Basics
July 23, 2020

Pranav Harish

Distinguishing Social Anxiety Disorder from Other Possible Conditions

You have an overwhelming fear of social situations or being judged negatively by others all the time. It causes significant anxiety and distress in your life. Believe it or not, it is more common than you think. People with social anxiety disorder often describe it as an intense feeling of their world falling apart.

However, several conditions share similarities such as social avoidance, with social anxiety disorder. But, the "avoidance" factor depends on an individual. You may avoid social interactions, not because you have a fear of social situations, but due to many other reasons, as discussed below.

That's why the social anxiety disorder differential diagnosis is not simple.

Panic Disorder

You have panic attacks unexpectedly that seem to appear out of nowhere. It feels intense and life-threatening. Then you may have panic disorder.

But, a person having a panic disorder experiences anxiety due to the anticipation and fear of having panic attacks. While a person with social anxiety disorder experiences anxiety and panic attacks due to fear of social situations.

Separation Anxiety Disorder

People with this condition are concerned about their separation from attachment figures - parents, family, or caregiver. They may avoid social situations due to fear of this separation. They do not experience anxiety in the presence of the caregiver.

People with social phobia may have a fear of being judged negatively in the presence of a caregiver. But people with separation anxiety disorder do not have a fear of being criticized by others.

Selective Mutism

People with selective mutism fail to speak at specific social situations or to certain people. For example, a child diagnosed with this disorder is unable to talk at school but may speak at home.

Agoraphobia

It involves avoiding social situations or places in which escape seems to be hard. You fear that no help will be available when you experience anxiety or a panic attack.

If you have agoraphobia, then you may avoid a restaurant because of the crowd. You may be afraid of being trapped or unable to escape the restaurant. However, a person with social anxiety disorder will avoid the restaurant due to the fear of social interaction.

Generalized Anxiety Disorder (GAD)

In this case, the anxiety is not just related to a fear of social situations. People with generalized anxiety disorder worry about - health, relationships, work, school, and finances. People may anticipate disasters, unable to concentrate or find it hard to tolerate uncertainties. People with GAD try to plan and control situations to prevent anxiety.

Specific Phobia

If you experience an immense and unreasonable fear towards a particular object or situation that is hardly dangerous, then it is Specific phobia. You would do anything to avoid those from causing anxiety and distress.

Unlike social anxiety disorder, Specific phobia does not lead to a fear of social situations or interactions.

Anxiety Disorder due to Other Medical Conditions

Medical conditions that may cause trembling, face deformity, or stuttering can lead to embarrassment. Due to this reason, a person may develop social anxiety disorder and a fear of negative evaluation by others.

Autism Spectrum Disorder (ASD)

People with high functioning autism may have social anxiety. However, unlike ASD, people with social anxiety disorder do not show impairment in social communication.

All of these conditions allow a person to function in social situations and interactions, unlike social anxiety disorder. However, due to overlapping symptoms, the differential diagnosis becomes a bit complicated. Thus, only a psychiatrist or a therapist will be able to identify the specific symptoms and provide an accurate diagnosis.

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