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Help with Social Anxiety and Social Phobia

Symptoms, Self-Help, and Treatment to Deal with Social Anxiety

Lonely girl with social anxiety

Many people get nervous or self-conscious on occasion, like when giving a speech or interviewing for a new job. But social anxiety, or social phobia, is more than just shyness or occasional nerves. With social anxiety disorder, your fear of embarrassing yourself is so intense that you avoid situations that can trigger it. No matter how painfully shy you may be and no matter how bad the butterflies, you can learn to be comfortable in social situations and reclaim your life.

What you can do

  1. Pay attention to your breathing—don't hold your breath
  2. Challenge negative thinking and unrealistic expectations
  3. Get moving—short bursts of movement, several times a day, can reduce anxiety
  4. Use sensory input, such as relaxing and uplifting music, to calm yourself
  5. Challenge your fear of others by making face-to-face contact with friendly people
  6. Learn more by reading the related articles section

What is social anxiety disorder or social phobia?

Social anxiety disorder, also known as social phobia, involves intense fear of certain social situations—especially situations that are unfamiliar or in which you feel you’ll be watched or evaluated by others. These situations may be so frightening that you get anxious just thinking about them or go to great lengths to avoid them, disrupting your life in the process.

Underlying social anxiety disorder or social phobia is the fear of being scrutinized, judged, or embarrassed in public. You may be afraid that people will think badly of you or that you won’t measure up in comparison to others. And even though you probably realize that your fears of being judged are at least somewhat irrational and overblown, you still can’t help feeling anxious.

Social anxiety and body dysmorphic disorder (BDD)

Body dysmorphic disorder (BDD) is a body-image anxiety disorder that can sometimes co-occur with social phobia. While many of us have something about our appearance that we’re not happy with—a nose that’s too big, for example, or lips that are too small—our physical imperfections don’t interfere with our daily lives. Someone with BDD, however, may obsess over real or imagined defects to such an extent that they avoid other people and social situations. This isolation can even lead to suicidal thoughts and behavior. But as with social anxiety, there are plenty of things you can do to overcome the negative thoughts associated with BDD and regain control of your life.

Common social anxiety disorder triggers

Although it may feel like you’re the only one with this problem, social anxiety is actually quite common. Some people experience anxiety in most social and performance situations, a condition known as generalized social anxiety disorder. For others, anxiety is connected with specific social situations, such as speaking to strangers, mingling at parties, or performing in front of an audience.

Social anxiety triggers

At work: Public speaking, speaking up in a meeting, talking with “important” people or authority figures, being criticized.

At school: Being called on in class, taking exams, being teased or criticized.

In public: Using public bathrooms, eating or drinking in public, attending parties or other social gatherings, meeting new people, making small talk, performing on stage

In other situations: Making phone calls, being watched while doing something, being the center of attention, going on a date.

Signs and symptoms

Just because you occasionally get nervous in social situations doesn’t mean you have social anxiety disorder or social phobia. Many people feel shy or self-conscious on occasion, yet it doesn’t get in the way of their everyday functioning. Social anxiety disorder, on the other hand, does interfere with your normal routine and causes tremendous distress.

For example, it’s perfectly normal to get the jitters before giving a speech. But if you have social anxiety, you might worry for weeks ahead of time, call in sick to get out of it, or start shaking so bad during the speech that you can hardly speak.

Symptoms of Social Anxiety Disorder
Emotional Symptoms

Excessive self-consciousness and anxiety in everyday social situations

Intense worry for days, weeks, or even months before an upcoming social situation

Intrusive thoughts about things that make you anxious; you try to avoid thinking about them, but you can’t

Extreme fear of being watched or judged by others, especially people you don’t know

Fear that you’ll act in ways that that will embarrass or humiliate yourself

Fear that others will notice that you’re nervous

Physical Symptoms

Red face, or blushing

Shortness of breath

Upset stomach, nausea (i.e. butterflies)

Trembling or shaking (including shaky voice)

Racing heart or tightness in chest

Sweating or hot flashes

Feeling dizzy or faint

Behavioral Symptoms

Avoiding social situations to a degree that limits your activities or disrupts your life

Staying quiet or hiding in the background in order to escape notice and embarrassment

A need to always bring a buddy along with you wherever you go

Drinking before social situations in order to soothe your nerves

Social anxiety disorder in children

There’s nothing abnormal about a child being shy, but children with social anxiety disorder experience extreme distress over everyday situations such as playing with other kids, reading in class, speaking to adults, or taking tests. Often, children with social phobia don’t even want to go to school.

