Managing Social Anxiety

Social anxiety disorder is an anxiety disorder that can be treated with various forms of psychological counseling. Without treatment, individuals living with this condition may struggle with social situations, work, school, friendships, or leaving home. Seeking out professional help and support from a therapist can be overwhelming for those who fear social interactions. However, various treatment options are available, and you may find one you click with. 

If you are thinking about therapy but are hesitant to reach out for assistance, knowing what you might expect in social anxiety therapy can help you take the first step. You can form a professional connection with your therapist and learn unique skills dedicated to your symptoms through therapy. Over time, social anxiety can be treatable or manageable.

Social anxiety

Those living with social anxiety may feel anxious often, experience panic attacks, and avoid social situations and being in a public setting. They might struggle to speak verbally, know what to say during conversations, or remember information. In addition, they might experience physical symptoms of anxiety, such as the following anxiety symptoms: 

• A racing pulse
• High blood pressure
• Headaches
• Stomachaches
• Shakiness
• A lump in the throat 
• Sweating 

Many of those who experience social anxiety are self conscious and struggle with low self esteem. They may have a fear of being judged for their anxiety, actions, or feelings. Instead of attempting to spend time with others, they might spend the majority of their time at home or avoid crowds. People living with social anxiety may also feel overwhelmed with current events. People with severe social anxiety disorder might struggle to hold jobs, attend classes, or go to the grocery store. In some cases, social anxiety may develop into agoraphobia, the fear of being in open or public places, which often results in isolation and social withdrawal.  

Social anxiety can be present in children, teens, or adults. If you have been experiencing anxiety or fear about social situations accompanied by physical symptoms, consider seeking a therapist. 

Symptoms of social anxiety

What is social phobia? Social anxiety disorder, sometimes called social phobia, is a mental illness that can seriously impact a person's daily life. Signs and symptoms that may be indicative of social anxiety disorder can range in severity and include but aren't limited to the following:

• Fear or avoidance of social situations or places with other people
• Physical symptoms like rapid heart rate, blushing, sweating, or trembling
• Fear of judgment, embarrassment, or humiliation 
• Fear of saying the "wrong" thing 
• Feelings of self-consciousness and low self-esteem in social situations
• Panic attacks during social situations, such as public speaking 
• Difficulty making eye contact 

This condition is characterized by fear or anxiety related to one or more social situations. It lasts six months or more, not better attributed to another cause or medical condition. Social interactions, like public speaking, ordering a meal at a restaurant, phone calls, or a job interview, may cause intense fear for someone with social anxiety disorder. They may experience worry, negative thoughts, or fear surrounding social situations for several weeks before they occur. 

Is social anxiety genetic?

Anyone can develop social anxiety or social phobia. However, genetics and family history can play a part in developing this condition or similar symptoms, so the mental health history of family members can play a role. 

The National Institute of Mental Health, a public health organization, and leading federal agency for research on mental health conditions, indicates that various medications can be used to treat social anxiety disorder. Selective serotonin reuptake inhibitors, beta-blockers, and other medications are typically prescribed. Talk to a psychiatrist or seek professional help from a medical doctor before starting, stopping, or changing a medication. Please note that BetterHelp does not prescribe medication. 

Is social anxiety a disability?

Social anxiety disorder can be considered a disability if the individual with the diagnosis identifies as disabled. Those living with social anxiety disorder may receive SSDI in some cases. However, you can have social anxiety and not consider it a disability. 

What is social anxiety disorder therapy?

If you or a family member are experiencing symptoms of social anxiety, you may wonder how therapy might help. As therapy requires some level of socialization, it could feel overwhelming to consider the steps needed to reach out for help. Understanding the ins and outs may help you feel comfortable reaching out for help, no matter the reasons you're looking into social anxiety therapy. 

Over 400 modalities of therapy are available, targeting a variety of mental health conditions and symptoms. Many forms of therapy that are effective for other anxiety disorders can be effective for social anxiety disorder, such as cognitive-behavioral therapy (CBT) or exposure response prevention therapy (ERP). These therapies can examine a client's thoughts, emotions, and behaviors and offer research-based coping strategies, solutions, and activities that can be addressed in the session.  

