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Social anxiety disorder, also called social phobia, is an anxiety disorder in which a person has an excessive and unreasonable fear of social situations. Anxiety (intense nervousness) and self-consciousness arise from a fear of being closely watched, judged, and criticized by others.

A person with social anxiety disorder is afraid that he or she will make mistakes, look bad, and be embarrassed or humiliated in front of others. The fear may be made worse by a lack of social skills or experience in social situations. The anxiety can build into a panic attack. As a result of the fear, the person endures certain social situations in extreme distress or may avoid them altogether. In addition, people with social anxiety disorder often suffer "anticipatory" anxiety -- the fear of a situation before it even happens -- for days or weeks before the event. In many cases, the person is aware that the fear is unreasonable, yet is unable to overcome it.

People with social anxiety disorder suffer from distorted thinking, including false beliefs about social situations and the negative opinions of others. Without treatment, social anxiety disorder can negatively interfere with the person's normal daily routine, including school, work, social activities, and relationships.

People with social anxiety disorder may be afraid of a specific situation, such as speaking in public. However, most people with social anxiety disorder fear more than one social situation. Other situations that commonly provoke anxiety include:

Social anxiety disorder may be linked to other mental illnesses, such as panic disorder, obsessive compulsive disorder, and depression. In fact, many people with social anxiety disorder initially see the doctor with complaints related to these disorders, not because of social anxiety symptoms.

What Are the Symptoms of Social Anxiety Disorder?

Many people with social anxiety disorder feel that there is "something wrong," but don't recognize their feeling as a sign of illness. Symptoms of social anxiety disorder can include:

Children with this disorder may express their anxiety by crying, clinging to a parent, or throwing a tantrum.

How Common Is Social Anxiety Disorder?

Social anxiety disorder is the second most common type of anxiety disorder (after specific phobias) and the third most common mental disorder in the U.S., after depression and alcohol dependence. An estimated 19.2 million Americans have social anxiety disorder. The disorder most often surfaces in adolescence or early adulthood, but can occur at any time, including early childhood. It is more common in women than in men.

What Causes Social Anxiety Disorder?

There is no single known cause of social anxiety disorder, but research suggests that biological, psychological, and environmental factors may play a role in its development.

How Is Social Anxiety Disorder Diagnosed?

If symptoms of social anxiety disorder are present, the doctor will begin an evaluation by asking questions about your medical history and performing a physical exam. Although there are no lab tests to specifically diagnose social anxiety disorder, the doctor may use various tests to make sure that a physical illness isn't the cause of the symptoms.

If no physical illness is found, you may be referred to a psychiatrist, psychologist, or other mental health professional who is specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for an anxiety disorder. The doctor bases his or her diagnosis of social anxiety disorder on reports of the intensity and duration of symptoms, including any problems with functioning caused by the symptoms. The doctor then determines if the symptoms and degree of dysfunction indicate social anxiety disorder.

How Is Social Anxiety Disorder Treated?

For social anxiety disorder, the most effective treatment currently available is cognitive behavioral therapy (CBT). Medication may also be used to help ease the symptoms of social anxiety disorder so that CBT is more effective. Drugs may also be used alone.

Counseling to improve self-esteem and social skills, as well as relaxation techniques, such as deep breathing, may also help a person deal with social anxiety disorder.

What Is the Outlook for People With Social Anxiety Disorder?

The outlook for those with social anxiety disorder is generally good with treatment. Many people improve and enjoy more productive lives.

Can Social Anxiety Disorder Be Prevented?

Unfortunately, social anxiety disorder cannot be prevented, but seeking help as soon as symptoms surface can help make treatment more effective.