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Are you afraid of being judged by others? Are you self-conscious in everyday social situations? Do you avoid meeting new people due to fear or anxiety? If you have been feeling this way for at least 6 months and these feelings make it hard for you to do everyday tasks—such as talking to people at work or school—you may have social anxiety disorder.
Social anxiety disorder is an intense, persistent fear of being watched and judged by others. This fear can affect work, school, and other daily activities. It can even make it hard to make and keep friends. The good news is social anxiety disorder is treatable. Learn more about the symptoms of social anxiety disorder and how to find help.
What is social anxiety disorder?
Social anxiety disorder is a common type of anxiety disorder. A person with social anxiety disorder feels symptoms of anxiety or fear in situations where they may be scrutinized, evaluated, or judged by others, such as speaking in public, meeting new people, dating, being on a job interview, answering a question in class, or having to talk to a cashier in a store. Doing everyday things, such as eating or drinking in front of others or using a public restroom, also may cause anxiety or fear due to concerns about being humiliated, judged, and rejected.
The fear that people with social anxiety disorder have in social situations is so intense that they feel it is beyond their control. For some people, this fear may get in the way of going to work, attending school, or doing everyday things. Other people may be able to accomplish these activities but experience a great deal of fear or anxiety when they do. People with social anxiety disorder may worry about engaging in social situations for weeks before they happen. Sometimes, they end up avoiding places or events that cause distress or generate feelings of embarrassment.
Some people with the disorder do not have anxiety related to social interactions but have it during performances instead. They feel symptoms of anxiety in situations such as giving a speech, competing in a sports game, or playing a musical instrument on stage.
Social anxiety disorder usually starts 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, social anxiety disorder can last for many years, or even a lifetime.
What are the signs and symptoms of social anxiety disorder?
When having to perform in front of or be around others, people with social anxiety disorder may:
- Blush, sweat, or tremble.
- Have a rapid heart rate.
- Feel their “mind going blank,” or feel sick to their stomach.
- Have a rigid body posture, or speak with an overly soft voice.
- Find it difficult to make eye contact, be around people they don’t know, or talk to people in social situations, even when they want to.
- Feel self-consciousness or fear that people will judge them negatively.
- Avoid places where there are other people.
What causes social anxiety disorder?
Risk for social anxiety disorder may run in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain are involved in fear and anxiety and that genetics influences how these areas function. By studying how the brain and body interact in people with social anxiety disorder, researchers may be able to create more targeted treatments. In addition, researchers are looking at the ways stress and environmental factors play a role in the disorder.
How is social anxiety disorder treated?
If you’re concerned you may have symptoms of social anxiety disorder, talk to a health care provider. After discussing your history, a health care provider may conduct a physical exam to ensure that an unrelated physical problem is not causing your symptoms. A health care provider may refer you to a mental health professional, such as a psychiatrist, psychologist, or clinical social worker. The first step to effective treatment is to get a diagnosis, usually from a mental health professional.
Social anxiety disorder is generally treated with psychotherapy (sometimes called “talk therapy”), medication, or both. Speak with a health care provider about the best treatment for you.
Cognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat social anxiety disorder. CBT teaches you different ways of thinking, behaving, and reacting to situations to help you feel less anxious and fearful. CBT also can help you learn and practice social skills, which is very important for treating social anxiety disorder. CBT has been well studied and is the gold standard for psychotherapy.
Exposure therapy is a CBT method that focuses on progressively confronting the fears underlying an anxiety disorder to help you engage in activities you have been avoiding. Exposure therapy is sometimes used along with relaxation exercises. CBT delivered in a group therapy format also can offer unique benefits for social anxiety disorder.
Another treatment option for social anxiety disorder is acceptance and commitment therapy (ACT). ACT takes a different approach than CBT to negative thoughts and uses strategies such as mindfulness and goal setting to reduce your discomfort and anxiety. Compared to CBT, ACT is a newer form of psychotherapy treatment, so less data are available on its effectiveness. However, different therapies work for different types of people, so it can be helpful to discuss what form of therapy may be right for you with a mental health professional.
For more information on psychotherapy, visit the National Institute of Mental Health (NIMH) psychotherapies webpage.
