Social Anxiety: Shyness or Illness?

November 28, 2023

Social Anxiety: Shyness or Illness?

Ring-ring. The phone rings and the heart starts to pound. 'Gosh, who could it be?'

Does this fall under extreme introversion or is it a condition? Many people feel uncomfortable in their relationships with others. They hate answering the phone or placing an order at a restaurant. They could be considered introverted, but sometimes these symptoms can become a 'disease'. So where is the line? In this article, we will examine the phenomena of social anxiety, when it can be considered a disease, and when it's merely a temperament.

Social anxiety used to be known as social phobia. Social anxiety refers to fear or anxiety in specific social or performance situations. So would I fall under social anxiety? Looking at diagnostic criteria can be somewhat helpful in figuring this out, but it's always somewhat ambiguous to evaluate oneself based on rigid diagnostic criteria. Let's look at how social anxiety manifests in people outside of the realm of diagnostic criteria. It can be explored in three broad areas.


People with social anxiety often obsess over the following thoughts:

  • "I worry about what others think of me"
  • "I feel like other people are judging me"
  • "I feel like other people notice I'm anxious"
  • "They'll think I'm strange because my face is red, right?"
  • "What if the worst happens?"
  • "I'm afraid to engage in conversation with people"

Emotions/Physical Reactions

People with social anxiety often feel the following emotions or physical reactions:

  • Fear or discomfort when interacting with people or being surrounded by them
  • Accompanying physical reactions at that time: blushing, pounding heart, trembling, sweating, upset stomach, dizziness, faintness


People with social anxiety often act as follows:

  • Avoid situations where you will interact with people or stand in front of them: Approach strangers, Attend meetings, Start conversations, Go on dates, Go to work or school
  • Try to defuse a worrying situation when it arises: Think about what to say beforehand, Try not to attract attention, Speak quietly,
  • Over-analyze situations where social interaction occurred, pointing out one's flaws and saying things like "I was such a fool".

If you're still unsure whether you fall under social anxiety, let's look at the following example. The following is a reconstructed account from a case report on social anxiety published in an academic journal.

"I entered university when I was twenty. I've always been a model student, so I didn't have any major adaptation issues. I enjoyed the lectures too. But the problem was the group seminars. Strangely enough, I found attending these seminars to be extremely tough. Whenever I had to present in front of people, I felt like I was going insane. As my anxiety grew, I just stopped attending the group seminar classes. For a model student like myself, this was an unbelievable occurrence. When I went to see a cognitive therapist about this issue, the therapist asked me to describe the situation. At that time, it was my turn to present something to others. I spent a lot of time figuring out exactly what I had to say for the presentation. But while speaking, I realized I was mumbling. I felt extremely foolish. I was worried that people would perceive me as a timid and incompetent student. I felt anxious, my face became hot, and sweat trickled down my back. My hands, which were holding the script, and my voice started to tremble. When my hands began to shake, I thought others would notice, so I hid my hands under the podium. However, I couldn't hide my trembling voice, so I just avoided making eye contact completely. I didn't look at them, blindly read what was written in the script, and hastily finished my presentation. After the presentation, I quickly left the classroom before class ended. After returning home, I wondered why I had acted so foolishly. That was my last presentation. I still haven't finished my presentation classes."

Reading this content, one can understand that social anxiety is not simply shyness. The most crucial point in diagnosing social anxiety is whether 'it is so excessive that it causes significant distress to oneself or it causes problems in carrying out daily activities'. If what is considered shyness becomes too overwhelming, preventing you from successfully engaging in social activities, academics, or work, it may possibly be diagnosed as social anxiety. In this case, it would be helpful to consider medication or cognitive behavioral therapy. Taking medication will alleviate immediately present symptoms, and cognitive behavioral therapy will provide ways to cope with the issue of social anxiety from a long-term perspective.

To summarize, are you experiencing problems in life due to shyness? If so, consider the possibility of social anxiety and seek solutions. Are you an extreme introvert but not facing any problems in living life? If so, there's no need to worry excessively.


Fox, N. A., Henderson, H. A., Marshall, P. J., Nichols, K. E., & Ghera, M. M. (2005). Behavioral inhibition: Linkingbiology and behavior within a developmental framework. Annual Review of Psychology, 56, 235-262.

Clarke, A., Thompson, A. R., Jenkinson, E., Rumsey, N., & Newell, R. (2013). CBT for appearance anxiety:Psychosocial interventions for anxiety due to visible difference. John Wiley & Sons.

Warnock-Parkes, E., Wild, J., Thew, G. R., Kerr, A., Grey, N., Stott, R., ... & Clark, D. M. (2020). Treating socialanxiety disorder remotely with cognitive therapy. The Cognitive Behaviour Therapist, 13.

Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. Heimberg, M. Liebowitz, D. A. Hope,& F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment and treatment (pp. 69–93). New York: GuildfordPress.

[9] National Institute for Health and Care Excellence (NICE: 2013). Social; anxiety disorder: recognition,assessment, and treatment. Retrieved from:

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