Social Anxiety Disorder

Medically reviewed by Carina Fung, PharmD, BCPPS

Social Anxiety Disorder Diagnosis

There is no medical test used to diagnose social anxiety disorder. Your healthcare provider will likely take a holistic look at your mental and physical health when diagnosing your condition.

Your provider (or a specialist) may diagnose14 social anxiety disorder by:

  • Asking you about your signs and symptoms, including their frequency and severity
  • Conducting a physical exam to assess whether any health conditions or medications you’re taking might be triggering your symptoms
  • Discussing what social situations make you anxious to determine potential triggers

Specialists will likely consult the criteria listed in the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5, published by the American Psychiatric Association) to diagnose social anxiety disorder.

The characteristics of social anxiety disorder as listed by the DSM-5_ _are:

  • Intense fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others, including social interactions, being observed, and performing in front of others.
  • The social situations almost always provoke fear or anxiety.
  • The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the socio-cultural context.
  • The social situations are avoided or endured with intense fear or anxiety.
  • The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • The fear, anxiety, or avoidance is persistent, typically lasting for six months or more.
  • The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
  • The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or autism spectrum disorder.
  • If another medical condition (e.g., Parkinson’s disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive.

The DSM-5 also requires specification of whether social anxiety is “performance only,” which occurs when an individual’s fear is restricted to speaking or performing in public.

Do I have social anxiety?

Sometimes, it can be difficult to differentiate between social anxiety disorder and general shyness. The main difference is whether social aversion is harming work/education, relationships, and overall well-being.

People who are shy are able to function in social situations, while those with social anxiety entirely avoid such situations out of fear. Repeatedly avoiding interactions that may trigger severe anxiety and fear can ultimately lead to a multitude of problems in one’s personal and professional lives.

It is also important to note another type of social anxiety disorder: performance anxiety15.

People with performance type social anxiety disorder feel intense fear and the physical symptoms of anxiety only during speaking or performing in public or in large groups—not in other types of social situations. Most people with generalized social anxiety disorder, however, also experience symptoms of performance anxiety.

You may be shy but warm up to people once you begin to feel more comfortable. However, if you feel intense fear when faced with social interactions or public performances, you should ask your healthcare provider about the possibility of having social anxiety disorder.

Social anxiety disorder in children

Children with social anxiety disorder16 can present signs and symptoms different from those seen in adults.

The symptoms of social anxiety disorder in children tend to arise between the ages of 8 and 15. However, if children are not very communicative about how they are feeling, their parents might not even realize that anything is wrong.

Generally, children with this condition are very self-conscious about how they are perceived and how they may appear to others. They may express these worries by asking their parents things like, “What if I say the wrong thing?” or “Will everyone think I’m weird?”

Children with social anxiety may show distress by crying, freezing up, clinging to their parents, refusing to speak during social situations, or throwing temper tantrums. Like adults, children with social anxiety disorder often experience the physical symptoms of anxiety: sweating, shaking, flushing, or feeling out of breath.

In order to be diagnosed17 with social anxiety disorder, children must experience this anxiety with their peers (not just around adults) for a period of six months or more. Because some children may downplay or refuse to acknowledge their symptoms (out of fear of embarrassment), specialists will often ask parents, teachers, or other caregivers about a child’s signs and symptoms to more accurately understand their condition.

Disclaimer: The information on this site is generalized and is not medical advice. It is intended to supplement, not substitute for, the expertise and judgment of your healthcare professional. Always seek the advice of your healthcare professional with any questions you may have regarding a medical condition. Never disregard seeking advice or delay in seeking treatment because of something you have read on our site. RxSaver makes no warranty as to the accuracy, reliability or completeness of this information.

If you are in crisis or you think you may have a medical emergency, call your doctor or 911 immediately.