What are the social factors that trigger a panic attack

Panic attack

Social interactions can be nerve-wracking experiences at the best of times. Many of us may feel an element of anxiety about a family gathering, work event, or even a first date.

Social gatherings

To some degree, apprehension and self-consciousness get expected, mainly when we don’t hang out with or have social interactions with a specific person or group.

However, mild concern about social situations is different from the intense fear that socially anxious children and adults experience.

Social anxiety

Social anxiety disorder is a mental health condition in which an individual experiences high-level anxiety symptoms precipitated by the fear of being negatively evaluated or judged by others.

People with a social anxiety disorder may become so distressed by the thought of being humiliated or embarrassed by others that they end up avoiding most social situations and interactions.

Anxiety disorders

According to Verywell Mind, social anxiety disorder and panic disorder share similar symptoms, such as:

  • Persistent fear
  • Nervousness
  • Trembling and shaking

Mental disorders

However, there are qualities in both social anxiety disorder and panic disorder that have distinctly different features. 

In addition, both come with specific diagnostic criteria that make these mental disorders unique and distinct conditions.

Social anxiety and panic attacks

One of the differences between social anxiety disorder and panic disorder is the intense fear behind social interactions that tend to have distinct features.

For example, a person with panic disorder, whether they have Agoraphobia or not, may experience fear about having a panic attack in a social situation that may be physically difficult or emotionally embarrassing.

Social phobia

Often, a person with a panic disorder is afraid or intensely fearful of the physical symptoms of a panic attack and often believes their condition is medical rather than psychological.

Individuals with panic disorders often have ‘safe zones’ where they do not drift too far away from home or tend to remain in their geographical comfort zones.

Social anxiety disorder

On the other hand, social anxiety disorder involves:

  • Fear of being criticized.
  • Intense feelings of self-consciousness.
  • Fear of being the center of attention.

Unlike panic disorder, social anxiety disorder is a fear of public humiliation and profound discomfort in social settings that can be so intense that the person uses avoidance behaviours such as avoiding social and public interactions.


The anxiety and fear experienced in social anxiety disorder differ from Agoraphobia, as individuals’ concern is centred around public scrutiny and not having a panic attack.

Panic disorder symptoms

Symptoms of panic disorder involve recurrent panic attacks that occur suddenly and without warning. Symptoms include:

  • Difficulty breathing
  • Heart palpitations
  • Shaking
  • Thinking that you may be going crazy
  • Racing thoughts

Symptoms of social anxiety

Social anxiety disorder shares some of the symptoms of panic disorder, such as trembling or excessive sweating.

However, these symptoms are triggered when confronted with or thinking about social interactions.

Additional symptoms of a social anxiety disorder include:

  • Muscle tension
  • Avoidance of social contact
  • Low self-esteem
  • Blushing

Risk factors

The risk of developing SAD or social anxiety disorder often occurs in early adolescence and depends on many variables, such as:

  • Parenting styles
  • Isolated upbringing
  • Genetic factors
  • Social expectations
  • Brain structure
  • Early traumatic event
  • Environmental factors

Research suggests that the above indications put people at greater risk of developing anxiety disorders and mental disorders such as social anxiety disorder and panic disorder.

Mental health disorders

According to research from Verywell Mind, anxiety disorders or mental health conditions can be comorbid with social anxiety disorder.

For example, a person may be diagnosed with SAD (social anxiety disorder) and have a major depressive disorder, generalized anxiety disorder, obsessive-compulsive disorder, and other anxiety disorders.

Having social anxiety disorder increases the person’s chance of being diagnosed with another mental health condition and makes receiving treatment more complicated.

Co-occurring mental health disorders

Researchers from Verywell Mind have identified seven psychiatric disorders that are related to social anxiety disorder. They include:

  • Panic disorder
  • Generalized anxiety disorder
  • Substance abuse (such as alcoholism)
  • Avoidant personality disorder
  • Major depression
  • Eating disorders
  • Schizophrenia

Environmental risk factors that trigger a panic attack

Social factors that trigger a panic attack

Many social and environmental factors can trigger panic attacks, all of which depend on the individual.

