Social anxiety, also known as social phobia, is a long-term mental health condition that causes an intense fear of social situations.
According to research, social anxiety is one of the most common anxiety disorders and the third most common psychiatric condition after severe depression and alcohol dependence. So, if it’s something you struggle with, you’re certainly not alone.
Social anxiety can significantly impact a person’s life and prevent them from doing things they’d like to. But the good news is that there are plenty of ways to manage it and take back control.
In this article, we’ll explore exactly what social anxiety is and what can cause it, as well as tips for coping and advice on where to seek support.
What is social anxiety?
It’s completely normal to feel nervous or uncomfortable in some social situations; for example, meeting someone for a first date or giving a presentation at work.
However, having social anxiety goes far beyond feeling shy or the typical ‘stomach butterflies’ that we all experience every so often, and can make everyday interactions feel extremely difficult and anxiety-provoking.
Social anxiety is a mental health condition defined by the NHS as a long-term and overwhelming fear of social situations. This fear can cause disruption to a person’s life; sometimes impacting their relationships, work, daily routines, and other activities or commitments.
Social anxiety differs from agoraphobia, which involves a fear of having anxiety attacks or losing control in particular situations. Instead, social anxiety causes fear of feeling embarrassed or being judged in social situations.
What are the symptoms of social anxiety?
Social anxiety can have a significant impact on a person’s ability to socailise and communicate with others.
Some of the most common symptoms of social anxiety include…
- An intense fear of social situations and interactions in a variety of contexts.
- Worrying a lot about or purposely avoiding everyday activities – such as meeting strangers, engaging in conversation, making a phone call, working, or shopping.
- Constantly worrying about doing something you feel is embarrassing; such as blushing, sweating, or appearing to be incompetent in front of others.
- Finding it difficult to do things when other people are watching and convincing yourself that people are judging you.
- Fearing being criticised, avoiding eye contact, and experiencing low self-esteem.
- Often experiencing symptoms such as feeling sick, trembling, sweating, or heart palpitations.
- Having panic attacks that involve an overwhelming sense of fear and anxiety, lasting usually only a few minutes.
A lot of people with social anxiety may also experience other mental health issues, including depression, panic disorder, or generalised anxiety disorder.
What can cause social anxiety?
There’s no single cause of social anxiety, and for many people, the issue can arise as the result of a combination of biological and environmental factors.
Some potential causes include…
- Family history. People are more likely to develop social anxiety if a biological family member currently has (or has had) the condition. For example, this study found that people who have a first-degree relative with social anxiety may be two to six times more likely to develop it as well.
In addition to genetics, research has found that social anxiety can be picked up as a result of environmental influences within families; for example, a child picking up the behaviours of a socially anxious parent.
- Negative experiences. People who experience negative events in life, such as family conflict, abuse, or trauma, are more likely to suffer from social anxiety. Teasing, bullying, rejection, or ridicule can also have the same effect.
- Brain structure. Research has revealed that the brains of people with social anxiety react differently to social situations than people without the condition.
For example, this study found that people with social anxiety had increased blood flow in their amygdala (area of the brain associated with fear), and lower blood flow to the cerebral cortex (area of the brain associated with thinking and evaluating), than people without social anxiety.
- Gender. Research has found that women are more likely to experience social anxiety than men.
- Natural temperament. People who are naturally shy, withdrawn, or timid when faced with new situations may be more at risk of developing social anxiety.
- New work or social demands. Symptoms of social anxiety typically begin in teenage years. However, meeting new people or facing new demands at work (for example, having to make an important work presentation) can sometimes trigger symptoms for the first time.
- Having a condition or appearance that draws people’s attention can increase feelings of self-consciousness and trigger social anxiety in some people. For example, facial disfigurement and stuttering or trembling due to Parkinson’s disease.
5 tips for coping with social anxiety
Social anxiety can be incredibly difficult to cope with, but by practising certain lifestyle changes and working to alter your mindset, it’s possible to work through it.
We’ll cover a few examples below…
1. Take small steps
When trying to overcome social anxiety, taking small steps can be useful to avoid feeling overwhelmed. This can involve breaking down challenging situations into smaller tasks and gradually working on feeling more relaxed with each part.
A few ideas that you might like to consider trying include…
- Skip the self-checkout when you go to the supermarket and challenge yourself to chat with the cashier instead.
- Raise your hand in a work meeting to ask a question or share your opinion.
- Compliment a friend or co-worker’s outfit.
- Host a small gathering for your family and close friends. Socialising in your own space can help you to feel more comfortable and at ease.
Some people also find it useful to rename anxious feelings. For example, instead of saying to yourself “I feel so nervous about this”, try thinking, “I’m so excited about this” instead.
