Getting Over Social Anxiety With Help From Online Therapy

Do you often feel intense dread about social situations, to the point that it can be challenging to meet or interact with others? If you do, you might benefit from meeting with a mental health professional. It is estimated that around 12.1% of Americans are diagnosed with social anxiety disorder, accounting for over 40 million adults. Social anxiety is more than shyness, and a fair amount of research indicates that therapy can be valuable in treating symptoms. 

The nature of social anxiety can make it difficult to seek treatment, as talking with a therapist is a form of social interaction. However, various treatment forms are available; you do not have to partake in therapy in person. Learning more about how therapy benefits those with a social anxiety disorder diagnosis or those struggling with social interactions and fears can help you decide if treatment is right for you. 

What Are The Symptoms Of Social Anxiety? 

Social anxiety disorder is a serious and genuine mental health condition. If you’ve been told that you’re “just shy” or “need to put yourself out there more,” it can feel invalidating and isolating. This advice may be intended to help, but it can come across as dismissive. It may also compound your anxiety with feelings of embarrassment or shame by implying that what you are experiencing is just shyness or a lack of social skills. 

Having social anxiety is not shameful, and you’re not alone. The American Psychological Association recognizes social anxiety disorder (or social phobia) as a mental health condition that can severely impact your life. It’s different from shyness or introversion and is characterized by symptoms like:

• Intense worry about being watched, judged, or humiliated

• Disproportionate feelings of fear about social interaction

• Avoidance of situations where you’ll have to meet or talk to people

• Trouble making direct eye contact

• Difficulty speaking or performing in front of other people

• Physical symptoms of panic in the company of others, such as sweating, shaking, muscle tension, rapid heartbeat, or nausea

• Trouble focusing and concentrating when talking to people in social settings

• Negative consequences of symptoms in your personal or professional life

Social Anxiety is often diagnosed when the symptoms cause impairment in some area of functioning. According to the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association, this impairment typically lasts for six or more months. 

The negative thoughts and intense fear that can accompany social anxiety can make it difficult to get enough sleep, interfere with daily life, and even affect personal relationships with friends and family members. In some cases, social anxiety can be associated with additional mental health conditions, such as other anxiety disorders. Concerns about being judged negatively in social situations can also lead some people with social anxiety to turn to recreational drugs or substance abuse as a way of addressing their symptoms. 

Some people may experience symptoms temporarily or in a way that does not inhibit them. However, if your persistent feelings of anxiety are disrupting your life, there’s a chance you could be living with a social phobia.

Even if your struggles with social situations don’t quite meet the criteria for a diagnosable mental health condition, therapy is still available to support you. It’s common for people to find value in therapy even when they’re not living with mental illness. 

Can Therapy Benefit Social Anxiety?

Perhaps you’re convinced that your social anxiety is worth addressing, but you’re still unsure if talk therapy can make a difference. You may have already tried without success to talk yourself out of feeling anxious. You might wonder how talking to a counselor could differ. 

However, sessions with a trained psychotherapist differ from the self-talk you may already try. Therapists can provide clinically-tested strategies for reframing your thoughts and processing your emotions. In addition, they can teach you actionable techniques and coping skills. Some therapists use activities during sessions, such as art projects, role playing, journaling prompts, mindfulness, or relaxation exercises. All of these strategies may teach you new ways to address your symptoms. 

Below are a few studies on how therapy has shown promise in treating social anxiety disorder. 

Treatments Showing Promise For Social Anxiety

One randomized controlled trial looked at the outcomes of 108 patients after undergoing psychotherapy for social anxiety disorder. The study compared two treatment approaches: group therapy sessions led by a cognitive-behavioral therapist versus a mindfulness-based technique for stress reduction. Both groups receiving treatment showed measurable improvements in factors like:

• Symptoms of social anxiety

• Cognitive distortions

• Rumination (thinking obsessively about adverse outcomes)

Researchers in another study wanted to see whether people with social anxiety could benefit from therapy in the long run or if they only felt better temporarily. The authors conducted follow-up assessments on former patients who had received treatment five years previously. Results indicated that the positive effects of therapy continued long after the treatment was concluded.

Adapting some of the strategies used in cognitive-behavioral therapy may also help when people use them independently. One study adapted a specific CBT treatment protocol into a workbook that individuals could use to manage their own social anxiety. The results indicated that this self-directed treatment approach improved users’ mental health.

