Taking Social Anxiety Seriously
The difficulties of extreme anxiety can be made worse if the people in your life don’t see it as a serious problem. You may have been frustrated in the past by suggestions that you’re “just a little shy” or recommendations to simply “put yourself out there.” This advice may be intended to help, but it can come across as dismissive. It may also compound your anxiety with feelings of embarrassment and self-recrimination.
The American Psychological Association recognizes social anxiety disorder (also called social phobia) as a mental health condition that can severely impact one’s life. It’s different from shyness or introversion, and social anxiety can be characterized by symptoms such as:
- Intense worry about being watched, judged, or humiliated
- Disproportionate feelings of fear about social interaction, manifesting in the form of a social phobia
- Avoidance of situations where you’ll have to meet or talk to people
- Having specific social anxiety leading up to an event where you will be around people
- 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 impact on your social, personal, or professional life
Impacting Your Every Day Life
The intense fear and anxiety surrounding a social situation might impact your daily life in the form of panic attacks, and when left untreated social anxiety disorder may feel like it's taking over your life. If your persistent feelings of social anxiety are disrupting your life, there’s a chance you could be dealing with social phobia.
Some anxiety disorders may manifest in the form of wanting to avoid eye contact, having a fear of public speaking or giving a speech, or having poor social skills when starting conversations. Often, people may be judged negatively in work or school when giving a presentation or receive criticism poor social skills in teenage years, however, there are many treatments for social anxiety and support groups to help navigate these situations.
Even if your challenges with social situations don’t quite meet the criteria for a diagnosable mental health condition, there’s no reason you can’t talk with a therapist about them. It’s common for people to find value in therapy even when they’re not living with mental illness. Therapy can also help you get a formal diagnosis for social anxiety disorder and other anxiety disorders, allowing you to work through negative thoughts and symptoms such as blushing, sweating, trembling, or nausea. Knowing the signs and symptoms (especially specific anxiety symptoms) of anxiety disorder in adults may help you overcome social anxiety and panic disorder symptoms.
Can Therapy Really Help?
Consider that sessions with a trained psychotherapist are different from the kind of self-talk you may engage in when you’re in the grip of social anxiety. Therapists can provide you with clinically tested strategies for reframing your thoughts and processing your emotions in social situations.
The National Institute of Mental Health outlines various risk factors when treating social anxiety, noting it can be important to find a doctor or licensed therapist near you to help navigate signs of social anxiety or overwhelming fear in social situations. Typical in-person therapy appointments often cost around $100-$200 per session. Online treatment may cost about $65 to $90 per week, depending on the platform. Each platform might have various insurance acceptance policies and rights reserved.
Two Different Treatments Show Promise For Social Anxiety Disorder
A randomized controlled trial looked at the outcomes of 108 patients after undergoing psychotherapy for social anxiety disorder. The study compared two different treatment approaches: group therapy sessions led by a cognitive-behavioral therapist versus a mindfulness-based technique for stress reduction related to social anxiety. Both groups receiving treatment showed measurable social improvements in factors such as:
- Symptoms of social anxiety
- Cognitive distortions
- Rumination (thinking obsessively about negative outcomes)
Long-Lasting Effectiveness Of Therapy
These researchers in clinical trials wanted to see whether people with social anxiety could benefit from therapy in the long run or if they only felt better temporarily, and the social phobia remained post-treatment. The authors conducted follow-up assessments on former patients who had received treatment five years previously. Results indicated that the positive effects of therapy on anxiety continued long after the treatment concluded.
Environmental factors, substance abuse history, and previous mental health conditions can all play a role in how social anxiety might manifest. The American Psychiatric Association also outlines the benefits of breathing exercises to help calm nervous systems in anxiety-inducing scenarios for any condition that draws attention or may have uncontrollable side effects.
Even Self-Directed Therapy Can Help With This Phobia
Adapting some of the strategies used in cognitive-behavioral therapy may help even when people use them on their own. One study adapted a specific CBT treatment protocol into a workbook that individuals could use to manage their own anxiety. The results indicated that even this self-directed approach to treatment improved participants’ mental health, helping them navigate their social anxiety and social phobia.
What Kind Of Therapy Works Best?
Mental health professionals are constantly testing and refining their approaches to treatment for social anxiety. As a result, there are many different types of therapy available for those seeking help on a variety of social challenges. For example, what works for young people having a panic attack in a public restroom might not work for someone at work with a deep fear of public speaking. The following have shown promise for treating social anxiety:
Mindfulness-based interventions (MBI)
Cognitive-behavioral therapy (CBT)
One of the best-studied treatments for anxiety, CBT therapy uses a variety of therapist-guided methods to help patients modify their thoughts and 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)
In this approach, the therapist works together with the patient to gain insight into the emotional roots of unhealthy attitudes, beliefs, and behaviors. A comprehensive meta-analysis published in 2022 indicated that PDT “could produce significant SAD [social anxiety disorder] symptoms reduction”.
Based on the idea that avoiding the things we fear tends to reinforce anxiety, exposure therapy encourages patients to encounter the sources of their anxieties in a controlled, deliberate way. Research has shown that it can be effective for a wide range of phobias,including social phobia.
Does Medication Help?
Under the guidance of a licensed psychiatrist, some types of medication may provide relief from symptoms of social anxiety disorder:
Despite the name, antidepressants (including selective serotonin reuptake inhibitors) can often alleviate the symptoms of both social anxiety and depression.
These medications may temporarily suppress some of the physical symptoms of social anxiety, including sweating, irregular pulse, and dizziness, though most psychiatrists don’t recommend them for long-term anxiety treatment.
This class of sedatives can be a short-term way to reduce anxiety, but due to the potential for abuse, they’re not usually prescribed long-term.
Moreover, some medications may come with unwanted side effects.
Why Online Therapy May Be Helpful
For people experiencing social anxiety, the prospect of undergoing therapy may seem intimidating. Simply locating a provider for treatment may involve significant social interaction with healthcare professionals. Moreover, therapy itself involves discussing personal insecurities with a stranger. Still, a number of options for engaging in therapy over the internet have emerged in recent years, which may make the process easier.
It may also be possible to choose the mode of communication that feels most comfortable to you. Those who prefer a greater sense of discretion may prefer 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 of these options are available from the familiar setting of your own home, which may feel more comfortable than traveling to a therapist’s office.