Most of us get nervous in social situations like giving a presentation at work or school, meeting new people at a party, or going on a date. We might feel flushed or get butterflies in our stomachs—but when those types of everyday interactions cause significant distress, it could be something more serious: social anxiety disorder, also known as social phobia.
If you are afraid of being judged by others, are self-conscious in everyday social situations, tend to avoid meeting new people due to fear or anxiety, and these feelings make it hard for you to do everyday tasks, it’s more than just shyness.
Whether you’ve felt this way for some time or you’re now having trouble adjusting to post-pandemic (or ongoing pandemic) life, you’re not alone. In this post, MyWellbeing therapist Mary Cotter explains what social anxiety is, some ways that you can cope, and how a therapist can help.
Social anxiety disorder, or social phobia, involves high levels of anxiety, fear, and avoidance of social situations due to feelings of embarrassment, self-consciousness, and concern about being judged or viewed negatively by others.
“Most people experience some discomfort in certain social situations,” says Mary. “Typically it’s temporary. For people with social anxiety disorder, it can be really debilitating.”
Excessive, ongoing anxiety and worry that are difficult to control and that interfere with day-to-day activities may be a sign of generalized anxiety disorder—when there is a social component, it could be classified as social anxiety.
“Generalized anxiety isn’t specific to a thing, place, time, or event; it’s a little bit of everything. On the other hand, someone with social anxiety might think, I don't want to go to this event because I’m so afraid of what people might think of me,” says Mary. Or I don’t want to go to this party because I’m afraid I might say something embarrassing.”
Again, feeling a little stress in social situations is normal, but when common, everyday experiences become difficult to endure, it might be social anxiety disorder.
“Different symptoms are going to occur for different people, and social anxiety and general anxiety share many of the same manifestations,” says Mary.
“A very common experience is overheating, sweating, or in some cases, people’s hands may get very hot. They might freeze, be unable to move, or feel very heavy. Other ways social anxiety can present may include feeling lightheaded or dizzy. With social anxiety, these symptoms can occur just by thinking about a stressor, such as an event, or seeing a person, even when you haven’t begun to interact with them yet.”
While everybody feels stressed or anxious at some point, for some people, these feelings do not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school, and relationships. If this is the case, it might be social anxiety disorder, which must be diagnosed by a mental health practitioner.
Whether you’re dealing with stress, feelings of social anxiety, or a diagnosis of an anxiety disorder, there are ways to cope. The first step is to gauge how much of an impact it’s having on your life. Is it having a negative impact on your relationships or career? Is avoiding situations causing you to feel depressed because you’re missing out on events or opportunities?
Social anxiety disorder is generally treated with psychotherapy, medication, or both. If your experience is less severe than what would be required for a diagnosis, support from a therapist can still help.
“First of all, a good therapist will affirm and validate how you feel,” says Mary. “That is very important. I find it beneficial to use motivational interviewing—it’s a collaborative method where you help people help themselves by engaging in a conversation and asking questions that might better prepare someone for these social situations. These questions may include:
It’s like the Socratic method, a cooperative dialogue based on asking and answering questions to stimulate critical thinking and to draw out ideas and underlying presuppositions.”
Your therapist could also use cognitive behavioral therapy, which is a problem-focused, action-oriented style of talk therapy that teaches clients practical ways to identify, challenge, and replace unhelpful response patterns with adaptive, healthy thoughts, feelings, and behavioral patterns to reach one’s desired goals.
“Decatastrophizing is another method,” Mary said, “where you take things to their logical conclusion. Ask yourself, What’s the worst thing that could happen? What’s the best thing that could happen? What’s likely to happen? And what’s that going to feel like for you? What about in a month or a year? It helps people understand how much power a thought can have over them. By exploring all these possibilities, someone can choose to pull back and not give that thought so much power anymore.”
Another method of treatment is exposure therapy, in which you identify certain social situations you’re afraid of and work your way up from easier to more difficult scenarios while practicing relaxation techniques so you can tolerate anxiety.
Many therapists pull elements from different approaches and tailor their treatment according to each client's needs, so when it comes to making a plan for tackling social anxiety, you’ll work with your therapist to determine the best method and treatment for you.
“In my work with clients, we break down frightening events into manageable moments,” says Mary. “For example, one client was very anxious about going to a greenmarket in a new area, so we identified several areas of concern and attempted to tackle them one by one.”
“She was stressed about finding the place and getting a parking spot and then going to the market and feeling as though people were looking at her and judging her for all sorts of reasons, mostly negative ones. Our plan was to bite off a little at a time.”
“First, she went to the market and found a parking spot. Now she knows where it is and how to get a spot. Next, we will tackle how to feel safe and good about going to the market itself.”
Selective serotonin reuptake inhibitors (SSRIs), such paroxetine (Paxil) or sertraline (Zoloft), or serotonin and norepinephrine reuptake inhibitor (SNRI), such as venlafaxine (Effexor XR), can be used. Finding the right medication for your situation can take some trial and error and it may take several weeks to several months of treatment for your symptoms to noticeably improve, so speak to your healthcare provider about which combination of treatments might be right for you.
“One of the most important things people can do is to break down those frightening events into manageable moments,” says Mary. “For example, if the situation causing social anxiety is a party, take an overview of the event. Think about how you might feel getting there, being there, and during whatever happens afterward and break it down into small pieces that you can control.”
“Ask yourself, before I go, is there someone I can call to see if we can go together? Or someone I could touch base with while I’m there? Could I have a signal with that person to help extract me from a situation that makes me uncomfortable or when I’m ready to leave?”
“Is there someone I can talk to on the phone before a stressful situation who can listen to my worries and concerns and be a social support for me even if they’re not physically present? Just talking through something out loud can be so helpful and supportive.”
“You can also journal, write down your thoughts and feelings, or just scribble some notes—whatever works for you. And always remember that you don’t have to engage with someone. Sometimes avoiding someone is the best possible thing you can do for yourself. Just because you have social anxiety doesn’t mean you need to swing the pendulum in the exact opposite direction and engage with everything and everyone if it doesn’t serve you.”
“More than fifteen million Americans have social anxiety disorder—that is profound,” says Mary. “It can be a very isolating thing. Regardless of whether or not you are diagnosed, you should take your feelings seriously and know that they are valid, that you are not alone, and that you deserve support.”
“One of the hardest things about having social anxiety is the self-consciousness and fear that can make it very hard to reach out for help, and which in turn can make the anxiety worse. The absolute number one thing I would say to anyone suffering from social anxiety is that there is help out here, and do whatever you possibly can to reach out.”
Looking for support with social anxiety? Book a free consultation with Mary or use our matching form to find the right therapist for you.
Caitlin is MyWellbeing's Content Lead, a writer, speaker, communication coach, and the founder of Commcoterie, a communication consultancy. She teaches teams how to use professional coaching communication techniques in their everyday conversations, helps leaders engage their teams with effective and inclusive communication, and partners with service providers to activate their programs and offerings with their own clients through inspiring communication strategies. Find out more, including how to work with her, at www.commcoterie.com.