Social Anxiety and Depression

Social Anxiety Help

Larry Cohen, LICSW

Social Anxiety and Depression

Anxiety Disorders Association of America
July 2009

About 15 million U.S. adults, or 7 percent of the population, have social anxiety disorder in any given year, and it isn’t uncommon for many to receive at least one other diagnosis.

Murray Stein, MD, MPH, and John Walker, PhD, write in Triumph Over Shyness: Conquering Social Anxiety Disorder that social anxiety disorder “frequently travels in the company of other emotional difficulties” such as alcohol or drug abuse, depression, and other anxiety disorders….

One in three people with social anxiety disorder also have major depression, and those with both disorders are more likely to have more severe depressive symptoms.

Additionally, studies show that social anxiety disorder during one’s adolescence or young adulthood seems to predict depressive disorders later in life. Researchers are studying whether or not early treatment of social anxiety disorder reduces the risk for depression down the road.

Symptoms of major depression include the following and last for at least two weeks:

  • Loss of interest in hobbies and activities
  • Feeling sad, down, or anxious
  • Feeling hopeless, helpless, or worthless
  • Difficulty concentrating or making decisions
  • Insomnia or oversleeping
  • Decreased energy
  • Low appetite or overeating
  • Blaming yourself for your situation
  • Thoughts of death or suicide

Social anxiety disorder and depression are treated in similar ways. The following treatments can be effective in treating both disorders:

Cognitive-behavioral therapy (CBT)

A short-term form of psychotherapy, CBT focuses on identifying, understanding, and modifying thinking and behavior patterns. In CBT the patient is actively involved in his or her own recovery, has a sense of control, and learns skills that are useful throughout life.


Some selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are approved by the FDA to treat both social anxiety disorder and depression….

Attention training

Recent studies have shown attention training can be as effective in treating social anxiety disorder as CBT and medication. Other studies have shown it to be effective in reducing depression symptoms. Attention training helps patients practice how not to focus on threatening words or on images of threatening faces.

Regular exercise

Although not a treatment for social anxiety disorder, regular exercise may be very helpful as an adjunct to other treatments. Scientists have found that regular participation in aerobic exercise can decrease overall levels of tension, elevate and stabilize mood, improve sleep, and improve self-esteem. Even five minutes of aerobic exercise can stimulate anti-anxiety effects.


If you have any questions or comments, please email Larry Cohen, LICSW, with offices in Washington, DC.

Social Anxiety Help is a founding regional clinic of the National Social Anxiety Center (NSAC):