Anxiety Social Anxiety Disorder Symptoms and Diagnosis Differences Between Shyness and Social Anxiety Disorder By Arlin Cuncic, MA Arlin Cuncic, MA Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." She has a Master's degree in psychology. Learn about our editorial process Updated on July 22, 2020 Learn more." data-inline-tooltip="true"> Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Amy Morin, LCSW Medically reviewed by Amy Morin, LCSW Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk, "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time. Learn about our Medical Review Board Print Tara Moore / Stone / Getty Images Table of Contents View All Table of Contents Effects Key Differences Screening Shyness and social anxiety disorder share many characteristics. If you have spent your whole life feeling as though you are just a shy person, how do you know if it is something more serious? As a parent of a shy child, you might also wonder if the behavior is normal or may be signs of a disorder. Effects of Social Anxiety Childhood is the time when social skills develop in preparation for the challenges of adolescence and adulthood. Children who suffer from SAD often do not develop appropriate social behaviors. As children grow with the disorder, they may become accustomed to having social fears and create a life based on avoidance. Social anxiety disorder can have a devastating impact on your education, career success, financial independence, and personal relationships. Often it will lead to an isolated lifestyle and subsequent depression or substance abuse. At the same time, it is unfortunate that people wait so long or never get help when this disorder is treatable. In fact, studies show that nearly 70% of individuals suffering from SAD may be successfully treated with cognitive therapy. Social Anxiety vs. Shyness Unfortunately, social anxiety disorder (SAD) is often dismissed as just extreme shyness. The reason many people don’t seek help for SAD is that they don’t realize that they have a recognized psychiatric condition. Statistics show that although symptoms usually start in childhood, only about 50% of adults with the disorder receive treatment, and those who do seek treatment wait a long time to do so, 15 to years after symptoms begin. Key Differences In general, the main symptoms that distinguish shyness from SAD areThe impairment of functioning that it causes in a person’s lifeThe intensity of the fearThe level of avoidance People with social anxiety disorder don’t just feel nervous before giving a speech. They may worry about the speech for weeks or months beforehand, lose sleep due to anxiety, and have intense symptoms of anxiety during the feared situation such as a racing heart, shortness of breath, sweating, or shaking. The symptoms usually do not go away but get worse as the situation progresses. The person with SAD usually realizes that their fears are unfounded but is still unable to control them. Screening for Social Anxiety Disorder Your doctor or mental health care professional can conduct an in-depth interview to determine whether you meet the criteria for a diagnosis of SAD. However, as an initial step, he or she may have you complete a screening measure to determine the need for a more thorough follow-up evaluation. One such screening test is the “Mini-SPIN” (Mini-Social Phobia Inventory) that consists of just three questions. The Mini-SPIN (and it’s sister version the full SPIN) were created by Dr. Jonathan Davidson of the Department of Psychiatry, Duke University Medical Center. Studies have shown the Mini-SPIN is an efficient tool for diagnosing SAD among people of different cultures and languages. To complete the SPIN, your doctor will have you rate the following three items in terms of how true they are for you on a scale of 0 to 4, where 0 is “not at all” and 4 is “extremely present.” Being embarrassed or looking stupid are among my worst fears.Fear of embarrassment causes me to avoid doing things or speaking to people.I avoid activities in which I am the center of attention. Generally, total scores of 6 or higher are indicative of possible SAD, however, only a trained mental health professional can make a diagnosis based on a full interview. In addition to the SPIN and Mini-SPIN, there are several other instruments that may be used to screen for social anxiety disorder including: Fear of Negative Evaluation Scale Liebowitz Social Phobia Scale Social Avoidance and Distress Scale Although screening instruments are very helpful in identifying potential problems with social anxiety, there is no substitute for a complete diagnostic interview conducted by a mental health professional. Your doctor will be able to provide a full assessment or refer you to another professional more experienced in diagnosing the disorder. A Word From Verywell If you believe that your shyness may actually be social anxiety disorder, it is important to make an appointment with your family doctor or mental health professional. Leaving symptoms untreated over a long period can worsen your anxiety and could lead to other problems such as depression or substance abuse. On the other hand, effective treatment such as cognitive-behavioral therapy (CBT) and medication are available and have been shown to help with a social anxiety disorder. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. 4 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Chapdelaine A, Carrier JD, Fournier L, Duhoux A, Roberge P. Treatment adequacy for social anxiety disorder in primary care patients. PLoS ONE. 2018;13(11):e0206357. doi:10.1371%2Fjournal.pone.0206357 Nordahl HM, Vogel PA, Morken G, Stiles TC, Sandvik P, Wells A. Paroxetine, Cognitive Therapy or Their Combination in the Treatment of Social Anxiety Disorder with and without Avoidant Personality Disorder: A Randomized Clinical Trial. Psychother Psychosom. 2016;85(6):346-356. doi:10.1159/000447013 Social Anxiety Disorder: Recognition, Assessment and Treatment. National Center for Biotechnology Information, U.S. National Library of Medicine. 2013. Garcia-lopez L, Moore HT. Validation and Diagnostic Efficiency of the Mini-SPIN in Spanish-Speaking Adolescents. PLoS ONE. 2015;10(8):e0135862. doi: 10.1371/journal.pone.0135862 Additional Reading Connor KM, Kobak KA, Churchill LE, Katzelnick D, Davidson JR. Mini-Spin: A brief screening assessment for generalized social anxiety disorder. Depression and Anxiety. 2001; 14:137-140. Rosenthal J, Jacobs L, Marcus M, Katzman M. Beyond shy: When to suspect social anxiety disorder. The Journal of Family Practice. 2007; 56: 369-374. By Arlin Cuncic, MA Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." She has a Master's degree in psychology. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit