Social anxiety disorder is a common but disruptive mental health disorder. Understanding this treatable chronic illness requires replacing the myths with the facts.
Social anxiety disorder, also referred to as social phobia, is a mental health disorder characterized by significant anxiety. This anxiety is caused by overwhelming, irrational fears of being scrutinized by others in social situations.
Social anxiety disorder is a serious mental health disorder that affects a person’s ability to function in life. Unfortunately, it often goes undiagnosed and untreated. This is largely due to the many social anxiety misconceptions and myths that people believe to be true.
1. Myth: Social anxiety is the same as being shy.
Fact: Social anxiety disorder goes far beyond just being shy.
Many people are shy or afraid of at least some social situations, such as public speaking. People with social anxiety disorder experience anxiety that is out of proportion to the social situation. Affected individuals will go to great lengths to avoid participating in social activities.
Unlike people who are simply shy, people with a social anxiety disorder will worry obsessively about social situations for hours, days or weeks in advance. When faced with the situation, they usually have a “meltdown,” which can involve a panic attack, a tantrum, bolting or “freezing up.”
Unlike shyness, social anxiety disorders can disrupt many areas of life function. For example, people with social anxiety disorders are at a higher risk of leaving school early and achieving reduced levels of education.
When it comes to being shy vs. having social anxiety, labeling social anxiety disorder as shyness can be dangerous. Many affected individuals do not seek help for this treatable disorder and suffer significant consequences because of it. People who have concerns about whether they are merely shy or suffer from social anxiety disorder should seek a professional opinion.
2. Myth: Social anxiety only affects public speaking.
Fact: Social anxiety disorder adversely affects most aspects of life function.
One study estimates that around 92.6% of people with social anxiety disorder report that they have an impaired ability to properly fulfill their roles in life due to their anxiety. While social anxiety and public speaking fears are often related, many other situations can create overwhelming amounts of anxiety as well.
In the same study, about a quarter of people without social anxiety disorder had significant anxiety in specific social situations and try to avoid them. These include:
- Public speaking (21.2%)
- Speaking up in class or at a meeting (19.5%)
- Meeting new people (16.8%)
- Talking to someone in authority (14.7%)
- Going to parties (13.4%)
- Expressing disagreement (12.4%)
- Entering an occupied room (11.9%)
- Working while being watched (11.8%)
- Eating, drinking, or writing while being watched (8.1%)
- Using a bathroom away from home (5.7%)
Social anxiety adversely affects many aspects of life. Affected individuals are less likely to marry and less likely to have children. Many are unable to have haircuts, go grocery shopping or even answer the phone. Some will not even go online because the thought of strangers being on the internet at the same time causes them unbearable anxiety. They tend to have fewer friends, lower-quality social relationships and a reduced social support system.
3. Myth: Social anxiety isn’t very common.
Fact: Social anxiety disorder is among the most common of all mental health disorders, and it is increasing in prevalence.
Data from The World Health Organization (WHO) shows that the prevalence of social anxiety disorder is 4% worldwide and 12.1% in the United States. Prevalence rates are largest in high-income countries, especially North America. However, the highest rates of social anxiety disorder in high-income countries are among people of lower income.
Social anxiety statistics show that rates of social anxiety and anxiety, in general, are on the rise. A 2017 report by WHO showed that anxiety disorders are more prevalent in North America than elsewhere in the world, and the rates are increasing. Reports like these prove how common social anxiety disorder is.
This concerning increase cannot simply be explained by increased awareness of anxiety disorders. Rather, western society is becoming more anxiogenic (anxiety-inducing) due to the increasingly fast-paced and mentally demanding environment its citizens live in.
A 2017 survey by the American Psychiatric Association (APA) showed that concerns about health, safety, relationships, finances and politics are causing increased anxiety among Americans. This is especially true for American millennials. The report also highlights the negative impact of this anxiety on the mental and physical health of Americans. When the APA repeated the same survey one year later, they found that anxiety rates had already increased by 5%.