What Type Of Therapy Works Best For Social Anxiety?

Mental health professionals are often testing and refining their treatment approaches. As a result, there are many different types of therapy available. The following types of therapy have all been shown to be effective in treating social anxiety symptoms. 

Mindfulness-Based Interventions (MBI) 

Adapted from mindfulness meditation, these techniques encourage clients to focus non-judgmental attention on their bodies, thoughts, and emotions to defuse anxiety. A 2010 meta-analysis of prior research concluded that this type of therapy could reduce distressing symptoms related to social anxiety.  

Cognitive-Behavioral Therapy 

As one of the most-studied treatments for anxiety, cognitive behavioral therapy (CBT) uses various therapist-guided methods to help clients modify their habits of thought and change their instinctive emotional reactions to stressors like social situations. Researchers reviewing the scientific literature found that “all forms of CBT appear likely to provide some benefit for adults.”

Psychodynamic Therapy (PDT) 

Psychodynamic therapy is a type of talk therapy often showcased in pop culture. In this approach, the therapist works with the client to gain insight into the emotional roots of their maladaptive (unhelpful) attitudes, beliefs, and behaviors. A comprehensive meta-analysis published in 2022 indicated that PDT “could produce significant SAD [social anxiety disorder] symptoms reduction.”

Exposure And Response Prevention Therapy (ERP) 

Because avoiding what we fear may reinforce anxiety, exposure therapy encourages clients to encounter the sources of their fears in a controlled, deliberate way. Research has shown that it can be effective for a wide range of phobias, including social phobia. 

Can Medication Offer Relief To Social Anxiety? 

Under the guidance of a licensed psychiatrist, some types of medication may relieve symptoms of social anxiety disorder. Some of the most commonly prescribed medications for social anxiety are selective serotonin reuptake inhibitors (SSRIs). Other medications that are sometimes prescribed include beta blockers and serotonin and norepinephrine reuptake inhibitors (SNRIs), among others. Depending on your situation, the severity of your anxiety, and other medical conditions you may have, your doctor may prescribe you one of these.

However, some research indicates that psychotherapy may be preferable to medication for treating social anxiety. The effects of pharmaceuticals may not last for long after you stop taking them, unlike therapy, which can produce improvements that continue for years afterward. If you are taking medication for an existing medical condition that interacts with anti anxiety medications, these treatments may not be right for you. In these cases, your doctor may recommend social anxiety therapy—either on its own or in addition to other interventions, such as an anxiety support group. 

Before starting, changing, or stopping a medication, consult a medical doctor like a psychiatrist for insight and support. Your healthcare provider may want to consult with you about your symptoms or conduct a physical exam before making adjustments to your medication plan. 

Counseling Options 

For people experiencing social anxiety, the prospect of undergoing therapy may seem intimidating. Locating a provider for treatment often involves social interaction with healthcare professionals, and therapy may include discussing personal insecurities with a stranger. However, several options for engaging in therapy over the internet have emerged in recent years, which may make the process easier. 

Online cognitive behavioral therapy (CBT) for social anxiety through a platform like BetterHelp offers various benefits compared to in-person treatment. For example, many online platforms enable you to search for care providers directly instead of seeking a referral from a primary care provider. This process may feel less anxiety-provoking if you find social interaction challenging.

It may also be possible to choose the mode of communication that feels most comfortable to you. Those who prefer a sense of anonymity may appreciate the option to talk with their therapists via text message or online chat. Others can schedule voice-only sessions or use a video chat service. All these options can be used in the familiar setting of your own home, which may feel more comfortable than traveling to a therapist’s office.

Although internet-enabled therapy is a more novel method than in-person visits, the evidence suggests it can be as effective. Both randomized controlled trials and large-scale meta-analyses have demonstrated that internet cognitive-behavioral therapy works as well as face-to-face therapeutic sessions. Some clients find that they’re better able to connect with their therapists due to the increased sense of control that the remote messaging platforms provide.

Takeaway

Social anxiety can be a distressing experience with a considerable negative impact on quality of life. Various psychotherapeutic approaches can help alleviate symptoms, including exposure therapy, psychodynamic therapy, mindfulness-based interventions, and cognitive-behavioral therapy. Regardless of whether your fear of social situations is severe enough for a diagnosis, you may be able to find relief by working through it with a mental health professional, and you’re not alone.