Social Anxiety: The Cause, The Cure, and Everything in Between

Do you feel like every time you’re around people, you have to put on a show? Are you afraid of being judged by others? If so, you might be experiencing social anxiety.

Do you feel like every time you’re around people, you have to put on a show? Are you afraid of being judged by others? If so, you might be experiencing social anxiety. Social anxiety can make it hard to enjoy social activities and can even cause physical symptoms such as nausea and headaches.

But there are ways to deal with social anxiety. This guide will explore the causes of social anxiety, the different types of treatments available, and how to find assistance.

What is social anxiety?

Also known as social anxiety disorder or SAD, social anxiety causes people to feel fear or anxiety in social situations. A person with social anxiety disorder may feel anxious or afraid in situations where they feel they may be scrutinized, evaluated, or judged by others, such as:

  • Talking to strangers.
  • Speaking in public.
  • Dating.
  • Making eye contact.
  • Entering rooms.
  • Using public restrooms.
  • Going to parties.
  • Eating in front of other people.
  • Going to school or work.
  • Starting conversations.

Some of these situations might not cause problems for you, but others may be a nightmare. It all depends on the individual. For some, social anxiety may only happen in one or two specific situations. Others experience it in most social situations.

Usually, social anxiety begins during late childhood and may resemble extreme shyness or avoidance of situations or social interactions. It occurs more frequently in females than in males, and this gender difference is more pronounced in adolescents and young adults. Without treatment, a social anxiety disorder can last for many years, or even a lifetime.

What does social anxiety feel like?

Experiencing social anxiety may be different for everyone, but if you have social anxiety and you’re in a stressful situation, you may feel:

  • Very self-conscious in social situations.
  • A chronic fear of being judged by others.
  • Shy and uncomfortable when being watched.
  • Hesitant to talk to others.
  • The need to avoid eye contact.

For some people, social anxiety may be so severe that it interferes with their ability to work, study, or take part in other activities.

What causes social anxiety disorder?

It’s difficult to pinpoint the exact cause of social anxiety disorder, as it is likely due to a complex interaction of genetic and environmental factors. However, there are some possible causes that have been identified.

Possible causes include:

  • Inherited traits – Anxiety disorders tend to run in families. This suggests that both genetics and learned behavior may play a role in their development.
  • Brain structure – People who have an overactive amygdala may be more prone to anxiety and fear. The amygdala is a part of the brain responsible for the fear response, and when it’s overactive, it can cause a person to feel fear more readily. This can lead to increased anxiety in social situations, as the person is constantly on alert for potential threats.
  • Environment – In some other cases, some people developed an anxiety disorder after experiencing an unpleasant or embarrassing social situation.

Signs and symptoms of social anxiety disorder

Risk factors

Several factors can increase the risk of developing social anxiety disorder, including:

Family history

Studies have shown that people with social anxiety disorder are more likely to have a family member with the condition.

Negative experiences

If they experience bullying or other forms of social rejection, children may be more prone to developing social anxiety disorder, according to research.

A study published in the journal Pediatrics found that children who had been teased, ridiculed, or humiliated by their peers were more than twice as likely to suffer from social anxiety disorder as those who had not. In addition, the study found that other negative life events, such as family conflict, trauma, or abuse, were also associated with an increased risk of social anxiety disorder.


Children who are shy, timid, withdrawn, or restrained when facing new situations or people may be at greater risk for anxiety disorders and depression. These children may have difficulty making friends, participating in class, and joining activities.

New social or work demands

Symptoms of social anxiety disorder typically begin in the teenage years, but they may also start for the first time in adulthood. Common triggers include meeting new people, giving a speech in public, or making an important presentation.

Having an appearance or condition that draws attention

People who have a visible physical difference, such as a scar or birthmark, may be more likely to develop social anxiety disorder because they’re self-conscious and fear that others will stare or make comments.

How can it affect your life?

Without treatment, social anxiety disorder can cause or worsen different problems. Individuals who struggle with social anxiety might have difficulties connecting or communicating with others, leaving them feeling isolated and outnumbered.

This lack of social support can lead to further anxiety and keep them from experiencing opportunities in their lives, such as finding jobs, pursuing educations, or participating in social gatherings. The disorder can cause:

  • Low self-esteem.
  • Problems being assertive.
  • Negative self-talk.
  • Hypersensitivity to criticism.
  • Poor social skills.
  • Isolation and difficulties with social relationships.
  • Low academic and employment achievement.
  • Substance use disorder, such as drinking too much alcohol.
  • Suicide or suicide attempts.

People with social anxiety may also experience other mental health issues such as depression, substance use disorder problems, or suicidal ideation.

What can I do about social anxiety disorder?

If you’re struggling with social anxiety and find that it’s affecting your ability to participate in social activities or make and maintain social connections, you may need to seek treatment. There are also a few things you can do to ease social anxiety disorder on your own.

Tips for overcoming anxiety

Participate in social situations gradually

To overcome social anxiety or fears of certain situations, people might want to expose themselves gradually to the things that scare them. This can allow them to face their fears and become comfortable in these situations, helping them to feel more confident and less anxious.

For example, a person might start by sitting in a public place for a few minutes each day, then slowly increase their exposure as they become more comfortable. Overall, the key is to go at a pace that feels right for the person, allowing them gradually to build their experience and skill in the things they fear.

Take time to relax

One effective strategy for decreasing anxiety is engaging in mood-boosting activities that release feel-good chemicals in the brain. Activities such as listening to music, reading, playing video games, and practicing meditation all stimulate the dopamine, serotonin, and endorphin systems of the brain, chemicals that are intimately involved in our feelings of happiness and well-being.

