Etiology (Biopsychosocial Model)

Biological: Amygdala hyperactivity, heritability estimates ~30%.

Psychological: Fear of embarrassment, negative self-image.

Social: Childhood teasing, bullying, cultural pressure.

Symptoms & Diagnosis (Mnemonic: FEAR ME)

F - Fear of social situations where one may be judged

E - Exposure causes fear/anxiety almost always

A - Avoidance or intense distress in such situations

R - Reaction is out of proportion to threat

M - Minimum 6 months duration

E - Everyday functioning impaired

Treatment

Cognitive Behavioral Therapy (CBT): Includes social skills training and exposure-based techniques.

Medications: SSRIs or SNRIs (e.g., sertraline, venlafaxine) for moderate to severe cases.

Group Therapy: Provides support and helps with desensitization.

Mindfulness & ACT: Mindfulness and Acceptance & Commitment Therapy approaches can also be beneficial.