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What is Social Anxiety Disorder?

Many people would describe themselves as shy, saying they worry about being judged by others. Social anxiety disorder (aka social phobia) goes well beyond that, many teens and young adults struggle with social anxiety to an extent that dramatically affects their life.

Most people get nervous about talking in front of a room full of people or can’t find the courage to ask someone they like on a date.

For adolescents and young adults who struggle with social anxiety disorder (SAD), the thought of getting into an uncomfortable situation can be paralyzing.

The average age of onset is 13 years old, making it tricky to tell if your child suffers from SAD or is just going through an awkward teenage phase.

Signs of Social Anxiety

  • Extreme anxiety in social situations
  • Physical symptoms like nausea, sweating, and a racing heart
  • Fear of embarrassment
  • Avoiding situations or interactions that may be embarrassing
  • Worrying that people may notice the anxiety


Some people have specific social anxiety, for example, they are irrationally afraid of meeting strangers, talking on the phone or using public restrooms. Others have generalized social anxiety where any number of circumstances could feel overwhelming.

People with social anxiety will start to avoid many situations in their life. This often increases over time to the point where their entire life revolves around avoiding social situations.

Something this is mildly embarrassing to a confident person, however, this may feel unbearable to someone with Social Anxiety. Even when they are alone, they spend time worrying about scenarios and planning how to avoid or get out of them.

This can cause a downward spiral and lead to low self-esteem and depression.

What Leads to Social Anxiety in Teens and Young Adults

Social anxiety can have several origins. Often, people will internalize a belief based on one event that affected them or something that they have been told and taken to heart.

Social anxiety can also develop as a trauma response, where certain types of situations are perceived as unsafe and cause a fight, flight, or freeze response. Some examples of potentially triggering events are:

  • Being bullied
  • An embarrassing event that happened to the person, or to someone else.
  • Controlling or overly-protective parenting causing a child to be fearful of the perceived risks of many social situations.


The events or time periods that triggered social anxiety for some people may appear trivial to someone else. Imbalances in brain chemistry can lead people to blow situations out of proportion.

Another factor that may explain the prevalence of social anxiety is social media. Teens and young adults often put as much attention to their digital identity as their real one.

Social media never sleeps and especially considering the prevalence of cyberbullying, it’s no wonder many people suffer from social anxiety.

Substance Abuse and Social Anxiety

Studies show that social anxiety is the 3rd largest mental health issue and that the average person struggles for 10 years before seeking treatment.

People struggling with anxiety are 3 times more likely to develop a co-occurring substance abuse disorder, compared to the general population.

Shelli Yearsley, senior clinician for Adolescents at Sandstone Care, notes that most of her clients have some form of anxiety that they self-medicate with drugs and/or alcohol. She notes that many substances cause anxiety as a side-effect.

“This leads to a vicious cycle of using substances to treat anxiety, then causing more anxiety, then using more or a new combination of substances to counteract the side-effects.” This downward spiral can have debilitating effects.

Treatment for Social Anxiety and Substance Abuse in Colorado

While it can seem daunting, social anxiety is very treatable. There are many approaches to social anxiety treatment including Cognitive Behavior Therapy, which has been proven as an effective treatment modality.

So many people are secretly suffering, chances are someone near you is or has struggled with social anxiety.

Sandstone Care treats social anxiety along with co-occurring substance abuse and addiction issues. We teach coping skills to effectively manage anxiety without substances.

We have individual and group therapy options to help get at the roots of the issue. We also help families, so that they can support themselves and their loved ones through the healing process.

Sandstone Care’s clinical team has extensive experience working with teens and young adults with co-occurring mental health and substance abuse disorders.

We have both teen and young adult programs in Denver and Boulder, CO.  Call (888) 850-1890 for a confidential phone consultation.

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