As people try to create a treatment for social phobia, the endeavor is complicated by the fact that nobody can actually pinpoint an underlying cause for the disorder. While people engaged in substance abuse have a higher incidence of social anxiety disorders than non-abusers, this behavior is by no means the main cause. Genetics seem to play some role, as well as traumatic events. So finding treatments is difficult because there is no one pinpointed cause of social anxiety.
The genetic cause of social anxiety may not be a cause at all. This is because it’s possible that children learn from a parent’s own anxiety disorders and social isolation, with some of them adopting the same view of the world. And yet there are also cases of twins raised separately; if one twin ends up with a social anxiety disorder, the other twin has a much higher likelihood than average for developing a similar disorder. So while some kind of “family” connection is seen, nobody has quite pinned down what role genetics actually play.
The place where social and cultural influences have definitely been shown to be a partial cause for social anxiety is in the realm of trauma. If the person, especially as a child, had some humiliating public experience, this could trigger a traumatic response that magnifies itself over the years. Often the phobia then becomes associated with that particular type of event going on into the future. So this sort of trauma tends to lend itself to specific phobias like pubic speaking, rather than to a more generalized type of anxiety disorder.
Brain chemistry, however, also plays a role as a cause of social anxiety. This can either be one’s inherent brain chemistry, or the problems may result from substance abuse. Or there can be a mix of both, as the person self-medicates with alcohol or drugs, as their own treatment for social phobia difficulties. They may feel better at first, but eventually these substances are more likely to make the phobias worse.
So even though many of the causes of these anxieties are known, there can often be several factors operating at once, from social to physical. When a person is dealing with more than one potential cause, treating their social anxiety can be more challenging.
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