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Social Anxiety Disorder: Causes, Symptoms, and Evidence‑Based Coping Strategies
Social anxiety disorder (social phobia) is a persistent, intense fear of being judged, scrutinized, or humiliated in social situations. It causes significant distress and functional impairment.
Contributing Factors
- Genetic/Biological: Heritable temperament traits; amygdala hyper‑reactivity.
- Negative Experiences: Bullying, rejection, public embarrassment.
- Temperament: Behavioral inhibition, shyness in childhood.
- Cognitive Factors: Negative self‑beliefs, fear of negative evaluation, catastrophizing.
Core Symptoms
- Intense anxiety in social/performance situations
- Avoidance of social interactions
- Physical symptoms: blushing, sweating, trembling, nausea, palpitations
- Anticipatory anxiety days/weeks before events
Effective Treatments
- Cognitive Behavioral Therapy (CBT): Gold standard; includes exposure, cognitive restructuring, social skills training.
- Medication: SSRIs (first‑line), SNRIs, beta‑blockers for performance anxiety.
- Self‑Help: Gradual exposure, mindfulness, challenging negative thoughts.
Social anxiety is a treatable medical condition—not a character flaw. Early professional intervention improves outcomes.
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