Cognitive-behavioral therapy is often used to treat social anxiety. The subtype of cognitive behavioral therapy (CBT) called exposure therapy can be used for conditions such as social anxiety disorder and obsessive-compulsive disorder (OCD). Another form of treatment that you may see used for social anxiety disorder is called acceptance and commitment therapy (ACT). 

According to the National Library of Medicine, anxiety disorders are common and can present differently. Although it can be common to try cognitive-behavioral therapy first, the most effective treatment for anxiety can vary depending on symptoms and goals. Some people might use a combination of talk therapy and medication, while others might partake in a short-term course of exposure therapy. Talk to a mental health provider to discuss which option works best for you. 

How does social anxiety therapy work? 

Therapists and counselors specializing in social anxiety can suggest home remedies or practices to help you set yourself up for success in social situations. These practices include but aren't limited to:

• Sleep hygiene and getting enough sleep
• Reframing cognitive distortions (unwanted or unhelpful negative thought patterns) 
• Relaxation exercises, like progressive muscle relaxation or breathing exercises
• Physical exercise 
• Social situation roleplay scenarios and other role-playing exercises 
• Journaling 

Therapy is often dedicated to helping clients gain new coping skills, build confidence, reduce stress, learn stress management techniques, roleplay, and openly discuss symptoms. Mental health professionals may also help clients learn how to converse with others or make friends without feeling anxious. 

If you believe you may have social anxiety disorder or another mental health condition and want to pursue a possible diagnosis, speak with a medical or mental health professional, such as a psychiatrist or psychologist who specializes in treating social anxiety disorder. 

Cognitive-behavioral therapy combines aspects of cognitive and behavioral theories. The term "cognitive" refers to thoughts and perceptions. When thoughts are combined with behaviors, your actions may reflect your thought patterns. CBT helps clients address underlying thoughts and beliefs and challenge them through exercises, restructuring activities, and creativity.  

CBT is a form of talk therapy. During these sessions, the client can talk to the therapist about any concerning symptoms, thoughts, or behavioral patterns. In the case of restructuring a thought in social anxiety therapy, the therapist may ask the client to identify beliefs surrounding their fear of socialization. For example, the client might feel that others do not like them. The therapist can help the client understand how this thought drives their behaviors in social situations. They might be letting their thought about others' perceptions of them keep them from socializing or making friends. 

CBT can also help clients develop social skills through techniques like roleplaying, motivational interviewing, or exposure therapy. Roleplaying a social situation, acting out a scene, and doing homework between sessions can aid in the process. Some therapists invite clients to attend group therapy sessions with others experiencing social difficulties. In these sessions, they can practice socialization, tell interesting stories, and learn how others have found support.

What is the goal of therapy for social anxiety?

In social anxiety therapy, goals can vary depending on a client's wishes. For example, some clients may come to counseling hoping to prepare for a public speech. Others might have the goal of eliminating the symptoms. While social anxiety might not be cured in every case, it can often become manageable with treatment. 

Therapists may ask that patients set goals for themselves. Goals can change over time as an individual's skills change. For example, someone may start therapy with the goal of leaving their home to go to the grocery store and end with the goal of making more friends. When treatment has been finished and goals are achieved, clients can look back and see all they have achieved. Therapists may use reward systems to help these clients feel proud of themselves for their efforts. 

Therapists for social anxiety

There are a few options if you're considering therapy for your social anxiety, mental health condition, or other concerns. You can ask your primary care physician for a physical exam and referral, reach out to your insurance company to be referred, or contact therapists listed online. You can also try online social anxiety therapy if you feel shy and fear leaving your home. 

Through online counseling, you can control how far you go and how fast. You can start therapy through the live chat session option available through many online platforms, moving up to phone or video sessions as you're comfortable. In addition, you can join sessions with a nickname if you'd like to stay innominate with your therapist while you get to know them. 

A recent study on internet-based cognitive-behavioral therapy found that it can be as effective as an in-person treatment for addressing symptoms of social anxiety. With the value of at-home sessions in an environment that you feel comfortable in, you can make online counseling work for you in ways that in-person therapy might not. If you're interested in getting started, consider signing up for a platform like BetterHelp to outline your preferences and get matched with a compassionate provider.