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Does Social Anxiety Cause Substance Abuse?

Social anxiety in some cases can lead people to developing a substance abuse disorder. Learn more here.

What Is Social Anxiety?

Social anxiety disorder is also called social phobia. Social phobia is a chronic mental disorder where one fears social situations. Social anxiety disorder is a common problem that may begin during one’s teenage years. While in many cases, social anxiety gets better over time, many people that have social phobia need treatment to cure it.

Impact of Social Anxiety

When grappling with social anxiety, you may fear the regular daily routines like eating or drinking in social places, dating, public speaking, or simply meeting up with friends. The fear can be so intense that it prevents you from meeting with others due to reasons such as fearing negative judgment, rejections, or negative scrutiny.

According to Mental Health America, in 2021, 7% of the American population, or fifteen million people, had social anxiety. 75% of these people experience their first symptoms as teenagers or during childhood. Additionally, people who have social phobia are also more highly linked to developing major depressive disorders and substance use disorders.[1]

What Causes Social Anxiety?

The following are some of the common things that may lead to social anxiety disorder.


According to the National Institutes of Health, those with a parent who suffered from or are suffering from social phobia have a 30-40% greater likelihood of developing the same condition.[2]

In recent studies, a parent may pass a gene known as SLCGA4 that causes social phobia in their child. SLCGA4 transports the neurotransmitter serotonin, which is a chemical that stabilizes moods and soothes nerves. Both the excess and shortage of serotonin can lead to symptoms of social anxiety. People diagnosed with social phobia, along with depression, struggle with consistent production of serotonin.

Social Experiences

Social phobia may also be a learned behavior, especially during multiple embarrassing or unpleasant social encounters. Parents who model anxious behaviors to their children or are overprotective may also cause their children to develop social anxiety.

Cultural Influences

Cultural influences also significantly affect how you feel or behave during social occasions. There are many different factors that, depending on different cultures, can affect the trajectory of social anxiety disorder. Such factors may include changes in social norms, individualism vs. collectivism, gender role identification, and many others. 

Substance-Induced Social Anxiety

Withdrawing from or using substances such as alcohol may lead to substance-induced panic attacks or other social phobia symptoms. One may drink alcohol to boost their self-confidence or relax, but it may end up causing social anxiety disorder. Instead of giving relief or relaxing feelings, the substance results in extreme anxiety and panic.

Psychological Factors

Research shows that your brain structure may contribute to social anxiety disorder. Your brain’s amygdala controls your fear response. If you have an overactive amygdala, you experience a heightened fear response that increases anxiety during social occasions.

Signs and Symptoms of Social Anxiety

There can be many signs and symptoms of social anxiety disorder, many of which are detailed below. 

Physical Symptoms

Physical symptoms of social anxiety include:

  • Blushing
  • Excessive sweating
  • Nausea
  • Trembling or shaking
  • Lightheadedness or dizziness
  • Difficulty speaking
  • The trouble with catching your breath
  • Feeling your mind is blank
  • Muscle tension

Psychological Symptoms

Psychological symptoms of social anxiety can include:

  • Intense worry about social situations
  • Extreme worrying that goes for weeks or days before an event
  • Avoiding social situations
  • Excess worry about embarrassing yourself in social situations
  • Fear that other people will know that you are nervous or stressed out
  • Drinking alcohol to have the courage and face any social situation
  • Extreme anxiety that causes you to miss work or school

Impact of Social Anxiety

Social anxiety can also lead people to being so fearful of events happening that they end up missing out on certain things that are either pleasurable or necessary for achievement. Some of these things can include:

  • Asking questions in class
  • Going to job interviews
  • Using public restrooms
  • Eating in public
  • Talking on the phone
  • Shopping

Does Social Anxiety Cause Substance Abuse?

Research shows that there is a connection between social anxiety and substance abuse in many ways.

If you struggle with social anxiety, you might self-medicate with alcohol or other drugs in order to lessen symptoms. However, social phobia often worsens drug addiction, and drug effects may also cause extreme stress, creating a struggle between the person wanting to lessen their anxiety but in turn creating more of it.