Coping with social anxiety in the moment

Feeling vulnerable in certain situations has always been part of the human condition. Over time, the nervous system has evolved to provide instinctual ways to quickly relieve the stress and anxiety generated by this vulnerability.

Talking face-to-face: a rapid anxiety reliever

Face-to-face social interaction with a sympathetic person is the most effective way to calm your nervous system and relieve stress and anxiety. Interacting with someone who is kind can quickly put the brakes on damaging stress responses like “fight-or-flight” and release anxiety-relieving hormones. Although it’s not always realistic to have a friend to lean on when social anxiety strikes, maintaining a supportive network can help keep stress and anxiety in check.

Using your senses to relieve stress and anxiety

Another instinctual way to quickly reduce stress and anxiety is to engage one or more of your senses—sight, sound, taste, smell, touch, or movement. By viewing a favorite photo, smelling a specific scent, listening to a favorite piece of music, tasting a piece of gum, or hugging a pet, for example, you can quickly relax and focus yourself.

When you’re anxious in a social situation, you can use your senses to soothe, comfort, and invigorate yourself quickly—in just a few minutes—and feel in control again. Of course, not everyone responds to each sensory experience in the same way. The key to quick stress and anxiety relief is to discover the unique sensory experiences that work best for you.

Controlling your breathing

Many changes happen in your body when you become anxious. One of the first changes is that you begin to breathe quickly. Rapid, shallow breathing throws off the balance of oxygen and carbon dioxide in your body—leading to more physical symptoms of anxiety, such as dizziness, a feeling of suffocation, increased heart rate, and muscle tension.

Learning to slow your breathing can help you bring physical symptoms of anxiety back under control. This HelpGuide meditation can help you manage your breathing and learn to cope with fearful emotions.

A breathing exercise to help you stay calm in social situations

  1. Sit comfortably with your back straight and your shoulders relaxed. Put one hand on your chest and the other on your stomach.
  2. Inhale slowly and deeply through your nose for four seconds. The hand on your stomach should rise, while the hand on your chest should move very little.
  3. Hold the breath for two seconds, then exhale slowly through your mouth for six seconds, pushing out as much air as you can. The hand on your stomach should move in as you exhale, but your other hand should move very little.
  4. Continue to breathe in through your nose and out through your mouth. Focus on keeping a slow and steady breathing pattern of 4-in, 2-hold, and 6-out.

Challenge negative thoughts

Social anxiety sufferers have negative thoughts and beliefs that contribute to their anxiety. These can include thoughts such as:

“I know I’ll end up looking like a fool.”

“My voice will start shaking and I’ll humiliate myself.” 

“People will think I’m stupid.”

“I won’t have anything to say. I'll seem boring.”

Challenging these negative thoughts is an effective way to reduce the symptoms of social anxiety.

How to challenge negative thoughts

The first step is to identify the automatic negative thoughts that underlie your fear of social situations. For example, if you're worried about an upcoming work presentation, the underlying negative thought might be: “I’m going to blow it. Everyone will think I’m completely incompetent.”

The next step is to analyze and challenge them. It helps to ask yourself questions about the negative thoughts: “Do I know for sure that I’m going to blow the presentation?” or “Even if I’m nervous, will people necessarily think I’m incompetent?” Through this logical evaluation of your negative thoughts, you can gradually replace them with more realistic and positive ways of looking at social situations that trigger your anxiety.

It can be incredibly scary to think about why you feel and think the way you do, but understanding the reasons for your anxieties will help lessen their negative impact on your life.

Unhelpful thinking styles

Ask yourself if you’re engaging in any of the following unhelpful thinking styles:

Mind reading – Assuming you know what other people are thinking, and that they see you in the same negative way that you see yourself.

Fortune telling – Predicting the future, usually while assuming the worst will happen. You just “know” that things will go horribly, so you’re already anxious before you’re even in the situation.

Catastrophizing – Blowing things out of proportion. For example, if people notice that you’re nervous, it will be “awful,” “terrible,” or “disastrous.”

Personalizing – Assuming that people are focusing on you in a negative way or that what’s going on with other people has to do with you.

Lifestyle changes that can help you feel more confident

The mind and the body are intrinsically linked—and more and more evidence suggests that how you treat your body can have a significant effect on your anxiety levels, your ability to manage anxiety symptoms, and your overall self-confidence.