Health care providers may prescribe medication to treat social anxiety disorder. Different types of medication can be effective in treating this disorder, including:
- Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Anti-anxiety medications, such as benzodiazepines
SSRI and SNRI antidepressants are commonly used to treat depression, but they also can help treat the symptoms of social anxiety disorder. They may take several weeks to start working. Antidepressants may also cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe, especially if the dose starts off low and is increased slowly over time. Talk to your health care provider about any side effects that you may experience.
Beta-blockers can help control some of the physical symptoms of social anxiety disorder, such as rapid heart rate, sweating, and tremors. Beta-blockers are commonly the medication of choice for the “performance anxiety” type of social anxiety disorder.
Benzodiazepines, which are anti-anxiety sedative medications, are powerful and begin working right away to reduce anxious feelings. These medications can be very effective in rapidly decreasing anxiety, but some people build up a tolerance to them and need higher and higher doses to get the same effect. Some people even become dependent on them. Therefore, a health care provider may prescribe them only for brief periods of time if you need them.
Both psychotherapy and medication can take some time to work. Many people try more than one medication before finding the best one for them. A health care provider can work with you to find the best medication, dose, and duration of treatment for you. People with social anxiety disorder usually obtain the best results with a combination of medication and CBT or other psychotherapies.
For basic information about these and other mental health medications, visit NIMH’s Mental Health Medications webpage. Visit the U.S. Food and Drug Administration (FDA) website for the latest warnings, patient medication guides, and information on newly approved medications.
Many people with social anxiety find support groups helpful. In a group of people who all have social anxiety disorder, you can receive unbiased, honest feedback about how others in the group see you. This way, you can learn that your thoughts about judgment and rejection are not true or are distorted. You also can learn how others with social anxiety disorder approach and overcome the fear of social situations.
Support groups are available both in person and online. However, any advice you receive from a support group member should be used cautiously and does not replace treatment recommendations from a health care provider.
Both psychotherapy and medication can take some time to work. A healthy lifestyle also can help combat anxiety. Make sure to get enough sleep and exercise, eat a healthy diet, and turn to family and friends who you trust for support. To learn more ways to take care of your mental health, visit NIMH’s Caring for Your Mental Health webpage.
How can I support myself and others with social anxiety disorder?
A good way to help yourself or a loved one who may be struggling with social anxiety disorder is to seek information. Research the warning signs, learn about treatment options, and keep up to date with current research.
If you are experiencing social anxiety disorder symptoms, have an honest conversation about how you’re feeling with someone you trust. If you think that a friend or family member may be struggling with social anxiety disorder, set aside a time to talk with them to express your concern and reassure them of your support.
Know When to Seek Help
If your anxiety, or the anxiety of a loved one, starts to cause problems in everyday life—such as avoiding social situations at school, at work, or with friends and family—it’s time to seek professional help. Talk to a health care provider about your mental health.
Are there clinical trials studying social anxiety disorder?
NIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditions—including social anxiety disorder. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.
Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit NIMH's clinical trials webpage.
Behavioral Health Treatment Services Locator
This online resource, provided by the Substance Abuse and Mental Health Services Administration (SAMHSA), helps you locate mental health treatment facilities and programs. Find a facility in your state by searching SAMHSA’s online Behavioral Health Treatment Services Locator. For additional resources, visit NIMH's Help for Mental Illnesses webpage.
Talking to a Health Care Provider About Your Mental Health
Communicating well with a health care provider can improve your care and help you both make good choices about your health. Find tips to help prepare for and get the most out of your visit at Taking Control of Your Mental Health: Tips for Talking With Your Health Care Provider. For additional resources, including questions to ask a provider, visit the Agency for Healthcare Research and Quality website.
If you or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifeline website.
This publication is in the public domain and may be reproduced or copied without permission from NIMH. We encourage you to reproduce and use NIMH publications in your efforts to improve public health.If you do use our materials, we request that you cite the National Institute of Mental Health. To learn more about using NIMH publications, please contact the NIMH Information Resource Center at1-866‑615‑6464, email email@example.com, or refer to NIMH’s reprint guidelines.
