Social Anxiety Disorder

It is not uncommon for children and adults on the Autism Spectrum to experience clinically sufficient social anxiety to warrant a co-morbid diagnosis of Social Anxiety Disorder.

Social Anxiety Disorder is about more than just shyness.  Social Anxiety is a disabling anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social or performance situations.  It is the fear of  interaction with other people that brings on self-consciousness, feelings of being negatively judged and evaluated, and, as a result, leads to avoidance, feelings of inadequacy, inferiority, embarrassment, humiliation, and depression.
To meet the diagnostic criteria of social anxiety disorder, the person must experience significant distress or impairment that interferes with his or her ordinary routine in social settings, at work or school, or during other everyday activities. Where the person has an existing diagnosis / medical condition, it must be clinically evidenced that the anxiety experienced is unrelated to the other condition or out of proportion to what would normally be felt with that condition.

Specific and Generalized Social Anxieties

A specific social anxiety would be the fear of speaking in front of groups (only), whereas people with generalized social anxiety are anxious, nervous, and uncomfortable in almost all social situations.

It is much more common for people with social anxiety to have a generalized type of this disorder.  When anticipatory anxiety, worry, indecision, depression, embarrassment, feelings of inferiority, and self-blame are involved across most life situations, a generalized form of social anxiety is at work.

Symptoms of Social Anxiety Disorder

People with social anxiety disorder usually experience significant emotional distress in the following situations:

  • Being introduced to other people
  • Being teased or criticized
  • Being the center of attention
  • Being watched while doing something
  • Meeting people in authority (“important people”)
  • Most social encounters, especially with strangers
  • Going around the room (or table) in a circle and having to say something
  • Interpersonal relationships, whether friendships or romantic

The physiological manifestations that accompany social anxiety may include intense fear, racing heart, turning red or blushing, excessive sweating, dry throat and mouth, trembling (fear of picking up a glass of water or using utensils to eat), swallowing with difficulty, and muscle twitches, particularly around the face and neck.

Constant, intense anxiety that does not go away is the most common feature.

People with social anxiety disorder know that their anxiety is irrational and does not make “head” (i.e., cognitive) sense.  Nevertheless, “knowing” something is not the same thing as “believing” and “feeling” something.

For people with social anxiety, thoughts and feelings of anxiety persist and show no signs of going away -despite the fact that socially-anxious people “face their fears” every day of their lives.