Can Social Anxiety Cause Depression

Can Social Anxiety Cause Depression? exploring the hidden connection in 2023

Writen By: Sana Ihsan
Reviewed By: Huma Khan
Publish Date: December 1, 2023

Have you ever wondered if the butterflies in your stomach during social interactions could lead to something more complex? The question is captivating: Can social anxiety cause depression? We are going to explore and find out the answer to this question. We’ll uncover how the unease in social situations may play a significant role in shaping the landscape of our mental well-being.

So, when you are feeling really nervous at social gatherings, like when you meet new people or are around your colleagues, that’s social anxiety. Now, think about this: Can social anxiety also make you feel sad, even when you are not in those social situations? This leads us to our question: Can social anxiety cause depression? If you want to find out the answer to this question, then stick around till the end.

In this blog post, we will discuss what social anxiety and depression actually are. We will discuss further: Can social anxiety cause depression? We will elaborate on both disorders further, discuss their causes and symptoms, and explain the link between depression and social anxiety. So, join us to understand the powerful connection between depression and social anxiety.

What is Social Anxiety? 

Social anxiety, clinically known as social anxiety disorder or social phobia, is characterized by intense fear, anxiety, and self-consciousness in social situations. Individuals with this condition often worry about being scrutinized or negatively judged by others, leading to avoidance behaviors that can significantly impact daily functioning, relationships, work, or school.

Sometimes, it’s normal to feel a bit nervous, like when you’re at an official gathering or giving a presentation. But when it comes to social anxiety and depression, everyday situations make you really anxious. This 2019 study suggests that social anxiety is linked to increased awkwardness and agitation during social interactions but does not affect other aspects of performance, like speaking ability.

Another 2021 study further suggests that people with social anxiety disorder (SAD) often experience emotional solitude, which is a feeling of isolation and loneliness despite being around others. This is because SAD makes it difficult for people to form and maintain close relationships.

Prevalence of Social Anxiety

Social anxiety disorder is a common mental health disorder that affects about 7% of adults in the United States. It is more common in women than in men. About 12% of adults have experienced social anxiety disorder at some point in their lives. Social anxiety disorder can also affect adolescents, with about 9% of adolescents experiencing the disorder.

Symptoms of Social Anxiety

Here are some of the common symptoms of Social Anxiety:

Emotional Symptoms

  • Fear of situations in which you may be judged negatively
  • Worry about embarrassing or humiliating yourself.
  • Intense fear of interacting or talking with strangers.
  • Fear that others will notice that you look anxious.
  • Fear of physical symptoms that may cause embarrassment, such as blushing, sweating, trembling, or having a shaky voice.
  • Anxiety in anticipation of a feared activity or event.

Behavioral Symptoms

  • Avoidance of doing things or speaking to people out of fear of embarrassment
  • Avoiding situations where you might be the center of attention.
  • Analysis of your performance and identification of flaws in your interactions after a social situation
  • Preferring familiar environments and avoiding new or unfamiliar places to reduce social discomfort.
  • Finding it challenging to start conversations or engage with others, which causes social isolation
  • Relying heavily on digital communication methods and avoiding face-to-face interactions 

Physical Symptoms

  • Experiencing blushing, a reddening of the face triggered by feelings of embarrassment or self-consciousness.
  • Noticing a fast heartbeat and an accelerated heart rate in response to heightened anxiety in social situations.
  • Experiencing trembling or shaking and increased tightness and tension in the muscles is a physical manifestation of anxiety.
  • Noticing increased perspiration, difficulty breathing, and sweating as a response to heightened stress or nervousness
  • Feeling discomfort in the stomach or experiencing nausea as a physical reaction to social anxiety
  • Feeling dizzy or lightheaded, possibly due to changes in blood flow and oxygen levels caused by anxiety.

Cognitive Symptoms 

  • Finding it hard to focus or concentrate on tasks due to preoccupation with anxious thoughts
  • Engaging in repetitive and distressing thoughts is often centered around potential negative outcomes in social situations.
  •  Engaging in self-critical or pessimistic internal dialogue contributes to heightened anxiety.
  • Imagining and expecting the worst possible outcomes in social scenarios, even when unlikely, causes social anxiety and loneliness
  •  Holding excessively high standards for oneself in social interactions leads to increased stress.
  • Constantly questioning one’s abilities and fearing judgment from others contribute to a lack of confidence in social situations.

