The Relationship Between Social Anxiety and Depression

June 25, 2025

Authored by: Taylor Shaw, B.S.

Edited by: Rey-Phillip Genaldo, LMFT

Social Anxiety Disorder, previously classified as social phobias, is an anxiety disorder related to the fear of social situations in which an individual is exposed to possible scrutiny by others. Some of the symptoms of social anxiety include social fears, shyness in social situations, avoiding eye contact, low self-esteem, panic attacks, agoraphobia, negative thoughts, isolation, self-conscious attitudes, and fears related to social interactions.

Studies have shown that those with Social Anxiety Disorder (SAD) are more likely to experience depressive symptoms and have poor quality of life. Additionally, SAD can both increase risk of depressive disorder, and significantly impair the quality of life of individuals.¹ These two mental heath conditions can impact one another, and the physical symptoms of Social Anxiety Disorder may cause an already struggling individual to further isolate, instigating comorbid depression. Specifically, the presence of comorbid Social Anxiety Disorder in adolescents who are already depressed is associated with a more malignant course and character of subsequent depressive illness.²

If you or a loved one are struggling with Social Anxiety Disorder, Major Depressive Disorder, or comorbid depression and SAD, mental health treatment can help. AMFM Mental Health has over a decade of experience helping individuals overcome social anxiety and depression with attentive mental health professionals, providing personalized treatment plans and therapeutic interventions. Call today to take the first step to a better life; you don’t have to walk through this alone.

Comorbid Depression and Social Anxiety

Comorbid depression and social anxiety disorder refers to when an individual is diagnosed with both mental health conditions at once. Because social anxiety disorder is an early, adolescent-onset disorder, it’s related to a substantially and consistently increased risk for subsequent depression.³ When an individual is experiencing the physical symptoms of Social Anxiety Disorder, they experience fear (usually out of proportion with the sociocultural context) surrounding social situations. Often, as a result, these individuals will isolate, sometimes to the point of agorophobia, and through this isolation, depressive symptoms will emerge.

A recent study on comorbidity of social phobias and comorbid psychiatric disorder found that when compared with individuals with no comorbid psychiatric disorder, social phobias alone were associated with increased rates of suicidal ideation, financial dependency, and having sought medical treatment, but not associated with higher rates of having made a suicide attempt or having sought treatment from a mental health professional.⁴

Along with previous evidence that comorbid Social Anxiety Disorder is associated with a more malignant course and character of depression, the results of one recent study call for targeted prevention with the aim of reducing the burden of Social Anxiety Disorder and its consequences.⁵

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More on Social Anxiety

Social Anxiety or Social Phobias are classified by the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as having the following attributes:

Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.
The social situations almost always provoke fear or anxiety.
The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context.
The social situations are avoided or endured with intense fear or anxiety.⁶

Additionally, the fear cannot be attributed to another medical disorder, and must be experienced for a period of at least 6 months. If social anxiety is occurring in children, the DSM-V makes the distinction that it must occur alongside peers, and not only when a child is with adults.

Epidemiology of Social Anxiety Disorder

Epidemiological studies have shown that Social Anxiety Disorder has a worldwide prevalence of 5 to 10%, and that prevalence rates in children and adolescents are similar to those of adults, with the disorder more commonly affecting women than men.⁷

More on Depression

Major Depressive Disorder (MDD) or Clinical Depression is a mood disorder that is known for causing feelings of sadness, a loss of interest in pleasurable activities, and a range of other emotional and physical symptoms. Symptoms of depression can affect your daily routine, relationships, and overall quality of life. Mental health treatment, through a combination of psychiatry and therapeutic care, can help you to manage these symptoms over time, increasing the quality of life.

Major Depression can affect individuals of varying ages and other demographics. Causes of depression can vary, including genetics, self-esteem, experiences you’ve had in life, and a chemical imbalance within your brain. Depression therapy can help you in overcoming depression and may include the use of depression medications and holistic therapies.

Psychiatric Treatment for Depression

There are a variety of different antidepressant medications that have been proven as effective treatment (in combination with psychological treatment) for depression and other mental health issues. Some types of antidepressants are listed here, but inquire with a licensed medical professional or psychiatrist for detailed information on different treatments. Never take psychiatric medication unless it is prescribed to you, and be sure to consult with medical professionals in case of external risk factors.

Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are antidepressant medications that treat different neurotransmitters in order to block the reabsorption of serotonin or norepinephrine, keeping more of the chemicals in the synaptic cleft. Sertraline (Zoloft), an SSRI, has seen success in providing relief for individuals experiencing depression and symptoms of social anxiety disorder. Both are effective treatments for depression, but depend upon the individual, and should be approached with medical guidance and professional advice. Click here to learn more about the importance of medication management.

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Types of Therapy for Depression and Social Anxiety

Comorbid depression and social anxiety disorder can affect individuals differently, which often requires individualized treatment. There are a variety of depression treatment options that can be used to address the emotional, cognitive, and behavioral aspects of this condition. Some of the most common psychotherapy modalities used in depression counseling sessions at our California locations include:

Group Therapy

Group therapy sessions can be used to help provide structured times to help you understand that you are not alone in your struggles, that your peers are also walking through these challenges, while also providing guidance, suggestions and communications from psychologists with specialized backgrounds. These support groups can span a variety of backgrounds, including but not limited to art therapy, somatic therapy, and narrative therapy.

Cognitive-Behavioral Therapy (CBT)

Cognitive-Behavioral Therapy (CBT) is a form of therapy that’s focused on restructuring and reprogramming maladaptive and negative thought processes. Psychologists are trained to help you change your cognitive and emotional processes in order to outgrow coping mechanisms that may no longer be serving you.

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is most commonly referred to as “talk therapy,” and is designed to help process emotions. Qualified professionals offer psychological therapy to move forward with healthy ways of engaging in interpersonal relationships and alleviating physical and emotional distress.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

EMDR Therapy is a renowned method of reprocessing most often used in trauma therapy. By activating the prefrontal cortex through a series of bilateral stimulation, qualified professionals can lead you through traumatic experiences, helping you to alleviate the distress symptomized by trauma.

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Citations

Ratnani IJ, Vala AU, Panchal BN, Tiwari DS, Karambelkar SS, Sojitra MG, Nagori NN. Association of social anxiety disorder with depression and quality of life among medical undergraduate students. J Family Med Prim Care. 2017 Apr-Jun;6(2):243-248. doi: 10.4103/2249-4863.219992. PMID: 29302525; PMCID: PMC5749064.

Stein MB, Fuetsch M, Müller N, Höfler M, Lieb R, Wittchen H. Social Anxiety Disorder and the Risk of Depression: A Prospective Community Study of Adolescents and Young Adults. Arch Gen Psychiatry. 2001;58(3):251–256. doi:10.1001/archpsyc.58.3.251

Beesdo K, Bittner A, Pine DS, et al. Incidence of Social Anxiety Disorder and the Consistent Risk for Secondary Depression in the First Three Decades of Life. Arch Gen Psychiatry. 2007;64(8):903–912. doi:10.1001/archpsyc.64.8.903

Schneier FR, Johnson J, Hornig CD, Liebowitz MR, Weissman MM. Social Phobia: Comorbidity and Morbidity in an Epidemiologic Sample. Arch Gen Psychiatry. 1992;49(4):282–288. doi:10.1001/archpsyc.1992.01820040034004

Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 16, DSM-IV to DSM-5 Social Phobia/Social Anxiety Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t12/

Rose GM, Tadi P. Social Anxiety Disorder. [Updated 2022 Oct 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555890/