Learn More About Social Anxiety
Social anxiety disorder is the characterized by the intense fear of certain social situations. This often leads to someone avoiding those situations, which can negatively impact their life. Social anxiety can be treated through therapy, medication, or a combination of the two. Below you’ll find articles and other resources that can help you understand and deal with social anxiety.
What is Social Anxiety?
Key Terms
A deep worry about being seen as awkward, boring, embarrassing, or “not good enough.” This fear drives most of the thoughts and behaviors in social anxiety, even when there’s no real threat or judgment happening.
A pattern of staying away from situations that feel scary or uncomfortable. People with social anxiety might avoid parties, speaking up in class, or even texting friends. Avoiding these things can make the anxiety worse over time.
Cognitive distortions are unhelpful thinking patterns that twist how someone sees themselves or others. Examples include “Everyone will laugh at me” or “If I blush, I’ll look weak.” These thoughts feel real but are usually exaggerated or inaccurate.
Habits used to hide anxiety or prevent embarrassment, like staring at a phone to avoid eye contact or rehearsing what to say before talking. These behaviors feel protective but often keep the anxiety going in the long term.
How much a mental health condition affects someone’s daily life. In social anxiety, this could mean skipping school, avoiding friendships, or passing up opportunities. Impairment helps professionals understand how serious the condition is.
FAQs
What causes social anxiety disorder?
Social Anxiety Disorder is often caused by a mix of genetics, brain chemistry, and environmental factors like childhood bullying or overcritical parenting.
Is social anxiety the same as just being shy?
No. While shyness is a personality trait, social anxiety disorder significantly disrupts a person’s life.
Can social anxiety develop later in life?
Yes. Although it often begins in adolescence, it can emerge at any age due to stress or major life changes.
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Signs & Symptoms
Key Terms
Fear of judgment is the core concern of Social Anxiety Disorder. People with social anxiety often believe others are watching them closely and judging them negatively, even during normal activities like eating, speaking, or walking into a room.
Individuals with Social Anxiety often experience anticipatory anxiety, where they worry far in advance of a social event. Their mind jumps ahead to imagine all the things that might go wrong, which can build intense fear before anything even happens.
In Social Anxiety Disorder, anxious thoughts can include assumptions that others are thinking negatively of them. For example, one might think others see them as boring or stupid, even without any proof.
During conversations, people with Social Anxiety may focus inward on their voice, posture, or face, which makes it hard to pay attention to others or be spontaneous.
For people with Social Anxiety, symptoms like sweating, trembling, blushing, or a racing heart can appear in social situations, especially when they feel watched.
People with Social Anxiety are not just anxious about the situation itself, but also about others seeing their anxiety. They might fear that blushing, shaking, or stuttering will make them look weak or strange.
These are subtle habits meant to avoid attention or criticism, like speaking quietly, avoiding eye contact, or sticking to familiar topics. These habits can actually prevent social growth.
FAQs
Social situations make me uncomfortable. Do I have Social Anxiety Disorder?
You might or might not. If your discomfort is mild to moderate and doesn’t keep you from doing the things you want and need to do, you might not have Social Anxiety Disorder. Social Anxiety Disorder is diagnosed when the fear of others’ judgments makes people avoid social situations, endure them with intense distress, and keeps them from functioning at work, home, or school.
How are Social Anxiety and being introverted different?
Introversion is a personality trait, and describes people who generally prefer quieter, less stimulating environments and who enjoy time alone, one-on-one, or in small groups. Introverts may not prefer large group settings or speaking in front of others. People with Social Anxiety, on the other hand, often fear, avoid, or endure group settings or speaking in front of others with high distress. They have difficulty functioning as a result of their social fears.
Treatment Options
Medication for Social Anxiety: Types, Side Effects, & Management
by: Alysha Woods, MSN, PMHNP-BCKey Terms
CBT for social anxiety helps people identify the negative thoughts that fuel anxiety, such as “Everyone will judge me” or “If I say something wrong, I will be humiliated.” A therapist helps the person examine whether these thoughts are true, and teaches them to think in more realistic and helpful ways. CBT also includes practicing feared situations in small, manageable steps. This reduces anxiety over time and helps build confidence. CBT is effective because it addresses both the thinking patterns and the behaviors that keep social anxiety going.
Exposure therapy for social anxiety is a specific type of CBT focused on gradually facing the situations that cause fear, rather than avoiding them. A therapist helps the person create a list of social situations that cause anxiety, then they practice them one by one, starting with the easiest. Examples might include asking a stranger for directions, making small talk, or giving a short speech. The goal is to teach the brain that these situations are not dangerous and that anxiety fades with practice. This treatment works because it changes how the brain responds to fear through direct experience.
Some people with social anxiety avoid so many situations that they miss chances to develop social skills. Social skills training focuses on teaching things like making eye contact, using open body language, starting and ending conversations, and managing group dynamics. It can happen in individual or group therapy. A big part of social skills training is practicing in a supportive environment and getting feedback. It is helpful when anxiety comes from both fear and a lack of experience. The more someone learns and practices, the less awkward they feel, and the more confident they become.
ACT for anxiety takes a different approach from traditional therapy. Instead of trying to get rid of anxiety, it helps people accept that anxiety is part of being human and focus on living a meaningful life anyway. ACT teaches mindfulness skills to help people stay present rather than getting caught in anxious thoughts. It also helps people clarify their values and take small steps toward goals they care about, even if anxiety is still there. ACT is effective because it reduces the struggle against anxiety and increases the ability to live with purpose and flexibility.
