Amelia Aldao Ph.D.
5 Overlooked Signs of Social Anxiety Disorder
This condition can look different for everyone.
Posted Oct 29, 2019
Close to 15 million American adults suffer from a social anxiety disorder. But despite this high prevalence, there are many misconceptions about what it really means to have this condition. So today, I’d like to go over five often-overlooked signs of social anxiety disorder.
I’m drawing from my experiences as a licensed clinical psychologist with 10+ years of conducting cognitive-behavioral therapy (CBT) for social anxiety, as well as an academic researcher with 60+ scientific publications on anxiety.
1. Social anxiety disorder is not just about fears of public speaking.
The prevailing image of a person with a social anxiety disorder is that of someone who’s shaking, stuttering, or sweating profusely in front of an audience. But a social anxiety disorder is much more than fears of public speaking! Yes, these are front and center for many people, but they do not represent the experience of everyone with social anxiety.
Some people with this disorder might be particularly afraid of making small talk, looking people in the eye, writing emails, making phone calls, speaking up in class, eating in front of others, or playing group sports, just to name a few. In fact, many people with social anxiety might not have any fears whatsoever about public speaking—they might even love it!
When we diagnose a social anxiety disorder, we’re not looking for the client to be afraid or worried about any particular social situation. Instead, what we care about is whether they are experiencing extreme fears about social situations that are interfering with their lives. For example, are fears of making small talk getting in the way of someone networking effectively at work events? Is anxiety about playing group sports interfering with their ability to socialize on weekends?
I cannot emphasize enough how important this point is. In my work as a clinical psychologist who specializes in social anxiety, I have frequently met with clients who weren’t quite sure about whether they had this condition because they didn’t really worry about public speaking. In many cases, this misinformation had led them to delay treatment—which, of course, only made their anxiety worse! By the way, did you know that one-third of people with social anxiety disorder wait more than 10 years to get help?
2. Social anxiety fears go beyond concerns about being evaluated negatively.
We tend to think of social anxiety as encompassing fears of being embarrassed, not living up to a certain standard, or having our shortcomings exposed. But many people also experience social anxiety about receiving positive feedback and being the center of "good" attention—for example, being praised for a job well done, getting a good evaluation, or being nominated for an award.
In many cases, this concern is driven by worry that there’s been some sort of a mistake and that they will be discovered as a fraud. This is what we often call “impostor syndrome,” and it can have ravaging effects on how people perform across a number of situations.
3. Social anxiety worries are about the future and the past.
When we think of worries, we tend to think of the future: By definition, we worry about what’s to come. But people with social anxiety also frequently get stuck worrying about the past—or ruminating, to be more precise. They replay social situations in their heads over and over again, second-guessing their performance: “Oh my, what if this person didn’t like me?” “What if I said the wrong thing?” “What if they think I’m boring?”
This type of rumination is called “post-event processing,” and it’s a very interesting—and destructive—way of looking at the world. It entails ruminating about the past, while also worrying about the future. A thought like, “What if they don’t like me?” has a grim implication for the future: “What if I end up alone?”
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Needless to say, the more that people engage in post-event processing, the more they second-guess themselves, and the more anxious they get about the future. People with social anxiety get trapped in a mental loop of regrets about the past and worries about the future.
Breaking free from this habit is very difficult, but it is also key to overcoming social anxiety disorder. Cognitive-behavioral therapy (CBT) is particularly helpful here, as it teaches clients to think about their anxiety differently.
4. Social anxiety does not equal introversion.
This is a very common misconception that I see a lot, particularly on social media. Let me unpack. Introversion is a characteristic of someone’s personality, and it is diametrically opposed to extroversion. Both refer to the amount of social interaction that a person wants or needs—and they have nothing to do with fear or anxiety.
Specifically, people who don’t need a lot of social interaction in their lives tend to be introverted, and those who do need a lot of social interaction are extroverts. So, whereas an introvert might be ready to leave a party after an hour, an extrovert might be the last person to leave. An introvert might get “emotionally tired” faster than an extrovert and value their alone time a lot more.
But whether someone needs a lot of social interaction or not has nothing to do with whether they are anxious about those very same social situations. Just because we enjoy doing something, it doesn’t mean that it won’t make us anxious (much like rollercoasters!). So, both introverts and extroverts might feel anxiety about social situations, and they might experience it intensely enough that it might be a sign of social anxiety disorder.
5. Social anxiety is not always easy to spot.
There’s a notion that people with social anxiety hide away from the world and do not engage socially—that they avoid parties and social events. But this could not be further from the truth. There are two reasons for this. First, as I mentioned above, social anxiety is very heterogeneous, so some people with this condition might be perfectly fine engaging in the type of unstructured social interactions that happen at parties (like small talk).
Second, although people with social anxiety are highly motivated to avoid the situations that make them anxious (aren’t we all?), avoidance does not always equal “not showing up.” There are, in fact, many types of subtle avoidance that people carry out. For example, one could go to a party but drink excessively or spend a lot of time on one’s phone, to name a couple.
These subtle avoidance behaviors are particularly problematic because they tend to create dependency. Over time, the person will come to rely on them more and more, which, in turn, will make them feel more anxious and thus more likely to engage in subtle avoidance in the future. In the case of drinking or using substances, this comes with its own set of dangers, as it might lead the person to develop a substance use disorder.
So, this brings us to the end of today’s post. I hope you find this information useful. Do you have questions about social anxiety disorder? (Or anxiety more broadly?) Leave them in the comment sections below!
As always, please remember that these posts are for informational purposes only. If you think that you—or someone you know—might be struggling with social anxiety or any other disorder, please consult with a mental health professional.
© Dr. Amelia Aldao, Ph.D.
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