Understanding and Overcoming Social Anxiety: Symptoms, Causes, and Effective Treatments

Do you get nervous every time you need to speak in front of more than two people? Does attending a party with friends stress you out? Would you rather stay home than go out with your group? If any of these may be true, you might be suffering from social anxiety.

What is Social Anxiety?
Social Anxiety Disorder is a condition characterized by symptoms of anxiety that arise in social situations, often due to embarrassment or fear of humiliation.

Typically, social anxiety develops at a young age, and if left untreated, can persist and worsen over time. Social anxiety can be generalized- affecting all social situations- or specific, such as stage fright, which occurs only when speaking before a large audience. In the Western world, social anxiety disorder affects around 12% of people at some point in their lives.

Social anxiety presents with classic symptoms of anxiety, sometimes even escalating to a full-blown panic attack when the person is in a triggering social setting. Symptoms may include blushing, excessive sweating, chills, stuttering, nausea or dizziness, a choking sensation, shortness of breath, hot or cold flashes, and muscle tension. Frequently, a person who experiences a panic attack in a certain social setting will develop a fear of it happening again and begin to avoid similar situations- leading to a decline in functioning and quality of life.

Social anxiety is driven by the person perceiving various social situations- such as speaking in public or mingling with a group of friends- as threatening. When someone with social anxiety imagines a social situation, they often immediately picture embarrassing or humiliating scenarios. For example, they might worry that they’ll blush or sweat excessively, that their voice will tremble, and worst of all, that everyone will notice and think they’re awkward or incapable.

Because of this internal script, when the person is actually in the feared social setting, they’re not focused on the present moment, but rather consumed by their physical sensations and fears. Every minor event in the situation gets interpreted negatively, reinforcing the belief that social situations are scary, dangerous, or overwhelming.

As a result, many people with social anxiety avoid social interactions. Others may develop coping behaviors that help them feel more secure, such as drinking alcohol at social events, wearing sunglasses indoors, or avoiding eye contact altogether.

It is very important to treat social anxiety, as it can spiral into more serious and even dangerous conditions, ranging from social isolation and impaired daily functioning to decreased employment or academic opportunities, and even substance abuse in an attempt to numb the anxiety.

How Is Social Anxiety Treated?
Today, the most recommended and effective treatment for social anxiety disorder is Cognitive Behavioral Therapy. This therapy can be delivered individually or in group settings. In more severe cases, medication may be considered alongside psychological treatment.

CBT helps individuals identify and change the thought patterns that fuel their anxiety. It also teaches relaxation techniques that can help reduce the physical tension associated with social anxiety. With these tools, patients learn that the likelihood of social humiliation is much lower than they fear, and that successful social integration is much more possible.

For those who already avoid social gatherings, CBT introduces gradual exposure to these situations, allowing them to become more comfortable and reduce their anxiety over time.

Group therapy is often especially effective for treating social anxiety, as participants share the same fears and symptoms. The group setting itself acts as a form of exposure therapy and offers tremendous benefit through shared experience.