Get active

Make physical activity a priority. Run, walk, dance, move, or exercise every day. Aim for 30 minutes of activity on most days, remembering that short bursts of 5 or 10 minutes can work just as well for you as longer workouts. If you hate to exercise, try pairing it with something you do enjoy—such as window shopping while walking laps of a mall or dancing to your favorite music.

Avoid or limit caffeine and sugary foods

Coffee, tea, soda, energy drinks, simple carbohydrates, and sugary foods act as stimulants that increase anxiety symptoms. Reducing the amount of candy and desserts you eat is only part of the solution to reducing your sugar intake, as sugar is also hidden in foods such as bread, cereals, canned soups and vegetables, pasta sauce, margarine, frozen dinners, low-fat meals, and fast food. Your body gets all the sugar it needs from the sugar naturally occurring in food so all this added sweetness just means a lot of empty calories—and increased anxiety.

Add more omega-3 fats to your diet

Omega-3 fatty acids—“good fats”—support brain health and can improve your mood, outlook, and ability to handle anxiety. The best sources are fatty fish (salmon, herring, mackerel, anchovies, sardines), seaweed, flaxseed, and walnuts.

Drink only in moderation

You may be tempted to drink before a social situation to calm your nerves, but alcohol increases your risk of having an anxiety attack.

Quit smoking

Nicotine is a powerful stimulant. Contrary to popular belief, smoking leads to higher, not lower, levels of anxiety. If you need help kicking the habit, see: How to Quit Smoking

Get enough quality sleep

When you’re sleep deprived, you’re more vulnerable to anxiety. Being well rested will help you stay calm in social situations.

  • Make sure your bedroom is dark, cool, and quiet. Curtains, white noise machines, and fans can help.
  • To wind down, calm the mind, and prepare for sleep, try taking a warm bath, reading by a soft light, listening to soothing music, or practicing a relaxation technique before bed.

Focus on others, not yourself

When we’re in a social situation that makes us nervous, we tend to get caught up in our anxious thoughts and feelings. We monitor our bodily sensations and do our best to control them—all the while fearing that the people around us can tell we’re nervous and are judging us for it.

The hope is that by paying extra close attention we can better manage the situation. But this excessive self-focus just makes us more aware of how horrible we’re feeling, triggering worse anxiety! What’s more, it prevents us from fully concentrating on the conversations around us or the performance we’re giving.

How can I stop thinking that everyone is looking at me?

Switching from an internal to an external focus can go a long way toward reducing social anxiety. This is easier said than done, but you can’t pay attention to two things at once. The more you concentrate on what’s happening around you, the less you’ll be affected by anxiety.

Focus your attention on other people—but not on what they’re thinking of you! Instead, do your best to engage them and make a genuine connection.

Remember that anxiety isn’t as visible as you think. And even if someone notices that you’re nervous, that doesn’t mean they’ll think badly of you.

Really listen to what is being said—not to your own negative thoughts.

Focus on the present moment, rather than worrying about what you’re going to say or beating yourself up for a flub that’s already passed.

Release the pressure to be perfect. Instead, focus on being genuine and attentive—qualities that other people will appreciate.

Face your fears

One of the most helpful things you can do to overcome social anxiety is to face the social situations you fear rather than avoid them. Avoidance keeps social anxiety disorder going. It is okay to have feelings that cause you anxiety, but if these feelings are not addressed it will be increasingly difficult to move past them.

Avoidance leads to more problems

While avoiding nerve-wracking situations may help you feel better in the short term, it prevents you from becoming more comfortable in social situations and learning how to cope in the long term. In fact, the more you avoid a feared social situation, the more frightening it becomes.

Avoidance may also prevent you from doing things you’d like to do or reaching certain goals. For example, a fear of speaking up may prevent you from sharing your ideas at work, standing out in the classroom, or making new friends.

Challenging social anxiety one step at a time

The key is to start with a situation that you can handle and gradually work your way up to more challenging situations, building your confidence and coping skills as you move up the “anxiety ladder.”

For example, if socializing with strangers makes you anxious, you might start by accompanying an outgoing friend to a party. Once you’re comfortable with that step, you might try introducing yourself to one new person, and so on.

Working your way up the “anxiety ladder”

Don’t try to face your biggest fear right away. It’s never a good idea to move too fast, take on too much, or force things. This may backfire and reinforce your anxiety.

Be patient. Overcoming social anxiety takes time and practice. It’s a gradual step-by-step progress.

Use the skills you’ve learned to stay calm, such as focusing on your breathing and challenging negative assumptions.

