Social anxiety: understanding it

Nerves before a presentation or interview are normal. They usually fade once you get going, and they don’t stop you from doing what you want to do.

For more on everyday nerves and confidence, see the Building social confidence guide.

Shy people often feel uneasy with new people at first and may wait for others to make the first move. Most shy children do well once they get past an early adjustment period.

Shyness becomes more of a concern when it leads to a lot of avoidance or withdrawal.

With social anxiety, worry about being judged feels constant rather than occasional. People may avoid things they want or need to do, or dread events for a long time beforehand.

Only a trained professional can tell you whether what you feel is social anxiety. This guide helps you understand it, not diagnose it.

Common body signs

• A racing or pounding heart
• Blushing
• Feeling sick or a churning stomach
• Shaking or trembling
• Sweating
• Your mind “going blank”

Some people also have panic attacks: a sudden wave of intense fear that usually lasts only a few minutes. The Panic attacks guide explains these in more detail.

Thoughts often focus on doing something embarrassing, like blushing, sweating or seeming incompetent, and on being judged or criticised. People often expect the worst from social situations.

Thoughts can sound like

• “Everyone can see how nervous I am.”
• “I have nothing interesting to say.”
• “If I mess up, they’ll never forget it.”
• “They were just being polite.”

People may avoid eye contact, speak very softly, or hold a stiff posture. They may avoid group chats, parties, phone calls or eating with others.

Some people only notice the cost later: missed chances, loneliness, or feeling exhausted after every social event.

Examples

• Answering questions in class or meetings
• Job interviews
• Performing, playing sport or trying out
• Public speaking

For practical help with talks, see the Public speaking & presentations guide.

Examples

• Asking for help in a shop or restaurant
• Eating or drinking in front of others
• Group conversations and parties
• Meeting strangers or starting conversations
• Taking or making phone calls
• Using public restrooms

Many people find it hard to do things when others are watching, even simple tasks they do easily alone, like writing, typing or working.

The Social anxiety at work, college & class guide has ideas for these moments.

Dating is one of the situations often named in social anxiety, because it involves being seen and possibly rejected.

The Social anxiety at parties, events & dating guide goes deeper on this.

In studies, people overestimated how many others noticed an embarrassing T-shirt, and how much their own comments stood out in a group discussion. We judge from our own rich inner experience, and forget others are busy with theirs.

When anxious, attention often turns inward to a picture of how we think we look. In research, people felt less anxious and saw themselves more kindly when they focused outward on the situation instead.

Common safety habits

• Avoiding eye contact
• Holding a drink tightly to hide shaking
• Rehearsing sentences in your head
• Staying near the exit or one safe person
• Wearing clothes to hide blushing or sweating

Studies show that dropping safety habits while focusing outward lowers anxiety and improves how people see their own performance. The Social anxiety: a step-by-step practice plan guide shows how.

In one study, socially anxious people rated their own performance more harshly than others did, both straight away and a week later. Replaying focused on themselves made those feelings more negative.

Avoiding a feared situation brings quick relief. But it also means you never get to learn that you could cope, so the fear stays the same size or grows.

This is why gradual, gentle practice is at the heart of the therapies that help most.

Social anxiety sometimes runs in families, though researchers aren’t sure why some family members develop it and others don’t. Genes affect how brain areas involved in fear and anxiety work.

Some young children are consistently cautious and quiet with new people and situations. In one long-term study, children who were steadily this way as young children had higher odds of social anxiety as teens.

Temperament is a starting point, not a fate. Many cautious children never develop social anxiety.

Growing up with very controlling parents is one suspected factor. Overprotection can also keep a shy child from getting practice with new people and situations.

Stressful experiences, like being criticised or humiliated, can increase caution around people. Childhood stress and trauma are also suspected factors.

Many people don’t seek help because they believe social anxiety is simply who they are. In fact, it responds well to therapy, and benefits of CBT have lasted a year or more after therapy ended.

The spotlight effect means we overestimate how much others notice about us, good or bad.

Social anxiety is a fear of being judged, not a dislike of people. Many people with it long for closer friendships, which is part of why it hurts so much.

Avoiding people can lead to loneliness. The Loneliness: understanding it guide may help.

Social anxiety sometimes improves with age, but it often does not go away without treatment.

Avoiding people and opportunities can leave you feeling lonely and low. If low mood lasts, see the Depression: understanding it guide and talk with your clinical provider.

Socially anxious people often report using substances to manage anxiety in social situations, even though some substances may not actually calm the body’s stress response. Social anxiety is linked to a higher risk of substance use problems.

The Alcohol & your mind guide has more. If you notice you need a drink to face people, that is worth sharing with a professional.

Some people with social anxiety have panic attacks in feared situations. The Panic attacks guide and the Breathing for anxiety, panic & big feelings guide have calming skills.

NIMH calls CBT the “gold standard” therapy for social anxiety. It teaches new ways of thinking and acting in social situations and often includes gradual exposure to feared situations.

A review of 101 trials found individual CBT had the largest effects and should be the first treatment offered to adults.

Group CBT can offer special benefits for social anxiety. Support groups let people get honest feedback and see how others cope, though group advice is not a replacement for professional care.

Guided self-help means working through a CBT-based workbook or online course with regular support from a therapist. Self-help with support was effective in a large review.

A primary care provider can do a first mental health check and refer you to a mental health professional. You can also search for services at FindTreatment.gov, SAMHSA’s locator.

Any treatment choices are best made together with your clinical provider. The Therapy: the basics guide explains what to expect.

Find A Helpline (findahelpline.com) lists free, confidential helplines in more than 175 countries, searchable by country and topic.