Social anxiety disorder
If a person suspects that he / she or a loved one is suffering from social anxiety disorder, it is important to remember that the condition is treatable and call in the help of a professional as soon as possible.


What are the symptoms of a social anxiety disorder?

The following symptoms are indicative, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM – 5), accepted worldwide as the most authoritative source:

Note that an official diagnosis may only be made by a qualified person.
  1. A notable fear or fear of one or more social situations where someone is exposed to possible judgment by other people, for example:
    1. social interaction (meeting new people or having conversations with strangers);
    2. to be observed (eg while eating or drinking); or
    3. to act in front of others (e.g., to deliver a speech).
    4. (In children, this anxiety should happen in peer situations and not just in adult situations.)

  2. The person fears that they will show symptoms of anxiety or reveal certain behaviors that can be negatively assessed (ie they will be humiliated or embarrassed, which will result in rejection or offending).
  3. Social situations will almost always result in fear or anxiety (in children, this fear or anxiety will usually be expressed by crying, "throwing" an anger attack [floor nut], freezing, clinging to someone, recoiling or to be bot still).
  4. Social situations are avoided or endured with intense fear / anxiety.
  5. The fear / anxiety is disproportionate to the real threat posed by the social situation.
  6. The fear, anxiety or avoidance is long-lasting and is present for six months or longer.
  7. The fear, anxiety or avoidance causes considerable discomfort or impairs the person's functioning in different situations, e.g. at work, socially and in other important areas.
  8. The fear, anxiety or avoidance is not due to the effect of a drug (drug or medication) or some other medical condition.
  9. The fear, anxiety or avoidance is not better explained by another psychological condition, e.g. panic disorder, autism spectrum disorder (OSV) or something else.
  10. If another medical condition is present (eg Parkinson's disease, obesity, etc.), the fear, anxiety or avoidance is excessive but unrelated.
Did you know?
We specify someone's social anxiety as "action only" when it is limited to situations where the person has to speak or act in public.
It is predominantly limited to people who have to act in public as part of their profession, e.g.
  1. musicians
  2. dancers
  3. athletes
  4. people who need to talk in public on a regular basis
These symptoms can also occur in academic situations. People with anxiety who are "only action related" do NOT fear other social situations.
Two-thirds of people with social anxiety disorder experience a different psychiatric condition at the same time (we are talking about comorbidity, ie disorders that occur together).
Disorders that are frequently associated with social phobia are:
  1. agoraphobia
  2. alcohol abuse or addiction
  3. depression
  4. other addictions, e.g. to drugs or medication
  5. eating disorders


Situations that can trigger symptoms

Below are some triggers. There may be many more, but these are the common ones:

  1. to be introduced to new / strange people
  2. eye contact
  3. to be mocked or criticized
  4. to be the center of interest
  5. to be watched while doing something, e.g. make calls, write, eat, etc.
  6. to have to say something in public
  7. to meet people in positions of authority
  8. to feel uncomfortable or insecure in social situations
Did you know?
MYTH: People with social anxiety disorder / social phobia are always shy.
FACT: People with social anxiety disorder are NOT always shy people. They can often be very comfortable between people, but their anxiety is accelerated in specific situations.
Social anxiety disorder or social phobia is the third biggest mental health problem in the world.


Treatment of social anxiety disorder

Why is treatment necessary for social anxiety disorder?
Just as with a specific phobia, social anxiety disorder / social phobia is a more severe degree of anxiety. In some cases, there is even an inability of the person to walk out of his / her front door without fear or have contact with other people. In addition to the negative impact that a social anxiety disorder has on someone's functioning, it can also lead to, or be related to, other disorders such as eating disorders or addiction to alcohol, medication or drugs.

Good news!
Social anxiety disorder responds very well to treatment, provided that the client remains motivated to work on this.

Family problems, a lack of personal relationships and difficulties in finding and retaining work, are problems that are also associated with social anxiety disorder.

Help and support from a registered psychologist is extremely important to treat this disorder. Psychotherapy is also often used in combination with medication to treat a phobia.

How is social anxiety disorder treated?
As with most psychological problems, it is usually necessary to seek help from a professional. The following are the most common:

  1. Medical research
    A thorough evaluation by a medical doctor can be a valuable first step in making sure that there are no medical triggers for the anxiety. If not, the next step is to investigate the psychological nature of the anxiety.
  2. Psychotherapy
    A registered psychologist with experience in the treatment of disorders in this field can draw up a treatment plan with you to discuss the psychological approach that can be followed, as well as the other professionals to be involved.
  3. Support groups
    A support group can be invaluable to someone suffering from social anxiety disorder. Within the group, people share their “stories” and challenges and learn from each other's skills and experiences. However, finding a support group in one's environment is not always easy. Online searches sometimes produce good results. More information can be found on the SADAG website found.
  4. Medication
    Medication is often needed and for this the psychologist can refer you to a psychiatrist who will do a full assessment and consider and prescribe appropriate medication if needed. If someone is at all sensitive to addiction (in other words, can easily become addicted to something), it is of cardinal importance to inform the psychiatrist, medical practitioner, psychologist and all others involved.
  5. Lifestyle
    As a basis for working on social anxiety disorder, it is always necessary to make healthy lifestyle choices that promote mental health, e.g. regular exercise, healthy sleeping habits, balanced eating, and time to think and relax. Rest and routine promote mental health.


How do I support someone with a social anxiety disorder?

It is important to remember that the person does not actively choose to be anxious. He / she usually knows that the anxiety / fear does not make rational sense. It doesn't help to mock them or argue with them about it. The best thing one can do is encourage the person to get professional help, especially if it hinders their functioning. The therapeutic process may be difficult and exhausting for them. This is precisely when encouragement and support will be very valuable.



Do not give up if you do not quickly see an improvement in your symptoms. Change requires time, especially when working at a deeper level. It may also take some time to work out the right medication and dosage for you. Stay in touch with your treatment team and keep track of your appointments consistently. It can also help set goals for yourself to attend certain social situations where you may be challenged or exposed.

Relevant articles

  • Anxiety disorders

    Anxiety disorders

    However, if the body "exaggerates" this anxiety (if there is not really a logical reason for the feeling of anxiety) or if it occurs more frequently than ...


If you or a loved one is struggling with mental health issues, we suggest the following options:
  1. call your GP (if available);
  2. go to your nearest hospital emergency room;
  3. call one of the following emergency numbers: SADAG (the South African Depression and Anxiety Group) 24-hour helpline: 0800 456 789 or suicide crisis line: 0800 567 567; or
  4. contact Wie is ek?