Can depression cause social anxiety disorder? Or is the reverse true, and being socially anxious causes you to become depressed? Given the close relationship between these disorders, it is natural to ask questions about why you feel depressed if you are socially anxious, or why you may become socially anxious if you are depressed.
Feelings of anxiety and worry about being around others can evolve into feeling down in general, particularly if you isolate yourself or stop participating in activities. At the same time, certain symptoms of depression can also make you fear being around people for a myriad of reasons.
Social Anxiety and Depression
Research shows that there is a strong relationship between having social anxiety disorder (SAD) and developing depression later in life.
The generalized type of social anxiety disorder is also associated with an increased co-occurrence with major depressive disorder, panic disorder, post-traumatic stress disorder, and alcohol use disorders among others.
Other Associated Risks
If you have both SAD and depression, a 2001 study (in Primary Care Companion Journal of Clinical Psychiatry: Psychotherapy Casebook) shows that you are also at risk for a number of other related problems due to this combination.1
- an increased risk of problems with alcohol
- impairments in social and occupational functioning
- lesser response to treatment
- risk of suicide
In addition, if you have been diagnosed with social anxiety disorder and also depression, you are more likely to have more severe and chronic symptoms.
SAD and Later Depression
According to a 2001 study in the Archives of General Psychiatry, although developing social anxiety disorder at an early age has been linked to developing depression later on, not everyone who has SAD becomes depressed.2
When social anxiety disorder appears at a young age, appropriate treatment may reduce the risk of developing depression at a later age.
Social Withdrawal Differs Between Social Anxiety Disorder and Depression
Imagine a young college student who wants to make friends and go to parties but fears that she will embarrass herself in front of others. As a result, she stays in her dorm room night after night, wishing she could be a part of the group.
Contrast this with the student who avoids social contact because it’s just not any fun to her–the thought of going to parties or getting together with a friend holds no promise of enjoyment.
Although both SAD and depression may involve social withdrawal, the cause of the withdrawal is different.
- People with social anxiety disorder withdraw out of fear of negative evaluation by others.
- People with depression withdraw due to a lack of enjoyment.
People with SAD expect that they could enjoy themselves if they could somehow interact appropriately with others, whereas those with depression don’t ever expect to enjoy themselves.
Treatment of SAD and Depression
Depression is often what leads people to seek help, even though social anxiety disorder may be the underlying problem. Usually, people who have SAD will not speak to anyone about the problems that they face and often do not realize that they have a treatable illness. As a result, most people with social anxiety disorder do not usually receive treatment unless the disorder occurs alongside another condition.
Unless a medical professional is trained to look for secondary disorders, SAD may continue to go misdiagnosed. Unfortunately, treating depression without addressing the underlying social anxiety disorder can be ineffective.
Although many of the treatments recommended for depression are also effective in treating SAD, such as selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT), treatment must still be tailored to the specific disorder.
A Word From Verywel
If you experience both SAD and depression, your doctor or mental health professional will devise a treatment plan designed to address symptoms of both disorders.
If you’ve not yet sought a diagnosis for symptoms of anxiety or depression that you are experiencing, it is important to make an appointment. Earlier diagnosis and treatment is related to better outcomes in terms of depression resulting after social anxiety disorder.
Arlin Cuncic , The Link Between Social Anxiety Disorder and Depression, March 25, 2020, https://www.verywellmind.com/social-anxiety-and-depression-go-hand-in-hand-3024695.