What are the Different Types of Social Anxiety Disorder?

What is the Difference Between Generalized and Specific Social Anxiety

Most people with social anxiety disorder fear public speaking.
Public speaking anxiety is one type of social anxiety disorder. Getty / Keith Brofskey

Social anxiety disorder (SAD) is a common disorder affecting more than 15 million people in the United States. SAD involves fear of social and performance situations in which others may judge you negatively. Most people with the disorder are extremely self-conscious, and may actually have physical symptoms such as nausea, shaking or feeling faint when around people or performing.

The current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not recognize different types of social anxiety disorder as did the previous version (DSM-IV).

In the past, two types of social anxiety disorder have been identified, that differ in terms of their symptoms: generalized SAD and specific SAD.

The following two sections describe how SAD was categorized in the past.

Generalized Social Anxiety Disorder

Those with generalized social anxiety were described as having fears about most social and performance situations, including 

People with generalized social anxiety were thought to be uncomfortable around anyone but their closest family members. Generalized SAD was considered to be a more severe form of the disorder and was usually accompanied by greater impairment in day-to-day functioning.

Specific Social Anxiety Disorder

In specific social anxiety disorder, anxiety and fear were thought to be linked to just a few social situations rather than most or all. For instance, a person may have a fear of public speaking but be fine mingling at a party. This form of social anxiety was still thought to be extremely harmful, that it could limit people from enjoying life fully, meeting friends or even succeeding in a career. 

DSM-5 and Types of Social Anxiety Disorder

With the release of the new DSM, the generalized and specific types of social anxiety disorder were no longer recognized.

Instead, a "performance only" specifier could be added to a diagnosis of SAD. In this way, it seems there are still categories of social anxiety disorder (SAD) as there have been in the past; however, the way that your doctor makes a diagnosis make look different than prior to the DSM-5.

According to Dr. John Grohol at Psych Central, the reason given by the American Psychiatric Association (APA), publisher of the DSM-5, for doing away with the generalized subtype, was that it was problematic to operationalize what was meant by "fears include most social situations." However, they did acknowledge that people who only fear performance situations appear to represent a distinct type of SAD, who are unique in terms of age of onset, physical symptoms, and response to treatment.

How Can Specific and Generalized SAD Be Treated?

Regardless of whether you have generalized or specific social anxiety disorder, it is important to know that help is possible and you can be effectively treated. With both forms, cognitive behavioral therapy (CBT), a form of psychotherapy that addresses current problems and reframes negative thinking, can be very helpful. You will learn strategies and practices to help you cope with different situations until your fears are lessened. After going through cognitive behavioral therapy, many people with anxiety say that it changed their lives and opened doors for them; they can do things they never thought they could, like travel or perform in front of others. 

In some cases, particularly for those with more severe generalized social anxiety disorder, your doctor may recommend that you try medication. This can help calm your mind and suppress negative self-talk, allowing you to focus on therapy and begin to make progress. 

Finding a Therapist for Social Anxiety

Look for a therapist who specializes in anxiety disorders. Without a background in these conditions, your therapist may not understand how harmful it can be or may minimize what you are feeling.

A healthcare provider who understands social anxiety disorder and cognitive behavioral therapy will work with you to develop effective strategies to manage the disorder. 

A Word From Verywell

It is important to understand the type of social anxiety disorder diagnosis you have been given. Work with your doctor or mental health professional to learn more about your diagnosis and what it means in terms of your treatment and prognosis.

Sources:

Dalrymple K, D’Avanzato C. Differentiating the subtypes of social anxiety disorder. Expert Rev Neurother. 2013;13(11):1271-1283. doi:10.1586/14737175.2013.853446.

Heimberg RG, Hofmann SG, Liebowitz MR, et al. Social anxiety disorder in DSM-5. Depress Anxiety. 2014;31(6):472-479. doi:10.1002/da.22231.

National Institute of Mental Health. Anxiety Disorders

University of Pennsylvania Department of Psychiatry. Social Anxiety Disorder

Psych Central. DSM-5 Changes: Anxiety Disorders & Phobias. 

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