4. Myth: Social anxiety can’t hurt you.
Fact: Social anxiety disorder causes significant impairments.
Data from the U.S. National Comorbidity Survey Replication (NCS-R) study showed that social anxiety is common, undertreated and associated with significant impairment in function in multiple aspects of life.
A large U.S. study found people with social anxiety earn 10% lower wages, are 10% less likely to earn a college degree and are 14% less likely to be in a managerial, technical or professional role. They are also more than twice as likely to need welfare assistance. Additionally, social anxiety disorder causes:
- Reduced productivity at work, especially if there is comorbid depression
- Impaired family relations, social networks and romantic relationships
- Reduced health-related quality of life
- High incidence of suicidal thoughts and a high lifetime rate of suicide attempts
- Higher use of health care services
Social anxiety disorder is often associated with co-occurring mental health disorders. These disorders can significantly affect a person’s ability to function in life. A variety of studies have shown alarming rates of comorbidity in people with social anxiety disorder:
- About 80% will have another mental health disorder in their lifetime
- Up to 65% will get a depressive disorder, and the depression is often from distress over their anxiety symptoms
- About 20% of adults with a social anxiety disorder will develop a substance use disorder
- More than 41.3% of people aged 14 to 24 with social anxiety disorder have a substance use disorder
There are physical effects of social anxiety if left untreated, including physical symptoms and increased risk of general health problems. Notably, comorbid social anxiety disorders can reduce treatment response in many comorbid conditions.
5. Myth: People with social anxiety disorder can just get over it.
Fact: Social anxiety disorder is nearly always a chronic condition in those who don’t seek treatment.
Data shows that people don’t “just get over it.” Social anxiety disorder is associated with a young age of onset and long duration unless treated. One U.S. study demonstrated that it has a low untreated recovery rate: only 37% over 12 years.
One of the greatest barriers to people seeking social anxiety disorder treatment is the myth that people can “will” themselves to change or simply think their way out of their symptoms. There are effective therapies available for social anxiety disorder, but people who think they can just get over it are unlikely to seek the necessary help.
Unfortunately, only about half of adults with a social anxiety disorder ever seek treatment, and those who seek treatment only do so after around 15 to 20 years of symptoms. These numbers are unfortunate, given the level of suffering that can come with the untreated disorder and the fact that effective treatments are available.
The staff at The Recovery Village has the expertise and experience needed to help people with overcoming social anxiety disorder and co-occurring substance use disorders. Our treatment approach is comprehensive and holistic. Please feel free to contact us for a confidential discussion if you have concerns about yourself or a loved one.
American Psychiatric Association (APA). “Majority of Americans say they are anxious about health; Millennials are more anxious than baby boomers.” May 22, 2017. Accessed June 11, 2017.
American Psychiatric Association (APA). “Americans say they are more anxious than[…] increase in anxiety.” May 7, 2018. Accessed June 11, 2017.
British Psychological Society & The Royal College of Psychiatrists. “Social anxiety disorder.” Social Anxie[…]reatment, Ch 2, 2013.” Accessed June 11, 2019.
Bruce, Steven; et al. “Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study.” American Journal of Psychiatry, June 1, 2005. Accessed June 11, 2019.
Katzelnick, David; et al. “Impact of generalized social anxiety disorder in managed care.” American Journal of Psychiatry, December 1, 2001. Accessed June 11, 2019.
Ruscio, Ayelet; et al. “Social fears and social phobia in the US[…]y Survey Replication.” Psychological Medication, January 2008. Accessed June 11, 2019.
Stein, Dan; et al. “WHO World Mental Health Survey Collabora[…]th Survey Initiative.” BMC Medicine, July 31, 2017. Accessed June 11, 2019.
World Health Organization (WHO). “Depression and other common mental healt[…]bal health estimates.” 2017. Accessed June 11, 2019.
The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.