Social anxiety disorder (SAD), also known as social phobia, is a disorder characterized by intense anxiety in social situations causing considerable distress and impaired ability to function in at least some parts of daily life. These situations may involve scrutiny or judgment by others. A person with SAD experiences considerable distress in everyday social situations, such as attending a social event, being asked to introduce themselves, or even performing simple tasks while being observed by others. This distress can be so severe that he or she agonizes over upcoming events for weeks ahead of time.
People with social anxiety disorder may have anxiety about a specific situation, such as public speaking, eating or drinking, or performing a particular task in front of others. Most people with social anxiety disorder have a more generalized anxiety, in which they fear multiple social situations. Their anxiety may be so broad that they experience anxiety around almost everyone.
While shy people may be uneasy around others, they generally don't experience the same kinds of extreme anxiety or engage in the extreme avoidance of social situations as someone with social anxiety does. While SAD has a number of characteristics in common with shyness, SAD exceeds normal "shyness" as it can lead to excessive social avoidance and substantial social or occupational impairment. SAD is a very exaggerated form of shyness, which can be described as "extreme shyness" or "painfully shy". As a group, those with generalized social anxiety are less likely to graduate from high school and are more likely to rely on government financial assistance or have poverty-level salaries.
Usually people with SAD can remember the first time they exhibited physiological symptoms of anxiety in the presence of others, such symptoms as shaking, blushing, stammering, etc. These symptoms caused intense embarrassment or shame, and became associated with the particular situations involved, for example, a presentation, or a conversation with the opposite sex. Fear of these symptoms reoccurring, which would be perceived as humiliating and embarrassing, takes on a life of its own, and the person will go to great lengths to avoid the situation that produced them. Overcoming fear of physiological symptoms is crucial to recovery. It is the intense distress over the symptoms, rather than the symptoms itself that causes the limitation. For example, there are people who blush easily, are aware they blush easily, and can brush it off without any distress at all. If there is no distress over the symptoms, then the symptom cannot produce social anxiety. If there is distress, and that distress leads to avoidance, then the negative cycle of social anxiety is perpetuated, and the provoking situation is likely to cause even greater distress and symptoms in the future.
Most people actively avoid situations and objects that trigger intense anxiety. Those who are afraid of spiders or of being in high places can structure their lives in a way to avoid such situations, while continuing to lead normal lives. For those having social anxiety, however, avoiding social situations means isolating themselves from society. Although avoidance allows you to feel better in the short term, the longer term consequences of chronic avoidance are considerable. Avoidance soon becomes a pattern, causing the person to avoid more and more situations, and eventually becoming socially isolated. Social isolation may lead to depression and reinforce low self-esteem. This pattern of avoidance can be extremely difficult to break, and may eventually interfere with the development of a normal life.
Social anxiety is often accompanied by low self-esteem and depression. Failed social interactions, whether the failure is actual or imagined, tends to lower a person's opinion about themself. Long periods of isolation that follow from avoiding social situations can result in a lack of personal relationships, which the SAD sufferer may interpret as being "unlikeable/unlovable", uninteresting, and unworthy of friendship. Additionally, unchallenged cognitive distortions continually chip away at a person's self-esteem.
A common response of SAD sufferers is to actively avoid situations that trigger anxiety and this pattern of avoidance eventually interferes with the development of a normal life. Many with severe SAD have never developed long lasting friendships, been in a romantic relationship, or pursued professional careers for which they are qualified because of the inherent social demands. Some are disabled to the point that they cannot leave their home, out of fear of the intense anxiety that accompanies their perception of being judged. To varying degrees, SAD forces individuals to withdraw within themselves and become consumed with self-defeating introspection, effectively shutting them out of their own lives and concealing their skills, talents and passions from the rest of the world. Hence, this disorder has profound effects on the individual, his or her loved-ones, and society-at-large.