An estimated 15 million adults live with social anxiety disorder, or an extreme fear of social situations, according to the Anxiety and Depression Association of America. Even with so many people affected, plenty still minimize the disorder, misinterpreting symptoms as personality traits or completely failing to recognize it as something millions live with every day.
Here are just seven facts about what it's really like to live with social anxiety.
Social anxiety is not a personality trait.
"I think a lot of people associate social anxiety with shyness or being antisocial, when it is actually a fear of judgment or criticism in social situations," Samantha Stone, a 24-year-old woman who lives with social anxiety disorder, explained to Mic.
Yet far too many interpret this fear as a personality trait, like shyness.
"People with social phobia are usually shy as children, but not all shy people have social phobia," clinical psychologist Sheela Raja told Mic. "Many shy kids go on to be quieter adults," she said, noting that shy individuals still lead average social lives. Those living with social anxiety disorder, she said, feel prohibited from socializing in this way and the distinction between the two, she concluded, "is really when people are avoiding situations to the point that it's interfering with their life."
This disorder is also not caused by, nor necessarily has any bearing on, individuals' desire to socialize. As the Social Anxiety Institute explains, many people who live with social anxiety "do not define themselves as being shy" and in fact want to socialize, but feel prevented from doing so because they feel "smothered and trapped in anxiety thoughts, feelings and habits" when they attempt to.
Stone confirmed this experience. "I am not a shy person by any stretch of the imagination and do not avoid social situations," she said. But even so, when in certain situations, she still experiences a "mental reaction, a deep fear of judgment or criticism from my peers or colleagues."
It's not a personal reaction to specific people.
Raja said one of the biggest misconceptions about individuals with social anxiety is "they're stuck-up or they don't want to be friendly, they're not nice — that type of stuff — when really the person is going through a lot internally."
"Because social cues and verbal communication are so important in forming new friendships, my anxiety often makes me come off as being cold, disinterested, and even mean," Alana Saltz wrote on the Huffington Post. "Over the years, I have had so many people tell me that they thought I hated them when we first met. People have said that I can come off as being cold and not interested in them."
Saltz said she's "usually interested in the conversations I'm having, and I very rarely dislike someone. Once I'm comfortable, I might even share too much. But getting to that place can be challenging. ... So, if you ever notice someone being quiet, shy, awkward or reserved, don't automatically assume that they're self-centered, mean or dislike you. It's entirely possible that they're really just nervous or struggle with social anxiety."
It's not directly caused by events themselves.
Specific social situations like giving a presentation in class or going on a date don't necessarily cause their reactions. Rather, social anxiety disorder involves a debilitating interpretation of events.
This is known as "interpretation bias" — or, as one study defines it, "the tendency to interpret ambiguous situations in a positive or negative fashion" — which multiple studies have found is a crucial element of experiencing social anxiety.
"It's not a situation that makes you anxious, but how you interpret that situation," Peter Shalek, the founder of Joyable, an online mental health startup, told the Atlantic in May. "Being on the phone is not anxiety-inducing, but how you interpret it is."
It's not just an emotional or psychological experience.
Just like other forms of anxiety disorders, social anxiety manifests not just emotionally or psychologically, but physically as well. People with social anxiety may feel "like their heart is racing, maybe their chest feels really tight" Raja said, adding that these symptoms can even feel like a panic attack.
Stone said that in addition to a "mental reaction, a deep fear of judgment or criticism from my peers or colleagues," she also experiences physical side effects, like an irregular heartbeat and shaking.
Their experiences may be different based on gender.
Anxiety overall is a gendered experience: In fact, 23% of women suffer from "any anxiety disorder," compared to 14% of men. But one 2012 study found that not only do more women experience social anxiety, they experience it differently than their male counterparts. Specifically, women in the study experienced more "internalizing disorders" whereas men experience more "externalizing disorders."
"Women who have social anxiety disorder tend to be more depressed, and social anxiety takes a toll on their whole life, in terms of all of their social interactions, whereas for men it tended to be a little more specific to dating ... and they tend to deal with it with alcohol and drug use," Raja explained of the findings.
Additionally, shifting societal gender roles can produce unique forms of social anxiety. "If men used to experience social anxiety around whether they were perceived as strong and tough enough, women might now experience those fears as well if they are competing for 'alpha female' status," Chloe Carmichael, the creator of AnxietyTools.com, told Mic. "Similarly, if women used to experience social anxiety around whether they were perceived as gentle and friendly, men might now be hyper vigilant around a fear of having 'said the wrong thing' or having been overassertive, other social concerns that might typically have been more feminine."
Its effects extend beyond socializing.
While they may feel the most immediate effects of the disorder in social interactions, these effects can even extend to one's professional success.
"It can really impact people workwise," Raja said. "Regardless of whether or not you have a job in the public sphere, most of us do need to — at least within a smaller group of people – get up and state what your opinion is."
The tendency of those with social anxiety to "continually critique themselves to the point where they feel like they shouldn't say anything at all, because it might not be the right thing, because they have such a fear of humiliating or embarrassing themselves," Raja said, can hold people back from achieving their full potential.
Plenty are actively fighting for a better life.
Many individuals with social anxiety are actively working to overcome these obstacles. The key, Raja said, is not to avoid situations that may spark these behaviors — but to use treatments like cognitive behavioral therapy to tackle them head on.
"Anxiety has a natural flow," she said. "The body kind of revs up but at the same time it will naturally calm down. So part of cognitive behavioral therapy is building up a hierarchy of situations the person is avoiding, then learning some relaxation skills and then slowly helping them face their fears."
It's also crucial to remember that a certain amount of social anxiety is normal and even beneficial. "Healthy social anxiety helps us stay attuned to how others are feeling and even how group dynamics are forming — and this is actually helpful to a degree," Carmichael said. "If you start dropping out of social activities or can't seem to find anyone with whom you can just be yourself, that's when you know it's time to get some support and learn new skills."