Shyness vs Social Anxiety:Is There A Difference

Social Anxiety is a complex disorder characterized by an intense fear of being humiliated or criticized in social situations, specifically of embarrassing oneself in front of others. Shy people can be very uneasy around others but they do not experience extreme anxiety in anticipating social situations, nor do they necessarily avoid them. Most shy people do not meet the requirements of a Social Phobia diagnosis. Social Phobia disrupts normal life, affecting careers and relationships, whereas shyness does not. The question about what constitutes “shyness” as opposed to “social anxiety disorder” originated because of the problems of over or under-diagnosing the amount of social anxiety felt. If we treat everyone who is simply “shy” as having a disorder, it leads to stereotyping and waste of resources. If we under-diagnose social anxiety disorder, then people with the symptoms will not receive needed treatment. In the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) social phobia (also listed as social anxiety disorder) is defined as a "marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others" (American Psychiatric Association [APA], 1994, p. 416).
Social fears can be limited and isolated to specific situations like public speaking, but can also extend to small gatherings and casual conversations. The individual with Social Anxiety in anticipation of, or when exposed to the phobic situation, typically reacts with symptoms like palpitations, blushing, sweating, overthinking, nausea. These symptoms arise though the person realizes the reaction is unreasonable. These situations are typically avoided. With social phobia, symptoms interfere with a person's daily routines, social activities, relationships, and occupational/academic function. Additionally, social phobia tends to be concurrent with other conditions, such as alcoholism and depression. It is estimated that 50% of patients that suffer from social phobia usually have drug, alcohol, or other mental health problems. Social Phobic individuals possess a depression rate four times higher than average(Bruce “Social Anxiety Disorder: A Common, Under-recognized Mental Disorder”). The requirements needed to be diagnosed with Social Anxiety or Social Phobia, are set forth in the DSM-IV and state the the fear must be persistent of one or more social or performance situations, the exposure to the social situation provokes anxiety, the person must recognize that the fear is excessive or unreasonable, the feared social or performance situation is avoided or endured with intense anxiety or distress, and the avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is a marked distressed about having the phobia. Most “shy” people do not meet these requirements. Less than 25% of shy persons meet the criteria for Social Anxiety Disorder(Dalrymyple et al, 1999). Shyness is not a psychiatric diagnosis. It is often defined by self attribution as being either shy or not shy (Heckelman & Schneier, 1995). Shyness is anxiety, inhibition, reticence, or a combination of these in social and interpersonal situations, and nervousness or anxiety about evaluation by others. Shyness is considered a normal facet of personality that combines the experience of social anxiety and inhibited behavior, but is also described as “stable temperament.” Just because an individual is shy, it does not mean that they have social phobia(Chavira et al, 2002). When shyness is paired with persistent lack of social skills, i.e. poor eye contact, or trouble initiating conversation or problems with unrealistic expectations, negative feelings, and poor self esteem, a social phobia diagnosis is likely. While shyness and social phobia are conditions that typically overlap, social phobia is more defined(Heiser, 2009). There is definitely a link between social phobia, shyness and other psychiatric disorders(Heiser, et al, 2003). As shown in Dr. Heiser’s research we find that social phobia is more prevalent in subjects that classified themselves as highly shy as opposed to those than those considered to be not shy. The link was found between social phobia and shyness. Social phobia also was found in individuals that were introverted as well as neurotic. Therefore, shy people with social phobia tended to also be more introverted and neurotic than shy people that did not exhibit social phobia. The results of the study how social phobia and shyness overlap as well as the relationship to social phobia to other diagnoses and aspects of personality. There is a spectrum of shyness that ranges from a normal level to a higher level that overlaps the experience of those with Social Anxiety Disorder, but they are different(Heiser et al, 2009). A major difference between social anxiety and shyness is that, as stated earlier, shyness is a normal facet of personality, where as social anxiety disorder is not. Some people may view their shyness as a positive quality. A person who has social anxiety may not view having a panic attack or getting nauseous at the thought of going to a party, as positive. Rates of shyness range from 40-50%(Carducci & Zimbardo, 1995) while rates of social phobia range from 3-16%(Furmark et al, 1999). By the numbers alone we can see that shyness is more prevalent and thus more acknowledged, than Social Anxiety Disorder. Many variables are taken in to account to distinguish shyness from social phobia(Chavira et al, 2002). The severity of avoidance, level of social impairment, and degree of occupational functionality between those with social phobia and those who identified as either shy or not shy, all were taken into account to determine whether a shy individual met the requirements of social phobia. While being shy can be inconvenient, it doesn’t nearly have the impact on normal life as social phobia does. Social phobic individuals, for example may choose to not go for the promotion at work because they would have to give a presentation, and would rather avoid the situation and the anxiety. Similarly, students with social phobia may find it difficult to do group presentations, or submit their work for peer review, in anticipation of their perceived negative thoughts. Based on all the variables,and research preformed an important question was raised. Does Social Anxiety Disorder differ from shyness qualitatively, or quantitatively? It the difference was only qualitative, all people with social anxiety disorder would be shy, and this is not the case. Based on research only about half of those diagnosed with social anxiety disorder, report being shy. Many people are shy without having fear, or anxiety or having distress about it(Dalrymyple et al, 1999). However, we live in a time where every “disorder” is easily treatable. Just like there is an app on your smart phone for pretty much everything, there is also a pill. Before 1980, Social anxiety disorder was just simply extreme shyness. Everyone gets anxious is certain social situations, especially in ones that are performance based. Dr. John Grohol raises a good point about biomedical and pharmaceutical companies and their research(or lack there of), taking a normal feeling like shyness, and turning it in to something that can be diagnosed, and naturally, treated with what else, medication. Such critics acknowledge that certain individuals my indeed suffer from social anxiety, the increased publicity of Social Anxiety Disorder, may influence shy individuals to seek treatment though they may not have the disorder(Grohol, 2007). Drugs, like Zoloft, have commercials that mention the general symptoms of social anxiety that could easily be considered shyness, thus giving a shy individual the impression that they have social anxiety and need to be medicated(“Zoloft” 2003). There seems to be a correlation between when Social Anxiety Disorder became recognized by the the DSM, and when the pharmaceutical companies began advertising on television. Various drugs are available for the treatment of SAD, like selective seretonin reuptake inhibitors (SSRIs), monamine oxidase inhibitors (MAOIs) and beta blockers specifically for "performance phobias.” Some also believe that the category of “social phobia” and “anxiety” is not that well defined. It is often hard to diagnose, based on it’s concurrence with other mental health issues, like depression. Doctors diagnose social anxiety by asking patients about their anxiety levels based on various social situations they would be in. This creates very subjective criterion because it is based solely on that particular patient and their perception of their anxiety.

