What is social anxiety?
Feeling anxious is a human emotion and it’s natural to feel nervous about certain social situations, such as meeting a new group of friends. But, when you begin to exist in a constant state of anxiety, you could be experiencing more than a passing feeling of shyness.
Social anxiety can hurt your confidence and self-esteem. It might make you feel very alone and lead you to avoid social situations out of fear of saying or doing something embarrassing. This fear can make it hard to build relationships and handle everyday tasks like shopping, answering the phone, or making eye contact. Social anxiety is more than just being shy—it’s an ongoing fear of being watched and judged by others. Often starting while you are a teenager, social anxiety is more common in women.
You might recognise you have a problem feeling anxious in social situations, but may feel unable to ask for help. Without help, social anxiety can get worse. Over time, some people may turn to drugs or alcohol to ease uncomfortable feelings in social situations. This can lead to substance and alcohol abuse.
Social anxiety disorder often happens alongside other conditions. These can include depression, substance use disorder, generalised anxiety disorder (GAD), panic disorder, and post-traumatic stress disorder (PTSD).
Symptoms of social anxiety
Social anxiety is more than feeling shy. It’s a fear that doesn’t go away by itself and affects everyday activities, relationships (friends, family, romantic and colleagues), and your self-confidence. You might experience physical and/or mental symptoms.
Mental symptoms
- Worrying about an upcoming social situation for weeks in advance.
- Distress or panic when faced with lots of people.
- Inability to think straight.
- A feeling of the mind going blank.
- Worrying about accidentally offending people.
- Overly criticising yourself after a conversation.
- Worry about everyday activities (e.g. meeting new people, speaking on the phone, starting conversations, or working) or embarrassing yourself in front of others.
- Fear of being criticised.
Physical symptoms
- blushing
- sweating
- heart palpitations
- trembling
- nausea
- stuttering
- panic attacks
Physical symptoms can make your fear of judgment worse, which can cause more mental symptoms. This can create a cycle of worry you can feel stuck in.
Writer Russell Norris shares 10 of his most common social anxiety triggers, and his tips on how to handle them on Happiful.
Causes of social anxiety
We aren’t sure what causes social anxiety yet, but early studies suggest that increased activity in the amygdala (a collection of cells in the brain that control the fear response), is linked to those with social anxiety. Experts think social anxiety may develop due to sensitivity, genetics, and early negative social experiences or environmental influences.
Traumatic experiences in early childhood and environmental influences such as bullying, parental neglect/criticism, emotional, physical and sexual abuse, parental death and family conflict, are all common triggers. Children of parents with social anxiety are also likely to develop the condition.
Our brains can however be reprogrammed to learn new habits and behaviours and this is often done through talking therapy.
What can make social anxiety worse?
There are many different things we can do that may make our social anxiety worse.
- Avoidance: If you find yourself avoiding or trying to leave situations that make you feel anxious, this can prevent you from experiencing positive social experiences. Positive social experiences can help you to feel more confident and may help challenge negative thoughts. Avoiding social situations can lead to reduced confidence in your social skills as you have less chance to practice them.
- Using ‘safety behaviours’: These are things you do to help you feel less anxious in the moment, but actually make things feel worse long term. This happens because you start to believe you need to do these things to cope with your anxiety. Safety behaviours can include things like keeping quiet during conversations, avoiding eye contact, or making sure to have someone you know with you whenever socialising.
- Increased self-focus: You might find yourself paying too much attention to how you look or feel physically during social interactions. For example, focusing on if you are blushing, stammering, or sweating too much. This can lead you to overestimate how much you are reacting, making you feel more anxious and self-conscious.
Do I need help for social anxiety?
If you feel like social anxiety is having a big impact on your life, it can be a sign it’s time to find help. If you find yourself avoiding social situations, spending a lot of time worrying or planning how to deal with social situations or events, or are worried your anxiety may be getting worse, speaking with your GP can be a helpful first step. They will be able to help signpost local services and support options in your area. You can also self-refer for NHS talking therapies if you live in England, are 18 or over, and want help with anxiety or depression.
Counselling for social anxiety
A 2005 study revealed that only half of adults seek professional help for anxiety disorders and those who do have struggled with the condition for 15-20 years. Unfortunately, unless you seek treatment for social anxiety, it’s unlikely to get better on its own.
But the good news is there are lots of strategies you can employ if you suspect you have a social anxiety disorder, and psychotherapy is one of the most effective in reducing anxiety symptoms, particularly CBT.
Cognitive behavioural therapy
Cognitive behaviour therapy (CBT) is the most common form of psychotherapy treatment for social anxiety. It aims to identify and reduce the beliefs and behaviours that are fuelling the condition, for example, avoiding answering the phone at work because you think you will say something wrong prevents the person from understanding that the action is harmless.
CBT helps you recognise what triggers your unhelpful thinking and thus behaviours, allowing you to change your response before slipping back into unhelpful ways.
Counsellor Marian Hanson explains CBT in this short video:
Exposure therapy
An important element in the treatment of social anxiety through CBT is exposure therapy. Exposure therapy works to gradually ‘expose’ yourself to situations that you fear or cause extreme anxiety, and in doing so, you retrain the brain so that extreme panic is not your default response.
There are a variety of exposure strategies that can help you confront your fear:
- In vivo exposure: directly facing a feared situation in real life.
- Imaginal exposure: vividly imaging the situation that you fear.
- Virtual reality exposure: facing the feared situation with virtual reality technology.
If you struggle with large groups of people, for example, your therapist will work with you on a scale of situations that slowly allow you to be more comfortable with the ultimate fear. You may be given some therapy homework that involves imagining yourself in a crowded group of people but visualising safety and comfort. Or, you may be asked to sit on a park bench for 10 minutes, being in close proximity to people, or to walk to the nearest bus stop and home.
These lengths of time gradually increase so you become more comfortable in the feared scenario and slowly gain confidence to conquer social anxiety.
Want to know more? Read Grace Victory's tips to relieve social anxiety on Happiful.
Where to find support
It can be really difficult to ask for help with social anxiety because this in itself could be a trigger. But it’s important to know that help is available and can have a profound effect on the way you move forward, anxiety-free.
Counselling for social anxiety
If you’re ready to reach out to a counsellor, there are a host of professionals on Counselling Directory. You can use our advanced search to narrow down your search criteria, such as the type of session or location, whether online or in-person. Take the time to find a counsellor best suited to you and your needs.
Support groups
If you're not quite ready to reach out to a therapist, that's OK. You can also find help through online peer support services and connect with like-minded individuals experiencing similar symptoms. Anxiety UK hosts an online support group dedicated to individuals with anxiety which may be helpful in your treatment.
Self-help
The NHS also recommends self-help to reduce social anxiety. Self-help techniques can be useful in better understanding your social anxiety, finding ways to decrease feelings of stress and anxiety, and breaking down situations into smaller, more manageable chunks to feel more comfortable. Try the NHS easy to read or audio guide for social anxiety self-help.
