“Social anxiety” is an expression used to describe a reaction of distrust, apprehension, or actual fear in situations in which a person is subjected to the judgment of, or comparison with, other people. It does not matter whether this comparison is always “physical,” or whether other people actually express negative opinions or attitudes about what the person says or does. It is enough that their presence, or the awareness that they may judge or comment on what the person has done or said, is perceived as threatening.
The person naturally tends to focus on how to avoid or manage negative, rejecting, or mocking attitudes from others. This makes them hypersensitive to such attitudes and leads them to overestimate their impact and humiliating or disqualifying consequences.
At the same time, social anxiety “paralyzes” the person and reduces or removes their ability to react, or simply to “ignore” thoughts of inadequacy or inferiority. As a result, they are forced into an unpleasant and distressing position, even when none of what they feared actually happens.
The way a person with social anxiety views themselves can take two different paths:
On the one hand, they may believe that they are genuinely incapable, awkward, or inadequate. This often occurs when a depressive mental state sets in and self-esteem declines.
Alternatively, the person may retain good self-esteem in principle but regard themselves as socially “incapable,” believing that they are therefore destined for a difficult and impoverished social life, with few opportunities or achievements.
Furthermore, what a person with social anxiety fears most is being recognized as such while they are trying to conceal their distress. If other people notice their awkwardness, make well-meaning jokes about it, or notice that the person is “on edge,” the person feels “exposed” and humiliated.
For this reason, social anxiety becomes worse when anxiety is accompanied by visible signs, such as sweating, trembling, stuttering, or blushing. Likewise, distress is greater when the person realizes that others have noticed certain instinctive behaviors that accompany their discomfort in social interactions, such as keeping their gaze lowered or avoiding eye contact, not smiling or using facial expressions during a conversation, or taking jokes and irony at their own expense seriously and literally.
Anxiety and phobia
This form of anxiety may simply cause discomfort in certain situations, or it may make those situations so distressing that the person systematically avoids them.
In the latter case, the term “phobia” is used: the person is literally frightened when forced to face the feared situations, and the anxiety does not disappear after the initial moments—that is, there is no adaptation; on the contrary, the anxiety intensifies.
Nevertheless, even in the absence of avoidance, social anxiety can impair performance or lead the person to avoid putting themselves directly in front of others, to choose or accept the first solutions they find because they fear they will not find anything better, to be unable to say “no,” or to stand up for their position when they are in conflict with others or have to “fight” to obtain what they want.
Social anxiety limits a person’s freedom to comment, talk about themselves, express their thoughts or preferences, make suggestions to others—in short, to “play their cards” and feel equal to others in everyday relationships.
The person may, instead, manage certain relationships successfully, such as those with trusted people or those in which they are confident that they are clearly superior to others—for example, because of their professional expertise. However, in relation to their peers, such as colleagues, they may still assume a psychologically subordinate or fearful position.
There is also a form of social anxiety by projection, meaning feeling embarrassed on behalf of others when they make fools of themselves, or rather because the person perceives the ridiculous or amusing behavior of others who are performing in public as unpleasant or embarrassing for themselves, almost as though they were identifying with the situation from an anxious point of view.
Social anxiety or social phobia may begin at a particular point in life, or it may begin as a personality trait, initially in a flexible form, and later develop into a disorder, especially when the person comes into contact with the social environments of their peers, school, the pressure to seek romantic and sexual relationships, and so on.
Avoidant Personality
When anxiety involves more or less all types of relationships (“generalized” social anxiety) and begins early in life and then persists, the person’s personality may become “avoidant.”
The “avoidant” person no longer appears anxious because they have developed a lifestyle centered around excluding social situations, which are not even considered as possibilities. Anxiety and distress may be replaced by a kind of “aversion” to situations involving unavoidable group contact with other people, while some one-to-one relationships remain possible and can still be cultivated.
New situations are poorly tolerated, and the person loses the motivation to seek better adaptation to their environment, convinced that the only possible solution is to find an adequately isolated space for themselves. Contact with other people is accepted when necessary but reduced to the bare minimum.
Social anxiety is often worsened by the way other people respond to it.
A fearful person is often subjected to bullying or exclusion in peer environments, but their “defensive” position also contributes to this, as it can trigger an instinct in others to dominate or overpower them. Furthermore, the person tends to overestimate these “pack” behaviors and feels excessively disqualified, even though a different attitude might have been enough to turn the situation in their favor.
Other people do not perceive the person’s suffering. They often do not take it into account beyond the individual episode in which they see the person feeling uncomfortable, and they frequently mistake anxious distrust for a kind of snobbishness, disinterest, or emotional coldness.
Moreover, a person with social anxiety does not usually want to explain the reason for their discomfort or apparent withdrawal, because they dislike being identified as “shy.” As a result, they may paradoxically avoid clarifying the misunderstanding.
Can These Disorders Be Treated?
Social anxiety and social phobia are treatable disorders, often to a degree that goes beyond the expectations of people who have suffered from them for years or even throughout their lives.
However, an important variable is the overall diagnostic picture, which also takes into consideration other psychological aspects, such as mood stability or the presence of obsessions or delusions that may contribute to different forms of social distress.
Adolescent social phobia, like any other anxiety disorder, may be the first episode of bipolar disorder.
It is also important to make a differential diagnosis, that is, to distinguish, starting from a situation of social distress, the “social phobia” underlying mechanism from other possible mechanisms. For example, social distress may be rooted in a “delusion of reference,” which leads the person to believe that they are the target of unpleasant comments or attention from others, resulting in social distress and social isolation.
This latter pattern of social distress, which gives rise to secondary social anxiety, is a relatively common form of disorder that develops in chronic cannabis users or following amphetamine abuse.