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Social Anxiety Disorder and Addiction

Medically Verified: 2/1/24

Medical Reviewer

Chief Editor

All of the information on this page has been reviewed and verified by a certified addiction professional.

Social anxiety disorder and addiction are two mental health conditions that often exist simultaneously and feed off one another. Social anxiety can lead people to self-medicate with drugs and alcohol, while substance abuse and addiction can make people want to isolate themselves from their friends and family. While substance abuse can cause social anxiety, it is more common for people with a social anxiety disorder to abuse drugs and alcohol to cope with their symptoms, ultimately developing a substance use disorder.

Even though all forms of anxiety increase the risk for substance abuse and addiction, social anxiety is unique because human connection and peer support is a vital aspect of recovery. As a result, successful treatment involves integrated therapy that addresses both issues at the same time.

What is Social Anxiety Disorder?

Social anxiety disorder is a legitimate mental health condition that can severely affect a person’s life. People with this condition may experience intense anxiety, fear, embarrassment, or self-consciousness about everyday interactions because they fear being judged or scrutinized by others. Social anxiety disorder usually begins in the early to mid-teen years. However, symptoms can also appear in young children or adults.

While it is normal to feel anxious before a presentation or to be shy around new people, people with social anxiety experience these symptoms at a greater intensity, making it difficult to function in everyday life. They may avoid common situations, such as going to work or school, starting conversations, meeting new people, making eye contact, dating, eating in public, or standing up in a room where people are seated.

Signs and Symptoms

Symptoms of social anxiety disorder may evolve over time. In times of high stress, they may become more severe. In more comfortable situations, symptoms may not be noticeable at all.

Emotional and behavioral symptoms of social anxiety disorder include:

  • Experiencing intense fear of social situations in which one may be judged by others
  • Constant worry about embarrassing or humiliating oneself
  • Intense fear of talking to or interacting with others
  • Being scared that others will realize one’s nervousness
  • Fear of being noticed due to physical symptoms (blushing, shakiness, sweating, etc)
  • Avoiding social situations or activities
  • Enduring social events with intense fear and anxiety
  • Spending excess time analyzing social situations or one’s performance
  • Expecting bad consequences or negative experiences during social situations

Physical symptoms of social anxiety disorder include:

  • Redness of skin or blushing
  • Racing heartbeat
  • Sweating
  • Trembling
  • Nausea
  • Upset stomach
  • Difficulty catching one’s breath
  • Dizziness
  • Muscle tension
  • Feeling as though one’s mind has gone blank

The Relationship Between Social Anxiety Disorder and Substance Abuse

In most cases, social anxiety disorder develops before addiction as a result of trying to self-medicate symptoms. As a result, a diagnosis of social anxiety disorder increases the risk for other conditions, like drug addiction and alcoholism.

Social Anxiety and Alcohol Abuse

Unfortunately, social anxiety disorder and alcoholism are closely linked. Alcohol is a depressant that many people use to relax after a long day at work or decrease their inhibitions to enjoy social settings. Although alcohol produces temporary relief of anxiety symptoms, alcohol abuse can lead to a range of serious problems.

People who abuse alcohol may act out in embarrassing or humiliating behaviors. They may do things they normally would not do sober. And, when they sober up and remember the things they did, people with a social anxiety disorder may become extremely embarrassed and upset. They may drink more to overcome these feelings of shame and embarrassment. In the end, binge drinking simply becomes a part of the cycle of anxious and obsessive thinking, worsening one’s social anxiety.

Studies show that nearly 20% of people with social anxiety disorder also struggle with an alcohol use disorder. This number may be higher in women.[2]

Social Anxiety and Drug Abuse

People with social anxiety disorder may also abuse certain types of drugs to try and cope with their anxiety symptoms. Some of the most commonly abused drugs among people with social anxiety are marijuana, benzodiazepines, and opioids. All of these substances are known to slow down the central nervous system and promote feelings of relaxation and calmness.

In one study, up to 26% of people who struggled with marijuana addiction also had social anxiety disorder.[3] In another study, up to 75% of patient cases suggested that an anxiety disorder predated a substance use disorder.[4]

Treatment for Social Anxiety Disorder and Addiction

Substance abuse and addiction can interfere with the success of a treatment program in many different ways. For example, substance abuse often makes people isolated or withdrawn from their loved ones, and social anxiety can exacerbate the level of avoidance and isolation a person experiences. These individuals may also experience an extreme fear of being judged for their addiction or for seeking treatment, causing them to avoid getting help for a long time.

When a person finally does seek help, an integrated approach that involves dual diagnosis therapy is ideal. Therapies used to treat social anxiety disorder and drug or alcohol addiction include:

  • Cognitive-behavioral therapy (CBT)
  • Psychotherapy (talk therapy)
  • Exposure therapy
  • Antidepressants/anti anxiety medication
  • Peer support groups
  • Holistic therapies (yoga, meditation, art, etc)

Both substance abuse and social anxiety disorder are best treated through therapeutic interventions that minimize the need for medication. This approach helps break the cycle of using medication to deal with symptoms while teaching patients new coping mechanisms. CBT is particularly helpful in targeting both addiction and social anxiety by helping clients learn to regulate their emotions and manage their anxiety in safe and effective ways.

Find Dual Diagnosis Addiction Treatment in North Carolina Today

Asking for help with addiction is never easy, and if you have social anxiety, the thought of picking up the phone and speaking with a stranger can be terrifying. Here at Carolina Center for Recovery, we understand what you’re going through – and we’re not here to judge you. Our team of qualified mental health professionals can provide you with a full continuum of care in a compassionate and accepting environment.

For a confidential and risk-free consultation, call and speak with one of our treatment representatives today.