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Have you ever felt tremendous panic and fear about going to a social function or interacting with people? You might have something called social anxiety disorder.
Social anxiety disorder is the third most common mental health condition after substance abuse disorder and depression. It’s also the most common type of anxiety disorder (Rose, 2021).
If you have experienced troublesome anxiety symptoms when you’re around other people, you might be wondering if there is a social anxiety test to see if you, too, have this disorder.
While there is no one test you can take for social anxiety, there are screening assessments your healthcare provider can use. If your symptoms of social phobia are bothersome, there are treatments that can help.
What is social anxiety disorder?
Social anxiety (also called social phobia) is the fear of being judged negatively in social situations. While everyone experiences this occasionally, a person with social anxiety disorder (SAD) feels this way with almost all social interactions (Rose, 2021).
SAD causes people to suffer intense fear in front of others and to avoid social events when possible. When a person with social anxiety can’t avoid socializing, they might endure it with extreme anxiety. These experiences can cause people with social anxiety disorder to have problems in their personal and work lives (Rose, 2021).
Researchers have found that 8.4–15% of people worldwide will experience social anxiety disorder at some point in their lives. SAD affects children, teenagers, and adults equally. It is more common in women than in men (Rose, 2021).
We don’t know precisely what causes social anxiety disorder. Having someone else in your family with SAD might be a factor, but so far, scientists haven’t found specific genetic markers for this disorder. Environmental factors such as trauma and chronic stress likely have a significant influence. There is also some evidence that people with SAD have changes in their amygdala, the area in the brain that controls fear (Rose, 2021).
Social anxiety disorder: signs, causes, how to overcome
Is there a social anxiety test?
There is no single social anxiety test, but there are some other assessments your healthcare provider may use to diagnose you.
Physical screening tests
Before diagnosing you with any mental health condition, including social anxiety, your healthcare provider will likely ask about your medical and family history, anxiety symptoms, and when they started. Some other health conditions can cause anxiety, so your healthcare provider might want to rule these out. Some tests that your provider might order are (Chand, 2021):
- Complete blood cell count (CBC)
- Thyroid function tests
- Urine drug screen
Mental health screening tools
Once they’ve ruled out other medical causes, your healthcare provider or a mental healthcare professional might administer one of several scientifically validated questionnaires to screen for social anxiety disorder. These social anxiety tests can’t diagnose SAD independently, but they can help clinicians gather the information they need to make a diagnosis (Johnson, 2019).
They might use one of the following frequently used screening tools for social phobia (Johnson, 2019):
- The 7-item Generalized Anxiety Disorders Scale (GAD-7) (also used for social anxiety)
- Social Phobia Inventory (SPIN)
- Liebowitz Social Anxiety Scale (LSAS)
The person administering the test will ask you to rate various symptoms you might be experiencing. They will also watch how you behave during the screening. Some people with social anxiety often speak quietly and avoid direct eye contact (Rose, 2021).
Anxiety: signs, symptoms, and solutions
The exact questions asked will depend on the screening test being used, but most likely will include questions about how strongly you feel the following in social settings (Johnson, 2019):
- Nervous, anxious, or on edge
- Unable to stop or control worrying
- As if you worry too much
- Like you have trouble relaxing
- As if you become annoyed or irritated easily
- Afraid something awful might happen
Your provider might also ask you about how much you fear negative evaluation, experience distress due to the physical symptoms of anxiety, and fear uncertainty when in social situations (Rose, 2021).
What are the common symptoms of social anxiety?
The symptoms of anxiety that you might experience are unique to you, but researchers have uncovered that symptoms often share similar themes. If you have anxiety, you may experience some of these symptoms (Chand, 2020).
- Fear of losing control
- Fear of physical injury or death
- Fear of “going crazy”
- Fear of negative evaluation by others
- Frightening thoughts, mental images, or memories
- Perception of unreality or detachment
- Poor concentration
- Confusion or being overly distractible
- Narrowing of attention
- Hypervigilance about threats
- Poor memory
- Difficulty speaking
- Increased heart rate or heart palpitations
- Shortness of breath
- Rapid breathing
- Chest pain or pressure
- Choking sensation
- Dizzy, light-headed
- Sweaty, hot flashes, chills
- Nausea, upset stomach, diarrhea
- Trembling, shaking
- Tingling or numbness in arms and legs
- Weakness, unsteadiness, feeling faint
- Tense muscles, rigidity
- Dry mouth
Anxiety chest pain: is it just in your head?
- Avoidance of situations or other cues that trigger anxiety
- Urge to escape or take flight
- Pursuit of safety, reassurance
- Restlessness, agitation, pacing
Affective (mood) symptoms
- Nervous, tense, wound up
- Frightened, fearful, terrified
- Edgy, jumpy, jittery
- Impatient, frustrated
What triggers these symptoms?
In social anxiety disorder, these anxiety symptoms are triggered when you feel like you are the center of attention or being criticized. You might have a persistent fear of feeling clumsy, embarrassing yourself, or being judged negatively. Some situations that commonly cause feelings of social anxiety include (Bandelow, 2017):
- Public speaking
- Interacting with authority figures
- Speaking with superiors on the job
- Talking with persons of the gender you are attracted to
What are the treatment options for social anxiety?
Untreated social anxiety can severely affect your quality of life. Fortunately, there are several scientifically-backed ways to treat social anxiety disorder.
Cognitive-behavioral therapy (CBT)
CBT is a type of talk therapy used to uncover and change the thoughts, feelings, and behaviors that are causing you distress. Cognitive techniques are routinely used and have been found to be effective for treating SAD (Kaczkurkin, 2015).
One theory about social anxiety is that it comes from (Kaczkurkin, 2015):
- Having negative perceptions about yourself
- Overestimating the cost of a social mishap
- Perceiving that you have little control over your emotional responses
- Believing that your social skills are inadequate
Cognitive-behavioral techniques can help you replace these unhelpful beliefs with ones that make you feel more calm and confident (Kaczkurkin, 2015).
What is behavioral therapy and who is it for?
Several medications can help manage the symptoms of social anxiety disorder. These can be used alone or in combination with cognitive-behavioral therapy (Rose, 2021).
Some classes of medication that are used to treat social phobia include (Rose, 2021):
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Studies comparing medications and talk therapy trials suggest that medication has faster effects, but CBT has longer-lasting results (Rose, 2021). For some people, a combination of both medicine and psychotherapy will be most effective.
When should you get help for social anxiety?
You should contact a healthcare provider or a mental health professional if your symptoms of social anxiety disorder are beginning to interfere in your daily life, work, or relationships. SAD can be debilitating if left untreated, but your healthcare providers can help you access effective treatments.
- Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19(2), 93–107. doi: 10.31887/DCNS.2017.19.2/bbandelow. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573566/
- Chand SP, Marwaha R. (2021). Anxiety. [Updated 2021 May 1]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470361/
- Johnson, S. U., Ulvenes, P. G., Øktedalen, T., & Hoffart, A. (2019). Psychometric properties of the General Anxiety Disorder 7-Item (GAD-7) scale in a heterogeneous psychiatric sample. Frontiers in Psychology, 10, 1713. doi: 10.3389/fpsyg.2019.01713. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691128/
- Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in Clinical Neuroscience, 17(3), 337–346. doi: 10.31887/DCNS.2015.17.3/akaczkurkin. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610618/
- Rose GM, Tadi P. (2021). Social anxiety disorder. [Updated 2021 Jul 7]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK555890/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.