Social anxiety can be defined as an intense fear or worry of social interactions, whereas depression can be defined as persistent sadness experienced by a person. Depression and social anxiety are the commonly diagnosed psychological conditions in America. While these are separate mental health conditions, they can happen at the same time, producing a unique challenge. According to a 2016 review of studies, for almost 70 percent of individuals diagnosed with both the conditions, first comes social anxiety, then depression. In  many cases, social anxiety causes depression.

If a person is suffering from social anxiety, they may have difficulty in making friends and preserving close relationships. Fear or worry of social interaction could even lead to missed opportunities. Without proper treatment, social anxiety symptoms often lead to:

• Depression
• Isolation
• Feeling of hopelessness
• Frustration

Some people experiencing social phobia also have a history of being ignored, rejected or bullied.These experiences could affect self-confidence and self-esteem and trigger depression afterwards in life. Though, it seems social anxiety is likely to cause depression than the other way around, remember that anxiety could also occur as a sign of depression. Moreover, being constantly depressed could potentially aggravate an underlying social phobia.

Symptoms of Depression and Social Anxiety

To be diagnosed with depression and social anxiety, you must show symptoms of both the conditions simultaneously. Social anxiety causes both emotional and physical signs, before, after, or during social interactions.Some of the physical symptoms of social anxiety are nausea, light-headedness, excessive sweating, fast heartbeat, shortness of breath. On the other hand, emotional symptoms are constantly worrying about daily social situations, avoiding social settings, avoiding eye contact, low self-esteem, or fear of being humiliated or embarrassed in public.

Some of the symptoms of depression are body aches, suicidal thoughts, feelings of hopelessness, sleeping too much, difficulty in sleeping, inability to concentrate, reduced interest in favourite tasks or activities, fatigue or low energy, or lack of motivation.

Triggers of Social Anxiety

Several factors could increase the danger of developing social anxiety disorder, such as:

Performances: These may include public speaking, musical performances or athletic competitions. People with social anxiety disorder who fear these kinds of situations often find that they have difficulty in performing to their overall ability because of their relatively permanent state of worry and nervousness. Fears or apprehensions about public speaking can also hinder career advancement.

Making Small Talk: Though small talk or conversation comes easily for some people, those with social anxiety may find this type of talk challenging. Small talk could cause anxiety about sounding stupid or saying the wrong thing.

Meeting New People: Nothing triggers social phobia like a room full of strangers. Going to a party or meeting individuals for the first time where you don’t know anybody might be difficult if you have social anxiety disorder.

Triggers of Depression

Many factors can be responsible for the onset of depression, such as:

Loss and Grief: Both are a significant situational trigger of depression. Nevertheless, diagnosis might be tricky because the signs or symptoms may just be assumed as a normal reaction to loss. Dealing with grief is a personal experience and how it can be handled depends on the person’s state of mind, personality, life experience, age and the situation being aggrieved.

Stress: Mental stress is a main cause of depression because of its physical effects on the brain and body. Stress leads to hormonal changes which are present in around 70 percent of depressed people. The adrenal glands, pituitary and hypothalamus are interrupted from their normal regulation of emotion and mood.

Rejection: People have a natural need for acceptance, affirmation and approval from others. Social exclusion and rejection can be stressful for individuals and have been linked with low self-esteem. Some individuals are very sensitive to social rejection and tend to have high rejection sensitivity.

Treatments for Depression and Social Anxiety

Medication: Selective serotonin reuptake inhibitors are often used when treating depression and social anxiety. These include sertraline and paroxetine. The physician can also recommend serotonin-norepinephrine reuptake inhibitor such as venlafaxine, or also combine an anti-anxiety medicine with an antidepressant. Other medicines used for anxiety are lorazepam, diazepam, clonazepam and alprazolam. However, anti-anxiety drugs are not permanent healing solutions. Some of these medicines can be habit-forming and produce a sedative effect on some individuals. Moreover, they might have dangerous adverse effects when consumed with alcohol.

Changing Thought Patterns: Cognitive behavioural therapy is a productive type of psychotherapy and helps understand how the thoughts influence the behaviours and feelings. As social anxiety is often triggered by irrational fears, one target of therapy can be to develop realistic thought patterns. Instead of always thinking of worst-case scenarios or situations in social settings, a person will learn how to focus on realistic scenarios.

Lifestyle Remedies: Along with medication and talk therapy, lifestyle changes could help recovery, including avoiding drug and alcohol use, which can aggravate symptoms of depression and anxiety; eating balanced diet; getting enough sleep; exercising regularly. It might also help to take part in social activities and interact with people you are familiar and comfortable with. This can reduce isolation and loneliness, easing depression.

Other Therapies: The therapist may also advise other therapies to address worries and fears such as exposure therapy or group therapy. Group therapy is a chance to practice social interactions in a controlled, safe environment. You can get feedback from individuals who understand what you have been actually going through. Moreover, you are able to talk without any inhibitions and judgment. With the help of exposure therapy, you will face social fears and worries under the direction of a therapist.

The exposure will be simple in the beginning and then becomes intense and complex with the passage of time. Also, repeated exposure helps slowly reduce social anxiety. As soon as you are able to handle your depression positively, your mood and depression may improve. With right treatment and positive thinking, people with depression and social anxiety can overcome these psychological issues.