6 Signs of Living With Social Anxiety

You’re at an office holiday party surrounded by co-workers and people you’ve never met before. Suddenly, your boss nudges you to a podium to give a speech about last year’s record sales numbers. You immediately begin to sweat, tremble, your mouth feels dry, and you feel nauseous. What’s happening?


“It’s normal to feel nervous in some social situations. For example, going on a date or giving a presentation may cause that feeling of butterflies in your stomach. But in social anxiety disorder, also called social phobia, everyday interactions cause significant anxiety, fear, self-consciousness and embarrassment because you fear being scrutinized or judged by others.” All of the fear and anxiety results in avoidance and disruptions to your daily life, work, school or other activities.


While it doesn’t have one specific cause, there are many risk factors that can increase a person’s likelihood of developing a social anxiety disorder. A person who’s naturally more reserved and someone who’s experienced trauma like childhood abuse or neglect are at a greater risk of developing the disorder. Additionally, someone with a first-degree blood relative – a parent or sibling – who has the disorder is up to six times more likely to experience a social anxiety disorder.


Several factors can boost your chance of getting social anxiety disorder, including:

  • Family history. You’re at greater risk of developing social anxiety disorder if your biological parents or siblings suffer from the condition.
  • Children who are harmed by teasing, rejection, ridicule, bullying, or humiliation may be more susceptible to social anxiety disorder. Plus, other negative things in life, like family conflict, trauma or abuse, may be linked to social anxiety disorder.
  • Children who are restrained, shy, timid, or withdrawn when dealing with new situations or people can be at greater risk.
  • Even though social anxiety disorder symptoms normally begin in the teen years, new social or work demands – meeting new people, giving a public speech, or making a big work presentation – may trigger first-time symptoms.
  • Something that draws attention to yourself, like facial disfigurement, stuttering, or Parkinson’s disease tremors can make you feel self-consciousness and trigger the disorder in some people.


If you think you have social anxiety but aren’t ready to see a healthcare professional for diagnosis, you can look for several signs which may indicate you have the disorder. Self-diagnosis can never replace the opinion of a trained professional– but it may help you better understand what you’re dealing with. The following may be signs you’re living with social anxiety.

  • You’re so self-aware that you become physically ill. Everyone at some point is concerned with how others will judge and accept them, but with social anxiety, you’re so preoccupied with it that worry and fear overwhelm every fiber in your body until you become physically ill.
  • You may blush, feel nauseous, or suffer other physical symptoms. It’s normal to be nervous sometimes in public, but blushing elevates your discomfort to a whole new game. You find yourself struggling to hide the heat and redness creeping up your neck and into your face – all the while, someone nearby smirks or laughs at your pain.
  • You worry for weeks prior to a big event, succumbing to something called anticipatory anxiety. 
  • You suddenly discover that you can’t talk – to anyone. Your mouth becomes dry, the words stuck in your throat, as thoughts race through your brain, and you’re powerless to control them.
  • You’re worried about humiliating yourself and avoid anywhere other people congregate.
  • You can’t stop worrying – about nothing, and everything. The fear is unreasonable but it’s all you think about.


Your doctor may offer a diagnosis based on:

  • Physical exam to help decide if a medical condition or medicine has triggered symptoms of social anxiety.
  • Talking about your symptoms, how often they happen, and when they happen.
  • Review a number of scenarios to see if you become anxious.
  • Self-reported questionnaires about your symptoms.
  • Criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Treatment depends on the degree to which social anxiety disorder affects your daily life. The two most popular forms of treatment for social anxiety disorder are counseling, medications, or both.


Social anxiety can be debilitating in certain situations, but with commitment and proper care, you can learn to overcome the symptoms and regain a semblance of control over your life. Some people turn to medicine or counseling, while others have discovered the benefits of ketamine therapy to manage their symptoms.


What Is Persistent Depressive Disorder?

Depression is one of the most common forms of mental illness worldwide, but its symptoms are often misperceived as “just a bad day.” But if symptoms linger for months or years and interfere with daily life, you may be experiencing the first warning signs of something called persistent depressive disorder.


Persistent depressive disorder (PDD), also called dysthymia, is a chronic form of depression. You can lose interest in normal daily tasks, lack productivity, feel hopeless, and have poor self-esteem and an overall sense of failure. These feelings linger for years and may substantially restrict your relationships, work, school, and daily activities. And the symptoms may lead to other related conditions, both mentally and physically worrisome, but can often be managed with treatments like ketamine.


While PDD isn’t as serious as major depressive disorder, a diagnosis can only be made after experiencing a mix of depressive symptoms for two-plus years, according to the National Institute of Mental Health. It affects a little more than one percent of the adults in the United States. Almost 50 percent of these cases are deemed “severe,” with the average age of occurrence being 31 years.

The condition can harm children and adolescents, too. Research shows that about 11.2 percent of 13 to 18-year-olds are affected by it in their lives, with girls more likely to experience depression than boys.


  • Lasting anxiety, sadness, or “empty” moods.
  • Less ability to think, focus, and/or make decisions.
  • Low energy and fatigue.
  • Feeling desperate.
  • Weight and/or appetite changes caused by under- or over-eating.
  • Changes in sleep habits, leading to fitful sleep, problems sleeping, early morning wakeups, or getting too much sleep.
  • Poor self-esteem.

But symptoms are manageable. Some people believe PDD can be treated with therapies like psychotherapy, traditional antidepressants, or newer options like ketamine – and have seen improvement in their lives. The catch is being persistent.

“Persistent depressive disorder is difficult to live with and its symptoms are hard to manage — but they are manageable,” said Heather Jones, who’s suffered from depression for 25 years, beginning when she was a teenager. “If you are feeling as I was, that you have tried so many things and nothing has fully helped, keep trying. Keep advocating for yourself and stay on top of new treatments.”



According to the World Health Organization, depression and its many forms is one of the leading causes of disability worldwide, but PPD – like so many others – is missing a root cause. No one knows what causes PDD. It could be linked to some changes in the brain involving a chemical called serotonin, which helps your brain make judgments and handle emotions. Other medical problems and continual life stressors may play a part.

Gender may be important, too, as women are more likely to develop PDD. Some research indicates that genetics could also play a role, passed down between blood relatives.


Persistent depressive disorder is a kind of depression. It’s less harsh than major depressive disorder — but it’s continual. Most mental healthcare professionals agree with the diagnosis requirement, that it lasts two years in adults and at least a year in children and teens. During this timeframe, symptoms can be severe and don’t subside or lessen on their own. Some forms of depression can be caused by seasonal changes, for example, but not persistent depressive disorder.


Depression often occurs with other illnesses, like heart disease or cancer. It can also happen with anxiety disorders or substance abuse. Often, people who suffer from PDD symptoms grow used to the mild depressive warning signs and don’t look for help. However, early diagnosis and consistent treatment is key to recovery.

A diagnosis may be made by a licensed doctor or other medical professional specializing in mental healthcare. The goal of both is to uncover a physical reason for the symptoms or discover a personal or family history of mental illness that could be considered a precursor to PDD onset.


The traditional form of treatment for PDD is psychotherapy with the goal of altering distorted views of oneself and your environment. Psychotherapy, either in-patient or out-patient, also works to better relationship skills, and recognize and manage stressors. In the last several years, however, researchers and doctors have discovered that a treatment featuring the use of ketamine holds great promise for treating depression symptoms. In some cases, ketamine and other treatments are used as a last-resort effort.

If you or someone you love suffers from depression, you may be able to find relief with ketamine treatment.

Call Us