Social Anxiety describes how someone can feel anxious in the presence of strangers, acquaintances, friends and family. Social Anxiety is an intense and persistent fear of social situations, often driven by the fear of being judged, humiliated, or rejected by others. This isn’t just mere shyness, it is a condition that severely impacts a person’s ability to function in society and daily life, causing distress in everyday interactions and leading them to avoid social situations altogether. Symptoms can include intense anxiety and fear social settings. The fear / anxiety may be experienced as physical symptoms like sweating, blushing, trembling, and a rapid heartbeat.

While not all people will necessarily trigger anxiety for a person with social anxiety, the feelings of anxiety diminish when alone and not thinking about other people’s judgments, reactions or negative experience of the person with social anxiety. In essence, in the absence of others, there is little to no anxiety, while General Anxiety Disorder feels anxious even when alone and not thinking about other people.

Social Anxiety is usually a side effect of some other category of problem and is commonly found with Autism, ADHD or Trauma. Social Anxiety is primarily a biologically driven condition. Circumstances can often exacerbate the condition, but is rarely the sole cause of Social Anxiety.

Understanding Social Anxiety

Humans are social animals, so we biologically feel the need to be part of a social group. Not only is no single person is perfect, no single person is efficient at surviving on their own. In modern society, it is possible to survive without others, but it isn’t good for our mental health to be isolated for long. This leads to an intrinsic desire to be around other people to fill in the gaps and improve our chances of survival. This biological drive evolved through our heritage long before we constructed anything close to learned civilisation (where we constructed written language and began to write things down).

In essence, your very body can be food to something, and before we tamed the world, we were yet another meal to something else. In numbers, this risk decreased. With suitable numbers and intelligent use of tools, we became the dominant predator. This led to technology and what we call the modern world. We have a biological need to be with people.

Part of working well in groups is supporting the group itself, as if that were an entity separate to the individuals in that group. The group entity is an amalgam of the wants and needs of the individual members, where the loudest voice is often the goal setter of the group. To work with the group means working in a similar way to the group, which requires us to adjust and adapt to what the group values and defines as “normal for us”, often mistaken for just “normal”.

When an individual works contrary to the group, the members of the group will judge that individual’s actions as “wrong” and often use the emotion (emoted internal feeling) of disgust to indicate to you that you’ve done the wrong thing. We want to correct that, so we feel bad about the error and try something else in the hopes that it is now judged “right”. We receive a small amount of adrenaline when we feel like we’ve done the wrong thing to provide energy support for trying again and doing the right thing. The feeling of “bad” we feel should be proportional to the amount of “wrong” we did, and that wrongness is a psychological driver for us to learn a new way to do things and avoid the old way.

Anxiety is how we describe the feeling of an extra preparedness state we adopt when we are uncertain of the future and have some reason to believe the consequences could be bad (for us or others). This natural feeling is useful in increasing our reaction time, mental flexibility and stamina in the face of disaster. If the feeling is ongoing without an ongoing cause, it can be harmful to us. When we feel anxiety in the absence of good cause, we call this an Anxiety Disorder (General Anxiety Disorder, Anxiety and Anxiety Disorder are interchangeable terms).

Aetiology of Social Anxiety, the cause

Most Anxiety Disorders are due to biological causes. Many are exacerbated by circumstance drivers (events external to yourself), and a rarely solely due to those – usually short term (6-12 weeks) and clear up once the external driver is managed. If your Anxiety has lasted longer than 12 weeks, it is likely due to biology.

The difference between Social Anxiety and General Anxiety is that Social Anxiety is specific to people and what you think people’s opinion about you is, while General Anxiety is ongoing anxiety in the absence of others and your thoughts about their opinion. Like General Anxiety Disorders, It is still fundamentally driven by biological conditions, frequently exacerbated by circumstance, and rarely solely driven by experience aka Trauma. Trauma is rarely the cause of any long term mental health condition, even though it is the most talked about.

There are two fundamental neurological biological drivers for Social Anxiety.

The most common is mis-reports from your Amygdala, the part of your Limbic System of your brain that determines if you are Safe or Not Safe. This is most commonly (around 90%) due to low quantities of or inefficient use of the neurotransmitter Noradrenaline, the secondary neurotransmitter of the Dopaminergic System, or sometimes high levels of Noradrenaline (about 10%). For the first category, SNRI medication like Desvenlafaxine helps, although some find Sertraline (SSRI) works better – often those who seek frequent use of caffeine or nicotine to feel more emotionally stable. For the oversupply issue, where people tend to avoid caffeine and nicotine, Clonidine or Propranolol works well if your blood pressure is okay to high.

If your brain is misreporting your safe environment as “not safe”, you will naturally initially look for danger, and upon not finding it, start to miscalculate what the danger is. The absence of wild predators often leads us to assume the most abundant animal that we interact with is the issue – other humans. In the absence of finding a human to fault, we look to ourselves as the cause of the problem, and that becomes a neurologically self driven self worth attack. Medication can help this. There is a high correlation of Autism and ADHD with Social Anxiety of this kind.

The second most common driver is exhaustion. You have run low on energy for some reason, and your body is trying to compensate by producing additional Adrenaline. This can be due to too much activities being required of you right now, low blood sugar, malnutrition, difficulties with breathing due to a lung issue, heart and blood related issues and or chronic conditions such as Lupus, Chronic Fatigue and Fibromyalgia.

To compensate for low energy, as stated above, our body uses Adrenaline. After the initial reserves have been depleted, our body needs to make more. The high level of blood adrenaline can trigger negative thoughts, and the mental mechanism to require the body to make additional adrenaline is to also have negative thoughts. Similar to the Amygdala problem above, those take the form of trying to find fault around us, in people around us, and finally ourselves.