You’re Not Shy or Stuck Up. You Have Social Anxiety Disorder.

Some people believe social anxiety disorder (SAD) is synonymous with shyness. Others, including some physicians, don't believe it exists at all. But for those living with SAD, it's very real.

If you have SAD, you constantly worry about being negatively judged by others. You might find it difficult to eat or talk in public, or to use public bathrooms. You might find it impossible to attend social events. As with other anxiety disorders, you might know your fear is irrational but feel powerless to stop it.

Studies show that 2 to 13 percent of the U.S. population experiences social anxiety, at some point in their lives, to the degree that it would be considered SAD. It is the most common type of anxiety disorder in teenagers. It is more common in women and often starts in childhood or early adolescence. Some evidence suggests that, like other anxiety disorders, it occurs more frequently in children and adults with ADHD.

SAD and shyness are not the same. Shyness is considered a personality trait. People who are shy experience nervousness or anxiety when faced with a social or interpersonal situation but accept that being shy is part of who they are. Those with social anxiety might be shy or might be extroverts, but they view SAD as a negative and often are hard on themselves for feeling the way they do.

[Self-Test: What Does Anxiety Look Like?]

The following are all symptoms of SAD, though everyone might not experience all symptoms. Some people might exhibit symptoms in only one type of situation, while others might experience multiple symptoms in various social situations. In some instances, these symptoms can overlap with or mirror those of ADHD.

• Self conscious in front of other people
• Extreme fear that others will judge you
• Can worry for days or weeks before an event
• Avoidance of situations requiring social interaction and intensely uncomfortable if in a social situation
• Keeps conversation with others to a minimum
• Difficulty making or keeping friends
• Panic attacks, including shaking, blushing, nausea or sweating, when in a social situation
• Difficulty talking to others

While some people with SAD might stay in the background, others are outgoing in situations that don’t require them to perform whatever action triggers problems. For example, if someone is anxious about eating in public, he might not have a problem talking in public. Symptoms of social anxiety disorder rise only when an individual's triggers are activated.

SAD can interfere with your ability to make friends and participate in social activities. But it can also cause problems in relationships, cause you to miss school or work, or cause you to get lower grades because of your fear of answering questions or talking in class.

Teens with social anxiety often experience depression as well. Some research has found that if you have SAD, you are six times more likely to also have dysthymia or another mood disorder. You are also at a higher risk for substance abuse. Early treatment may reduce the risk of developing depression and other coexisting conditions.

[Panic Buttons: Stopping Anxiety and Its Triggers]

Like other anxiety disorders, there is help if you have social phobia. Cognitive behavioral therapy (CBT) has been found to help people understand triggers for anxiety and teaches techniques, such as thought logs, mindfulness and relaxation exercises, to help control anxious feelings. Some people use medications to help control the anxiety. This can be especially effective when first beginning CBT.