Most people get anxious in social settings from time to time. But if your anxiety makes it difficult for you to function, you might have a social anxiety disorder, also known as social phobia.
Social anxiety disorder isn’t just where you feel shy or nervous around new people. It’s a mental health condition that makes attending and participating in social situations difficult. It could even affect long-standing relationships with family and close friends. People with social anxiety usually worry that others dislike or judge them.
The good news is that social anxiety disorder is highly treatable. Therapy, coping skills, and self-care strategies can help you manage your anxiety.
Understanding social anxiety disorder
Also known as social phobia, social anxiety disorder is a mental health condition characterized by extreme anxiety in social situations. People with this disorder often worry about being judged, scrutinized, or disliked. This may lead them to avoid other people or feel intensely uncomfortable around them.
What is social anxiety disorder?
We all get anxious in certain social situations. It’s understandable to feel nervous about speaking publicly or meeting new people.
Social anxiety disorder, however, is disproportionate because it affects how you function. For example, you might get so anxious that you start sweating before seeing a good friend. Or, you might avoid going to the doctor because you’re anxious about interacting with them. You may even recognize your irrational fear but struggle to overcome it.
Interacting with other people is a standard part of daily life. Because of this, social anxiety disorder can impact your quality of life and make it difficult to function. Your anxiety might affect your performance at school or work. It can also show up when you need to interact with others, whether shopping, ordering pizza, or going to the bank.
Normal shyness vs. social anxiety disorder
Social anxiety disorder may be mistaken for shyness and vice versa. They’re actually two different things.
“Shyness is a personality trait. Social phobia is a clinical disorder,” says Michelle Coleman, a Grow Therapy Licensed Professional Counselor (LPC). “People with social anxiety have more symptomatology, more functional impairment, and a lower quality of life.”
Someone may be shy without having social anxiety. Although they feel awkward and reserved in certain social situations — like when meeting new people — they don’t experience disproportionate fear around interacting with others.
“If you are unable to go to an event and become overwhelmed at the thought of going to the activity and possibly experiencing physical reactions (nausea, sweating, heart racing, dizziness), it may be social anxiety,” Coleman says.
Symptoms of social anxiety disorder
Social anxiety disorder has many emotional, physical, and behavioral symptoms. The symptoms may differ from person to person. Similarly, not everybody with the disorder experiences the same level of intensity. For some people, the symptoms may be mild, while for others, it may be more extreme.
Emotional symptoms of social anxiety disorder
As the name suggests, you may be consumed by anxiety in the face of social situations — resulting in one or more emotional symptoms. Common emotional symptoms of social anxiety include:
- Constantly thinking about excuses to get out of social appointments
- Intrusive thoughts about being humiliated in social situations
- Ruminating on past social interactions and wondering whether people like you
- Worrying that others are judging you or that they’ll notice your nervousness
Before or during social events, those with a social anxiety disorder may experience dread or extreme nervousness and feel an overwhelming sense of self-consciousness, especially in instances where they’re required to hold attention.
Physical symptoms of social anxiety disorder
Anxiety can have physical symptoms, too. Blushing, a rapid heart rate, and sweating are all physical signs of social anxiety. Other symptoms include:
- Difficulty speaking or thinking clearly
- Dizziness or lightheadedness
- Fatigue after socializing
Additionally, it’s not uncommon for a social anxiety disorder to manifest through tense muscles and trembling or shaking.
Behavioral symptoms of social anxiety disorder
You may change your behavior to accommodate your anxiety. You might find excuses to avoid social interactions — sometimes via telephone or video call. Your fear may lead you to put off necessary errands and activities to avoid talking to others. Other behavioral signs include:
- Constantly using your phone in social situations to avoid interaction
- Missing school, work, and/or social appointments
- Trying to blend into the background in social settings
Social anxiety, particularly in more severe instances, may also lead to abusing substances such as drugs and alcohol to gain comfort. If left unattended, substance abuse can enhance symptoms of social anxiety and cause other collateral damage to an individual’s physical and mental well-being.
Therapy for social anxiety
Causes and risk factors
As with most mental health conditions, the causes of social anxiety are unclear. However, experts have identified factors that can increase your risk of developing the condition. These risk factors can include:
- Being raised by over-controlling or critical parents
- Brain structure and function
- Genetics
- Having an insecure attachment style
- Past experiences of abuse or trauma
If you have one or more of the above risk factors, your chances of developing social anxiety disorder — or another mental health condition, like generalized anxiety disorder — are higher. However, it doesn’t necessarily mean you will inevitably develop the condition.
Diagnosis of social anxiety disorder
To be diagnosed with social anxiety disorder, you’ll need to speak with a qualified mental healthcare professional, like a psychiatrist or psychologist.
In the United States, mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) to diagnose mental health conditions. The DSM-5 sets out criteria for diagnosis.
