Social anxiety refers to concerns about being judged, rejected, or negatively evaluated in social situations. When these concerns become excessive, we may speak of social anxiety disorder.
But what does this mean? Is it a mental health condition?
Social anxiety disorder (SAD) is considered a mental illness. It disables affected people to engage in everyday activities in which they could be scrutinized by others (work, school, events with family/friends) and it generates severe psychological distress when they are exposed to these situations.
However, there are other psychological paradigms with different opinions on this question. Generally speaking, whether or not social anxiety is considered as a disease depends on 2 basic criteria:
- It depends directly on the psychological approach or theory we use to understand the human being.
- It depends on the intensity of the anxiety. How present are the symptoms and how severe is the person’s distress?
Here, we will first portray and analyze distinct views on the question of whether or not social anxiety is a mental illness. Then, we will see if social anxiety qualifies for disability and, if so, how to apply for it.
The 4 Different Paradigms
The following is a brief summary of the most common psychological approaches that define and address social anxiety disorder.
|Generally speaking, psychology’s concept of social anxiety is based on the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM-V defines social anxiety disorder as an intense fear in the face of social situations that may lead the person to feel embarrassed, humiliated, or judged (DSM-V, 2018).||In psychoanalysis, social anxiety is called social phobia. Social phobia is the displacement of a traumatic relationship to other interpersonal relationships. The displacement occurs because it replicates the emotions of an early traumatic relationship and leads to the desire to avoid those feelings (Freud, 1895).|
|Social anxiety disorder is seen as a mental illness. It leads to severe distress and functional impairment and should be treated. This is the predominant view in the world today.||Social phobia is not seen as a mental illness, but as a psychological makeup resulting mostly from early childhood experiences. It does not need to be eradicated.|
|World Health Organization||Coaching|
|The World Health Organization bases its diagnoses on the International Classification of Diseases manual (ICD), now in its tenth edition. The ICD-10 also uses the term social phobia and diagnoses it as the fear of behaving in a humiliating or embarrassing way, as well as being the center of attention in social settings (ICD-10, 2015).||In coaching, social anxiety is the fear of not performing well in front of others, resulting in negative impressions. It is a physical and emotional discomfort that is triggered by mental barriers. These mental barriers, such as the fear of being judged, can be overcome by seeing the positive side of the experience (Etchebarne, 2017).|
|Social phobia is seen as a mental illness and an inability to control certain emotions in the limbic system, which regulates our behavior. It calls for treatment.||Social anxiety is regarded a mental barrier that we impose on ourselves. It should be seen as an opportunity for personal growth and spiritual improvement.|
As becomes clear, the answer to our initial question depends on the paradigm it is approached from. However, what if we were to find a middle ground between these four opinions?
Trait Anxiety & Its Relationship to Mental Illness
Anxiety can be divided into two subgroups: state anxiety and trait anxiety. While state anxiety refers to the anxiety a person experiences in a specific moment, trait anxiety describes the person’s general propensity to perceive stimuli as threatening and react with anxiety (Schmidt, Shoji Muñoz, 2018).
The latter can help us discern between normality and illness.
For example, feeling sad does not automatically mean you have a depressive disorder. In fact, feeling sad is normal and necessary, and many would say it makes us “feel more alive”. The same is true for social anxiety.
When talking about trait anxiety, we mean that it determines how anxious you are and places you on a scale from 0 to 100.
Being located somewhere in the middle is the norm. The farther we move away from the middle towards the both extremes, the fewer people can be located along the graph.
Keep in mind that both, a lot and very little anxiety, can become problematic. People with very low scores on trait anxiety may fail to worry about their social appearance, make nasty comments, behave rudely and fall out of line. The personal and professional consequences can be detrimental.
To find your position on this scale, it can be helpful to answer the following questions regarding your general fearfulness:
- Does my propensity to react with anxiety affect my daily activities?
- Does it prevent me from performing certain actions?
- Can I control it?