For More Information
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. 22-MH-8083
They feel symptoms of anxiety in situations such as giving a speech, competing in a sports game, or playing a musical instrument on stage. Social anxiety disorder usually starts during late childhood and may resemble extreme shyness or avoidance of situations or social interactions.Which anxiety disorder is more than shyness? ›
Social Anxiety Disorder: More Than Just a Little Shyness.Is social anxiety just shyness? ›
Shyness is another trait that often gets mixed up with social anxiety and introversion. It's even been suggested that social anxiety simply represents an extreme form of shyness. Like people with social anxiety, shy people usually feel uncomfortable around strangers and hesitant to open up in social situations.Is social anxiety disorder is not just shyness a common but underdiagnosed condition? ›
Social anxiety disorder (SAD) is a common but unfortunately under-recognised type of anxiety disorder, leading to 80 percent of the patients undertreated. SAD can present a diagnostic challenge to primary care physicians as patients may present only when they start developing psychiatric comorbidities.What is commonly mistaken for social anxiety? ›
Social Anxiety is frequently misdiagnosed
clinical depression. manic-depressive disorder (bipolar disorder) panic disorder. schizophrenia, all types.
Extreme social anxiety: A person with extreme social anxiety may experience more intense symptoms of social anxiety, such as a panic attack, in social situations. Because of this, people with extreme social anxiety usually avoid social situations at all costs.What is the rarest type of anxiety? ›
Illness anxiety disorder (hypochondria) is extremely rare. It affects about 0.1% of Americans. It typically appears during early adulthood. Illness anxiety disorder can affect all ages and genders.What personality disorder is extremely shy? ›
Avoidant personality disorder is part of a group of personality disorders that can have a negative effect on your life. If you have avoidant personality disorder, you may be extremely shy, unlikely to speak up in a group, have trouble in school or relationships, have low self-esteem, and be very sensitive to criticism.Is there a disorder for being too shy? ›
Many suffer from more than just shyness, experts say. They have a condition called social anxiety disorder, also known as social phobia. The condition has been officially recognized as a psychiatric disorder since 1980.Am I socially awkward or socially anxious? ›
While social awkwardness may describe an alternative way of living in the world, social anxiety is a defined medical condition that can cause severe social impairment. According to the Social Anxiety Institute, social anxiety disorder (SAD) describes an intense, recurrent state of emotional stress in social situations.
Someone with social anxiety may feel extremely nervous in social situations, but present as extroverted and confident. Other people might not even be able to detect their anxiety. Shyness tends to be more apparent, although it often presents as situational. In other words, shyness tends to flare at certain times.Am I an introvert if I have social anxiety? ›
Social anxiety is not just an extreme form of introversion. Introversion is related to social energy, while social anxiety is a mental health condition related to fear of social interactions.What is no longer classified as an anxiety disorder? ›
Obsessive-compulsive disorder (included in the obsessive-compulsive and related disorders), acute stress disorder, and posttraumatic stress disorder (included in the trauma and stress-related disorders) are no longer considered anxiety disorders in DSM-5.Is shyness a symptom of autism? ›
Likewise, a child with autism may not speak, look at other people or play with their peers. Both shy children and those with autism may appear quieter and more reserved than other children, and may find it harder to make friends.What is undiagnosed social anxiety disorder SAD? ›
Social anxiety disorder (SAD), also known as social phobia, is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable distress and impaired ability to function in at least some aspects of daily life.Are there different levels of social anxiety? ›
6. Are there different types of social anxiety disorder? Individuals with social anxiety disorder vary considerably in the number and type of social situations that they fear and in the number and range of their feared outcomes. These two features (feared situations and feared outcomes) can vary independently.Can you be socially awkward but not autistic? ›
Many biological conditions can lead to social difficulties, including autism. However, not all autistic individuals will display social awkwardness (though they may struggle inwardly). Moreover, not everyone who is socially awkward is autistic. And, in fact, they don't necessarily have a diagnosable condition.Is social anxiety a form of autism? ›
Autism and social anxiety are two separate conditions. Autism is neurodevelopmental condition and presents in early childhood, whereas social anxiety disorder is a mental health condition that can develop in childhood or adulthood. People can have one or both.What age does social anxiety peak? ›
The two most common periods of onset were during adolescence (ages 14–17) and early childhood (prior to age 10).How do I know if my social anxiety is severe? ›
Very self-conscious in social situations. A persistent, intense, and chronic fear of being judged by others. Shy and uncomfortable when being watched (giving a presentation, talking in a group) Hesitant to talk to others.
