What we treat

Social anxiety

It's common to feel nervous in some social situations, like a date, for example. But with social anxiety disorder, or ‘social phobia’, social interactions trigger extreme anxiety, fear, self-consciousness and embarrassment. It can have a big impact on the way that the person functions in everyday situations and can be very distressing for those suffering from it.

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Symptoms of social anxiety

Experiencing social anxiety disorder is different from being a shy or quiet person. Social anxiety is intense fear, shyness or nervousness triggered by social situations. For example, you might be very anxious about being negatively judged by other people, fearing criticism or being afraid of doing something that you feel will be embarrassing or 'stupid'. You may also experience physical symptoms of anxiety such as panic attacks, sweating, blushing, having a racing pulse or a dry throat and mouth, trembling, dizziness, upset stomach or nausea, and muscle twitches. You will likely avoid situations that trigger these feelings, for example, group situations like parties, or situations where you might be the centre of attention or have to interact with strangers.
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You may spend a great deal of time anxiously anticipating an upcoming social situation. In such situations, you may have a number of methods you use to cope if you’re unable to avoid the situation entirely. We often don’t notice that these attempts to cope can be part of what keeps the anxiety going. Certainly, people who experience social anxiety often report that they miss out on opportunities during their life as a direct result of avoiding specific situations. If you’re experiencing social anxiety, you will likely over-analyse your performance after a social situation, reliving it over and over and identifying more and more flaws in your interactions that others will probably not have noticed – a habit sometimes referred to as 'post-mortemising'.

People with social anxiety often experience significant distress in the following situations:

Being introduced to or interacting with new people
Being teased or criticised
Performing on stage
Being watched or observed while doing something
Public speaking
Meeting people in authority
Making eye contact
Talking, making phone calls if in public
Being in an intimate situation with one person
Going to work or school
Starting conversations
Dating
Entering a room in which people are already seated
Returning items to a store
Eating in front of others
Parties or social gatherings

Avoiding common social situations

Social anxiety disorder symptoms can change over time. They may flare up if you're facing a lot of changes, stress or demands in your life. Although in the short term avoiding situations that produce anxiety may make you feel better, your anxiety is likely to continue long term if you don't get treatment.

Causes of social anxiety

It's normal for people to be sensitive to – and give a great deal of thought to – social interactions with other people. This helpful awareness can become social anxiety if it escalates into an unhelpful pattern of persistent fear and avoidance.

There is no single cause of social anxiety disorder, but it can often appear in teenage years and often stems from a fear of being judged negatively by others. Social anxiety symptoms can get better on their own, or you might find that they get better as you get older. However, if your social anxiety symptoms are significantly impacting your life, it might be a good idea to consider seeking help.

How to deal with social anxiety

Dealing with social anxiety can feel like a huge challenge when you’re in the midst of it. But there are treatments that can help you so your social anxiety doesn’t have to hold you back or prevent you from fulfilling your potential. If you go to your GP, they’ll be able to help you decide on the right treatment for you. Interventions like CBT and medication are common methods of helping someone with social anxiety disorder. Many of the symptoms that can appear with social anxiety, such as paranoid thinking also respond well to CBT.

Many people with social anxiety also find support groups can be helpful. A support group can give you unbiased, honest feedback about how others see you. This can help you to learn that your thoughts about judgment and rejection are not true or are distorted. You can also learn how others with social anxiety disorder approach and overcome their fear of social situations.

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Many of the symptoms that can appear with social anxiety, such as paranoid thinking, also respond well to CBT. To find out more about this psychological issue, please read more on our PTSD page.

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How to support a loved one experiencing social anxiety

Social phobia is often termed the 'silent' disorder as it can go undetected by those around them or is confused with shyness or introversion. However, it can have a profound impact on the person suffering from it.

If you know someone who you think might be suffering from social anxiety disorder or social phobia, there are ways you can help.

Talk

If you can talk to the person about it, doing so might help both of you understand more about their anxiety, what goes through their mind, and how they behave in certain situations. The person suffering may feel very isolated, and being listened to can be an important part of the healing process.

Read resources

There are lots of resources and information about social anxiety disorder and social phobia online. Learning as much as you can about it yourself, including the signs and symptoms and the best methods of treatment, will help you understand what they’re going through and what might help them.

Be encouraging

One of the first steps is to encourage them to seek help from a GP. The GP will be able to refer them for treatment, which will ultimately help them recover.