Northeast Wisconsin
  • Northeast Wisconsin
  • January 2014
Written by  Lisa Klarner

Understanding social anxiety disorder

Imagine walking through a department store when suddenly your heart begins to race, your palms sweat and you find it difficult to breathe. For someone with social anxiety disorder, an everyday situation like shopping in public can cause as much anxiety as someone else may feel when giving an impromptu speech in front of a large group.

Defining social anxiety

A person with social anxiety disorder (SAD) fears embarrassment. They feel like people are watching or judging them. They are trapped in their mind, spending most of their time dwelling on the past or worrying about the future. The SAD sufferer knows the thoughts are irrational, but is unable to stop the thoughts from controlling their mind and body.

A person with SAD believes that their symptoms are very obvious to everyone. Reliving experiences over and over, dreading the thought that the people the sufferer interacted with are surely discussing the unexplained embarrassment they observed.


According to the Social Anxiety Institute, SAD is the third most prevalent mental disorder, following depression and alcoholism. It is estimated that 7 percent of the United States population has the disorder, but it is difficult to get an accurate number because many people don’t seek treatment. SAD is often confused with extreme shyness and, once a person has an inkling that they may have SAD, they could wait up to 10 years before seeking treatment. Asking for help is difficult because of the fear of judgment and criticism — even when it comes to close friends and family members.


The symptoms that a person with SAD may experience vary in type and intensity. Typically, there are one or two symptoms that are more problematic to a person than others. A few of the physical, cognitive and behavioral symptoms are listed below. The behavioral reactions may be the best way to identify SAD in someone you know.


  • Trembling
  • Blushing
  • Sweating
  • Twitching
  • Shaky voice
  • Disorientation
  • Shortness of breath


  • Low self-esteem
  • Negative thoughts about self
  • Unrealistic demands of self
  • Thoughts of inadequacy
  • Self-consciousness


  • Avoidance of eye contact
  • Fear of eating in public
  • Declining to speak up in group settings
  • Difficulties making friends and dating
  • Avoidance of feared social situations


Perhaps you can relate to some of these symptoms and wonder if you may have SAD. If you worry about what people think of you or if you get nervous when you go somewhere new, this doesn’t necessarily mean you have SAD. There are three main categories that mental health professionals may consider when evaluating someone who might have SAD. Does the person:

Experience significant and persistent fear of social situations?

Almost always experience anxiety symptoms in feared situations?

Avoid feared situations or endure them only with intense anxiety or distress?

The key words within these criteria are “significant,” “almost always” and “intense anxiety.” The primary differentiator between a person who has SAD versus someone who doesn’t is the impact that the fears have on their ability to live a full life. The ever-growing volume of negative thoughts gain more power, the intensity of symptoms increase and the person becomes more likely to avoid uncomfortable social situations.

Mental health professionals can help to determine if you, a family member or a friend have SAD. There are also some great tools online that you can use to self-diagnose prior to seeking counseling. As an example, with the Leibowitz Social Anxiety Scale, users look at a series of common anxiety-producing situations and select their level of fear and avoidance to obtain a preliminary SAD diagnosis.

SAD is treatable!

If you or a loved one have SAD, please know that it is treatable! There are many tools and therapies available to help those with SAD to greatly reduce symptoms and to live more fulfilling lives. There is hope!

This article is part of a continuing series. Read more about SAD in the March issue of Nature’s Pathways.

Lisa Klarner is a speaker and consultant, and is the author of “Releasing the Secret Pain: Moving Beyond Social Anxiety Disorder.” She is an expert in social anxiety disorder (SAD) because she’s been there — she struggled with SAD for many years. Lisa is the owner of Peaceful Horizons, which is dedicated to helping people understand and move beyond SAD. She uses her own experiences and her passion for educating people on the disorder to deliver powerful presentations and workshops. For more information, check out Lisa’s website, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 920-475-5252.

Reference: “The Leibowitz Social Anxiety Scale Test.”


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