Shyness is normal. Social Anxiety is not. Researchers have complied volumes of data supporting the complexity of Social Anxiety disorder. The disorder has many requirements that most shy people do not meet. More severe anxiety paired with distress about having anxiety and significant impairment in multiple areas of functioning might indicate more problematic social anxiety – a diagnosis of social anxiety disorder – not just “normal” shyness. We’ve seen that there is a thin line between shyness and the social anxiety disorder where the two overlap but are two very different aspects. Those with social anxiety as opposed to shyness seem to report a higher rate of disruptions to their normal lives and higher rates of negative effects on their relationships and in work and school performance. As well as higher stress levels about having said anxiety.

Works Cited Bruce, Timothy J."Social Anxiety Disorder: A Common, Underrecognized Mental Disorder." American Family Physician. n.p., 15 Nov. 1999. Web. 11 Aug. 2015. Burstein M, Ameli-Grillon L, Merikangas KR. Shyness versus social phobia in US youth. Pediatrics. 2011;128:917-925. Carducci BJ, Zimbardo PG. Are you shy? Psychol Today. 1995;28(6):34"40
Chavira, Denise A., Murray B. Stein, and Vanessa L. Malcarne. "Scrutinizing the relationship between shyness and social phobia." Journal of Anxiety Disorders 16.6 (2002): n. pag. Web. 23 Jul. 2015. Furmark T, Tillfors M, Everz PO, et al. Social phobia in the general population: prevalence and sociodemographic profile. Soc Psychiatry Psychiatr Epidemiol. 1999;34:416-424. Dalrymple, K. L., & Zimmerman, M. (2013, November). When does benign shyness become social anxiety, a treatable disorder?. Current Psychiatry, 12(11), 21-38. Diagnostic and Statistical Manual of Mental Disorders: Dsm-iv-tr. Washington, DC: American Psychiatric Association, 194. Print. Grohol, John M., Psy.D. "Social Anxiety Disorder? Or Just Plain Shy?" World of Psychology. N.p., 11 Nov. 2007. Web. 14 Aug. 2015. Heckelman, L. R., & Schneier, F. R. (1995). Diagnostic issues. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social Phobia. Diagnosis, Assessment and Treatment (pp. 3-21). New York: Guilford Press. Heiser, Nancy A., Samuel M. Turner, Debroah C. Beidel, and Roxann Roberson-Nay. "Differentiating social phobia from shyness." Journal of Anxiety Disorders 23.4 (2009): n. pag. Web. 22 Jul. 2015. Heiser, Nancy A.,Turner, Samuel M., and Debroah C. Beidel. "Shyness: relationship to social phobia and other psychiatric disorders." Behaviour Research and Therapy 41.2 (2003): 209-221. Print. "Zoloft - Social Anxiety Disorder - Spotlight (2003) - 0:60 (USA)." Zoloft. N.p., 25 Nov. 2003. Web. 14 Aug. 2015.