Charles Langston:What is social anxiety? It's common but it doesn't have to be debilitating.

When we first meet Anxiety,Charles Langston the latest emotion helping a 13-year-old girl named Riley in Disney's summer blockbuster "Inside Out 2," the character introduces herself by saying that Fear - another emotion we meet in the first "Insider Out"film - protects Riley "from the scary stuff she can see," while her job "is to protect her from the scary stuff she can't see."  

It's a fitting way to describe how many people with anxiety feel about the uneasy concern they experience over something unknown that's coming up. Though people experience anxiety in different ways and in many different situations, social anxiety is among the most common, with nearly 15 million U.S. adults diagnosed with the condition last year alone.

"While all fears and anxieties have underlying causes that can be addressed therapeutically," notes Juanita Guerra, PhD, a clinical psychologist in New Rochelle, New York, "left untreated, any form anxiety can become debilitating, be it generalized anxiety disorder or social anxiety disorder." 

What is social anxiety? 

Social anxiety is defined in the Diagnostic and Statistical Manual of Mental Disorders as a persistent intense fear or concern about being in specific social situations because one believes they will be mercilessly judged, embarrassed or humiliated. "This leads to an avoidance of anxiety-producing social situations or to enduring them with intense fear and anxiety," says Guerra. Social anxiety often also brings with it a fear of rejection, causing many people to avoid putting themselves in any circumstances where they will be evaluated by another person. 

Guerra says that everyone experiences some degree of anxiety or uneasiness in social situations but that when social anxiety begins to interfere with one’s ability to function and meet demands of daily living such as with work, school, and relationships, "it can become pathological in nature and the affected individual should consider accessing mental health services." 

Indeed, left untreated, "social anxiety disorder can increase the risk for other mental health issues such as depression and substance use disorder," cautions Dr. Elizabeth Hoge, a psychiatrist and director of the Anxiety Disorders Research Program at Georgetown University. 

It's also worth noting that social anxiety disorder differs from generalized anxiety disorder "since it is ignited by anticipation or preparation associated with being with other people," explains Joanne Broder, PhD, a media psychologist and fellow of the American Psychological Association. This is one of the reasons social anxiety is so common. "Many other forms of anxiety are more specific to other fears such as fires, heights, taking tests, snakes, public speaking," she says, "which could all be more avoidable than being in social situations." 

What causes social anxiety? 

Though no single thing causes social anxiety, Broder says it may stem from past trauma or a negative experience regarding rejection, embarrassment, bullying, humiliation, or ridicule. She says it can also occur when someone gets out of practice of being around others or when someone finds themself in a new school or work setting "and simply doesn't know what to do, how to act, what to wear, etc."

More extreme ends of social anxiety such as social anxiety disorder may be related to genetic or environmental factors. "People with a family history of anxiety disorders are more likely to develop social anxiety," says Guerra.

It can also be related to growing up amid excessive family conflict or harsh discipline, learned through a parent dealing with social anxiety, or be the result of frequent poor childhood interactions "that could have negatively impacted a child’s confidence over the long run, leading to the development of social anxiety."

How to resolve social anxiety 

Resolving more mild forms of social anxiety starts with preparing for unknown situations before they occur by learning what's likely to transpire and even by role playing with other people, says Broder. She also recommends learning and repeating mantras for self-encouragement when feeling stuck and recognizing that "you are most likely not the only person in the room feeling socially anxious."  

Guerra says that exposure therapy such as regularly practicing being in social situations is the best way to feel more comfortable with it. "Once you do it and realize that it did not kill you or result in something disastrous, you will be able to see that the fear in your head was much worse than the actual reality," she says. 

In more serious cases such as an individual suspecting they have social anxiety disorder, "he or she should speak to their doctor, who can provide referrals for treatment," says Hoge. Effective treatments include talk therapy, cognitive behavioral therapy, and medication. 

"However you choose to deal with your social anxiety, be patient with yourself," suggests Guerra. "Progress can be slow but never underestimate the power of taking baby steps."