Test Your Knowledge

The exact cause of social anxiety disorder is unknown. Feelings of inferiority and low self-esteem appear to be at the root of social anxiety disorder. Patients with the disorder tend to believe that showing anxiety is a sign of weakness, and they believe that other people are more confident or competent than they really are.

The disorder may have a genetic component and runs in families. Researchers also believe that biochemical factors may influence development of anxiety disorders. A neurotransmitter called serotonin helps regulate mood and emotions, and it is believed that an imbalance may help cause social anxiety disorder in patients who are more sensitive to serotonin’s effects.

The composition of the brain may also be partly responsible for social anxiety disorder. A structure deep in the brain called the amygdala appears to be responsible for controlling the fear response. People with an overactive amygdala may have heightened anxiety in circumstances where it does not seem reasonable.

Certain factors may increase the risk of developing social anxiety disorder. These include:

• Environment. Some experts believe that aspects of social anxiety disorder may be based in learned behaviors that result from watching how others with the disorder react in social situations.
  
  
• Genetics. Research indicates there may be a genetic component to social anxiety disorder.
  
  
• Age. Social anxiety disorder usually begins in childhood or early adolescence, commonly around age 13, and seldom develops after age 25.
  
  

• History of mental illness. Individuals with other mental health conditions, including depression or other anxiety disorders, are more likely to have social anxiety disorder.
  
  

• Negative experiences. Children may develop social anxiety disorder after they have been teased, bullied, rejected, ridiculed or humiliated. Family conflict and sexual abuse are also sources of psychological trauma that may lead to social anxiety disorder.
  
  

• Temperament. Children who are shy or withdrawn in new situations or when meeting new people may be at increased risk for social anxiety disorder.
  
  

• Substance abuse. People with substance abuse problems (e.g., drugs, alcohol) have social anxiety disorder more than the general population. However, it is uncertain if substance abuse is a risk factor for the disorder or a result of it. However, if the symptoms of social anxiety disorder are believed to be related to substance abuse, social anxiety would not be diagnosed.
  

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