Social Anxiety vs. Autism: Differences & Similarities

Unlike autism, social anxiety is classified as a mental disorder. Today we'll compare social anxiety vs. autism.

steven zauderer
Steven Zauderer
September 20, 2023
min read

Key Differences

Social Anxiety Disorder

Unlike autism, social anxiety is classified as a mental disorder. There is no typical time at which it can arise, though it can be triggered by events in someone's life at an early or later date. Young Children, adolescents, adults, and the elderly can be diagnosed with social anxiety.

Although some researchers have found links to social anxiety and potentially suicidal thoughts, that is no self-harm widely found in people that are diagnosed. Additionally, the criteria that are used for a proper diagnosis include an irrational fear of specific situations or distress that's felt among someone with their peers.

Fearful thoughts among peers are more common in young children. A noticeable lack of self-consciousness is also a big sign of social anxiety.

The lack of confidence and too much focus on imperfection can cause someone to display fear over it, like a prominent scar on the face that's easy to see, being overweight, or a history of bullying.


Autism Spectrum Disorder, or ASD for short, is characterized by an inability to observe the social signals in others.

It carried multiple symptoms, some of which may not deal with social anxiety at all. People with ASD can have issues performing tasks that their peers have no problem doing on their own.

Being a developmental disability, autism isn't a mental disorder and can be detected in infants as young as six months.

Most people with autism will eventually learn to cope with their symptoms at some time later on. For those that undergo therapy, this period is often shorter. When autistic people won't express fear all the time when around people, but misunderstand.

Autism is also a social inhibitor, where someone may come off as hot and afraid, but awkward in voice, mannerisms, and speech. Furthermore, autistic people of all ages are concerned so much about the thoughts of other people on the level of social anxiety disorder.

Key Similarities

Social Anxiety Disorder

One major similarity that SAD has with ASD is anxiety itself. People with both disorders have found themselves in predicaments that are highly challenging for them to be in. Social anxiety disorder causes rapid fear, usually from themselves and how they're perceived by everyone around them.

The worry of people watching them all the time, how they speak, behave, and jitter can cause rapid heartbeat and even panic attacks. The panic attacks could be easily seen in people around or barely noticeable.

Like autism, a lack of social communication could be a feature. Some may attempt to have a conversation, but the constant worry over what so many around them think of them can cause someone with no therapy to fall out of place.

Autism cannot be treated with any sort of prescription. Some people may take pills meant for other disorders to calm down. Self-harm is possible, especially in smaller children that become overwhelmed with anxious feelings.


One easy-to-notice similarity that ASD shares with SAD is the inability to make friends and bond with people.

With either disorder, the possibility of loneliness comes up, and with it depression. Both SAD and ASD may host numerous symptoms that may even appear as something else altogether, as social anxiety can give way to repetitive actions like nail biting, hitting objects with the hands, or anything else to avoid thinking about negative thoughts.

They're both sometimes misdiagnosed as ADHD, although autism has this occur more often. Nervousness to certain people may be intimidating, but the opposite sex and anyone attempting to get close might be similar.

It's a chore for autistic people and those with social anxiety to adapt to new plans in their environment. When changes are forced upon them, negative reactions are likely to be seen. Alternatively, it could result in deeper introversion that is difficult for them to pull themselves out of.


Social Anxiety Disorder

Here are the most common symptoms of SAD:

  • Fear over being judged unfavorably - The disorder can produce an irrational fear over what other people around them think. This fear may go on for some time, even when someone isn't in a social environment. It can cause marked bouts of depression and awkwardness when returning to social settings. The thought is hard to forget about, no matter how hard they try. When there is an effort to avoid it, certain actions by people nearby may trigger bad thoughts again.
  • A deep fear for conversation with people they don't know - While someone could speak with one that's trusted, strangers could be avoided at all costs.
  • Shying away from others looking at them - People with SAD hate being in the center of everyone's attention. To prevent this from happening, one might sit away from everyone else in a place where there's no one else around, eat by themselves, or avoid walking in locations where large groups would see them.
  • General fear when being around people - They may avoid speaking and stammer when they do talk, or find a way to be alone in whatever situation they find themselves in.