Interpersonal and Functional Symptoms:

  • Struggling in educational or professional settings due to social anxiety affects concentration and productivity.
  • Finding it challenging to establish and maintain meaningful connections with others, which causes social anxiety and isolation,
  • Disruption of regular activities and routines due to social anxiety-related avoidance behaviors
  • Missing out on personal growth opportunities, such as workshops or networking events, due to depression and social anxiety
  • Reacting strongly to perceived criticism leads to heightened stress and emotional distress.
  • Avoiding involvement in community or social initiatives due to anxiety about interacting with others.

The majority of these symptoms must be present for at least six months, significantly impair day-to-day functioning, and not be consistent with any other medical condition in order for someone to be diagnosed with social anxiety disorder.

How does Social Anxiety Affect Individuals? 

Social anxiety can significantly impact individuals, both emotionally and behaviorally. People experiencing social anxiety may feel intense fear or discomfort in social situations, leading them to avoid social interactions. Emotionally, individuals with social anxiety may struggle with low self-esteem, excessive worry about judgment, and persistent feelings of incompetence. 

According to research, nearly 30% of adults in the USA dealing with social anxiety disorder had severe impairments, around 39% faced moderate challenges, and approximately 31% experienced mild difficulties over the past year.

This 2020 study found that one in four university students in Ethiopia has social anxiety disorder, which negatively impacts their quality of life. Female students, tobacco users, and those with a family history of mental illness are more likely to have social anxiety disorder.

But can social anxiety cause depression? The answer is still not explained in detail. Well, let’s understand depression first.

What is Depression? 

Depression is a mood disorder that makes you feel sad all the time and lose interest in things you used to enjoy. It can also make it hard to think and remember things and disrupt your eating and sleeping habits. Feeling sad about tough situations is normal. But depression is different—it sticks around almost every day for at least two weeks, and it comes with more than just feeling sad. 

Now let’s explore the various forms of depression, and then we’ll move towards answering our question, which is: Can social anxiety cause depression? 

Forms of Depression

Following are the various forms of depression. 

1. Seasonal Affective Disorder (Seasonal Depression)

This type of major depressive disorder tends to emerge during the fall and winter when daylight hours decrease. People with seasonal affective disorder may experience low mood, a lack of energy, and changes in sleep patterns during these seasons. Interestingly, symptoms often improve with the arrival of spring and increased sunlight.

2. Prenatal Depression

Prenatal depression occurs during pregnancy and involves persistent feelings of sadness, hopelessness, or irritability. Hormonal changes, coupled with the stress and anticipation of becoming a parent, contribute to this form of major depressive disorder.

3. Postpartum Depression

Postpartum depression sets in within four weeks of giving birth. New mothers with this condition may feel overwhelming sadness, fatigue, and difficulty bonding with their babies. It can impact daily functioning and requires attention for the well-being of both the mother and the child.

4. Atypical Depression

Atypical depression differs from its typical form. In this case, individuals may experience mood reactivity, meaning their mood improves in response to positive events. Other distinctive features include increased appetite, often leading to weight gain, and heightened sensitivity to perceived rejection or criticism.

5. Clinical Depression 

This is a common and severe form of depression characterized by persistent low mood, loss of interest or pleasure in activities, and a range of physical and cognitive symptoms. It significantly impacts daily life.

6. Melancholic Depression

Melancholic depression is a subtype of major depressive disorder marked by intense feelings of sadness, hopelessness, and a lack of response to positive stimuli. 

 7. Manic Depression 

Manic depression, or bipolar disorder, involves extreme mood swings between manic episodes (elevated mood, high energy) and depressive episodes (low mood, loss of interest). It is a mood disorder with distinct periods of mania and depression.

8. Psychotic Depression

Psychotic depression combines severe depression with psychosis. Psychosis involves distorted thinking and perception. Individuals with psychotic depression may experience delusions or hallucinations alongside depressive symptoms.

Common Symptoms of Depression

Here are some of the most common symptoms found in all forms of depression:

  • Experiencing heightened irritability, frustration, or a sense of restlessness.
  • No longer finding joy or interest in activities or hobbies that were once enjoyable.
  • Feeling a lack of hope and a tendency to expect negative outcomes.
  • Continual feelings of profound sadness, anxiety, or an overall sense of emptiness
  • Challenges with sleep patterns, including difficulty sleeping, early morning waking, or oversleeping. Changes in appetite lead to unplanned weight shifts.
  • Thoughts of death or suicide, or actual attempts to harm oneself.
  • Feelings of guilt, worthlessness, or helplessness weigh on one’s emotional state.
  • Decreased energy levels, fatigue, and difficulties with concentration, memory, and decision-making.
  • Aches, pains, headaches, cramps, or digestive problems without a clear physical cause and persisting despite treatment

Can Social Anxiety Cause Depression? 

