Social Anxiety Disorder: Symptoms, Diagnosis, and Treatment Options

Social Anxiety Disorder

Since around the second year of middle school, I have gradually felt a sense of inexplicable anxiety in social situations, wanting to hide away, feeling as if someone is always watching me, or constantly thinking that others are criticizing me.
This feeling persists even when I am walking alone.
As a result, I have been continuously observing myself for any abnormalities.
After the second year of middle school, I felt increasingly distant from my classmates.
At that time, I thought my interests were somewhat unique, so I held back my desire to find like-minded friends until high school.
I did find one friend, but now I can only have meaningful conversations with him; the rest of the class feels like strangers to me, and I have no sense of camaraderie with them.
It seems impossible to chat with them, as if there is a wall between us that I can never overcome.
However, I noticed one classmate who does not have a phone, does not play online games, and has unique interests, yet he can still engage in pleasant conversations with others.
This made me realize that my lack of friends is not solely due to my unique interests.
I began researching online and discovered a condition called social anxiety disorder, which has symptoms very similar to my situation, including feeling like others are watching you, experiencing anxiety in social situations, blushing, trembling hands, and difficulty talking to authority figures.
This is also one of my symptoms, as I find it challenging to speak with teachers.
Question 1: Can the doctor determine if I truly have social anxiety disorder? However, at certain times, such as when I am with close friends or family, I do not experience these feelings.
Question 2: Is blushing and trembling hands in social situations still considered social anxiety disorder?
Question 3: If I do indeed have social anxiety disorder, can it improve on its own, or is treatment necessary? These symptoms come and go; sometimes I feel relaxed all day, while other times I feel anxious all day.
Question 4: If treatment is necessary, what kind of therapy would be required, and what would the costs be? Thank you very much.

Yu Yu, 10~19 year old female. Ask Date: 2015/09/23

Dr. Ding Shuyan reply Psychiatry

Hello, first of all, I want to mention that without seeing you in person and without interactive consultation, it is not appropriate to definitively say whether you have social anxiety disorder.
This online platform has good intentions, but it has its limitations and cannot replace seeing a doctor.
People with social anxiety disorder often do not seek medical help, as the educational culture in Taiwan does not easily highlight this issue.
Students may remain silent and not express their opinions, and some can even graduate from university without friends.
Employment depends on the nature of the job, and these individuals naturally tend to seek positions that require minimal interaction with others to avoid discomfort.
Many Eastern individuals may feel that they can tolerate their level of anxiety, and we do not force others to publicly express their opinions.
However, it is important to note that fear of interacting with others can stem from various conditions, not just social anxiety.
When you see a doctor, they should help you evaluate all possible factors.
Symptoms can fluctuate, so you might try keeping a record of the situations, times, locations, people present, and activities during which you feel better or worse.
Over time, this may reveal some patterns.
I encourage you to address this issue while you are still young.
Visiting a hospital with your health insurance card is not expensive.
If you go to a psychosomatic or psychiatric clinic, it will be even more affordable and generally manageable for most families.
Wishing you all the best.
Sincerely, Dr.
Ding Shuo-Yan.

Reply Date: 2015/09/23

More Info

Social Anxiety Disorder (SAD) is a prevalent mental health condition characterized by an intense fear of social situations where one may be judged, embarrassed, or scrutinized by others. Your experience of feeling anxious in social settings, fearing criticism, and experiencing physical symptoms like blushing and trembling aligns with the symptoms of SAD. Let's address your questions systematically.

Question 1: Do I have Social Anxiety Disorder?
Based on your description, it seems you may indeed be experiencing symptoms consistent with Social Anxiety Disorder. The key features of SAD include a persistent fear of social situations, anxiety about being judged, and physical symptoms such as blushing or trembling. The fact that you feel comfortable with close friends and family but anxious around others is common in SAD. This disorder often manifests in specific situations rather than being a constant state of anxiety.

Question 2: Is blushing and trembling in social situations indicative of Social Anxiety Disorder?
Yes, blushing and trembling are common physical manifestations of anxiety and can be associated with Social Anxiety Disorder. These symptoms often occur when individuals feel they are under scrutiny or fear negative evaluation. While these symptoms can be distressing, they are part of the body's natural response to perceived threats or stressors.

