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Fearing Judgement and Other Pervasive Symptoms of Social Anxiety Disorder

Updated: Jan 13

- Teresa Jacobson, DBH, LPCC-S, NCC

February 14, 2022

One of the more common and least understood disorders experienced among us is Social Anxiety Disorder (SAD), which involves an intense anxiety and fear of judgement of others, and many physiological manifestations.

People with SAD tend to understand the fears of being scrutinized by others are not always logically based. Acknowledgement of an irrational fear alone does not necessarily mean that someone can overcome the intense fears or distress. It takes a lot of work.

Known as the most common anxiety disorder, social anxiety disorder is often experienced as a racing heart, feeling flushed or turning red, excessive sweating, dry throat and mouth, trembling, swallowing and speaking with difficulty, dizziness or lightheadedness, and muscle twitches, accompanied by an overall intense fear with a sense of powerlessness (Richards, 2020).

Other common struggles include:

  • Worrying intensely about social situations

  • Worrying for days or weeks before an event

  • Avoiding social situations or trying to blend into the background if you must attend

  • Worrying about embarrassing yourself in a social situation

  • Worrying that other people will notice you are stressed or nervous

  • Utilizing alcohol or other substances to face a situation

  • Missing school or work due to anxiety

Social anxiety disorder is a “constant fear of being judged or scrutinized, or humiliated in front of them” (Higuera, 2020). These intense fears can lead to avoidance, which can “ease” the anxiety in the moment, but leads to worsening fears.

“Millions of people all over the world suffer from this devastating and traumatic problem every day, either from a specific social phobia or from a more generalized social phobia” (Richards, 2020). In the United States alone, social anxiety disorder is considered the third largest psychological disorder in the country.

“People with this disorder have trouble talking to people, meeting new people and attending social gatherings” due to the fear of being judged or scrutinized by others (Higuera, 2016). Fearing evaluation is only one proponent of the intense fears experienced by those with social anxiety disorder.

The pervasiveness of this chronic condition can lead to avoiding all social situations, such as: asking a question, job interviews, shopping, using public restrooms, talking on the phone, and eating in public. Significant distress is often felt by people with social anxiety disorder when faced with these and other situations, such as (Richards, 2020):

  • Being introduced to other people

  • Being teased or criticized

  • Being the center of attention

  • Being watched while doing something

  • Meeting people in authority (“important people”)

  • Most social encounters, especially with strangers

“Although fears of evaluation typically characterize SAD, research has also provided preliminary support for additional phenomena that may hold theoretical linkages with SAD symptoms and thus provide additional avenues of treatment” (Fetzner, Sapach, Mulvogue, & Carlton, 2014). “In particular, thoughts connected with ineffectiveness, inadequacy, and insecurity in social situations.”

The exact cause of social anxiety disorder is unknown (Higuera, 2020). “However current research supports the idea that it is caused by a combination of environmental factors and genetics.” Negative experiences such as family conflict, bullying, or other forms of emotional, physical, or sexual abuse can also contribute to this disorder.

Liebowitz developed the Social Anxiety Scale, a self-assessment that is offered online which can be used to understand the level of distress caused by social anxiety disorder.

We've been reminded during COVID that social connection is an important human need. Cognitive Behavioral Therapy is an evidence-based practice that can help those who experience social anxiety disorder to help overcome anxiety thinking and negative expectations. If you couple cognitive behavioral therapy with mindfulness to ensure awareness of the present moment, and add continued self-compassion, social anxiety disorder can be conquered, even for those who have suffered for decades.

It is never too late to improve quality of life.


Teresa Jacobson is a Doctor of Behavioral Health and Licensed Professional Clinical Counselor Supervisor who is counseling Ohio and Kentucky adults of all ages and life experiences via secure Telehealth/Video visits. A strength-based, person-centered multi-cultural counselor, with an existential philosophy, Teresa can be reached by emailing, calling (513) 206-3026, or visiting



Fetzner, M.G, Teale Sapach, M. J. N., Mulvogue, M., and Carleton, R.N. (2014). “It’s not just

about being judged”: Interpersonal distrust uniquely contributes to social anxiety.

Journal of Experimental Psychopathology. DOI:10.5127/jep.042414

Higuera, V. (2018). Social anxiety disorder. Healthline. Retrieved from

Liebowitz, M.R. (2016). Liebowitz social anxiety scale. National Social Anxiety Center.

Richards, T.A. (2020). The least understood anxiety disorder. The Anxiety Network


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