Social anxiety disorder (SAD), also known as social phobia, is a mental health condition that affects millions of people around the world. According to the National Institute of Mental Health, an estimated 12.1% of U.S. adults experience social anxiety disorder at some time in their lives. While some symptoms of social anxiety are well-recognized, typically you would think of people who avoid going to large parties or avoid speaking up in class or professional settings, there are lesser-known symptoms that can significantly impact individuals' daily lives. In this post, I’ll explore some of these lesser-known symptoms to shed light on the many ways social anxiety can manifest, and significantly impact effected individuals.

One lesser-known symptom of social anxiety is hyperawareness of self. People with social anxiety often become excessively self-conscious in social situations. For some, even a simple trip to the store or a quick stop to order coffee, can trigger hyperawareness, leading to an intense focus on their physical appearance, body language, the sound of their voice, and just about every move they make. This self-consciousness can make them feel like they are constantly being scrutinized and judged by others, resulting in escalating anxiety and sometimes panic attacks. Individuals with social anxiety may describe the sensation as constantly having a spotlight on them when in public.

People with social anxiety may also develop hypervigilance, a state of heightened alertness to potential threats or negative evaluations from others. They may constantly scan their environment for signs of disapproval, criticism, or rejection, which can lead to an overwhelming sense of unease and tension. This hypervigilance further exacerbates their anxiety and can make social interactions extremely distressing, causing the urge to avoid basic activities and increasing the likelihood of isolation.

While it is commonly understood that individuals with social anxiety fear public speaking, a lesser-known symptom is the fear of speaking up in everyday situations. Whether it's expressing opinions, asking questions, or even making small talk, individuals with social anxiety may experience intense anxiety about voicing their thoughts or ideas. The concern is particularly strong when it comes to disagreeing with someone, whether it’s a stranger or a significant person in their life. This fear can hinder their ability to fully participate in conversations, express themselves authentically and enjoy fully reciprocal relationships.

Social anxiety can also manifest as excessive apologizing. Individuals with social anxiety may constantly apologize for their perceived mistakes, inconveniences, or even for taking up space in a social setting. Over-apologizing is typically driven by a deep-seated fear of being a burden or causing discomfort to others, even when there is no concrete evidence to say this is the case.

While avoiding eye contact is a well-known symptom of social anxiety, its impact is very often underestimated. People with social anxiety may find it challenging to maintain eye contact during conversations due to the fear of judgment, embarrassment, or feeling overwhelmed by the intensity of the interaction. This avoidance can make social interactions feel disconnected and may hinder the development of meaningful connections with others, be it personal, romantic, or professional.

A last, lesser-known symptom I’ll address is the difficulty speaking with authority figures, such as teachers, doctors, managers, or police.  Though others may struggle, to an extent, with these situations, for those with social anxiety, the sense of intimidation that leads to avoidance, can interfere with tasks of daily living that others take for granted, such as, asking about school assignments, getting clarification on work projects, or obtaining critical information about their health.

Social anxiety is a much more complex disorder than most people realize. It extends beyond its commonly recognized symptoms, to encompass a multitude of activities and situations involved in everyday living. Without help, those who struggle can become more and more isolated in their quest to avoid challenging and sometimes painful interactions.  With all of that said, social anxiety is extremely responsive to Cognitive Behavioral Therapy (CBT), utilizing exposure hierarchies, a well-trained therapist can help build confidence by starting with small steps, and building over time, challenging catastrophic thinking, and de-escalating physical symptoms of anxiety with research-based techniques.  Helping the public understand that the fear and physical symptoms that accompany social anxiety are real, and recognizing the complicated nature of this disorder will go far to decrease any stigma that surrounds it.