What is Crippling Anxiety? Crippling anxiety is a severe form of anxiety that can significantly interfere with the ability to function in day-to-day life. It's characterized by persistent excessive worry, difficulty concentrating, irritability, muscle tension, sleep anxiety, or sleep disturbances.What is false anxiety? ›
“False anxiety is the body communicating that there is a physiological imbalance, usually through a stress response, whereas true anxiety is the body communicating an essential message about our lives,” she writes.Who suffers from anxiety the most? ›
Women are more than twice as likely as men to get an anxiety disorder in their lifetime. Anxiety disorders are often treated with counseling, medicine, or a combination of both. Some women also find that yoga or meditation helps with anxiety disorders.What personality types are prone to anxiety? ›
Research has indicated that individuals with high emotional reactivity (high neuroticism) and introverted tendencies (low extroversion) are more likely to experience anxiety than other personality types .Is shyness a form of narcissism? ›
Covert narcissism is also known as shy, vulnerable, or closet narcissism. People with this subtype tend not to outwardly demonstrate arrogance or entitlement. Instead, they might put themselves down and seem anxious about what others think of them, rather than exuding charm or confidence.Are there three major types of shyness? ›
Two studies were conducted to further differentiate 3 forms of shyness previously identified in Chinese children--shyness toward strangers, anxious shyness, and regulated shyness--by examining the relation of the 3 forms of shyness to children's inhibited behavior, physiological reactivity (measured by heart period [HP ...Are 8 people with a mental illness generally shy and quiet? ›
8) People with mental illness are generally shy and quiet.
There is no strong causal relationship between personality characteristics and tendency to develop mental illness. Some mental disorders such as depression and anxiety can lead people to avoid or limit social contact.
ADHD and Shyness
Adults with ADHD can struggle with shyness. While shyness goes against the stereotypical image of a hyperactive, life-of-the-party type, ADHD is much more diverse than that image. Shyness has nothing to do with being an extrovert or introvert, or if you are hyperactive or inattentive.
Children who experience teasing, bullying, rejection, ridicule or humiliation may be more prone to social anxiety disorder. In addition, other negative events in life, such as family conflict, trauma or abuse, may be associated with this disorder.
Being shy and being introverted aren't the same thing, although they may look the same. An introvert enjoys time alone and gets emotionally drained after spending a lot of time with others. A shy person doesn't necessarily want to be alone but is afraid to interact with others.
crying or getting upset more often than usual. getting angry a lot. avoiding interaction with other children and adults. fear of going to school or taking part in classroom activities, school performances and social events.Why am I so quiet in social situations? ›
A pattern of not speaking up in groups is often due to a fear of being judged, a core belief that we're somehow flawed, and an underestimate of our social skills. Often, it's not that we are lacking social skills, it's that we need to address underlying thoughts and behaviors that maintain our avoidance of speaking up.Does social anxiety make you act weird? ›
They avoid situations in which they'll be judged.
Social anxiety causes people to think things like, "Other people will think I'm stupid," or "I'll mess up and everyone is going to think I'm a loser." Their extreme fear of rejection causes them to steer clear of uncertain social situations whenever possible.
In many cases, social awkwardness comes from extreme anxiety. Social anxiety is more than just feeling shy. The National Institute of Mental Health reports that 12.1% of U.S. adults experience a social anxiety disorder at some time in their lives.Why am I so quiet and shy? ›
Shyness is partly a result of genes a person has inherited. It's also influenced by behaviors they've learned, the ways people have reacted to their shyness, and life experiences they've had. Genetics. Our genes determine our physical traits, like height, eye color, skin color, and body type.Can you be talkative but have social anxiety? ›
Being a “social” person with social anxiety might sound a bit like an oxymoron — akin to “jumbo shrimp” or “exact estimate.” But the truth is, having social anxiety and being a talkative person are not mutually exclusive.Can I be an extrovert but have social anxiety? ›
Extroverts are typically known for being cool, calm and collected in most social situations, but that doesn't mean they're immune to experiencing anxiety as a result of social interaction. "While it may take on a different form than it does for introverts, extroverts can certainly have social anxiety," says Logan.What is high functioning anxiety? ›
Instead, high-functioning anxiety typically refers to someone who experiences anxiety while still managing daily life quite well. Generally, a person with high-functioning anxiety may appear put together and well- accomplished on the outside, yet experience worry, stress or have obsessive thoughts on the inside.What is permanent anxiety called? ›
Generalized Anxiety Disorder. Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it.What is life long anxiety called? ›
If you tend to worry a lot, even when there's no reason, you may have generalized anxiety disorder (GAD). GAD means that you are worrying constantly and can't control the worrying.