Question 3: Can Social Anxiety Disorder improve on its own, or is treatment necessary?
While some individuals may experience fluctuations in their anxiety levels, leading to periods of relative calm, Social Anxiety Disorder typically does not resolve without intervention. Many people find that their symptoms persist or worsen over time if left untreated. Therefore, seeking treatment is advisable. Treatment options can significantly improve symptoms and enhance quality of life.

Question 4: What treatment options are available, and what are the costs?
Treatment for Social Anxiety Disorder often includes psychotherapy, medication, or a combination of both. Cognitive Behavioral Therapy (CBT) is particularly effective, focusing on changing negative thought patterns and behaviors associated with anxiety. Exposure therapy, a component of CBT, gradually exposes individuals to feared social situations, helping to reduce anxiety over time.

Medications, such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines, may also be prescribed to help manage symptoms. The choice of medication and therapy depends on individual needs and should be discussed with a healthcare provider.

As for costs, they can vary widely based on location, the provider's fees, and whether you have insurance coverage. Therapy sessions can range from $100 to $250 per session, while medication costs depend on whether you have insurance and the specific medication prescribed.

Additional Considerations
1. Self-Help Strategies: In addition to professional treatment, consider self-help strategies such as mindfulness, relaxation techniques, and gradual exposure to social situations. Journaling about your experiences and feelings can also help you identify triggers and patterns in your anxiety.

2. Support Groups: Joining a support group for individuals with social anxiety can provide a sense of community and understanding, helping you feel less isolated in your experiences.

3. Family and Friends: Engaging with supportive friends and family members about your feelings can also be beneficial. They can provide encouragement and understanding as you navigate social situations.

4. Professional Guidance: It is crucial to consult with a mental health professional who can provide a thorough assessment and tailor a treatment plan to your specific needs. They can help you understand the nuances of your symptoms and guide you through the recovery process.

In conclusion, while it is possible to experience fluctuations in anxiety, Social Anxiety Disorder typically requires treatment for significant improvement. Seeking help from a mental health professional can provide you with the tools and support needed to manage your symptoms effectively. Remember, you are not alone in this journey, and many individuals successfully overcome social anxiety with the right treatment and support.

Similar Q&A

Understanding and Managing Social Anxiety Disorder: A Guide

Dr. Chen: I would like to ask about my frequent feelings of nervousness and fear of speaking in social situations. I often blush when I speak, and I believe I may have mild social anxiety disorder. I'm unsure how to manage and treat this condition.

Dr. Chen Wenke reply Psychiatry
Hello Kevin: Social anxiety disorder is actually a very common issue, differing only in severity. Regarding treatment, there are currently many medications that have shown good efficacy for individuals with this type of condition, such as some newer antidepressants. Anti-anxiety ...

Understanding Social Anxiety Disorder: Symptoms, Impact, and Solutions

Hello Doctor, I have had social anxiety since childhood, and I often experience the following issues: 1. I hesitate to greet people or speak too softly, so others can't hear me, which makes me feel rude. 2. I dislike social settings, which make me very uncomfortable. 3. I ge...

Dr. Wu Enliang reply Psychiatry
Hello, (1) Could this be social anxiety disorder? I have taken related online tests and the results indicate moderate social anxiety disorder. A: It is possible that it is social anxiety disorder. (2) Should I see a doctor or seek psychological counseling? A: If it is very distre...

Understanding Anxiety Disorders: Overcoming Social Phobia and Panic Attacks

Hello, doctor. I believe I have social anxiety disorder, phobias, panic disorder, and obsessive-compulsive disorder. The following issues are my symptoms, which have led to me having no friends and being unemployed for over a year. I would appreciate your help in addressing these...

Dr. Liang Sunyuan reply Psychiatry
Hello: Based on your description, you are experiencing a lot of anxiety and worry, which is indeed affecting your daily life. Medication, psychotherapy, and lifestyle changes can all help alleviate these symptoms. It is recommended to incorporate more activities that you enjoy or...

Overcoming Social Anxiety: Seeking Help and Finding Solutions

Hello Dr. Chen: As the title suggests, I believe I have social anxiety disorder. I have listed my symptoms and examples... 1. I am hesitant to go shopping alone because I have to speak to the store staff; even ordering food is difficult for me to initiate. 2. I am very afraid of ...

Dr. Chen Wenyu reply Psychiatry
Hello, Xiao Pang: Some anticipated anxiety and negative thinking may appear to others as "overthinking." In fact, the individual often knows they are overthinking, but how can they stop themselves from doing so? In your case, social anxiety disorder involves not only an...