Anxiety Disorders
Social Anxiety Disorder
ICD-10-CM: F40.10
1. Criteria
DSM Criteria
Criterion A
- Marked fear or anxiety occurs in one or more social situations involving possible scrutiny by others.
- The person fears acting in a way or showing anxiety symptoms that will be negatively evaluated.
DSM Criteria
Criterion B
- The social situations almost always provoke fear or anxiety.
DSM Criteria
Criterion C
- The social situations are avoided or endured with intense fear or anxiety.
DSM Criteria
Criterion D
- The fear or anxiety is out of proportion to the actual threat posed by the social situation and the sociocultural context.
DSM Criteria
Criterion E
- The fear, anxiety, or avoidance is persistent, typically lasting 6 months or more.
DSM Criteria
Criterion F
- The fear, anxiety, or avoidance causes clinically significant distress or impairment.
DSM Criteria
Criterion G
- The symptoms are not attributable to a substance or another medical condition.
DSM Criteria
Criterion H
- The disturbance is not better explained by another mental disorder.
DSM Criteria
Criterion I
- If another medical condition is present, the fear is clearly unrelated or excessive.
2. Context
- Social anxiety disorder is usually about being seen, judged, embarrassed, or exposed in front of other people. Some patients avoid those situations entirely, while others keep showing up but feel tense, preoccupied, and exhausted by the experience.
- Scrutiny theme: The feared outcome is usually some form of negative evaluation, like embarrassment, rejection, humiliation, or visibly looking anxious.
- Duration: This tends to be a stable pattern, not just a bad week or a rough stretch before one important event.
- Subtype thinking: Some people fear only performance situations, while others struggle across much broader social and interpersonal settings.
- Clinical focus: Common clinician-rated or self-report scale for social fear and avoidance.
3. Validated scales
Liebowitz Social Anxiety Scale
Common clinician-rated or self-report scale for social fear and avoidance.
SPIN
Brief self-report screen and severity tracker.
4. FDA approved treatments
FDA-indicated medications commonly used for social anxiety disorder
FDA labeling for social anxiety disorder exists for selected SSRIs and SNRIs; verify the specific product label before clinical use.
Common treatment side effects
Check drugs.com/sfx for common side effects. Direct side-effect links for the medications in this section are below when available.
Common off-label medications
Interventional psychiatry modalities
- TMS is under study in social anxiety disorder.
- Ketamine is investigational for refractory anxiety symptoms.
- ECT is not standard for isolated social anxiety disorder.
Related Guides
5. Top management articles
- Social anxiety disorder The Lancet review
- Cognitive behavioral therapy for social anxiety disorder Treatment literature
- Pharmacotherapy for social anxiety disorder Review literature
When to seek professional help
- Seek urgent help if there are thoughts of suicide, self-harm, or feeling unable to stay safe.3
- Seek urgent help if there are thoughts of harming someone else, escalating violent urges, or loss of behavioral control.3
- Take hopelessness seriously, especially if the person feels trapped, cannot imagine staying safe, or is withdrawing from support.4
- Use emergency services if there is immediate danger, severe agitation, psychosis, intoxication, or inability to care for basic needs. In the United States, call or text 988 for crisis support and call 911 for immediate danger. Use emergency services in your region if you are outside the U.S.3
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