One day, Brad Ormsby, 33, had to speak in front of a large group of people at work. He struggled to get out the words he needed to say, but he made it through the meeting. If you’ve ever wondered how to overcome social anxiety, the rest of his story will probably sound familiar.
“Unfortunately, it started happening more and more until one day, I was meeting with a client and had a panic attack,” said Ormsby, a digital marketer and entrepreneur based in Modesto, Calif. “It was horrible to say the least.”
This is when Ormsby realized he suffered from social anxiety disorder, a form of anxiety in which people fear social situations. Ormsby’s not alone in living with the disorder—around 12% of adults experience social anxiety at some point in their lives, according to the National Institute of Mental Health (NIMH).
For those like Ormsby, the symptoms of social anxiety can be overwhelming. “I can’t catch my breath, my face muscles get tense, it’s hard to carry on a conversation and impossible to just be myself,” he said. “I never know what’s going to trigger it, and at first, I didn’t know what was going on.”
If you’ve been wondering how to overcome social anxiety, you’re in the right place. This guide will cover the signs and symptoms of social anxiety, as well as actionable advice for managing this anxiety disorder.
What is social anxiety?
Social anxiety (also called social phobia) is an anxiety disorder characterized by extreme worry and fear in social situations.
It’s normal to experience some nerves before certain social situations, like a presentation at work or a party in which you might not know anyone. For people with social anxiety, however, this worry can be overwhelming, if not debilitating.
Most people have experienced fear about doing something embarrassing or not being accepted by their peers, said Chalice Mathioudakis, LMHC, a psychotherapist based in Providence, R.I. “But social anxiety is when these thoughts and feelings become so overwhelming that it starts to get in the way of daily life or functioning in a certain area of life,” she said.
Mathioudakis offers this example: Take a person who is required to attend meetings as part of their job. Every time they go to a meeting, however, they experience an increased heart rate, excessive sweating, and racing thoughts like, Do I look stupid? or, Am I embarrassing myself? “A person may be struggling with social anxiety when the fear of rejection and humiliation is excessive,” she said.
Around 15 million adults, or 6.8% of the U.S. population, has social anxiety, according to the Anxiety and Depression Association of America (ADAA). Social anxiety is slightly more prevalent in women than men, the NIMH notes. In addition, the prevalence of social anxiety is highest in the 18- to 29-year-old age group, as well as in adolescents ages 13 to 18.
“It most commonly surfaces during the adolescent years,” Mathioudakis said. “More than 75% of people experience their first symptoms during childhood or early teenage years.”
Heather Z. Lyons, Ph.D., a licensed psychologist and owner of Baltimore Therapy Group, said we shouldn’t mistake run-of-the-mill shyness for social phobia.
“It’s important not to confuse common shyness with social anxiety,” she said. “The two are quite different. When someone’s social aversion raises to the level of diagnosable social anxiety, their symptoms—including physical ones like a racing heart or sweating and psychological ones like fear and rumination about social interactions—are persistent across time and setting.”
Lyons said that for people with social anxiety, these symptoms can often be so debilitating they eventually lead to avoidance of social situations.
What causes social anxiety?
The causes of social anxiety vary, though they typically fall into one of two buckets: environmental and biological, Lyons said.
Environmental causes of social anxiety can include things like traumatic social experiences (like repeated bullying) or childhood home situations that lead to a lack of confidence and low self-esteem, she said.
“Children are naturally reluctant or even fearful in new social environments,” Lyons said. “However, caregivers generally support children through their wariness to help them develop confidence. Some caregivers are unavailable to do so or might even proactively tarnish children’s confidence in their ability to succeed in social situations.”
Mathioudakis adds that other environmental causes could be a single deeply humiliating experience; a health problem that led to hospitalization for months; or moving from one country to another and struggling to adapt to the new culture.
Social anxiety can also develop as a result of behavior modeling. “If a child had a parent who had social anxiety, and they observed them being consistently anxious in social situations, the child would have a higher likelihood of developing the disorder,” Mathioudakis said. “The child may have learned that social situations were a source of stress and threat through their parent’s modeling.”
Besides these environmental factors, Lyons said some people are biologically predisposed to anxiety. It’s possible, she added, that those suffering from social anxiety likely have other family members with some form of anxiety, too.
Furthermore, Mathioudakis said someone who already struggles with another mental health condition is more likely to have social anxiety.
“As many as 90% of those with social anxiety are also struggling with another mental health challenge as well, such as panic disorder, generalized anxiety disorder, depression, alcoholism or an eating disorder,” she said. “Having a social anxiety disorder may increase the risk of developing another disorder and vice versa.”