Build better relationships

Actively seeking out supportive social environments is another effective way of challenging your fears and overcoming social anxiety.

Take a social skills class or an assertiveness training class. These classes are often offered at local adult education centers or community colleges.

Volunteer doing something you enjoy, such as walking dogs in a shelter, or stuffing envelopes for a campaign—anything that will give you an activity to focus on while you are also engaging with a small number of like-minded people.

Work on your communication skills. Good relationships depend on clear, emotionally-intelligent communication. If you find that you have trouble connecting to others, learning the basic skills of emotional intelligence can help.

When self-help isn’t enough

If you’ve tried the techniques above and you’re still struggling with disabling anxiety, you may need professional help as well.

Therapy for social anxiety

Of all the professional treatments available, cognitive-behavioral therapy (CBT) has been shown to work the best for treating social anxiety disorder. CBT is based on the premise that what you think affects how you feel, and your feelings affect your behavior. So if you change the way you think about social situations that give you anxiety, you’ll feel and function better.

CBT for social phobia typically involves:

Learning how to control the physical symptoms of anxiety through relaxation techniques and breathing exercises.

Challenging negative, unhelpful thoughts that trigger and fuel social anxiety, replacing them with more balanced views.

Facing the social situations you fear in a gradual, systematic way, rather than avoiding them.

While you can learn and practice these exercises on your own, if you’ve had trouble with self-help, you may benefit from the extra support and guidance a therapist brings.

Group therapy

Group therapy uses acting, videotaping and observing, mock interviews, and other exercises to work on situations that make you anxious in the real world. As you practice and prepare for situations you’re afraid of, you will become more and more comfortable, and your anxiety will lessen.

Medication

Medication is sometimes used to relieve the symptoms of social anxiety, but it’s not a cure. Medication is considered most helpful when used in addition to therapy and other self-help techniques.

Three types of medication are used in the treatment of social anxiety:

Beta blockers are used for relieving performance anxiety. While they don’t affect the emotional symptoms of anxiety, they can control physical symptoms such as shaking hands or voice, sweating, and rapid heartbeat.

Antidepressants may be helpful when social anxiety disorder is severe and debilitating.

Benzodiazepines are fast-acting anti-anxiety medications. However, they are sedating and addictive, so are typically prescribed only when other medications have not worked.

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Resources and references

Signs and symptoms of social anxiety disorder

Social Anxiety Phobia Symptoms – An introduction to social anxiety and the symptoms used for diagnosis. (PsychCentral)

Social Anxiety Fact Sheet – Covers what can trigger social anxiety, signs and symptoms, and treatment options. (Social Anxiety Association)

Social anxiety disorder in children and adolescents

Social Phobia – Written for teens, this article provides an overview of social phobia, its causes, and tips for dealing with it. (TeensHealth)

Self-help

Shyness and Social Phobia: A Self-Help Guide – Offers self-help strategies for dealing with the symptoms of social anxiety disorder, including cognitive-behavioral techniques. (Moodjuice)

Shy No Longer – Series of self-help workbooks with step-by-step tips on how to cope with and overcome social anxiety disorder. (Centre for Clinical Interventions)

Self Help Strategies for Social Anxiety (PDF) – Information on how to “build a toolbox” of strategies for dealing with and overcoming social anxiety (AnxietyBC)

Treatment

What is Comprehensive Cognitive-Behavioral Therapy? – Describes how cognitive-behavioral therapy is used in the treatment of the physical and emotional symptoms of social phobia. (Social Anxiety Institute)

Treatment for Social Anxiety Disorder – Covers treatment options for social anxiety disorder, including cognitive-behavioral therapy, exposure therapy, and slow breathing. (Shyness & Social Anxiety Treatment Australia)

Support organizations for anxiety disorders

National Alliance on Mental Illness Information Helpline – Helpline with trained volunteers providing information, referrals, and support for those in the U.S. (NAMI)

Anxiety UK – Information, support, and a dedicated helpline for UK sufferers and their families. (Anxiety UK)

Anxiety Disorders, Canada – Provides links to services and helplines in different Canadian provinces. (Anxiety Disorders Association of Canada)

SANE Helpline – Provides helpline and support in Australia. (SANE Australia).

From our readers:

“Thank you so much for sharing that article. I couldn't believe how well it described everything that I experience. As I am in my 30s, this article gave me some hope that I may still have the chance to overcome this.” ~ Oregon

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Authors: Melinda Smith, M.A., Jeanne Segal, Ph.D., and Jennifer Shubin. Last updated: December 2016.