Doctors often prescribe social anxiety medications such as SSRIs (like sertraline or paroxetine, generics for Zoloft and Paxil) or SNRIs (like venlafaxine, generic for Effexor). These medications affect brain chemicals like serotonin that are involved in mood and anxiety. They do not work instantly but usually take a few weeks to help. Medication can reduce the intensity of anxious feelings and physical symptoms like a racing heart or shaking hands. This can make it easier to participate in therapy or face feared situations. It is often used alongside therapy, especially when the anxiety is severe or long-lasting.
FAQs
What therapy works best for social anxiety?
Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) are some of the most researched and effective approaches for social anxiety. They work by helping you recognize and change negative thought patterns, gradually build social confidence and coping skills, and practice engaging in social situations in real life. Many studies show they can significantly reduce avoidance behaviors and self-consciousness over time.
Do I need medication for social anxiety?
Medication isn’t always necessary, as therapy alone works well for many people with social anxiety. However, for severe or persistent symptoms, antidepressants or anti-anxiety medications can reduce intense fear and worry so therapy can be more effective. The decision often depends on personal preference and guidance from a healthcare provider.
Living with Social Anxiety
FAQs
How do I know if I have Social Anxiety Disorder and not just shyness?
Shyness is usually mild and doesn’t get in the way of life. Social Anxiety causes intense fear or distress that makes it hard to speak up, make friends, or go to school or work. It often leads to avoiding things you actually want to do.
If I have social anxiety does that mean I’ll always struggle socially?
No. Social Anxiety is treatable. Many people improve a lot with therapy, practice, and support. It may always be something you manage, but it does not have to control your life or limit your future.
Will social anxiety affect my career of education?
It can, especially if it makes you avoid speaking up, asking questions, or going to interviews. But once you recognize it and start learning tools to manage it, you can succeed in school and work like anyone else.
Can social anxiety make me feel depressed or hopeless?
Sometimes. Feeling isolated, rejected, or stuck can lead to sadness or even suicidal thoughts. If you feel this way, you are not alone and help is available. Reaching out is a strong and important step.
What are some things I can do everyday to manage my social anxiety?
Practice small social steps like saying hi, asking a question, or making eye contact. Notice your anxious thoughts and try not to believe everything they say. Treat yourself with kindness and take breaks when needed.
Should I try to push through the fear or avoid what scares me?
Avoiding makes anxiety worse in the long run. Facing your fears in small steps, with support if needed, helps your brain learn that you are safe. You don’t need to push too hard, just move forward gradually.
Can I have close relationships if I have social anxiety?
Yes. Many socially anxious people are deeply caring, thoughtful, and loyal. Relationships may take more effort, but they are absolutely possible. Therapy can help with trust, communication, and building confidence.
Overlapping and Similar Conditions
Key Terms
Comorbidity means having more than one mental health condition at the same time. It’s common with Social Anxiety Disorder and can affect how symptoms appear and how treatment works.
Some conditions share similar symptoms (like worry or avoidance) but they have different causes, patterns, or treatments.
FAQs
Can you have Social Anxiety Disorder and another anxiety disorder at the same time?
Social Anxiety Disorder is often comorbid with other anxiety disorders, and they share many overlapping symptoms. All involve worry, but social anxiety is focused on others’ judgments, while the focus of other anxiety disorders is different. Agoraphobia focuses on the inability to escape or get help. Panic Disorder focuses on the panic attacks themselves. Generalized Anxiety Disorder includes worries about a variety of topics; and Specific Phobias focus on the feared object or situation.
Are Social Anxiety Disorder and depression related?
Social Anxiety Disorder and depression are often comorbid, especially in older adults. The social isolation that can come with Social Anxiety Disorder can sometimes cause depression. In addition, both can involve worries about others’ negative evaluations, but for slightly different reasons (in depression, because they are not worthy of being liked; in Social Anxiety Disorder, because of embarrassing appearances or behaviors).
Are Social Anxiety Disorder and substance use disorders related?
Some individuals struggling with social anxiety might turn to substances to feel calmer in social situations, but then may worry about others judging their substance use, abuse symptoms, or withdrawal symptoms.
Are Social Anxiety Disorder and ADHD related?
Social Anxiety Disorder and ADHD can occur at the same time, and might make each other more difficult. Worries about social situations could be worsened if someone also has difficulty paying attention (e.g., to social cues). However, each disorder needs its own treatment if they are comorbid.
Are Social Anxiety Disorder and PTSD related?
Social Anxiety Disorder and PTSD can co-occur, and both can involve self-deprecating thoughts and significant avoidance of anxiety-provoking situations. Many people with PTSD also experience social anxiety symptoms, but only some people with Social Anxiety Disorder experience post-traumatic stress symptoms. This suggests that trauma could be a risk factor for both disorders.
Are Social Anxiety Disorder and Autism Spectrum Disorder related?
Social Anxiety Disorder and Autism Spectrum Disorder (ASD) can look similar from the outside, as both involve struggles to interact socially. However, they have different features and causes. Social Anxiety Disorder can develop at any time in an individual’s life, and involves fears of others’ judgments. ASD is a neurodevelopmental disorder, which means it develops early in life, and affects a wider range of behaviors and communication skills.
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