Living with a panic disorder often involves feelings of dread, doom, and gloom. Part of managing the symptoms of panic disorder is identifying what triggers panic attacks and how they can get managed psychologically.

Environmental influences

Some of the typical situations that trigger a panic attack include:

  • Stresses related to finances and legal issues
  • Social conditions such as events, outings, and obligations
  • Situations that remind a person of a traumatic event
  • Substance abuse such as drug and alcohol abuse
  • Certain medication side-effects
  • Other mental or physical health conditions
  • Specific types of food or a lack of nutrition
  • Conflicts in personal relationships

Fear response

In the above scenarios, a person with social anxiety disorder, panic disorder, or other anxiety disorders may experience constant fear, all of which affect their social skills and quality of life.


According to research from The Mayo Clinic, little is known about what causes panic disorder, but some factors may play a role:

  • Having a personality that is more sensitive or prone to negative emotions
  • Genetics
  • Major stress (or stressful situation)
  • Specific changes in the brain that causes functional impairment
  • Early childhood trauma or negative experiences with a primary caregiver or other family members such as sexual abuse or a serious incident
  • Smoking or excessive caffeine intake
  • Having other psychiatric disorders (or another particular disorder)
  • Enduring a negative parenting style in childhood
  • Social phobia
  • Having an overactive amygdala
  • Behavioral inhibition

Treating social anxiety disorder and panic disorder

Treating social anxiety disorder and panic disorder has proven to be a challenge for mental health therapists in the past.

Typically, treatment consisted of antidepressants where patients relapsed soon after coming off the prescribed drug administration.

Fortunately, studies have improved in recent years. In addition, a health care provider such as a mental health professional can provide medical advice, which helps reduce anxiety and improve patients’ quality of life.

Medical advice diagnosis

Professor David Clark from the Departments of Psychology and Psychiatry made significant breakthroughs for people with panic disorder and social anxiety disorder.

Advice diagnosis or treatment

Clark conducted trial studies on people with panic disorder and found that individuals are increasingly aware of body sensations than those who do not suffer from the condition.

Panic disorder treatment

A fundamental part of panic disorder is to misinterpret harmless body sensations such as intrusive thoughts and racing heart as signs of a severe threat to life or danger such as a heart attack or going crazy.

David Clark and colleagues developed a cognitive therapy designed to target the misinterpretations, hyper-attention, and safety behaviours that people adopt as part of the anxiety disorder.

Such treatment was found to be highly effective and superior compared to drugs and behavioural therapies.

Social anxiety treatment

In determining how best to treat social anxiety disorder, Clark and colleagues conducted video feedback sessions on participants to help them gain an accurate impression of how they appear in social situations.

The team identified several factors in social anxiety, such as negative self-imagery and focusing too much attention on oneself during social events or interactions.

The use of safety behaviours also got identified.

During trials, people were taught how to release safety behaviours and were advised to ‘get out of their heads’ and be present in social interactions.

Peer-reviewed studies

The trials concluded that video feedback sessions were highly effective and superior to other psychological therapies such as exposure therapy, interpersonal therapy, psychodynamic therapy and medications such as antidepressants (David Clarke et al.).

Getting in touch

Great outdoors - Centres for Health and Healing

People with social anxiety disorder and panic disorder are likely to develop increased anxiety symptoms during a social situation.

One of the keys to managing anxiety and panic disorder is understanding the triggers (internal and external) and implementing strategies to manage any unpleasant anxiety symptoms.

Many people with anxiety disorders benefit from therapy and are advised to speak to a mental health professional who can advise them on the best course of action 

If you are experiencing any of the anxiety symptoms mentioned above, speak to one of our mental health specialists today who will help.

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