PTSD and social anxiety disorder (SAD) commonly co-occur, and there are a number of possible reasons why people with PTSD, as compared to those without the diagnosis, may be more likely to develop fears of social situations.
What is Social Anxiety Disorder?
Before talking about the relationship between PTSD and SAD, it is important to first understand what is SAD.
SAD (sometimes also called "social phobia") is considered an anxiety disorder. According to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, to be diagnosed with SAD, you need to experience the following symptoms:
- You have a frequent and unending fear of social situations or situations where you are expected to perform in some way. In these situations, you come in to contact with unfamiliar people or experience the possibility of scrutiny by others.
- You experience fear about appearing anxious or acting in a way that will bring about embarrassment or humiliation.
- Your upcoming contact with a feared situation almost always causes anxiety, maybe even in the form of a panic attack.
- You recognize that the fear you experience in response to social situations is unreasonable or greater than it should be.
- You avoid situations you fear, or if you have to be in those situations, you do so with high levels of anxiety and distress.
- The above symptoms interfere considerably with many aspects of your life (work, relationships, etc.).
- The above symptoms are not due to the taking of some kind of medication or substance (i.e., alcohol) and are not due to a medical condition or other disorder.
Rates of SAD Among People with PTSD
The percentage of people with PTSD who also have SAD differs depending on the group of people that you look at. For example, in a large study of people from the general population, approximately 28% with a current or past diagnosis of PTSD also were found to have or have had a diagnosis of SAD. People who had PTSD at some point in their lives were three times as likely as someone without PTSD to have also had SAD.
Another study of patients seeking treatment for PTSD found that, of those patients with a diagnosis of PTSD, 43% also had SAD. In another study of a group of people who survived a disaster, though, it was found that only 8% of those with PTSD also had SAD. Finally, a couple of studies found that anywhere between 12 and 15% of combat veterans with PTSD have SAD, and this rate is higher than what is found among combat veterans without PTSD.
Why Are PTSD and SAD Related?
A number of theories have been proposed to explain why PTSD and SAD are related. First, the symptoms of PTSD may make a person feel different, as though they can't relate or connect with others. A person with PTSD may have difficulties communicating or interacting with others for fear of coming in to contact with trauma-related reminders. All of this may feed the development of SAD.
In addition, many people with PTSD feel high levels of shame, guilt and self-blame, and these feelings may lead to SAD. Finally, there is evidence that SAD among people with PTSD stems from depression. People with PTSD often experience depression, which may lead to social withdrawal, isolation and a lack of motivation that could contribute to the development of SAD.
Getting Help
If you have PTSD and/or SAD, it is important to seek out help. You can learn more about treatments for SAD from Arlin Cuncic, the About.com Guide to SAD. Fortunately, there are many effective treatments for SAD.
In addition, there are treatments for PTSD that have been shown to be successful in reducing PTSD symptoms. To the extent that your SAD is connected to your PTSD, by getting treatment for PTSD, you may also notice that your symptoms of SAD reduce as well. You can find PTSD and SAD treatment providers in your area through UCompare HealthCare from About.com as well as the Anxiety Disorder Association of America.
Sources:
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