Social anxiety symptoms
As with other mental health conditions, no two people with social anxiety have symptoms that are exactly the same—it can manifest in myriad ways. However, there are a handful of symptoms that are prevalent in people with social anxiety:
An overwhelming fear of humiliation or rejection. Mathioudakis said someone with social anxiety will often be overly preoccupied about being humiliated, rejected or embarrassing oneself.
Increased heart rate, sweating and struggling to catch one’s breath. Physical symptoms like these often occur during social situations for someone who has social anxiety. In addition, some people will experience nausea or feel sick to their stomachs, according to the NIMH.
The feeling that one’s mind is going blank. Alicia Butler, 38, a writer based in New York City who has social anxiety, said that although her social phobia has improved, she used to struggle when meeting new people.
“It felt like my whole body would seize up—mostly my brain—and I couldn’t figure out what to think and especially what to do with my hands,” she said. “It was like when you’re trying to run in a dream but can’t move. But instead of running, I just couldn’t think of the appropriate words to say.”
A rigid appearance. People with social anxiety often have a rigid body posture, as well as an overly soft voice, according to the NIMH. They might also find it challenging to make eye contact when speaking with people.
Avoidance of social situations. Those with social anxiety will often avoid social situations because of the overwhelming fear of judgment, rejection and humiliation.
Extreme self-consciousness. Some people with social anxiety will be overly self-conscious in front of others, often worried that they’re awkward or embarrassing, according to the NIMH.
Interference in daily life. Social anxiety is often severe enough that it interferes with one’s work, school and social relationships, according to Harvard Health Publishing.
Tips for overcoming social anxiety
If you have this disorder, you might wonder how to overcome social anxiety. For people with social anxiety, the strongest course of action is consulting a professional who can help determine the best treatment plan for you.
The following expert-backed tips can assist you on your journey to overcoming social anxiety:
Recognize the fear. Mathioudakis said an important first step in overcoming social anxiety is realizing that your fear is excessive. This acceptance is the initial step toward resolving the problem.
See a therapist. Lyons said meeting with a therapist is crucial when trying to overcome social anxiety. Therapists might use many techniques, such as cognitive behavioral therapy (CBT) and exposure therapy, to help you manage your symptoms.
Butler began seeing a therapist in her mid-20s. She recalls telling her therapist she was nervous because of an upcoming camping trip in which she wouldn’t know many people. Her therapist gave her actionable tips for how to manage her social phobia while on the trip.
“She told me to just be naturally curious about other peoples’ lives if I felt nervous—that it would take the attention away from me and that people love talking about themselves,” Butler said. If all else failed, her therapist recommended complimenting someone, as she said giving compliments helps people relax and trust each other.
Track your triggers. One way to manage social anxiety is by monitoring what sets it off. Lyons recommends keeping a journal in which you begin to collect data: Under what circumstances was your social anxiety triggered? Is it worse with certain people or situations? What strategies alleviate your symptoms?
Consider exposure therapy. In people with social anxiety, the amygdala—the part of the brain responsible for detecting danger—may be primed to search for social threats. Mathioudakis said exposure therapy can help desensitize one’s amygdala.
Speak with a therapist about medication. Although therapy is a great first line of defense for social anxiety, certain medications can help people manage their symptoms.
“Ask your primary care doctor or psychiatrist if antidepressants or anti-anxiety medication may be appropriate to help you decrease and manage symptoms,” Mathioudakis said.
Join a support group. Mathioudakis said support groups for social anxiety can facilitate putting skills into practice in a non-judgmental environment. You’ll be able to test things out in a safe space.
Engage in relaxing activities like meditation, yoga or deep breathing. These activities may help quell the panic associated with social anxiety.
Ormsby’s social anxiety comes and goes. Some days, he can go to a party and feel fine, while other days, he will have a panic attack. He copes with the unpredictability by practicing both yoga and meditation.
“I learned that meditation was the best way to deal with it naturally and started meditating,” he said.
How to get over social anxiety
Ormsby’s battle with social anxiety is ongoing. Although meditation helps, he nevertheless experiences social anxiety regularly. “Now, when it happens to me, I just roll with it,” he said. “It’s not as intense as it used to be, but it’s still very uncomfortable, to say the least.”
Butler, on the other hand, said her social anxiety has improved significantly over the years. For her, the key was growing her self-confidence. “The more confident I got, the better the anxiety got,” she said. “If I could relax a little, I could be myself and think of things to say and not feel awkward.”
One thing that helped Butler grow her confidence was taking a job as a tour guide in New York City. “I could stand in front of a group of people with a ‘script’ in my head, and eventually started improving what I would say,” she said. “If I screwed up, no one really noticed or cared.”
If you’re looking for solutions for how to overcome social anxiety once and for all, your best bet is to first consult a licensed professional, like a therapist, who can help you figure out which course of treatment is suited for you.
“Social anxiety is a diagnosis that has been well-researched, and the treatments for social anxiety are supported with years of empirical research,” Lyons said.