The relationship between social anxiety and depression

According to one study, approximately 8% of adults in the U.S. reported experiencing at least one major depressive episode within the past year. A similar survey showed that about 7% of U.S. adults were diagnosed with social anxiety disorder in the past year.

Not only do depression and anxiety disorders like social anxiety commonly occur in people of all ages, but they can also occur at the same time. When someone has two health conditions at the same time, it’s called comorbidity.

Because of how different conditions can interact with each other, your experience may be unique from others with social anxiety and depression. As a result, an individualized treatment plan tailored to your unique needs and preferences is essential. When it comes to treating this comorbidity, understanding the link between social anxiety and depression is extremely important.

Symptoms of social anxiety and depression

Depression and social anxiety involve physical, emotional, and psychological symptoms that can make it difficult to feel your best. This is especially true when someone experiences social anxiety and depression at the same time.

If you’re experiencing depression and social anxiety at the same time, you may experience the following symptoms: 

• Feelings of sadness or worthlessness
• Excessive guilt
• Appetite changes
• Difficulty sleeping
• Irritability and agitation
• Isolating from others
• Excessive worry about what others think of you
• Lack of interest in activities you usually enjoy
• Difficulty doing things when others are watching
• Excessive or unexplained blushing
• Trembling in front of others
• Avoiding situations where there will be other people

Recognizing social anxiety and depression

Because the symptoms of social anxiety and depression often overlap, it can be challenging to identify when someone has both conditions.

However, additional signs beyond the typical symptoms of social anxiety and depression can suggest that you may have both conditions. These signs include:

• Persistent social avoidance: You may avoid social situations due to fear of judgment, which aligns with social anxiety. You may also experience feelings of sadness or loneliness as a result of missing out on connecting with others, which is a sign of depression.
• Negative self-perception: Social anxiety with depression can create a complex self-image. Social anxiety can lend to a belief that you’re inadequate or unable to engage in social interactions, but you may still hold a core belief that you are worthy of social connection. Depression, on the other hand, can cause feelings of worthlessness, leaving someone feeling like they aren’t worthy of good social connections.
• Irritability and agitation: Irritability is a symptom of both depression and social anxiety. However, feelings of agitation can intensify when the two conditions occur together. This can cause you to become easily overwhelmed in social situations.

Causes and risk factors

Various psychological, environmental, and biological factors can cause depression and social anxiety. Various structural and hormonal differences in the brain can make the development of a mental health condition more likely for people with these differences. Others may have an increase in risk due to genetics.

Social anxiety and depression often have overlapping risk factors or causes. These can include:

• Family history of the condition
• Brain chemistry or structure
• Negative past experiences, like bullying or childhood trauma
• Chronic stress
• Major life changes
• Traumatic life events
• Substance use disorders
• Hormonal changes
• Temperament or personality

Can depression cause social anxiety?

Depression can cause emotional, psychological, and even physical symptoms. Over time, these symptoms can make engaging in social interactions and activities challenging.

Depression can cause a lack of interest, fatigue, and poor concentration, which can make it difficult to connect with others. Over time, these symptoms may bring down a person’s confidence in social settings. It’s important to remember that, with practice, it’s possible for you to learn to feel comfortable socially.

Some ways that depression may lend to the development of social anxiety include:

• Increased social withdrawal
• Negative self-perception
• Perceived decline in social skills
• Fatigue
• Poor concentration
• Low self-esteem

Can social anxiety cause depression?

In the same way that depression can contribute to social anxiety, the opposite is also true. However, when it comes to social anxiety as a cause of depression, the reasons are often different.

When someone has been experiencing symptoms of social anxiety, they may begin to feel poorly about themselves. We live in a social world, so when anxiety gets in the way of participating with others, it’s normal to feel frustrated. But when that frustration turns inward into self-criticism, depression is more likely to develop. 

Here are some ways that social anxiety may contribute to the development of depression:

• Chronic isolation
• Low self-esteem
• Fear of rejection
• Frustration and other negative emotions
• Reduced quality of life
• Stress
• Exhaustion 

Overcoming social anxiety and depression with treatment

Although navigating social anxiety with depression can be challenging, it’s possible to manage your symptoms with the right support. A variety of lifestyle changes and treatments can help you manage your symptoms.

Because of the overlap of symptoms and the way these conditions can influence each other, treating co-occurring depression and social anxiety requires a multifaceted approach. Your mental health professional should consider both conditions while taking into account your personal needs, preferences, and goals.

Some of the treatment options available for those struggling with social anxiety and depression include:

• Talk therapy: Cognitive-behavioral therapy (CBT), in particular, has been found to reduce the negative impacts of depression and anxiety disorders. You can also explore stress reduction techniques, like mindfulness, in therapy. 
• Medication: Research has found that depression and anxiety symptoms improve the most significantly when medication is paired with therapy. Not everyone will need medication, but it’s worth talking with your treatment team if you think it could be a fit for you. 
• Healthy habits: Regular exercise and sleep routines can help regulate your mood and provide predictability. Other self-care tools, like connecting with others and participating in support groups, can also be helpful in improving the effects of conditions like depression and anxiety. 

Keep in mind that progress can come in waves. So as you focus on treating one condition, the other may still cause difficulty. Because of this, it’s essential to stay open and honest with your treatment team. It’s important to remember that your treatment plan should be flexible and you may need to work with your healthcare provider to make adjustments.

Find care with Rula

Navigating social anxiety and depression can be challenging. However, with the right support, it’s possible to manage your symptoms. If you or someone you know is showing signs of co-occurring social anxiety and depression, consider reaching out to a mental health provider.

With Rula, you can find the right therapist for your unique needs and personal preferences. Using our therapist-matching platform, you can connect with a therapist who specializes in social anxiety and depression. After choosing a therapist who understands your background and accepts your insurance, you can schedule your first appointment for as early as this week.

Find a therapist with Rula