Anxiety Social Anxiety Disorder Symptoms and Diagnosis Social Anxiety Disorder Guide Social Anxiety Disorder Guide Symptoms & Diagnosis Causes Treatment Living With In Children What Causes Social Anxiety Disorder? You environment, genetics, and more can all come into play By Arlin Cuncic, MA Arlin Cuncic, MA Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master's degree in clinical psychology. Learn about our editorial process Updated on June 11, 2024 Learn more." tabindex="0" data-inline-tooltip="true"> Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Genetic Causes Environmental Causes Societal Causes Brain/Biological Causes Next in Social Anxiety Disorder Guide Social Anxiety Disorder Treatments Close Social anxiety disorder (SAD) causes people to dread social situations where they might be embarrassed or judged. It's relatively common, affecting around 7% of adults in the U.S. If you have social anxiety, you may wonder what caused it. The truth is that there is no single cause. Instead, it is likely the result of a complex interplay of factors, including genetic, biological, and environmental causes. Understanding which variables might play a role may help you determine which treatments might be the most helpful for you. At a Glance There is no single cause of SAD. In most people, the disorder is the result of a combination of factors. Genetic, environmental, and societal causes can all play a part in causing the condition. When receiving a diagnosis or treatment for social anxiety disorder, your doctor or mental health professional should discuss with you possible contributing factors to your social anxiety. Illustration by Brianna Gilmartin, Verywell Genetic Causes of Social Anxiety Disorder If you are diagnosed with social anxiety disorder, you probably have specific genes that make you more prone to developing the disorder. If you have a first-degree relative with SAD, you may also be two to six times more likely to develop the disorder. The genetic component of social anxiety disorder is also known as the “heritability” of the disorder. Although heritability rates can vary a great deal in studies, it has been estimated that around 27% and 56% of the underlying causes of SAD come from genetics. Heritability is the proportion of variation in a phenotype (trait, characteristic, or physical feature) that is thought to be caused by genetic variation among individuals. The remaining variation is usually attributed to environmental factors. Studies of heritability typically estimate the proportional contribution of genetic and environmental factors to a particular trait or feature. So far, researchers have not found a particular genetic makeup linked to SAD. They have, however, found specific genes linked to other anxiety disorders, such as agoraphobia and panic disorder. Environmental Causes of Social Anxiety The psychosocial causes of social anxiety disorder include factors in the environment that influence you as you grow up. If one of your parents has social anxiety disorder, then you are more likely to develop the disorder yourself. This could be due to both genetic and environmental influences. Psychologists have developed theories about how children may become socially anxious through learning. Ways Children Learn Social Anxiety Direct conditioning: Did you forget your lines in the class play? Did other kids make fun of you, or were you the victim of constant teasing or bullying? While it is not a necessary trigger, going through an early traumatic event may have an impact on the development of social anxiety, sometimes years later. Observational learning: If you did not experience a traumatic event yourself, did you see someone else in a traumatic social situation? For those already vulnerable to the disorder, this may have the same impact as going through the situation firsthand. Information transfer: Fearful and socially anxious parents unknowingly transfer verbal and non-verbal information to their children about the dangers of social situations. If your mother worries a lot about what other people think of her, chances are you have developed some of this same anxiety yourself. Your upbringing can also impact the likelihood that you will develop SAD. You are more likely to develop the disorder if: Lack of childhood social experience: As a child, you were not exposed to enough social situations and were not allowed to develop appropriate social skills. Childhood attachment issues: One or both of your parents was rejecting, controlling, critical, or overprotective. Children who do not form a proper attachment to their primary caregiver are at greater risk because they can't calm and soothe themselves when in stressful situations. Behavioral Inhibition in Childhood Do you know a toddler or young child who always becomes extremely upset when confronted with a new situation or unfamiliar person? When faced with these types of situations, does the child cry, withdraw, or seek the comfort of