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I am sorry if this question seems offensive in any way: I am asking truthfully because I do not know the difference in diagnosis.

My question is by which criteria social anxiety disorder is diagnosed as opposed to just being a generally (very) social anxious person.

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The Diagnostic and Statistical Manual of the American Psychiatric Association (APA), also known as the DSM, is the guide for any psychological disorders, and the DSM-5 which is the current version (APA, 2013) describes Social Anxiety Disorder as follows:

A. A persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.

B.  Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally pre-disposed Panic Attack.

C.  The person recognizes that this fear is unreasonable or excessive.

D.  The feared situations are avoided or else are endured with intense anxiety and distress.

E.  The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.

A key point the DSM also points out is that in Social Anxiety Disorder, the fear, anxiety, or avoidance is:

  • persistent
  • typically lasting 6 or more months
  • causes clinically significant distress or impairment in social, occupational or other important areas of functioning
  • not due to direct physiological effects of a substance (e.g., drugs, medications)
  • not due to a general medical condition not better accounted for by another mental disorder.

References

APA (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publishing.

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