So, before facing a social situation that feels scary, try doing something relaxing or enjoyable. Doing something you enjoy could help you to relax and take your mind off the upcoming situation.

Reframe your thoughts

If you hold onto the idea that you are shy, it can reinforce your current anxiety about talking with people or being in public. The subjective experience that we call shyness is closely linked to how we interpret and judge our own thoughts and experiences.

In other words, our inner monologues can have a big impact on how we behave and interact with others. This is where cognitive behavioral therapy (CBT) can help.

One CBT technique guides individuals through the process of reframing their thought patterns. For example, if you find yourself thinking, “It’s too difficult to start a conversation,” or “I’m nervous when I go out in public,” CBT encourages you to challenge these thoughts by asking yourself questions such as: “Is this really true?” or “How does thinking like this make me feel?” By identifying and removing negative or false thinking, CBT helps us see ourselves more clearly and accurately.

Avoid using alcohol and drugs as social lubricants

Many people feel that using alcohol and other substances can help them to temporarily reduce anxiety. But using these substances on a regular basis to cope with anxiety can actually lead to increased anxiety in the long term, as these habits can become addictive.

Furthermore, relying too heavily on substances to manage anxiety makes it more difficult for your body and mind to learn how to deal with stress in healthy ways. While substance use may help you to feel better in the short term, it can ultimately make your symptoms of anxiety worse and potentially lead to dependence or even a substance use disorder.

When should I talk to my doctor about social anxiety?

It’s normal to feel a little nervous before social events. But if you experience unusually high anxiety and fear about social situations, and the fear and anxiety are so intense that they interfere with your life, consider consulting a mental health professional.

Left untreated, social anxiety may lead to depression, drug or alcohol problems, school or work trouble, and a poor quality of life.

How is social anxiety disorder treated?

Prescription medication and psychotherapy are the two most common treatments for social anxiety disorder. They can be used alone or in combination.


Cognitive behavioral therapy (CBT) can be an effective type of psychotherapy for social anxiety disorder. It teaches you different ways of thinking, behaving, and reacting to situations to help you feel less anxious and fearful. Licensed mental health professionals, such as a psychiatrist, psychologists, or clinical social workers, provide CBT as part of their work.

Exposure therapy is a form of CBT that gradually exposes you to the situations, people, places, or activities you fear most. As you face your fears over time, you will learn that they are not as dangerous or scary as you thought.

Acceptance and commitment therapy (ACT) is a newer type of CBT that can be effective in treating social anxiety disorder. ACT helps you accept your thoughts and feelings without trying to change them. It also helps you commit to taking action in your life that is consistent with your values, even if it means feeling anxious.


Different types of medication can be effective in treating social anxiety disorder, including:

  • Antidepressants
  • Beta blockers
  • Antianxiety medications


Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed type of antidepressant. They can be effective in treating social anxiety disorder and have fewer side effects than other types of antidepressants.

Examples of SSRIs include:

  • Fluoxetine (brand name, Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)

Beta blockers

Beta blockers are usually prescribed to treat heart conditions, but they can also be effective in treating the physical symptoms of anxiety, such as a racing heart and trembling hands.

Examples of beta blockers include:

  • Propranolol (Inderal)
  • Atenolol (Tenormin)

Antianxiety medications

Antianxiety medications can help reduce the symptoms of anxiety, but they should only be used on a short-term basis. That’s because they can be habit-forming and cause side effects such as drowsiness, confusion, and dizziness.

Examples of antianxiety medications include:

  • Benzodiazepines (benzos, including Xanax, Librium, Ativan, and Valium)
  • Buspirone (BuSpar)
  • Hydroxyzine (Vistaril)

Support groups

Many people with social anxiety find support groups helpful. Support groups provide a safe and confidential environment where you can share your experiences and feelings with others who are also struggling with social anxiety and related conditions.

By joining a support group and participating in its meetings, you have chances to learn from others who are dealing with similar issues and challenges. You will also have the opportunity to share your own experiences and knowledge with others in the group.

Support groups are available through local mental health organizations and hospitals. There are also online groups that provide similar support.

How can I support myself and others with social anxiety disorder?

Educate yourself

One of the most important things you can do is seek out information. Research the warning signs, learn about treatment options, and keep up to date with current research. This will not only help you better understand what your loved one is going through, but it will also give you the knowledge you need to provide them with support and encouragement.

Additionally, simply being there for them and letting them know that you care can make a world of difference. Showing your loved ones that you are willing to listen and offer assistance can be instrumental in helping them manage their social anxiety disorder.


One of the most difficult aspects of social anxiety disorder is the feeling of isolation and loneliness that can come with it. When you’re struggling with social anxiety, it can be hard to reach out and connect with others. But remember, you’re not alone. There are many people who understand what you’re going through and who want to help.

If you’re struggling with social anxiety, the first step is to talk to someone you trust about how you’re feeling. This can be a friend, family member, therapist, or any other supportive person. It’s important to have an honest conversation about your symptoms and how they’re affecting your life. This will help the person understand what you’re going through and how they can best support you.

Similarly, if you think that a friend or family member may be struggling with social anxiety disorder, set aside time to talk with them about your concerns. Express your support and let them know that you’re there for them. Reassure them that they’re not alone in this and that help is available. Let them know that you care about them and want to see them find the help they need.

Know when to seek help

Do you find yourself avoiding social situations? Is your anxiety causing problems at school or work? It may be time to seek professional help.

Talking to a health care provider about your mental health is a good first step. They can help you understand your anxiety and develop a plan to manage it. There are also many effective treatments available, so don’t hesitate to seek help if you’re struggling.

Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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