Social anxiety and depression are two of the most commonly diagnosed mental health disorders in the United States.
Depression is characterized by persistent sadness, whereas social anxiety is an irrational fear of social interactions.
These are separate conditions, but they can co-occur, creating a unique challenge. In fact, for nearly 70 percent of individuals diagnosed with both disorders, social anxiety comes first, then depression.
In many instances, it’s the social anxiety that causes the depression.
A person with social anxiety may have trouble making friends and maintaining close relationships. Fear of social interaction may even result in missed opportunities. An inability to control the symptoms often leads to frustration, feelings of hopelessness, isolation, and ultimately depression.
Some people with social phobia also have a history of being bullied, rejected, or ignored. These experiences can affect their self-esteem and self-confidence, triggering depression later in life.
But although it appears that social anxiety is more likely to cause depression than the other way around, anxiety can also occur as a symptom of depression. So being depressed could potentially worsen an underlying social phobia.

To be diagnosed with social anxiety and depression, you must exhibit signs of both conditions at the same time. Social anxiety causes both physical and emotional symptoms before, during, or after social interactions.
SYMPTOMS OF SOCIAL ANXIETY
Physical symptoms include:
Emotional or psychological symptoms include:
  • fear of being embarrassed, rejected, or humiliated in public
  • low self-esteem
  • low self-confidence
  • avoidance of social settings
  • an inability to overcome social mistakes
Symptoms of social anxiety in children can differ from adults. A child may show some of the above symptoms.
Additionally, a child may also fear going to school, using a public bathroom, or reading out loud. They may also have tantrums or cry when uncomfortable in social settings.
There’s a cycle when social anxiety and depression co-occur. It starts with uncontrollable anxiety or an irrational fear in social settings. To avoid the physical, emotional, and psychological effects of this anxiety, you may withdraw from others.
Social anxiety is tricky. On one hand, you may want to make friends and share yourself with the world. But, on the other hand, you can’t overcome the overwhelming anxiety — so you avoid interactions with others whenever possible.
But while avoidance is one way to deal with anxiety, it can lead to other feelings like loneliness, guilt, shame, and ultimately depression.
SYMPTOMS OF DEPRESSION
In children, signs of depression can also include:
  • outbursts (tantrums and crying)
  • stomachaches
  • sensitivity to rejection
  • anger
  • poor academic performance