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What Causes Social Anxiety?

What Causes Social Anxiety?

Some social situations make everyone nervous. Interacting with others — either in the form of a date or an important presentation, for instance — can be very scary. That’s normal.

If these feelings of social anxiety go above and beyond normal levels, you may actually be suffering from a social phobia (also known as social anxiety). These symptoms can go on to disrupt your everyday life and your relationships with others.

Thankfully, with treatments like ketamine infusions or psychotherapy, even the most severe cases of this condition can find relief from their symptoms.

What causes social anxiety?

Like other anxiety conditions, social anxiety is not the result of a single factor but instead is a complex mix of factors like the following:

  • Inherited traits, from where your family has a history of anxiety or other mood disorders
  • Brain structure and the way the amygdala within the brain manages your response to fear
  • Environmental factors, such as a particularly embarrassing social situation

Risk factors for the development of social anxiety include:

  • Temperament
  • Negative social experiences
  • Personal history of other mood disorders

Common social situations that may contribute to your symptoms if you have social anxiety include:

  • Interacting with strangers
  • Parties or large social gatherings
  • Work or school
  • Starting new conversations
  • Eye contact
  • Dating
  • Entering a new room
  • Returning items that you have purchased
  • Eating around other
  • Using the restroom in public


The emotional and behavioral symptoms of a social anxiety disorder include:

  • Fear of being judged or situations that open you up to the judgment
  • Worry involving embarrassment or humiliation
  • Fear of interaction with strangers
  • Fear that others may notice your anxiety
  • Fear of embarrassment due to physical symptoms like blushing, sweating, or trembling
  • Avoidance of people, places, or situations out of fear or anxiety about the embarrassment
  • Intense anxiety during social situations
  • Overanalyzing your performance during a social situation
  • Expecting the worst from social situations

Physical symptoms of a social anxiety disorder include:

  • Blushing
  • Trembling
  • Sweating
  • Shaky voice
  • Fast heartbeat
  • Upset stomach
  • Trouble catching your breath
  • Dizziness
  • Lightheadedness
  • Muscle tension


The treatment for a condition like social anxiety disorder greatly depends on how your symptoms affect your basic ability to function in everyday life. Treatment options include ketamine infusions for anxiety, psychotherapy, and medications, among others.

Ketamine Infusion

Though it first rose to prominence for its use as an anesthetic, ketamine is now being touted as a vital and important new treatment for mental health conditions like social anxiety. Ketamine infusions may be the start of a whole new age of treatment for mood disorders.


Psychotherapy is about learning to recognize your negative thought patterns and developing skills that can allow you a greater level of confidence in social situations. One example of this being exposure-based cognitive behavioral therapy, where you are exposed to the situations that cause anxiety. This allows you to find safe ways to work through your anxiety.


Some people find success with antidepressant or anti-anxiety medications, but these can take time and may have unwanted side effects.

Contact us today to learn more about our innovative new anxiety treatment in Scottsdale, AZ.

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James T. Leathem, DO

Dr. James Leathem is a board-certified anesthesiologist and a member of the American Society of Anesthesiologists. He was born and raised in Connecticut and graduated from Florida Southern College with a bachelor of science in marketing management with minors in sociology and communications. He obtained his medical degree from Midwestern University’s Arizona College of Osteopathic Medicine and completed his residency in anesthesiology at Michigan State University and its affiliated McLaren Greater Lansing Hospital.

In 2015, after residency, Dr. Leathem returned to Arizona to practice anesthesiology. He joined Red Mountain Anesthesiologists and worked primarily at Banner Baywood Medical Center in Mesa, performing 100% of his own cases. He was made partner in the group after demonstrating 3 years of anesthesia excellence and administering over 4,000 anesthetics. In 2019, a corporate change occurred and an opportunity presented itself in which he was able to transition out of the hospital to surgery center and clinic-based anesthesia.

Dr. Leathem realizes that the only constant in life is change. In 2020, amidst the global pandemic, his career took a different direction. This change led him to collaborate with Dr. Wong and Dr. Sharma and they founded Advanced Wellness and Pain (AWAP). Their mission is to provide a variety of state-of-the-art procedural services that improve patients’ quality of life and overall physical and mental well-being.

Dr. Leathem believes that we are all a work in progress and that each day, one should strive to make positive changes in their life. He is here to help empower each patient on their journey to be their best self and live their best life. When you are being cared for by Dr. Leathem, you can be assured that he will give you his undivided attention and time.

Gregory Wong, MD

Dr. Wong is a Board-Certified Anesthesiologist and a member of both the American Society of Anesthesiology and the Arizona Society of Anesthesiology. He did his undergraduate training at the University of California at Davis, Davis, California; doctorate training at The University of Health Sciences of the Chicago Medical School, North Chicago, IL; and his post-doctoral training at the Integrated Program at the University of Arizona, Phoenix, AZ. He has spent his whole 24-year career practicing in Arizona.

Dr. Wong grew up in the Bay Area of California. He is married and is raising three daughters. At the early age of 12 years old, he knew he wanted to become a physician. His love of the human spirit, intrigue of human physiology, and compassion for human suffering led him to the path of anesthesiology and pain medicine.

Today, Dr. Wong realizes patients need a holistic biophysical-mental-spiritual care. This philosophy has brought him to the studies of regenerative medicine and infusion therapies. He has firsthandily witnessed the overwhelming success of these therapies for treating chronic pain and depression and the return of patients of “life-functionality.”

“There has never been a time more important than now to advocate for our patients in these difficult times. We owe it to our patients to offer these state-of-the-art treatment modalities that weren’t available before.”

Deepak Sharma, MD, MBA

Dr. Sharma is a Board Certified Anesthesiologist and a member of the American Society of Anesthesiologists. He completed three degrees at Drexel University in Philadelphia, PA: a Bachelor in Finance, a Master in Business Administration, and a Doctor of Medicine. He went on to complete residency at the Mount Sinai Morningside-West Hospital System in New York, NY and post-graduate fellowship at Stanford Medical Center in Palo Alto, CA.

Dr. Sharma is committed to treating his patients as a whole with a comprehensive biophysical-mental-spiritual approach. He is a lifelong learner and is constantly researching cutting-edge therapies backed by scientific studies. He has taken a particular interest in regenerative and infusion therapies after witnessing firsthand their significant benefits on those suffering from chronic pain and depression. In his free time, Dr. Sharma enjoys spending time with his family and friends, hiking, traveling, reading, and meditation.

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