The criteria for assessing social anxiety disorder, as defined by the DSM-5, include:
- Fear of social situations involving scrutiny from others
- Fear of behaving in a manner that could upset or offend others
- Fear or anxiety predominantly triggered by specific situations
- Avoidance of the feared situations or experiencing intense anxiety and fear when exposed to them
- Disproportionate fear or anxiety relative to the actual threat
- Persistent fear or anxiety
- Interference of symptoms with daily functioning
Before diagnosing an individual with social anxiety disorder, a mental health professional will typically conduct a thorough evaluation to ensure that the symptoms align with the specific criteria outlined in the DSM-5. During this evaluation, the healthcare professional may also rule out other potential diagnoses, such as generalized anxiety disorder, to ensure an accurate diagnosis.
Effective treatments
Although this condition can be difficult to cope with, it is treatable, says Coleman. “Social anxiety is not just part of your personality,” she says. “Social anxiety disorder is treatable with talk therapy and medications.”
The right treatments can help you manage your symptoms to function well in your daily life. With the right support, you can have a healthy, thriving social life despite your condition.
Types of treatments for social anxiety disorder
Your unique treatment plan depends on your symptoms. Social anxiety disorder treatments can include:
- Prescription medications (if necessary), such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), beta-blockers, and benzodiazepines
- Talk therapy, also known as psychotherapy, which entails talking with a qualified mental health professional
- Self-care strategies and coping mechanisms, which can help you function better in your daily life
- Learning social skills, which can help you feel more empowered in social settings
If you’re not sure where to start, speaking with a therapist is a good first step. Many different kinds of therapy can be used to treat social anxiety, including cognitive behavioral therapy (CBT), exposure therapy, and psychodynamic therapy.
In some cases, you may benefit from family counseling or group therapy. Group therapy can be an excellent way to flex your social skills in a safe environment where everybody’s in the same boat.
Finding a therapist for social anxiety disorder
For some people with social anxiety, the idea of speaking with a therapist can be daunting. Remember that therapists are there to help you, not judge or make you uncomfortable. They are trained to provide a safe space for you to be heard and understood. Although you may feel anxious about therapy, the benefits outweigh the discomfort.
Our marketplace makes it easier to find therapists for social anxiety disorder. Using our filters, you can:
- Look for therapists who treat anxiety disorders specifically
- Verify that they take your insurance
- Read their profiles to see if they’re a good fit for you
- Book an appointment without calling them
If in-person therapy sounds daunting, consider looking for a therapist who provides online therapy. You may even meet with a therapist online for a few sessions and then meet them in person, if that suits you. Our website allows you to search for therapists who offer online therapy.
If you’re feeling nervous before therapy, remember it’s OK to feel that way. Remind yourself why you’re doing it. Try calming activities before therapy, such as doodling or deep breathing exercises.
Coping strategies
There are many effective coping techniques you can use. Coleman suggests controlled breathing and guided meditation — you can find guided exercises for both online.
Coleman also suggests using distraction techniques when you feel overwhelmed. Distraction techniques can include counting things around you (e.g., counting how many pink things you can see, counting the number of plants in the room, or counting backward from 10). Additionally, social skills training is commonly recommended to those battling with social anxiety as a tool to manage their symptoms.
Social skills training
Social skills training (SST) is a type of behavioral therapy that teaches social skills. People with a social anxiety disorder may isolate themselves more, giving them fewer opportunities to practice social skills.
Social skills training can cover communication skills, conflict management, telephone etiquette, and more. It can include teaching you to be more assertive. Often, social skills training improves confidence through practice and exposure to social situations. This can increase self-assurance.
Living with social anxiety disorder
Although social anxiety can be debilitating, it’s possible to live a happy and productive life despite having the condition. Self-care strategies may help:
- Learning to recognize negative self-talk and distorted patterns of thinking. For example, you might assume someone dislikes you because they look bored during a social interaction.
- Engaging in positive self-talk before, during, and after social interactions.
- Practicing your social skills by sharing stories or making toasts with groups of people you know well.
- Building up a tolerance for social interactions by smiling at — or even complimenting — strangers.
- Giving yourself time to decompress after social occasions.
Different strategies work for different people. It’s a good idea to experiment and see which techniques work for you or talk with your therapist about the strategies best suited for your individual needs and circumstances.
Key takeaways
Social anxiety disorder is not just shyness but a mental health condition. The symptoms of this disorder can make it difficult to function in your day-to-day life. Although social anxiety can be debilitating, it’s possible to manage your symptoms in a healthy and effective way. Talk therapy is a good place to start your healing journey.
Looking for a therapist can be daunting and overwhelming for those battling a social anxiety disorder. Using our search tool, you can easily find a therapist that suits your needs. Our filters make it possible to search for therapists according to their location, the insurance they accept, and whether they offer online therapy. This tool can make it easier to find a therapist and begin your healing journey.