According to the Anxiety & Depression Association of America (ADAA), most people with social anxiety use alcohol to reduce anxiety symptoms. The ADAA also states that alcoholism may develop soon after the onset of social phobia or vice versa.[3]

Drugs That Can Point to Social Anxiety

Many drugs such as marijuana, cocaine, methamphetamine, or fentanyl cause anxiety as a side effect. The Drug and Enforcement Administration classifies all of these drugs with a high abuse potential, often resulting in severe psychological or physical dependence. This dependency may contribute to anxiety symptoms, especially if one tries to quit the drugs.[4]

How Can Social Anxiety Cause Substance Abuse?

As we’ve seen, people with social anxiety disorder often use alcohol and other substances to escape unpleasant emotions or extreme fear and panic. As people continue to use these substances to face social situations, they might start to create a dependence on them. This, in turn, can lead to a substance abuse disorder.

While abusing certain substances may provide temporary comfort, when its effects are over, anxiety symptoms often worsen.

Social Anxiety Disorder Treatment Options

Don't hesitate to find help if you are struggling with social anxiety or phobia. Treatment can include many different options, depending on what the patient needs.

Therapy has a lot of benefits, mainly because you can share what you are feeling. Once you share, your therapist helps you analyze your feelings and provide possible solutions. Therapy options for social anxiety include:

Cognitive Behavioral Therapy (CBT)

CBT involves changing negative thoughts, patterns, or behaviors with more positive ones. Your therapist will help you treat your anxiety through breathing and relaxation techniques.

Interpersonal Therapy

Interpersonal therapy for social phobia takes between twelve to sixteen sessions and helps you resolve interpersonal problems and communicate better with others. By finding the root cause of your social phobia, your therapist helps you with symptomatic recovery.

Psychodynamic Therapy

Psychodynamic therapy helps you to better understand your feelings, emotions, and thoughts in order to make better decisions. 

Family Therapy

Family therapy usually involves multiple members of the family unit talking with a therapist. Your therapist helps you communicate better and find the root causes of your anxiety. These root causes then help find a proper treatment for you.

Anxiety is an ongoing mental health disorder that also may need medications to help treat. Doctors commonly prescribe the following anxiety medications.


Doctors commonly prescribe antidepressants such as selective serotonin reuptake inhibitors (SSRIs) to treat social anxiety. Paroxetine (Paxil) or sertraline (Zoloft) are some of the most common and helpful.

Anti-Anxiety Medications

Anti-anxiety medications treat social anxiety and may include:

  • Diazepam (Valium)
  • Lorazepam (Ativan)
  • Clonazepam (Klonopin)
  • Alprazolam (Xanax)


Beta-blockers treat the physical symptoms associated with social phobia. These medications include atenolol (Tenormin) or propranolol (Inderal) and block the stimulating effects of adrenaline. 

Support groups are another option for treatment and offer safe spaces where people who battle the same conditions meet, share, and find solutions. You can join an online or a local support group that helps people battling anxiety. 

Treatment for Social Anxiety and Substance Abuse in California

Get help at Genesis Recovery, where we are committed to our patient's recovery. We have many different treatments available for those who want help with social anxiety.

You can develop both a substance use disorder and a mental health problem, like social phobia, simultaneously, which often requires a different level of care. There are many dual diagnosis treatment plans available at Genesis Recovery, including:

Integrated Care

Integrated health care involves a high degree of communication and collaboration among health care professionals. Our team members share patient care information among themselves and make a comprehensive treatment plan that addresses the psychological, social needs, and biological needs of patients.

Our interprofessional health care team has a diverse group of members including physicians, nurses, psychologists, and other health professionals available to help, depending on the needs of patients.

Holistic Therapies

We tailor holistic therapy to address a patient's body, mind, and spirit. An overall balance in the three areas supports healing and health. Our therapists draw on alternative and complementary practices that they may have.

Ongoing Support Following Rehab

Genesis Recovery provides various after-rehab support options, including regular check-ups, alternative support groups, 12-step programs, and more.

Opportunities for Wellness at Genesis Recovery

While social anxiety can make you feel alone, you are still worthy of getting help if you need or want it. Contact us today at Genesis Recovery, and we will help support you every step of the way.


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