They often have insight into their difficulties. They often report that they have been shy most of their lives. They are sensitive to even minor perceived social rejection. Because they become so social isolated, they have greater academic, work and social impairment. They may crystallize into an avoidant personality disorder.
Social phobia is the third most common psychiatric disorder.
Onset is usually in childhood or adolescence. It tends to become chronic. It is often associated with depression, substance abuse and other anxiety disorders. The individual usually seeks treatment for one of the other disorders. Social phobia is vastly under-diagnosed.