2. Challenge negative thoughts
Many people with social anxiety may find that a lot of their headspace is taken up by worrying about a social situation having a negative outcome.
For example, you might worry about embarrassing yourself by accidentally saying something offensive, calling someone by the wrong name, spilling something on yourself, laughing at the wrong time, or becoming unwell in front of other people.
Imagining yourself in a slightly awkward situation can feel frightening, but it can be helpful to try and keep things in perspective. When negative thoughts creep into your mind, you could try challenging and replacing them with helpful thoughts instead.
For example, you might ask yourself questions like: “What’s the worst that could happen?”, “What would I tell a friend worrying about the same thing?”, “When other people say something silly or awkward in public, do I judge them?”
Remember, we’ve all experienced an awkward situation or two in our lives, but it doesn’t mean people think any less of you.
3. Try relaxation exercises
Just like general anxiety, social anxiety can bring about uncomfortable physical symptoms such as sweating, shortness of breath, upset stomach, lightheadedness, and heart palpitations.
Relaxation techniques, such as mindfulness and breathing exercises, can help to calm and manage physical symptoms.
For example, progressive muscle relaxation involves slowly tensing each muscle group in the body beginning with your toes and holding the tension for five seconds. Afterwards, slowly exhale as you physically release the tension and notice the looseness of your muscles.
For more ideas, you might like to check out our introduction to mindfulness and our article; 3 breathing exercises for anxiety and stress relief.
4. Practise being in social situations that scare you
Taking time to practise being in the social situations that scare you can help you feel better prepared to handle them if and when they come up.
You might like to ask a trusted friend or family member to act out some everyday conversations with you. Below are a few scenarios you could consider role-playing with a loved one…
- You pronounce the name of your friend’s partner wrong and they have to correct you.
- Your boss asks a question during a work meeting and you respond with the wrong answer.
- You’re in the pharmacy looking for a particular item and have to explain to the pharmacist exactly what you’re looking for.
To work on being prepared for all the best and worst-case scenarios, you might like to challenge yourself by asking your conversation partner to respond with positive, negative, and neutral reactions.
5. Don’t forget to take care of yourself
As well as addressing social anxiety itself, it’s important to make sure that you’re taking care of yourself in general as well. This includes eating a healthy balanced diet, staying active, getting enough good quality sleep, and spending time with loved ones.
Only when we take good care of ourselves are we able to properly work overcoming our struggles and fear – which includes social anxiety.
Experts also advise avoiding turning to alcohol and substance for relief as these can often intensify anxiety and worry.
When should you seek help for social anxiety and how can it be treated?
If you think you have social anxiety, it’s always worth speaking to your GP – especially if it’s having a big impact on your life. While certain things may help you to cope with social anxiety, it’s not always possible to work through symptoms yourself, which is where professional help can be useful.
Asking for help can feel difficult, but it could be the first step you take in improving your quality of life. And remember, social anxiety goes beyond feeling shy or nervous around new people; it’s a mental health condition and you’re completely valid in asking for support.
A GP will generally ask about your behaviours, feelings, and symptoms in order to find out more about how anxiety impacts you in social situations. If they believe you have social anxiety, they may refer you to a mental health specialist to undergo a full assessment and discuss treatment options.
Treatment for social anxiety can include cognitive behavioural therapy (CBT), guided self-help (which can involve a CBT-based workbook or online course with regular support from a therapist), or antidepressant medication. However, CBT is generally considered to be the most effective.
If you’d prefer, you can refer yourself directly to an NHS psychological therapies service (IAPT) without a referral from your GP.
What other support is out there for social anxiety?
If you’re struggling with social anxiety or anxiety in general, there are several charities, online forums, and support groups that offer help, guidance, and a chance to connect with other people.
Below are a few examples…
- Anxiety UK – offers a range of services for people struggling with anxiety including support groups, management courses, and therapy.
- HealthUnlocked anxiety forum – run by Anxiety Support, the world’s largest social network for health, it offers 24/7 online support and an opportunity to connect with people experiencing similar health challenges.
- Mind – provides advice and support for anyone experiencing a mental health condition. It also has a page on peer support for ideas on how to connect with other people going through similar things.
- Social Anxiety UK – contains useful information on social anxiety, as well as a forum and chatroom for support.
- Triumph Over Phobia (TOP UK) – offers support for anyone living with phobias, obsessive-compulsive disorder (OCD), and other related anxiety disorders.
Social anxiety can be extremely difficult to live with and may have a huge impact on a person’s quality of life. But while learning to manage it can be difficult, the most important thing to remember is that you’re not alone and, over time, you’ll be able to break free.
For further guidance and support, head over to the healthy mind section of our website. Here, you’ll find information on everything from how to break negative habits and develop positive ones to ways to step outside of your comfort zone.