a parent? This type of behavior in toddlers and young children is known as behavioral inhibition. Children who show behavioral inhibition as a toddler are at greater risk for developing SAD later in life. Research has found that children who exhibit behavioral inhibition have a seven-fold increased risk of developing social anxiety disorder. Around 40% of behaviorally inhibited kids later develop SAD. Because this temperament shows up at such a young age, it is likely an inborn characteristic and the result of biological factors. Early Intervention May Reduce the Risk If you are concerned that your child is excessively withdrawn or fearful in new situations, it may be helpful to discuss your worries with a professional. Since we know that behaviorally inhibited toddlers are more likely to become socially anxious children and socially phobic adults, any kind of early intervention may help prevent more serious problems later in life. Societal Causes of Social Anxiety Societal factors that can influence the development of social anxiety. For example growing up in a culture with a strong collectivistic orientation, such as Japan or Korea, may increase the risk of social anxiety. The syndrome taijin kyofusho in these cultures involves a fear of making other people uncomfortable. It's a reflection of a culture that emphasizes a concern for how you fit as part of the larger group. Brain Structure/Biological Causes of Social Anxiety Just as x-rays are used to "see inside" your body, the same can be done for your brain. Medical researchers use a technique called "neuroimaging" to create a picture of the brain. Newer techniques can look not only at brain structure but at types of functions in specific regions of the brain. For mental disorders, researchers may look for differences in blood flow in specific areas of the brain for people who are known to have a particular disorder. We know that four areas of the brain are involved when you experience anxiety. Brain Areas Involved in Anxiety The brain stem (controls your heart rate and breathing)The limbic system (effects your mood and anxiety level)The prefrontal cortex (helps you to appraise risk and danger)The motor cortex (controls your muscles) What this neuroimaging research has found is that there are differences in key brain areas in people who have social anxiety disorder. For example, research using a brain imaging technique called positron emission tomography (PET) has found that socially anxious brains have different blood flow patterns in response to anxiety-provoking situations. People with social anxiety disorder have increased blood flow in their amygdala, a part of the limbic system associated with fear. In contrast, the PET images of people without SAD showed increased blood flow to the cerebral cortex, an area associated with thinking and evaluation. It seems that for people with social anxiety disorder, the brain reacts to social situations differently than people without the disorder. Neurotransmitters If you have social anxiety disorder, there are likely imbalances of certain chemicals in your brain, known as neurotransmitters. These neurotransmitters are used by your brain to send signals from one cell to another. Neurotransmitters Involved in Anxiety Norepinephrine Serotonin Dopamine Gamma-aminobutyric acid (GABA) People with social anxiety disorder have been shown to have imbalances in some of these neurotransmitters. Understanding how these brain chemicals relate to social anxiety disorder is essential to determine the best medications for treatment. Best Treatments for Social Anxiety Disorder 7 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute of Mental Health. Social anxiety disorder. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author; 2013. Scaini S, Belotti R, Ogliari A. Genetic and environmental contributions to social anxiety across different ages: a meta-analytic approach to twin data. J Anxiety Disord. 2014;28(7):650-656. doi:10.1016/j.janxdis.2014.07.002 Kim EJ, Kim YK. Panic disorders: The role of genetics and epigenetics. AIMS Genet. 2018;5(3):177-190. doi:10.3934/genet.2018.3.177 Clauss JA, Blackford JU. Behavioral inhibition and risk for developing social anxiety disorder: a meta-analytic study. J Am Acad Child Adolesc Psychiatry. 2012;51(10):1066-1075.e1. doi:10.1016/j.jaac.2012.08.002 Doruyter AG, Dupont P, Stein DJ, Lochner C, Warwick JM. Nuclear neuroimaging in social anxiety disorder: a review. J Nucl Med. 2018;59(12):1794-1800. doi:10.2967/jnumed.118.212795 Elsaid S, Rubin-Kahana DS, Kloiber S, Kennedy SH, Chavez S, Le Foll B. Neurochemical alterations in social anxiety disorder (SAD): A systematic review of proton magnetic resonance spectroscopic studies. Int J Mol Sci. 2022;23(9):4754. doi:10.3390/ijms23094754 By Arlin Cuncic, MA Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master's degree in clinical psychology. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Helpful Report an Error Other Submit