Social anxiety

Last updated:

Reviewed by:

Dr Rhianna McClymont

, Lead GP at Livi

Medically reviewed

People with social anxiety disorder have an intense fear of social situations and avoid them whenever possible. Find out about the causes of social anxiety and how it’s treated.

What is social anxiety?

Social anxiety, also known as social phobia, is more than being nervous or shy in a public situation. It’s an overwhelming fear that takes over day-to-day life and makes social situations seem impossible. This causes anxiety, affects self-confidence and causes problems with relationships.

Social anxiety symptoms

Everyone worries about social situations or has feelings of self-doubt from time to time, but with social anxiety, you can’t overcome these feelings, and they dominate your life.

Emotional symptoms of social anxiety

  • Anxiety about daily social activities, like phone calls, starting conversations, talking in a group, making small talk or going to work or the shops

  • Fear of being judged or criticised by other people

  • Worrying about public embarrassment or humiliation – and showing it by stumbling or blushing

  • Worrying about offending other people

  • Not being able to make eye contact with other people

  • Low self-esteem

Physical symptoms of social anxiety

  • Feeling sick

  • Sweating

  • Racing heartbeat

  • Panic attacks

  • Feeling dizzy or lightheaded

Other mental health conditions that people with social anxiety might experience

  • Depression

  • Generalised anxiety disorder

  • Panic disorder

What causes social anxiety?

Social anxiety is one of the most common mental health conditions. It often develops in the teenage years, and it affects more women than men.

The exact causes are still not known. But it’s thought that genetics plays a part, as well as events that happened to you as a child, like bullying, abuse or having overly controlling parents.

Social anxiety diagnosis

It can be nerve-wracking talking about the range of thoughts and feelings you’re experiencing. But social anxiety is a common problem, and your doctor will be able to offer help.

They’ll ask you about how you feel in social situations and any other symptoms you’re experiencing. You may be referred to a mental health specialist for a full assessment.

Diagnosis of social anxiety is usually made because your fear is entirely related to social situations. Your symptoms aren’t a result of another mental health condition.

Social anxiety treatment

The most common treatment for social anxiety is cognitive behavioural therapy (CBT). You can have this as one-to-one therapy or in a group.

CBT helps you understand how your thoughts affect your behaviour. It teaches you how to change the negative patterns of behaviour and learn coping strategies for different situations.

Sometimes medication is also recommended. The most common medication for social anxiety is an antidepressant called selective serotonin reuptake inhibitors (SSRIs). In severe cases, beta-blockers or benzodiazepines might be prescribed for a short period to help relieve anxiety.

Many people find it helpful to talk to others who understand how they feel, but it can be challenging for people with social anxiety to have the confidence to attend support groups. Online forums or digital services can be a real lifeline, and there are many trusted support services run by charities. Talk to your doctor about what’s available.

Self-care for social anxiety

Another successful form of treatment is guided self-help. This is also CBT-based and involves working through a course or workbook with support from a therapist. It can be a positive treatment for social anxiety as you can work through it in your own time and on your terms.

There are many smaller steps you can take to help ease your symptoms, too:

  • Understand your anxiety – Start by understanding more about what triggers your social anxiety and how you respond to different situations. It might help to make a diary and note down any situation that makes you worried with details about how you feel, what you’re concerned about and if you managed to overcome the feelings.

  • Be aware of your breath – Keep calm when you feel the panic rising by breathing in slowly through your nose and then breathing out to the count of five.

  • Use grounding techniques – These remind you to stay connected to the present and keep you distracted from what’s worrying you in the present. Try counting certain objects in the room (like books or chairs), describing what you can see out loud or finding five blue things.

  • Break down the situation – If you’re anxious about a particular situation, make it more manageable by breaking it down into smaller parts. For example, if you’re afraid to go shopping, start by only walking to the shops. This will help you get comfortable with the journey and work your way up to going inside.

Last updated:
Reviewed by:
Lead GP at Livi Dr Rhianna McClymont
Dr Rhianna McClymont, Lead GP at Livi