Here are autism's most common symptoms:

  • Complete avoidance of eye contact - One feature commonly found in ASD is avoidance of looking people in the eyes, particularly when talking to them. It's not always due to shyness but is an indicator of their limited social ability.
  • Poor insight into social cues - Social cues are picked up on by people as children, but for someone with autism, that lack of understanding can make their behavior seem odd to others.
  • A lack of empathy for others - When autistic people are in a social setting, they may say and do things that come off as rude and uncaring. If someone nearby slips and falls, for example, a person with ASD may walk by without giving much thought to the possibility of the other person being hurt.
  • Inability to speak - More common in children, some with autism are non-vocal and will communicate through other means, such as writing things down and picking cards from a deck.
  • A preference for knowing what to expect - Autistic individuals dislike being taken out of familiar situations and prefer knowing what to expect. In small children, tantrums and self-harm may develop when placed in a setting they don't want to be in or are unfamiliar with.


Social Anxiety Disorder

  • Traumatic events - Things that occur during one's childhood can lead to SAD. Child abuse is a leading factor, as is bullying, fighting, and sexual abuse. When children are bullied, they often have problems with social ability, shying away from their peers, and making friends. fighting may lead to lasting scars, both physical and mental, that are hard for them to forget.
  • Rejection - Rejection from someone close can make future communication hard. Rejection can lower one's confidence, preventing them from forming relationships to avoid fear and upset.
  • Poor physical appearance - Bad teeth, balding hair alopecia, facial scars, physical deformities, and obesity can cause severe social anxiety.
  • Sheltered childhood - Children that are sheltered and don't make friends during childhood may show discomfort in public. Kids with few friends can develop poor social cues, making friendship burdensome.


  • Poor parental choices during the prenatal period - Smoking, alcohol consumption, and drug abuse during pregnancy raise the possibility of a woman conceiving a child with autism.
  • Having a family with a history of autism - If one or more parents have autism, the chances of their child carrying the disorder increase. Autism's hereditary traits have been studied to find a better understanding of how its carried from parent to child.
  • Environmental contributions - Kids may develop autism from staying in an environment that places them in a position where there's a lack of social interaction, lots of stress, and no taught knowledge of gross motor skills.
  • Parents having children at an older age - Older people that have children are more likely to have a baby with an autism diagnosis within the first year of the infant's life.


Social Anxiety Disorder

SAD is diagnosed based on the information contained in the DSM-5. When physicians are presented with a case, they tend to look for ongoing fears related to being judged by peers and strangers.

Psychologists will ask to see how long the symptoms have been going on.

The minimum is six months, but most that are up for a diagnosis will talk about the feelings lasting for a very long time, especially with adults.

Factors such as anxiety and fear being triggered in public areas are grounds for a diagnosis, as are people that are fearful for no apparent reason. This means that there isn't a rational threat behind their feelings, other than previous experiences or none at all.

Another major area that doctors look for is anxiety symptoms that can't be classified on their own, like panic disorder.


Since autism is often found in infants, pediatricians routinely check babies for symptoms that have 6 months passed from birth.

Some early signs that count as grounds for further analysis are the poor focus of the eyes and poor reaction to certain sounds, like a fan blowing or buzzing noises. Auditory and visual problems detected are typical, but many children go further observation during toddler age.

Psychiatrists set up interviews with parents and children to see how they behave in public, at home, and when other children their age are around.

For mild autism, the diagnosis might be a bit longer as doctors could be reluctant to classify it without knowing for sure if another disorder is the cause.

They may recommend to older patients or parents of children to receive an MRI, where brain enlargement and atypical neural connections help in the determination of an official diagnosis.


Social Anxiety Disorder

There is no cure for SAD. Social anxiety disorder is treatable with pharmaceuticals or interviews with a medical professional. The beginning treatment starts with a diagnosis.

