How To Know If You May Have Social Anxiety & What To Do About It
Social anxiety is more than just occasional shyness or nervousness around new people. Instead, it’s the experience of significant and sometimes overwhelming fear related to social situations, especially at the prospect of being judged or embarrassed.
People with social anxiety disorder (SAD) may experience strong physical symptoms of anxiety that can make them avoid social interaction altogether, which can negatively impact their relationships, work, and quality of life. Read on to learn about the specific symptoms of social anxiety and what you can do in case you’ve noticed these in yourself.
Symptoms can affect an individual as a result of virtually any type of social situation, not just when giving a speech or walking into a room full of strangers. For instance, a person might experience symptoms even when meeting a friend for coffee, answering a question in class, or calling a restaurant to place an order.
Here are several symptoms that may indicate social anxiety when experienced in relation to social situations:
- Sweating or shaking
- Difficulty making eye contact
- Nausea
- Going blank
- Increased heart rate
- Expecting the worst possible outcomes from social situations
- Fearing that others will notice one’s anxiety
- Being intensely self-conscious
- Rumination or analysis of performance after social situations
SAD can manifest differently in different people depending on a variety of individual factors, including how severe their social anxiety is. Those with mild social anxiety may still be able to attend social functions but may experience some level of symptoms in all or certain types of situations.
For example, they may be more at ease when speaking on the phone because the other person can’t see them, but they may experience symptoms when meeting new people in person. Someone with severe social anxiety, on the other hand, may be unable to withstand any type of social situation because of the extreme symptoms they experience — such as episodes of intense anxiety known as panic attacks.
Other people may not appear outwardly socially anxious because they self-medicate with substances like alcohol to calm their nerves. It may be one reason that substance use disorders — especially those involving alcohol — are commonly comorbid with SAD.
As many as 90% of individuals with SAD have some type of co-occurring disorder in addition, which is often the reason they choose to seek treatment at all. It’s estimated that only 30% of people with social anxiety pursue treatment because of it, with the rest originally being motivated to get help for their comorbid disorder — usually substance use disorder or major depressive disorder.
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.
Only a licensed healthcare provider can accurately diagnose SAD. If you’re experiencing symptoms, it’s typically best to meet with one for evaluation.
First, you might see your primary healthcare professional for a physical exam to ensure that there’s no medical cause for the anxiety symptoms you’ve been experiencing. Next, a mental health care provider can ask you more in-depth questions about your symptoms, health history, and family history since research suggests that risk factors for social anxiety disorder have a genetic component.
If they decide that SAD is the best fit for the symptoms you’re experiencing, they may provide an official diagnosis and suggest treatment options.
Getting treatment for social anxiety disorder can be important. First, some people with this condition assume that their fear related to social situations is just part of their personality when it may qualify as a mental health disorder instead. That means that with treatment, they may be able to enjoy a better quality of life and live a more authentic version of their personality.
Second, this disorder can disrupt a person’s functioning and relationships. It may make it hard for them to attend or participate fully in school or work. Plus, since research has linked loneliness and social isolation to various negative health outcomes, the social withdrawal that may be caused by symptoms can impact their overall well-being, too. Treatment can help mitigate these potentially negative effects.
Treatment for SAD typically consists of some form of psychotherapy, sometimes in combination with anti-anxiety medications like selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or beta-blockers, which are also used to treat depression.
Cognitive behavioral therapy (CBT) is one of the most common forms of therapy for this disorder. It focuses on helping the individual develop an awareness of cognitive distortions that may contribute to symptoms and learn to shift them.
For example, a person with SAD may be prone to catastrophizing, which could make them assume the worst will happen in a given social situation, or overgeneralization, which could make them worry that all future social situations will turn out the same as one that didn’t go well.
A cognitive behavioral therapist can guide individuals to recognize and course-correct cognitive distortions, teaching them skills to manage their anxious symptoms for improved functioning.
Connecting with a mental health professional
If you’ve been experiencing symptoms, you may benefit from meeting with a mental health care provider to treat social anxiety disorder. Research shows that even “brief CBT” conducted over the course of six weeks was enough to “effectively reduce social anxiety, social avoidance, and self-consciousness” in all participants. That said, for those who experience social anxiety, the prospect of meeting with a therapist in person can be intimidating or may trigger symptoms. In cases like these, online therapy might be a more comfortable option.
With an online therapy platform like BetterHelp, you can get matched with a licensed therapist whom you can meet with via phone, video call, or in-app messaging — whatever is most comfortable for you. All of your sessions can be done from the comfort of your home or anywhere you have an internet connection — no traveling to in-person appointments required. Research suggests that online and in-person therapy can offer similar benefits in most cases, so you can typically choose the format that is right for you.
Takeaway
Social anxiety exists in a category of mental disorders known as anxiety disorders, which are characterized by excessive, persistent worry or fear in some form.
According to the American Psychiatric Association, one of the key signs of social anxiety disorder is “significant anxiety and discomfort about being embarrassed, humiliated, rejected, or looked down on in social interactions.”
Physical symptoms of anxiety (e.g., nausea, trembling, headaches, and rapid heartbeat) can result from the thought or reality of a feared social situation. According to the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms must persist for at least six months in order for a clinical diagnosis to be considered.
Only a trained healthcare provider can offer a clinical diagnosis of mental health conditions like social anxiety. If you're experiencing social anxiety disorder symptoms or symptoms of other anxiety disorders, meeting with a mental health professional for evaluation and support is recommended.
Clinical social anxiety disorder is more than just shyness. If you experience an intense, debilitating fear related to being watched or judged in social gatherings that leads you to avoid them or endure them with marked distress, it could be a sign of this disorder. Whether your experience and symptoms qualify as a diagnosable disorder or not, speaking with a mental health professional can allow you to get support in managing them.
Social anxiety can legally be considered a disability if the individual can prove that their symptoms make it impossible for them to work. Outside of this, whether or not to use the “disability” label is up to each individual with a given condition.
According to the National Institute of Mental Health, social anxiety disorder arises from the complex interaction of risk factors, including genetics, stress, and environmental factors.
The onset of social anxiety usually happens during childhood or adolescence. An article published by the National Library of Medicine reports that the median age of onset is in the mid-teens.
Treating social anxiety disorder is often done through some form of talk therapy. The fear response in SAD can be addressed by partaking in the appropriate therapeutic approach — be it cognitive behavioral therapy, exposure therapy, or acceptance and commitment therapy — or joining a support group geared toward individuals working to overcome social anxiety. Some therapists practice social skills training, which may include role-playing techniques to reduce social anxiety fears in those with SAD.
Therapy can be supplemented by lifestyle changes. Eating a nutritious diet, exercising regularly, maintaining meaningful personal relationships (perhaps with a trusted family member), practicing mindfulness, refraining from substance use, and getting quality sleep can make a positive difference in overcoming the psychological symptoms of social anxiety disorders in everyday life.
Why am I socially awkward?
There are many reasons a person might feel awkward or ill at ease in social situations. Some people are naturally shyer or reserved or may only be comfortable in specific scenarios — such as in smaller groups or among people they know well. Some people may be more socially awkward because of an anxiety disorder or negative past experiences related to socializing.
These are just a few possibilities. If you're looking to improve your social skills or address symptoms of anxiety, working with a therapist could help.
A 2013 study estimates that around 12% of adults in the U.S. will experience social anxiety disorder (SAD) at some point in their lifetime. Without appropriate intervention, SAD can persist for years or even a lifetime, but help is available.
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