- In addition to the psychological distress, does it cause physical symptoms and discomfort?
- Do I feel like I need professional help?
As the graphic depicts, some level of social anxiety is good and helpful. As we point out in our article Does it Matter What Others Think of You, people who lack it quickly run into trouble.
They may have a hard time getting or keeping a job, they may seem overly rude and can have difficulties making friends or sustaining existing relationships.
However, experiencing too much social anxiety can be detrimental as well. The fearful reaction is triggered by a strong desire to convey a specific impression on others, combined with little confidence in the ability to do so.
Paradoxically, craving to be seen in a specific way decreases your chances of making this happen.
As pointed out above, this view differs depending on the psychological approach. However, all of them agree upon the notion that a person can experience excessive social fears and that they may be reduced if they cause the person to suffer.
Does Social Anxiety Qualify for Disability?
If social anxiety is considered a disease, can it disable me from work or school like a migraine does?
The United States is among the countries that most closely regulate this issue, and the U.S. Social Security Administration is in charge of this regulatory code (U.S. Social Security Administration, n.d.).
In the U.S., social anxiety qualifies for disability when the following conditions are met (Section 12.06):
- You have at least 3 of these symptoms; Restlessness, fatigue, difficulty concentrating, irritability, muscle tension or sleep disturbances.
- At least 2 of these mental abilities are affected; understanding, remembering or applying information, interacting with others, concentrating or keeping pace, adapting or controlling oneself.
If you meet these two conditions, you must submit the following documents for proof of disability:
- Evidence of any treatment or process for the disorder and improvement of mental health.
- Official medical record showing that you have a minimal ability to adapt to changes and to perform your functions on a regular basis.
For other countries, there is no exact information on what process should be followed. Be that as it may, in many people social anxiety generates physical discomfort (nausea, headache, etc.).
You can go to your physician and tell them about the physical pain, which can enable them to assist you with temporary disability.
Possible Disadvantages of Applying for Disability
In the United States, there are certain limitations for a person applying for Social Security Disability Insurance (SSDI) that can be viewed as either an advantage or a disadvantage (Social Security Administration, 2021).
- At the time of submission, you cannot be working in a position that requires the abilities you are filing for.
- When you are hired you may not work for more than 12 consecutive months.
- Receiving disability depends on your work experience and family income.
- Social anxiety can be considered a mental illness. However, there are alternative viewpoints.
- Assess your situation, seek professional help if you feel that you need it.
- Inform yourself about the disability processes in your country and check which conditions you meet and which ones you are not.
- If you are in the United States, remember to verify the 3 minimum symptoms to be submitted and the 2 minimum mental capacities affected to qualify for disability.
If you suffer from social anxiety and are interested in the available therapy options, feel free to see our complete treatment guide.
Administración de la Seguridad Social de Estados Unidos. Evaluación de la discapacidad en la Seguridad Social. Sección 12.06 Trastornos de ansiedad y obsesivos-compulsivos.
Administración de la Seguridad Social. (2021) Trabajar mientras se está incapacitado: Cómo podemos ayudar. Estados Unidos de América.
American Psychiatric Association. (2018). Manual diagnóstico y estadístico de los trastornos mentales (5.a ed.). Madrid, España: Editorial Médica Panamericana.
Etchebarne, I. (2017). Quisiera ser invisible, ¿tengo fobia social?
Freud, S. (1895). Obsesiones y Fobias. O.C. I. Madrid: Biblioteca Nueva, 1981.
Organización Mundial de la Salud. (2015). Clasificación Internacional de Enfermedades (10.a ed.). Washington, Estados Unidos: Oficina regional para las Américas.
Schmidt, V. P., Shoji Muñoz, A. D. (2018). La ansiedad estado-rasgo y el rendimiento académico en adolescentes de 14 a 16 años. Tesis de Licenciatura en Psicopedagogía, Universidad Católica Argentina, Facultad “Teresa de Ávila”, Paraná.
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