Depending on the symptoms and their level of severity, medication could be recommended by a doctor or psychotherapy. Psychotherapy may or may not involve prescription medication. In cases where it doesn't, patients are treated by speaking directly to a doctor.

The most common are psychologists, then psychiatrists, and group therapy sessions with other patients that are the same as them. Other mental healthcare professions could be involved, helping patients make small steps in confidence about themselves so that they don't exhibit fear when in a setting that causes flight mode.

A therapist may recommend that patients practice by socializing with people that share the disorder. These are all better achieved for patients that have people around to help them overcome their anxiety.


Like SAD, autism also has no way to be cured. It's also not treated with pharmaceuticals, though extreme features may warrant some medications, particularly the kind that cause harm to patients.

Most doctors, health experts, and health insurance companies will recommend Applied Behavior Analysis as a treatment for autism. The treatment itself is called ABA therapy and is conducted at ABA centers spread throughout the country.

ABA centers employ behavioral technicians that are trained to work with autistic people of every age. They reduce symptoms by engaging in positive and negative reinforcement with patients and giving care for a week, months, and even years.

ABA had evolved to focus more on improving without punishments. It's highly customizable, so not every client that goes into ABA therapy will receive the same treatment.

Co-Occurring Autism And Social Anxiety

It's certainly possible for one to have both disorders. However, social anxiety doesn't typically cause auditory and visual annoyances as it does for autistic people. Neither does it make a lasting impact on the way that knowledge is picked up.

Some that have ASD have problems understanding things that are spoken, written down, or directed toward them with body language. SAD isn't a lack of understanding but a persistent need to get away from people from unreasonable fears and judgments.


Can Social Anxiety Be Mistaken For Autism?

Yes, it has happened before and will continue to occur. Autism is a complex neurological disorder with a range of symptoms that sometimes overlap with other conditions, and one of them is SAD.

Misdiagnosis is a probable chance of happening when the initial diagnosis is made without several follow-up tests. As such, many psychiatrists now engage in multiple interviews with patients to see how their symptoms are progressing before anything official is done.

Social anxiety disorder might be mistaken for autism as well. In moderate cases of ASD, the characteristics resemble general anxiety and stress.

A misdiagnosis may not be found until a child is put into therapy and further evaluated. In older people with ASD, misdiagnosis is more common due to autism's major symptoms being exhibited no more.

Can Social Anxiety Feel Like Autism?

Since the similarities of both disorders are similar, they may feel the same in some people.

When this is the case, someone with autism will show problems with controlling their emotions, continue to not make eye contact, and abruptly walk away when people are coming in their direction. SAD individuals won't bother to speak and act shy with no will to gaze at anyone.

Is Social Anxiety A Form Of Aspergers?

Social anxiety isn't a form of Asperger's. What once was thought to be a separate condition with close ASD association is no longer classified as a disorder in the DSM-5.

Simply put, Asperger's is just autism and social anxiety disorder isn't a form of autism. The symptoms may look the same in some people but they're wholly dissimilar conditions generally treated in different ways.

Aspergers was very recently listed as a condition revolving around a lack of emptiness and the inability to pick up facial expressions. Again, these traits are characteristic of autism.

Does Social Awkwardness Always Mean Autism?

No, not everyone who is socially awkward has autism, just everyone with social anxiety not having SAD. Humans have complex central nervous systems that sometimes behave in ways meant to reduce the chances of being fearful or showing emotion.

These feelings can take place in anyone. Almost all people can temporarily get social anxiety. In one famous study, it was found that the general public fears being on stage alone more than the fear of dying.

Being awkward happens often and so does anxiety. They become problems when anxiety and fear forbid one's ability to live their life, go to school, form friendships, and fulfill their employment duties.

How To Tell The Difference Between Social Anxiety And Autism

The easiest way to tell the difference between SAD and ASD is by reaching out to medical professionals, psychiatrists, and mental health physicians.

Screening in children and adults isn't the same but individuals with ASD maintain symptoms that are broader in scale than social anxiety disorder.

steven zauderer

CEO of CrossRiverTherapy - a national ABA therapy company based in the USA.

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