The link between anxiety and depression is quite strong, as they often coexist and share similar features. If you are facing constant fear in social situations, it can take a toll on your mental health. That kind of answers our questions as well.

So, the answer is, YES, social anxiety can lead to depression. When someone feels very anxious in social situations for a long time, it can contribute to the development of depression. However, it’s important to note that this doesn’t happen to everyone with social anxiety, but there is a relationship between anxiety and depression.

This 2020 study proves that anxiety and depressive disorders are common mental illnesses that often occur together. They are more prevalent in women than in men.

This 2017 study also suggests that students with social anxiety disorder were more likely to experience depression and have a poor quality of life. The study also found that females were more likely to experience SAD than males. Moreover, a 2020 study also shows that over half of people with social anxiety disorder also have depression. The study also found that higher levels of social anxiety are associated with higher levels of depressive symptoms. These findings support the existing evidence that social anxiety and depression are closely linked.

Factors Contributing to the Connection between Anxiety and Depression

Here are some of the common contributing factors to the link between depression and social anxiety.

1. Psychosocial Factors

This refers to social and psychological aspects influencing the shift from social anxiety to depression. These may include challenges in forming connections, coping with societal expectations, and stigmas around social anxiety; all of these can lead to depression.

This 2021 study found that both social anxiety and depression are stigmatized among adolescents. Males scored higher on measures of personal stigma, while females had higher scores on perceived stigma. 

2. Impact of Chronic Stress

Persistent stress, often linked to ongoing social anxiety, can contribute to the development of depression. Chronic stress strains the body and mind, affecting overall well-being.

This 2023 study found that people with social anxiety are more likely to experience stressful life events that are caused by their own behavior. These events are perceived as more impactful, and people with social anxiety tend to blame themselves more for them, which can cause depression.

3. Isolation

Social anxiety may lead to isolation, limiting social interactions. Prolonged isolation is a known risk factor for depression, as it can intensify feelings of loneliness and disconnection.

4. Negative Thought Patterns

Unhealthy thought patterns associated with social anxiety, such as constant self-criticism and fear of judgment, can contribute to a negative mindset. This negative thinking, when persistent, may contribute to the onset of depression.

5. Shared Mechanisms and Neurobiology

There are common underlying mechanisms and neurobiological factors between social anxiety and depression, such as neurotransmitter imbalances or alterations in brain structures associated with mood regulation.  These shared aspects of the brain’s functioning may contribute to the progression from one condition to the next. 

How do you know if you have both SAD and MDD? 

If you frequently feel extremely anxious in social situations and also have persistent sadness, there is a chance you may have both Social Anxiety Disorder (SAD) and Major Depressive Disorder (MDD), commonly called “social depression.” Seeking a professional evaluation is crucial for an accurate diagnosis but here we are explaining some key similarities and differences between both disorders so that it can help you make a decision.

This 2023 study found that social interaction anxiety is associated with depression in both men and women, but the relationship is stronger in men for symptoms of self-dislikeness and worthlessness. 

Comorbid Condition

When someone has both SAD and MDD, it’s called a comorbid condition. This means they are dealing with both disorders at the same time. Comorbidity is common in mental health, and having SAD and MDD together can present unique challenges.

This 2001 study also suggests that social anxiety and depression are highly comorbid, with up to 80% of people with social anxiety also experiencing depression.

Similarities in Symptoms

Symptoms of social anxiety and depression can be similar in many cases, such as:

  • Changes in Appetite

Individuals with both disorders may experience changes in appetite, such as increased or decreased eating.

  • Impact on Daily Life: 

Both conditions can significantly impact daily functioning, affecting relationships, work, and overall quality of life.

  • Concentration Difficulties

Difficulties with concentration and focus can be common symptoms of both SAD and MDD.

  • Physical Symptoms: 

Both can manifest physical symptoms like changes in sleep patterns, fatigue, and stomach problems.

  • Emotional Impact

Feelings of hopelessness and emotional distress are shared aspects of both conditions.

