The causes of social anxiety disorder are not fully understood. Low levels of the neurotransmitter serotonin are common, similar to several other mood and depressive disorders. Social anxiety disorder is often misdiagnosed as depression or panic disorder. Remove social anxiety disorder and the depression almost always departs. This perception is essential to a panic disorder diagnosis.
Treatment usually involves two concurrent therapies.
CBT usually involves a 12-24 week course of both individual and group sessions. The cognitive aspects center on the patient's recognition of recurrent thought patterns and re-examination of possible outcomes. Once the patient understands the mechanism that brings on the discomfort, new behavioral responses are practiced, usually beginning in a supportive group setting, as a means of reaching alternative results. But the disorder has an unusual timing quirk. Episodes may recur up to as long as a decade apart.