsyD. “It is not just feeling anxious or overwhelmed in the social environment but specifically includes that preoccupation with being watched or judged.”

They might not be able to go grocery shopping for fear of having to interact with the cashier, or they might become socially isolated because they feel they cannot go out to a restaurant with a friend. 

Work life might also be affected if the person with social anxiety disorder feels they cannot speak on the phone or interact with colleagues at the office. Symptoms like these can make life with social anxiety exceedingly difficult.

Social anxiety can manifest as physical symptoms as well, says Dr. Marschall. “Many people with social anxiety disorder become so activated that they become physically ill and can vomit!”

Non-Generalized Social Anxiety Disorder

Non-generalized social anxiety disorder represents a more limited range of situations that evoke debilitating anxiety than its generalized counterpart.

This means that, while people with generalized social anxiety disorder experience intense anxiety in many types of social situations, people with non-generalized SAD are triggered by just one type of social context in particular, such as in a performance situation.

Non-generalized SAD still negatively affects the person experiencing it by making the specific social situation that triggers them feel terrifying or impossible—in this way, that aspect of daily life is affected.

Clinical Symptoms of Social Anxiety Disorder

According to the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders), social anxiety disorder is characterized by the following:

• Marked fear or anxiety about one of more social situations in which there is possible scrutiny
• The individual fears they will act in a way that will result in being negatively evaluated
• Exposure to these feared social situations invariably causes anxiety
• The person experiencing the anxiety avoids these social situations or endures them with extreme discomfort
• The anxiety is persistent and lasts at least six months
• The anxiety or the avoidance of the feared social situations causes marked distress or interferes with the functions of everyday life
• The anxiety is not caused by drugs or medications and is not explained by any other medical or mental health disorder

If you experience these symptoms, you might have social anxiety disorder.

Specific Social Phobias

Someone with social anxiety disorder can be triggered by a range of social situations or be triggered by just one in particular. 

For some, the social phobia is centered around some kind of public performance, such as giving a speech, participating in a sporting event, or playing a musical instrument in a concert. 

Others might react to interpersonal situations with extreme anxiety. Going on a date or even just meeting a new person might feel impossible. They might be unable to answer a question in class or make it through a job interview.

For some, the fears are much more based on what many people would consider everyday activities. Anything from ordering a drink in a coffee shop to eating in public to using a public restroom can make someone with social anxiety fear rejection, humiliation, and judgment. 

Related and Co-Occurring Disorders

Social anxiety disorder can present on its own or in conjunction with other mental disorders. 

Many people with social anxiety also experience other anxiety disorders such as generalized anxiety disorder (GAD). This is a condition involving excessive worry about a number of events or activities such as work or finances accompanied by several other physical manifestations of anxiety.

Social anxiety can also present with co-occurring panic disorder. Panic attacks, which are the onset of sudden extreme anxiety along with physical symptoms such as chest pain, palpitations, shortness of breath, sweating, trembling, and fears of losing control, going crazy, or dying, can also occur as part of social anxiety disorder itself. However, in contrast to social anxiety disorder where the primary concern is about the scrutiny of others, in panic disorder the concern is about the panic attacks themselves.

Someone with social anxiety might also experience a co-occurring depressive disorder. Major depressive disorder is defined by periods of depressed mood experienced as sadness, emptiness, hopelessness, or loss of interest or pleasure accompanied by difficulty focusing and thinking, changes in appetite and sleep patterns (like eating or sleeping too much or too little), loss of energy, agitation or being slowed down and sometimes thoughts of death or suicide. Anxiety can also be a symptom of depression, complicating diagnosis.

Treatment

Although social anxiety disorder can feel overwhelming, there are treatments out there that can address its symptoms and cut it off at the source.

Therapy

Therapy can be effective when dealing with social anxiety. 

• Exposure therapy, for example, can be especially useful. This approach involves slowly and methodically facing the situations or circumstances that cause social anxiety and learning how to become more comfortable in those settings. Over time, your body will learn to respond less fearfully. This might look like going into a coffee shop day after day; just setting foot in there is the first step, then maybe staying a minute longer each day, and eventually working up to ordering a drink from the barista. These incremental achievements eventually take the wind out of this source of your anxiety and help you "unlearn" the problematic anxiety response.
• Cognitive behavioral therapy (CBT) can also be an effective therapeutic approach. CBT focuses on identifying thought patterns that are automatic, negative, and unhelpful, and challenging and replacing those thoughts with more realistic and useful ones. For example, maybe you refuse to talk on the phone because you are certain you will say something embarrassing or do something humiliating. With CBT, you and your therapist can identify that association with phone calls and can learn to interrupt the negative thoughts that would otherwise prevent you from making a call.

• Acceptance and commitment therapy (ACT) can also be useful when treating social anxiety. This approach teaches you to acknowledge and “accept” the full range of your thoughts and feelings without attempting to change, deny, or avoid them. This acceptance then depletes the negative energy that accompanies trying to avoid those thoughts and feelings and encourages you to commit to actions that are consistent with your values.

After acknowledging everything you are feeling as part of your social anxiety, you can better manage your internal reactions and approach the situation with more clarity and self-acceptance. This is especially important for those experiencing social anxiety, who often feel ashamed of their symptoms.

Medication

Antidepressants like SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors) have been successful in treating symptoms of social anxiety disorder.

Beta-blockers like propranolol are sometimes used to decrease some of the physical responses associated with performance anxieties. Anti-anxiety medications like benzodiazepines (Klonopin, Ativan, and Xanax) can be useful, although come with the risk of tolerance and dependence.   

Group Support

In addition to therapy and medication, support groups and group therapy can be especially helpful to those with social anxiety disorder. By connecting with others who also experience social anxiety, you can learn what coping mechanisms have worked for them. You can also hear about others’ experiences in situations that have historically triggered you, all in a safe space that is designed to mitigate this type of anxiety. 

Interpersonal support can also be useful by letting you know that you are not alone in your symptoms—social anxiety can be incredibly isolating, so hearing that others live with it as well, and even thrive despite it, can be bolstering.

Social Anxiety vs. Social Anxiety Disorder

It is perfectly natural to experience social anxiety sometimes. Meeting new people can be scary, public speaking can be intimidating, and talking on the phone can be a chore. But the difference between experiencing some social anxiety and being diagnosed with social anxiety disorder mainly comes down to whether your fear, anxiety, or avoidance causes significant distress or impairment in your life. If your anxiety keeps you from doing things you would otherwise like to or need to do, it might be a clinical issue.

Final Thoughts

Social anxiety disorder is a common condition characterized by the deeply rooted fear of public humiliation or judgment. Living with social anxiety disorder might keep you from doing things socially, like eating at a restaurant or making a speech; it might make it difficult to make new friends or deal with coworkers. However, social anxiety is very treatable with therapy, group support, or medication if necessary. You don’t have to suffer alone.