This 2001 study also shows that these two conditions share some common symptoms, such as sadness, anhedonia (loss of pleasure), and social withdrawal.

Social Anxiety Disorder versus Depression

The 2001 study suggests that there are also some important distinctions between social anxiety and depression. For example, people with social anxiety are more likely to fear social situations, while people with depression are more likely to experience guilt, worthlessness, and hopelessness. The differences in symptoms of social anxiety and depression are as follows:

AspectSocial Anxiety DisorderDepression
Core SymptomsIntense fear of social situations or scrutinyPersistent sadness, loss of interest
Social InteractionsFear or avoidance of social interactionsSocial withdrawal and isolation
Emotional StateAnxiety, panic, or distress in social settingsOverwhelming sadness, hopelessness
Negative ThoughtsFear of judgment, embarrassment, or scrutinyNegative self-perception, worthlessness
Physical SymptomsSweating, trembling, and rapid heartbeatFatigue, changes in sleep or appetite
Impact on LifeImpaired functioning in social situationsImpaired daily activities and relationships
Treatment ApproachesTherapy (CBT), Exposure therapy, medicationTherapy (CBT), medication, and Lifestyle changes

Diagnostic Evaluation

A mental health professional would assess your symptoms to determine if you have both disorders. They consider the duration, intensity, and impact on daily life to make an accurate diagnosis and develop an appropriate treatment plan.

This 2001 study found that social anxiety disorder (SAD) is often underdiagnosed and undertreated. They also discuss the need for greater awareness and training among primary care providers about SAD.

Individuals At Risk of Developing Social Anxiety

Individuals with the following conditions may be at a higher risk of developing social anxiety:

  • Individuals with a history of trauma may be at higher risk.
  • A family history of depression increases vulnerability.
  • Having other mental health conditions can elevate the risk.
  • Prolonged stress due to untreated social anxiety is a significant risk factor.
  • A lack of social connections and support can contribute to vulnerability.
  • Persistent negative thinking associated with social anxiety increases the risk.
  • Specific cognitive vulnerabilities, like perfectionism or excessive self-criticism, can contribute to the risk.
  • Experiencing adversity in childhood, such as neglect or abuse, can heighten vulnerability.
  • Certain biological factors, including genetic predispositions and neurotransmitter imbalances, may play a role.
  • Managing chronic health conditions can add to the stressors that elevate the risk of depression.
  • Substance abuse, including alcohol or drug misuse, is linked to an increased risk of depression in those with social anxiety.
  • Insufficient coping mechanisms to deal with stress and anxiety contribute to vulnerability.
  • Economic hardship and limited access to resources may increase the risk of depression in individuals with social anxiety.

This 2021 study found that college students who use dysfunctional coping strategies, such as substance use and self-blame, are more likely to experience social anxiety and depression.

Untreated Social Anxiety Escalating into Depression

When social anxiety goes untreated, the chronic stress and isolation it causes, can become a breeding ground for depression. The persistent emotional burden, negative thought patterns, and impaired social functioning associated with untreated social anxiety contribute to the escalation of depression. Timely intervention and addressing social anxiety can help prevent this progression.

These 2001 findings also suggest that SAD is an important risk factor for depression and that it may make depression more difficult to treat. Therefore, it is important to screen for and treat social anxiety disorder in adolescents and young adults.

Coping Tips for Managing Social Anxiety and Preventing Depression

The following are some helpful coping tips for managing social anxiety.

  • Cultivate positive self-talk to counter negative thoughts.
  • Practice gradual exposure to feared social situations.
  • Incorporate relaxation techniques for anxiety management.
  • Embrace mindfulness techniques for emotional regulation.
  • Learn and practice social skills to boost confidence.
  • Engage in regular physical activity for stress relief.
  • Participate in support groups for shared understanding.
  • Maintain a healthy lifestyle with proper sleep and nutrition.
  • Set realistic goals to foster a sense of achievement.
  • Be mindful of substance use and its impact on mental health.

Treatment of Social Anxiety Disorder

Social anxiety and depression treatment are often similar, except for a few things that are specific to each of them. Here are the therapies that can be effective treatment methods for social anxiety.

Therapies

The following therapies can be effective in treating your social anxiety disorder.

  • Cognitive-Behavioral Therapy (CBT)

CBT helps individuals identify and change negative thought patterns and behaviors associated with social anxiety, fostering healthier coping mechanisms.

  • Exposure Therapy

This involves gradually facing feared social situations, helping desensitize individuals to anxiety triggers, and building confidence.