The four levels of anxiety are mild anxiety, moderate anxiety, severe anxiety, and panic level anxiety, each of which is classified by the level of distress and impairment they cause.Is shyness a form of Aspergers? ›
Social Skills: Individuals with Asperger's may appear to be 'loners' or come across as being shy and quiet. They may have difficulty holding eye contact, engaging with others of the same age and they may not know what to say to others to start or maintain a conversation.Am I autistic or socially anxious? ›
People with social anxiety are likelier to talk in a timid voice and stand far from others. Autistic people (who aren't masking) may be less aware of typical neurotypical social expectations and stand too close to people (Cuncic, 2021). Note that Autistic people tend to either: stand too close to people or.What is silent autism? ›
Some autistic people may not speak at all. In fact, around 25 to 30 percent of children with ASD are minimally verbal (which means they speak fewer than 30 or so words) or don't speak at all. When an autistic person doesn't speak, it's known as nonspeaking autism.What other mental disorders come with social anxiety? ›
- Avoidant Personality Disorder.
- Panic Disorder.
- Generalized Anxiety Disorder.
- Eating Disorders.
We can say that no one is "born" with social anxiety. You may remember circumstances and events from very early in life, but there is no "gene" that codes for social anxiety, and there is not an immutable set of genes that cause social anxiety to occur.What is the percentage of social anxiety disorder? ›
Fifteen million, or seven percent, of American adults have Social Anxiety Disorder [1 ]. More than 75% of people experience their first symptoms during their childhood or early teenage years [2 ]. People with social anxiety disorder are also at an increased risk for substance use disorder and major depressive disorder.Is social anxiety disorder the most common? ›
Social anxiety disorder is the third most common mental disorder, affecting upwards 5-12% of the general population at some point in life. Approximately 5% of children and adolescents suffer from social anxiety disorder.Can you be shy introverted and have social anxiety? ›
Both introverts and extroverts can be socially anxious
Introverted and extraverted individuals may both experience social anxiety. While extroverts may enjoy socializing with others and enjoy social interaction, they may still feel anxious around others at times.
Social anxiety disorder typically starts in childhood or adolescence. Among individuals who seek treatment as adults the median age of onset is in the early to mid-teens with most people having developed the condition before they reach their 20s.
Social anxiety disorder, also called social phobia, is a long-term and overwhelming fear of social situations. It's a common problem that usually starts during the teenage years. It can be very distressing and have a big impact on your life. For some people it gets better as they get older.Is there a spectrum of social anxiety? ›
Strong evidence exists that at least some forms of shyness, avoidant personality disorder, and selective mutism lie on a social anxiety disorder spectrum. For several other disorders that share a prominent focus on social comparison, significant subgroups of patients seem to have features of social anxiety disorder.How is social anxiety different from shyness or being an introvert? ›
With social anxiety, avoidance of social situations is rooted in fear and choosing to be alone because it's the only way to feel safe. When introverts choose alone time, it's more likely rooted in genuine enjoyment and self-care rather than self-protection.Can you be socially awkward and have social anxiety? ›
In many cases, social awkwardness comes from extreme anxiety. Social anxiety is more than just feeling shy. The National Institute of Mental Health reports that 12.1% of U.S. adults experience a social anxiety disorder at some time in their lives.Is social awkwardness autism? ›
Many biological conditions can lead to social difficulties, including autism. However, not all autistic individuals will display social awkwardness (though they may struggle inwardly). Moreover, not everyone who is socially awkward is autistic. And, in fact, they don't necessarily have a diagnosable condition.Am I shy or autistic? ›
Generally, identifying the differences in these behaviours boils down to the context. People with autism can generally have a lack of understanding of the social constructs and rules of socialising, whereas people with social anxiety have a full understanding and are overanalytical of these social constructs and rules.