Social Anxiety Disorder / Social Phobia
Some people have a very hard time in social situations because they fear them to the point where they can be diagnosed with Social Anxiety Disorder, also known as Social Phobia. You could think of Social Phobia as more typical shyness turned up to 11. The big difference is that the anxiety becomes a lot more prominent. If a run of the mill shy person went to a party they may not talk much, and they may report feeling inhibited, tongue-tied, and insecure, but they often aren't outstandingly nervous.
A socially anxious person may go to a party and be a shaky, frightened, nauseous mess for the first half of it. Also, when someone is shy they may worry about being seen as quiet or boring. Someone with Social Anxiety Disorder may worry about that too, but also about coming across as obviously anxious and uncomfortable, which they believe will lead to them being rejected and embarrassed. Because it's more severe, Social Anxiety Disorder also has much more of a negative effect on people's lives. Someone who is a little shy may not contribute much to a group conversation. A person with a bad case of Social Phobia may feel too nervous around people to be able to hold down a job.
Criteria for Social Anxiety Disorder / Social Phobia
Below are two sets of criteria for diagnosing someone with Social Anxiety Disorder. The descriptions below come from two sources, the Diagnostic and Statistical Manual, 5th Edition (DSM-5), and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). The DSM-5 is published by the American Psychiatric Association. The ICD-10 is based on classifications from the World Health Organization.
If you actually have Social Phobia you probably already know all about it. If not, this may be interesting reading. I'd caution anyone not to try to diagnose themselves or anyone else just based on some descriptions. A qualified professional has to make that call. Also, lots of people can read the criteria for various mental health issues and see little pieces of themselves in them, but that's usually a far cry from being officially diagnosable.
DSM-5 Criteria For Social Anxiety Disorder:
A. Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions (e.g., having a conversation, meeting unfamiliar people), being observed (e.g., eating or drinking), and performing in front of others (e.g, giving a speech).Note: In children, the anxiety must occur in peer settings and not just during interactions with adults.
B. The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (i.e., will be humiliating and embarrassing; will lead to rejection or offend others).
C. The social situations almost always provoke fear or anxiety. Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situation's. The social situations are avoided or endured with intense fear or anxiety.
E. The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural contexts. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
G. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning's. The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
I. The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or autism spectrum disorder.
J. If another medical condition (e.g., Parkinson's disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive.
Specify if: Performance only: If the fear is restricted to speaking or performing in public.
ICD-10 Criteria for Social Phobia:
Social phobias often start in adolescence and are centered around a fear of scrutiny by other people in comparatively small groups (as opposed to crowds), leading to avoidance of social situations. Unlike most other phobias, social phobias are equally common in men and women. They may be discrete (i.e. restricted to eating in public, to public speaking, or to encounters with the opposite sex) or diffuse, involving almost all social situations outside the family circle.
A fear of vomiting in public may be important. Direct eye-to-eye confrontation may be particularly stressful in some cultures. Social phobias are usually associated with low self-esteem and fear of criticism. They may present as a complaint of flushing, hand tremor, nausea, or urgency of micturition, the individual sometimes being convinced that one of these secondary manifestations of anxiety is the primary problem; symptoms may progress to panic attacks.
Avoidance is often marked, and in extreme cases may result in almost complete social isolation. Diagnostics of the following criteria should be fulfilled for a definite diagnosis:
(a) the psychological, behavioral, or autonomic symptoms must be primarily manifestations of anxiety and not secondary to other symptoms such as delusions or obsessional thoughts;
(b) the anxiety must be restricted to or predominate in particular social situations; and
(c) avoidance of the phobic situations must be a prominent feature. Includes: anthropophobia social neurosis Differential Diagnosis Agoraphobia and depressive disorders are often prominent, and may both contribute to sufferers becoming "housebound". If the distinction between social phobia and agoraphobia is very difficult, precedence should be given to agoraphobia; a depressive diagnosis should not be made unless a full depressive syndrome can be identified clearly.
Social Skills Training:
Like with shyness, some people with social anxiety have decent interpersonal skills. Their anxiety gets in the way and prevents them from deploying those skills effectively. Other people with social anxiety have rusty or underdeveloped communication skills. That they know they're awkward around people may contribute to their nervousness. Improving their people skills can help them feel more confident and capable in social situations.
The odd social deficit can be corrected simply by reading about a better way to act, but most of the time real world practice is needed. Again, someone with social anxiety should be educated on how to handle their maladaptive thought processes and beliefs about socializing. They should also have an idea of how to manage any nervousness that comes up. If they don't have this foundation then throwing themselves into the social world to try and learn new skills may do more harm than good.