Social anxiety: when shyness becomes a disorder

When considering the five major anxiety disorders, Social Anxiety is the most prevalent, affecting more than 11 million individuals.

However, many people confuse shyness with Social Anxiety, due to their similar characteristics. Therefore, let’s discuss how these two conditions differ.

SHYNESS

Unless you’re interested in pursuing a career in politics, acting or a similar type of career that involves performing in front of others, most people don’t like the thought of needing to give any type of presentation in the presence of others, whether they’re friends or perfect strangers.

Those who consider themselves to be “shy” (nearly 80 percent of children and adults in the United States), typically exhibit the following features:

Physical and emotional discomfort when interacting with others.

Feeling inhibited when needing to try something new.

Fear of making mistakes in the presence of others.

Excessive self-focus on behavioral (speech, body language) and physiological (blushing, excessive sweating) responses.

Feeling a sense of “anxious apprehension” during most social interactions.

SOCIAL ANXIETY

Anxious people have a strong tendency to overestimate probabilities concerning the occurrence of negative outcomes in their lives.

In addition, they also overestimate the severity of these outcomes should they occur, while simultaneously underestimating their perceived ability to handle these predicted negative events.

Those with a diagnosis of Social Anxiety are hypervigilant with respect to the threat associated with social-interpersonal interactions.

They define threat as the possibility others will judge them in an unfavorable manner (inadequate, awkward, irresponsible, rude, clumsy, etc.) due to something they said, forgot to say, did or omitted from doing.

This type of thinking results in becoming overly self-conscious regarding the possibility of suffering extreme embarrassment and unbearable humiliation during, and following, nearly any type of social encounter with others — direct (face-to-face) or indirect (talking on the phone).

In addition, the most common characteristics of socially anxious people would include:

A belief nearly any type of social interaction will result in a sense of vulnerability, thus, publicly exposing the type of person they really are — phony, weak and/or awkward; someone who’s not worthy of being accepted by others.

Although possessing many likable personal qualities, these positive characteristics are rarely seen by others, and then become rusty, due to their infrequent use in social situations. As a result, the strongly held belief they don’t possess these admirable qualities becomes further reinforced.

The tendency to lead a life of social isolation; typically resulting in feelings of loneliness and depression.

CLINICAL SYMPTOMS

Although most of us experience some degree of anxiety in social situations, those who evidence a diagnosis of Social Anxiety display the following clinical symptoms, as outlined in the Diagnostic & Statistical Manual (DSM-5), published by the American Psychiatric Association (2013):

1: A persistent fear of one or more social or performance situations, in which the person is exposed to unfamiliar people or to the possible scrutiny by others

2: Exposure to feared social situations provokes extreme feelings of anxiety. The most common would include talking on the phone, eating or writing in front of others, speaking in the presence of a group of people, interviewing for a job, shopping, and traveling

3: The person recognizes their fear is excessive and unreasonable

4: Feared social situations are directly avoided, or endured with intense anxiety and distress, creating significant interference with one’s daily activities. Subtle forms of avoidance may include avoiding eye contact, speaking quietly, slowly, and using short sentences, not expressing opinions or disagreeing with others, allowing one’s hair to cover their eyes, etc.

To summarize the primary difference between shyness and social anxiety, consider the following scenario. Two people are offered a job promotion, along with a $50,000 annual increase in income.

Both individuals are barely able to pay their monthly bills, and are expecting their first baby in just a few months. The promotion involves an additional responsibility of presenting in a weekly staff meeting, composed of 15 people, a 30-minute summary regarding the company’s short and long-term production goals for the following month.

The shy person becomes nervous at this news, yet accepts the job, knowing the weekly staff meetings will be anxiety-provoking.

The individual with Social Anxiety, without hesitation, declines the promotion, due solely to the requirement of needing to give an oral presentation to the company’s staff on a consistent basis (a direct avoidance strategy).

In Part 2 of this series, we’ll discuss the primary factors responsible for the development and maintenance of Social Anxiety.

Barry C. Barmann, Ph.D., is a licensed clinical psychologist in Nevada and California. His wife, Mary B. Barmann, MFT, is a licensed marriage and family therapist in California. Visit anxietytreatmentinclinevillage.com to learn more.