You have most likely heard countless times in school that humans are social creatures, “zoon politikon”, as Aristotle called them. In order to survive and have fulfilled lives, humans gather in groups and communities. If it’s true that we are born to socialize and form connections, then social anxiety seems paradoxical, it seems like a negative genetic mutation. Social anxiety, however, springs right from humans’ strong wish to belong, to be part of a group and to be accepted within it. The fear of rejection, of judgement, of being disliked as a whole, is what fuels this disorder. Although these anxieties are valid, when they become exacerbated, incontrollable, and reach a point where they have a negative impact on our lives, they transform into social anxiety.
Social anxiety is the most common anxiety disorder. What’s more, it is the 3rd most common psychological condition, right after depression and addiction.
It is characterized by a disproportionate and persistent fear of not embarrassing ourselves in social contexts, like: public speaking, socializing with strangers, stage performances.
People affected by this disorder avoid situations in which they could do or say humiliating things. Thus, many of them refuse to attend meetings, job interviews, or parties, becoming more and more isolated. Social anxiety condemns many people to solitude. They are, however, nowhere near close to being alone in their suffering.
13% of people worldwide meet the criteria for this diagnostic at some point during their lives.
In case you see yourself in the description above or have been diagnosed with social anxiety, you have probably wondered what caused it, or maybe you want to know the main causes in order to prevent yourself or your loved ones from developing this disorder.
There is no single main cause of social anxiety, but studies have discovered multiple different factors that contribute to the development of this condition, through their complex interactions. These factors are:
1. Genetic factors
Anxiety disorders are generally inherited from family members, generation by generation. If you have a first grade relative diagnosed with social anxiety, then your chances of developing it yourself are between 2 and 6 times higher than the rest of the population. Of course, these high chances could also very well root from learned behavior (for example, if your parents are anxious and avoidant themselves, you might imitate their behavior growing up). Research shows, however, that around 30% of cases spring from the sufferer’s genes.
2. Environmental factors
It is possible that social anxiety could be a learned behavior. Lots of children and teenagers develop this condition after a humiliating or negative experience.
How children “learn” social anxiety:
- Direct conditioning: You forgot the lyrics to a poem for your end-of-year kindergarten celebration and everyone started laughing at you? You didn’t know the answer to a question in school and your classmates humiliated you? These traumatic childhood experiences can have a strong impact in the development of this disorder. They taught you that being in the center of attention in social contexts, means you are vulnerable. You’re not allowed to make mistakes, and in case you do, the consequences will be devastating.
- Observational learning: Maybe you weren’t the target of the jokes and humiliation, but you were the witness of one of such situations. In case you have a predisposition to anxiety disorders, observing a traumatic social experience can have the same effect as experiencing one of these situations yourself.
- Informational transfer: Anxious and fearful, excessively protective parents that always try to control their kids’ actions often transfer verbal and nonverbal information about the dangers of social situations to their children, involuntarily.
3. Biological factors (Cerebral Structure)
The amygdala is responsible for controlling multiple emotions, including fear. The amygdala is an almond-shaped brain component, part of the limbic system, or the emotional system of the mind. People with a hyperactive amygdala can exhibit exacerbated feelings of fear. This leads to an increase in anxiety in social situations.
4. Behavior inhibited in childhood
If exposed to a new environment or person, children often get really upset. If they cry, withdraw themselves, or look for their parents’ comfort, we could say they are just shy or reserved, and they’ll get over it with age, when, in reality they exhibit an inhibited behavior. This behavior is associated with a heightened risk of developing social anxiety later in life. If you recognize your child in the description above, it may be necessary to call for professional help. A timely intervention makes the difference between a functional, healthy and an anxious, isolated adult or teenager.
5. Social factors
Studies show that social anxiety affects less people in collectivist cultures, like Japan or China. There, the individual is less important than the community they are part of. In contrast to individualist cultures like the U.S., where the individual is centric, and on their own. It is important for everyone to be unique and special, there being a lot of pressure to make an impression and be successful.
Instead, in collectivist cultures, there is a cultural syndrome called Taijin Kyofusho (Interpersonal fear disorder). It consists of the anxiety, fear, or conviction that your appearance and behavior could offend or make other people uncomfortable. People suffering from this syndrome are overfocused on the effects of their symptoms on others. It makes sense in cultures where everyone else comes before you.
These two phenomenon perfectly illustrate the fact that anxiety is a universal human experience. The form it takes is conditioned by the culture it shows up in.
Diagnostic
Social anxiety most often shows its first signs in teenage or pre-teenage years. If left untreated, it worsens, and clings onto other psychological conditions, especially depression. It can also associate with other anxiety disorders like generalized anxiety disorder or panic disorder.
There is no test that proves you do or do not suffer from social anxiety.
The diagnostic is established by a psychiatrist, following a consultation. Its assessment is based on experiences you describe and the behaviors they identify in your descriptions.
The social anxiety diagnostic criteria are:
- Fear or anxiety related to social situations in which you could be exposed to judgement.
- Fear of behaving in a way that could offend others or that your anxiety will become obvious, which will lead to others having a bad impression of you.
- Social situations almost always trigger fear or anxiety
- Social situations are avoided or endured with lots of fear and anxiety
- The fear or anxiety are disproportionately big in comparison to the threat the respective situation represents
- Fear, anxiety or avoidance are present and persistent for at least 6 months
- The fear, anxiety or avoidance cause stress and problems in the workplace, in relationships, at school or in other important life contexts.
Social anxiety – Treatment
Social anxiety can be debilitating by its nature. It affects the most important parts of life: relationships, career, education. Luckily, it can be successfully treated or kept under control, there being numerous drug-based and therapeutic treatments.
The most efficient forms of treatment are:
1. Cognitive-behavioral therapy (CBT)
Many studies proved the efficiency of this type of therapy in treating social anxiety. The main goal of this type of therapy is to provide techniques for changing the way a person with social anxiety thinks and behaves in situations that scare them. Although progress is slower than it is with drug-based therapy, the beneficial effects last longer.
Exposure therapy, the most utilized type of CBT in treating social anxiety,
is based on gradual exposure to situations patients fear. Although it might seem impossible or terrifying, the only way to combat anxiety is to confront it. Therapists make sure the patient is safe and will do the exposure in a rhythm adapted to their needs. This will grant the patient coping mechanisms necessary to manage their emotions. What’s more, a useful tool is knowing how to set realistic objectives. If an office party seems overwhelming, choose an objective you can attain. Talk to one or two people during the party, in order to get over this challenge. CBT sessions last between 12 to 16 weeks. In studies, participants suffering from social anxiety needed at least 6 weeks in order to show evident improvement.
2. Modified interpersonal therapy
People with social anxiety do roleplay and use other techniques in order to improve their social abilities.
3. Cognitive reorganization
This type of psychotherapy is focused on the cognitive symptoms of social anxiety, those being: fear of others’ evaluation and negative prejudices (attributing positive results to fate and negative results to your own flaws). Cognitive reorganization implies a series of elaborate exercises that all aim to identify negative thoughts. Ulteriorly, the therapist evaluates how real those fears are, and helps the patient build alternate thoughts to contradict the original ones.