Do You Really Suffer From Social Anxiety Disorder or is it Something Else?
Social anxiety symptoms and even diagnostic criteria often overlap significantly with those of other psychological disorders. Therefore, it can be quite confusing to figure out and determine which diagnosis is indicated. Furthermore, social anxiety often comes along with additional psychological conditions, such as major depression or substance use disorder, which may complicate things even further. In this section, we will compare SAD to psychological disorders that might be confused with it.
Given the similarity between social anxiety and other psychological disorders, it helps to look at the circumstances that trigger the anxiety as well as the specific content of the individual’s concerns. The following conditions are most commonly confused with SAD.
Social Anxiety or Depression?
Depressive disorders often come along with social retreat and are sometimes accompanied by fears related to social situations (Stangier, Heidenreich, & Peitz, 2009). It has been suggested that in these cases social anxiety disorder should only be diagnosed if its symptoms had been present before the beginning of the depressive episode or persist after it it has ended. Depression and social anxiety often co-occur, meaning that a person qualifies for both diagnoses at the same time.
Social Anxiety or Panic Disorder?
Since many people with social anxiety experience panic-like symptoms in social situations, SAD and panic disorder get confused quite often. In order to differentiate between the two conditions, the main concern of the individual during a panic attack is observed.
People with social phobia are mainly concerned with being rejected, negatively evaluated or humiliated by others, while people with panic disorder usually fear physical harm, such as a heart attack, or losing control over themselves in general (Stangier, Heidenreich, & Peitz, 2009).
Social Anxiety or Agoraphobia?
While both, socially anxious people and individuals with agoraphobia, tend to avoid places with many people (Schneider & Margraf, 1998, p. 11), their main reason for it differs as well. Agoraphobia is related to fears of helplessness, social anxiety to humiliation and embarassment (Stangier, Heidenreich, & Peitz, 2009).
Social Anxiety or Generalized Anxiety Disorder?
As might be suspected, the fears of generalized anxiety disorder not only relate to the social realm, but also to other areas, such as one’s finances and health, for example (Stangier, Heidenreich, & Peitz, 2009).
When the fears mainly circulate around social situations, physical symptoms can help to determine the diagnosis. While headaches, insomnia and mortal agony are more typical for generalized anxiety disorder, excessive sweating, blushing and difficulties breathing rather correspond to SAD (Reich, Noyes, & Yates, 1988).
Social Anxiety or Obsessive Compulsive Disorder?
The rituals of people suffering from obsessive compulsive disorder can sometimes be confused with social anxiety symptoms (Stangier, Heidenreich, & Peitz, 2009). However, the motivation for engaging in these behaviors differs from the motives that drive socially anxious people. Obsessive compulsive disorder is often also accompanied by shame and social retreat, which can complicate the diagnosis even further. Again, the driving forces for these behaviors need to be examined in order to draw conclusions regarding the right diagnosis.
Social Anxiety or Body Dysmorphic Disorder?
People suffering from body dysmorphic disorder are convinced to be physically ugly and tend to describe themselves as hideous. This constitutes their main motivation to avoid social situations (Stangier, Heidenreich, & Peitz, 2009). Socially anxious people may also be concerned about being negatively evaluated due to their looks. However, there is usually a whole range of other factors they consider to be possible reasons others might reject or humiliate them for.
Social Anxiety or Psychotic Disorder?
In the course of a psychotic disorder it often comes to social retreat, which in few cases can be of a fearful nature (Stangier, Heidenreich, & Peitz, 2009). Notwithstanding, individuals with psychotic symptoms can experience a lack of clarity in situations with many people present, which qualifies as their main motivation to avoid such settings.
Physical Causes of Social Anxiety
Psychological disorders can be the result of physical ailments. This also accounts for anxiety related disorders and symptoms. Therefore, it is important to check for potential physical causes of the anxiety in order to address the right problem (Stangier, Heidenreich, & Peitz, 2009). The following conditions have been reported to be possible organic causes of social anxiety disorder.
Substances & Medication-Induced Social Anxiety
Many pharmacological and illegal drugs can cause anxiety symptoms. Substance abuse and drug addiction often come along with social anxiety disorder (Stangier, Heidenreich, & Peitz, 2009). In most of these cases, the social phobia leads to the substance abuse disorder. Alcohol abuse, for instance, is often a result of SAD (Kessler et al., 1997). The individual drinks in order to calm the anxiety. Some do so only occasionally, others develop a habit of drinking daily.
There are cases, however, in which the substance abuse disorder precedes the development of social anxiety symptoms (Wagner, Stangier, Heidenreich, & Schneider 2004). This could be an alcohol addict who is worried about others noticing his or her shaking when being sober. It has been pointed out that in these cases a diagnosis of social anxiety disorder is usually not indicated.
As mentioned before,social anxiety disorder often goes hand in hand with additional psychological problems. Feel free to head over to our section on the most common co-occurring disorders of SAD to learn more.