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Social anxiety: When, how and why?

When does social anxiety start?

Social anxiety normally develops in childhood or early adolescence.

There are broadly two groups:

Group 1:
Social anxiety develops in adolescence between the ages of 11 to 19 years. The person may, or may not, have been previously shy. Social anxiety develops in this period because it is a time of becoming self-aware and self-conscious. It is a period where a person starts to think more about what other people think about them.

Group 2:
This is usually the more severe form. Parents will describe the person as always being that way since they were a child. The child would avoid any sort of social interaction. For example, if someone would come to the house, they would run upstairs, or if they saw someone they know walking in the street, they would look the other way. Another example is selective mutism. Here the child is capable of speech, but refuses to speak to other people – they will often only speak to the parents.

How common is social anxiety?

Social anxiety disorder is common.

It is difficult to give an accurate estimate. This is because most people with social anxiety never seek help – they see it as part of who they are. In addition, there can be some difficulty in the diagnosis, because it depends on subjective judgements.

There are estimates for social anxiety from 2{969778691359240c072e97759c2d0fb09c0cc365602a2d062bed06458e86e909} to 7{969778691359240c072e97759c2d0fb09c0cc365602a2d062bed06458e86e909} to 13{969778691359240c072e97759c2d0fb09c0cc365602a2d062bed06458e86e909} of the population.

A reasonable estimate would be 5{969778691359240c072e97759c2d0fb09c0cc365602a2d062bed06458e86e909} of the population. This has been used by many experts in the field.

This means, 1 in every 20 people suffer with social anxiety disorder. Imagine, for every 20 people you knew at school, 1 of them had social anxiety disorder. That person was probably very shy, would never speak up in class, and may have had 1 or 2 close friends.

So, if you suffer with social anxiety disorder, you are not alone. There are many people like you.

Why do I have social anxiety?

There is no direct answer for this. However, here are some factors:

  • There is no proven relationship between adverse evnets in childhood and adolescent, and the onset of social anxiety.
  • There does not seem to be a cultural effect. For example, in cultures which are more reserved like Japan, they have similar rates of social anxiety disorder to the US and UK.
  • Adolescence is a factor. It is a time of becoming self-conscious and thinking about what other people think about you.
  • There is a strong familial tendency i.e. social anxiety disorder tends to run in families.
  • There appears to be a genetic element. This has been confirmed by studies on twins.
  • The brain in someone with social anxiety disorder appears to be overactive in a particular area. This area is called the limbic system. This includes a part known as the amygdala. This is where the brain processes and regulates emotions and memories and determines possible threats. It is part of our survival mechanism which becomes activated when we are in danger. However, in someone with social anxiety disorder, it is overactive. It is like it is turned on all the time.


Social anxiety disorder is common. It affects about 1 in 20 people. It usually starts in childhood or adolescence. There is a family and genetic component to it. In the brain, the part which is responsible for emotions, like fear, is overactive.

Take care,


Dr Paul Ogilvie
Dr Paul Ogilvie