  • Dialectical Behavior Therapy (DBT)

DBT combines cognitive-behavioral techniques with mindfulness, emphasizing acceptance and change. It’s effective for addressing emotional dysregulation.

  • Interpersonal Therapy (IPT)

IPT focuses on improving interpersonal relationships and communication skills and addressing social anxiety by enhancing connections with others.

Medications for SAD and Depression

The medications for social anxiety and depression are as follows:

  • Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Commonly prescribed antidepressants can be effective for both depression and social anxiety by regulating neurotransmitters.

  • Benzodiazepines

These anti-anxiety medications may provide short-term relief for social anxiety symptoms, but they are generally prescribed cautiously due to the risk of dependency.

  • Beta-Blockers

Used to manage physical symptoms of anxiety (such as rapid heartbeat), beta-blockers can be helpful in specific social situations for some individuals.

Self-Help Books

Here we have mentioned self-help books for both social anxiety and depression.

1. Overcoming Social Anxiety and Shyness by Gillian Butler 

This book provides practical guidance on overcoming social anxiety and shyness, offering actionable strategies for building confidence in social situations.

2. Essential Strategies for Social Anxiety by Alison Mckleroy 

This book outlines key approaches to tackle social anxiety, emphasizing essential strategies to navigate and overcome challenges in social interactions.

3. Overcome Social Anxiety and Shyness by Matt Lewis

This book offers insights and techniques to conquer social anxiety,providing a comprehensive guide for individuals seeking practical solutions to improve their social confidence.

4. Overcoming Depression by Paul Gilbert

This book explores strategies and therapeutic approaches to overcome depression, emphasizing the importance of compassion-focused therapy.

5. How to Understand and Deal with Depression by Wendy Green 

This book provides insights into understanding depression and offers practical advice on coping mechanisms and self-help strategies.

6. Low: The 7 Ways to Deal with    Depression by Cyrus Brown 

This book outlines seven actionable ways to address and cope with depression, providing a comprehensive guide for individuals seeking practical solutions.

Conclusion 

In summary, we’ve explored the connection between social anxiety and depression, and we’ve answered the main question: Can social anxiety cause depression? So, now you guys know that the answer is yes. We have explained the treatment options and coping strategies. By understanding this link and taking proactive measures, individuals can better manage anxiety, reducing the risk of it leading to depression.

Frequently Asked Questions ( FAQs) 

Here are the answers to some of the most frequently asked questions about social anxiety.

1. What does severe social anxiety feel like?

Severe social anxiety can feel overwhelming, like an intense fear of judgment and embarrassment in social situations. It may lead to physical symptoms such as sweating, trembling, and a racing heart.

2. What makes social anxiety worse?

Social anxiety can worsen with negative self-talk, excessive self-criticism, and avoiding social situations. Stressful environments, fear of scrutiny, and past negative experiences can also contribute.

3. Can social anxiety ruin life?

While social anxiety can be challenging, with proper support and treatment, it doesn’t have to ruin life. Seeking help, practicing coping strategies, and gradually facing fears can significantly improve the impact of social anxiety.

4. What are the four levels of social anxiety?

Social anxiety levels vary, but broadly, they range from mild discomfort to severe fear. Levels may include:

  • Mild: Occasional discomfort
  • Moderate: Difficulty in specific social situations
  • Severe: Intense fear affecting daily life
  • Very Severe: High anxiety in most social interactions

5. Do I have social anxiety, or am I just shy?

Shyness involves discomfort in social situations, while social anxiety goes further with intense fear and physical symptoms. If anxiety significantly interferes with daily life, it might be social anxiety, and seeking professional guidance can provide clarity.

This 2001 research suggests that social anxiety, also known as social phobia, is a common mental health disorder characterized by an intense fear of social situations. While shyness is a common experience that most people have at some point in their lives, social anxiety is a more severe and persistent condition that can significantly interfere with a person’s life.

6. What is social depression?

The term “social depression” is not a formal diagnosis in the DSM-5, the standard classification system for mental disorders in the United States. However, it is sometimes used to describe a condition in which someone experiences symptoms of both social anxiety disorder and depression.

Social depression is also known as social withdrawal depression and is characterized by a loss of interest in social activities and a withdrawal from social interactions. People with social depression may feel isolated, lonely, and unappreciated. Individuals who feel depression in social situations may avoid them altogether or only participate in them out of obligation.