What is social phobia? As Pip claims for anxiety in young people rise

Teenagers and young adults account for almost one in three people who have recently begun claiming disability benefits for anxiety disorders, according to new research.

There were 24,681 claimants of personal independence payment – known as Pip – in England and Wales at the end of July this year with an anxiety disorder listed as their primary condition who had received the benefit for up to two years.

Of these, analysis by the Press Association found that 7,403 people (30%) were aged between 16 and 24. Meanwhile, a further 5,445 (22%) were aged 25 to 34, suggesting that more than half of recent Pip claimants for anxiety disorders are under 35.

Anxiety disorders encompass a range of conditions, including panic disorder and social phobia, also known as social anxiety disorder.

The research found that older people with anxiety disorders recorded as their primary condition accounted for a much smaller share of recent Pip claimants.
For example, the analysis found that 3,391 (14%) of people who have been claiming for up to two years are aged 45 to 54, some 2,649 (11%) are aged 55-64 and just 438 (2%) are 65 or over.

Anxiety disorders are often misunderstood, so we consulted some experts who explained exactly what social anxiety disorder is and highlighted its most common signs.

How would you define social anxiety disorder?

“Social anxiety disorder used to be referred to as social phobia and is about the level of intensity of worry that someone can experience that is triggered by social situations, so it’s quite focused on how a person is seen in social situations,” explains Caroline Clare, consultant forensic psychologist at Cygnet Health Care.

“For example, they might be worried about how other people view them or might be judging them, and that can lead to a lot of embarrassment and self-consciousness.”

Dr Ravi Gill, a health psychologist and founder of Smart Mind Health, agrees: “People who experience social anxiety know that the fear that they have around these certain situations is not OK, so their nervous system reacts in a way that sends them into a slight bit of panic.

“So, it’s not just nerves or a lack of confidence, or not knowing how to navigate something, social anxiety is a lot more than that. There’s a genuine fear that something is going to happen and a fear of being seen and getting it wrong.”

Gill adds that social anxiety disorder is also linked quite closely with imposter syndrome, and that the two often come together.

Clare highlights that the key difference between general shyness and regular daily worries and social anxiety disorder is the impact that it has on daily functioning.

“People with social anxiety disorder might feel like they need to avoid face-to-face contact, social media or telephone contact, social gatherings or going into the community during busier periods of time and might feel like they are not able to work or function how they wish to,” explains Clare.

What are some common telltale signs to look out for?

Social anxiety often presents as a mixture of emotions.

“Common emotions include shame, embarrassment, worry, and feeling like the situation is going to be too much for them,” says Gill. “Someone struggling with social anxiety might get themselves into a negative thought spiral of overthinking a particular situation.”

There are also common physical signs.

“Physical reactions such as butterflies in your stomach and tummy issues are quite common, and some people also report a racing heart, sweaty hands, blushing and trembling,” says Gill.

The NHS website also states that panic attacks, where you have an overwhelming sense of fear and anxiety (that usually only lasts for a few minutes), are also a symptom of social anxiety.

Clare adds: “People struggling with social anxiety disorder might also notice a disruption in sleep.”

How can social anxiety affect someone’s everyday life?

“Social anxiety impacts people’s everyday lives because it often means that people will avoid social situations and will limit themselves in terms of opportunities,” notes Gill.

“If you start avoiding one thing, it then can become quite easy to tell yourself to avoid something else. So, those feelings of social anxiety can easily be transferred into other areas of life and if they are not effectively managed or dealt with, it can be quite harmful.

“Therefore, the longer the symptoms are present, the higher the level of distress and impairment that it contributes to.”

Social anxiety can also have a negative impact on relationships.

“If you feel that you’re not able to use your own voice, or there’s a fear of being judged or saying something wrong, it means that you can become quite complacent as a partner,” says Gill. “Sometimes people will use alcohol as a way to loosen up or as a distraction to try and cope with social anxiety, and that can cause problems in relationships.

“Similarly, within friendships, if your friend is always the one that’s always having to spark up a conversation and facilitate meet-ups, it can be harder to continue those relationships.”

When should someone seek help about social anxiety?

“You should seek help when you begin to recognise that it’s starting to impact work, relationships and your own wellbeing,” says Gill.

Clare agrees and adds: “If you begin to notice physical health difficulties such as heart palpitations, feeling sweaty, feeling sick before or during the social situations, or notice that even short social interactions leave you feeling very drained and very fatigued afterwards, this might suggest that you would benefit from some extra support.”

What treatments can help manage it?

Identifying triggers is a helpful first step in understanding and managing social anxiety.

“Helping someone identify their symptoms of anxiety, such as racing thoughts or an increased heart rate, and the triggers for that and then rating those levels of anxiety so that person can really understand the areas that they are struggling with, can be helpful,” says Clare.

Cognitive Behavioural Therapy (CBT) is widely considered the gold standard and first-line psychological treatment for social anxiety disorder.

“CBT can help people actively work through these thoughts, and take into consideration the emotions, and then look at how those particular two things impact their behaviour,” says Gill.

Clare adds that sometimes a graded exposure approach can help.

“For this, we might get someone to identify the situations that they’re avoiding that create most anxiety and then set out some very small achievable steps to get them to start tolerating those better, alongside giving them some coping techniques to help with that situation,” explains Clare.

Mindfulness is often used as a supportive, complementary approach.

“Things like deep breathing therapy and grounding exercises can help support the nervous system when it gets overwhelmed,” says Gill.

In some cases, medication is prescribed.

“There’s a group of medicines called SSRIs (selective serotonin reuptake inhibitors) which can help lessen the impact of symptoms,” says Gill.

“A GP would complete a full clinical assessment, take into consideration clinical history, and then might prescribe something that targets sleep issues, or tummy issues or low mood.”