Social Anxiety: What It Is, Symptoms, Treatments & More

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Medically Reviewed By:
Mark Arredondo, M.D.

FRIDAY, March 3, 2023 (HealthDay News) -- Have you ever been in a social situation where you felt nervous? Maybe starting a new job caused you to sweat a lot on your first day. Or going to a party where you didn’t know anyone gave you a nervous stomach.

These are normal feelings that most people experience at different times in their lives.

But social anxiety is a much different experience. It can be debilitating and interfere with simple, day-to-day activities like going to work, attending social gatherings or even going to the store.

What is social anxiety?

Experts from the Anxiety and Depression Association of America describe social anxiety as “intense anxiety or fear of being judged, negatively evaluated or rejected in a social or performance situation.” Fear of appearing awkward or dumb intensifies anxious feelings and often leads to avoiding the social situation altogether.

Since avoidance is a common response, social anxiety can be a life-limiting disorder if left untreated.

The avoidance turns into missed opportunities, experiences or relationships, which leads to low achievement in school and work, poor social skills, low self-esteem, social isolation, depression and even suicidal thoughts or attempts.

If this sounds familiar, you’re not alone. Fifteen million American adults have social anxiety disorder, according to Mental Health America.

Social anxiety symptoms

Mayo Clinic says the criteria for diagnosing social anxiety disorder include:

  • Persistent, intense fear or anxiety about specific social situations because you believe you may be negatively judged, embarrassed or humiliated

  • Avoidance of anxiety-producing social situations or enduring them with intense fear or anxiety

  • Excessive anxiety that's out of proportion to the situation

  • Anxiety or distress that interferes with your daily living

There are also physical symptoms that someone with social anxiety can experience.

These include “intense fear, racing heart, turning red or blushing, excessive sweating, dry throat and mouth, trembling (fear of picking up a glass of water or using utensils to eat), swallowing with difficulty, and muscle twitches, particularly around the face and neck,” according to the Social Anxiety Institute.

Social anxiety treatments

Are you wondering how to overcome social anxiety?

The good news is social anxiety is a treatable condition.

The National Institute of Mental Health (NIMH) says the first step to getting help is speaking with a mental health professional who can provide you with a diagnosis and treatment plan.

Treatments include psychotherapy (or “talk therapy”) and sometimes medication.

Cognitive behavioral therapy (CBT), a type of psychotherapy, is a highly effective method of treatment for social anxiety.

Dr. Stefan G. Hofmann, director of the Psychotherapy and Emotional Research Laboratory at Boston University, said in a post for the National Social Anxiety Center that CBT “generally consists of about 12 to 16 weekly sessions and includes exposure strategies to target cognitive factors that maintain the disorder."

Hofmann added that once in therapy, the drop-out rates are very low and the response rate to therapy is nearly 75%.

Exposure therapy is another form of treatment for social anxiety disorder. Here, you’re exposed to one or more anxiety-producing social situations. This happens in a controlled environment where you’ll learn to practice coping strategies rather than avoidance, according to the American Psychological Association.

Your therapist might also decide to add social anxiety medication to your treatment plan.

NIMH places social anxiety medication into three categories.

  • Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) like Paxil and Zoloft, or serotonin-norepinephrine reuptake inhibitors (SNRIs) like Effexor XR

  • Beta blockers, prescribed and used occasionally to treat the physical manifestations of social anxiety like increased heart rate, blood pressure and shaking

  • Anti-anxiety medications, like benzodiazepines, may be prescribed and closely monitored because they can be addictive

It’s not unusual to try different medications until you find the one that’s right for you.

As with many medications, be aware you could experience side effects. It’s important to talk to your mental health professional if the side effects concern you.

Living with social anxiety disorder doesn’t have to be a devastating, life-altering condition. With proper diagnosis and treatment, many people with social anxiety have learned to live long and fulfilling lives.

If you or someone you know is in a mental health crisis, call or text 988. Free and confidential help is available 24 hours a day, seven days a week.

What This Means For You

Do you suffer from social anxiety? If so, there are therapies and treatments that can help.

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