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FAQs:

What is Social Anxiety Disorder?

Social anxiety disorder (formerly known as social phobia) is a mental health condition where you experience intense and ongoing fear of being judged negatively and/or watched by others. Social anxiety disorder is a common anxiety disorder. If you have a social anxiety disorder, you have anxiety or fear in specific or all social situations, including:

- Meeting new people.

- Performing in front of people.

- Taking or making phone calls.

- Using public restrooms.

- Asking for help in a restaurant, store, or other public places.

- Dating.

- Answering a question in front of people.

- Eating in front of people.

- Participating in an interview.

- A core feature of social anxiety disorder is that you’re afraid of being judged, rejected, and/or humiliated

Who Does Social Anxiety Affect?

Social anxiety disorder is a common mental health condition that can affect anyone. Most people who have social anxiety disorder experience symptoms before they’re 20 years old. Women and people designated female at birth (DFAB) experience higher rates of social anxiety than men or people designated male at birth (DMAB).

Is Social Anxiety Disorder Treatable?

Social anxiety disorder is highly treatable with cognitive behavioral therapy (CBT) and/or medication such as antidepressants (typically selective serotonin reuptake inhibitors also known as SSRIs or beta-blockers).

When Should I See My Healthcare Provider?

If you’re experiencing signs or symptoms of social anxiety disorder, be sure to talk to your healthcare provider. Getting treatment for social anxiety is crucial to feeling better and reaching your full potential. If you’ve already been diagnosed with social anxiety disorder, be sure to see your healthcare provider regularly. If you’re experiencing worsening or concerning symptoms, or think your treatment isn’t working, contact your healthcare provider as soon as possible. Don’t discontinue medications on your own without discussing them with your healthcare provider first.

What is a Psychologist?

A psychologist is a professional who practices psychology and studies mental states, perceptual, cognitive, emotional, and social processes, and behavior. Their work often involves the experimentation, observation, and interpretation of how individuals relate to each other and to their environments.

Can a Clinical Psychologist Write Prescriptions?

Psychologists are able to prescribe medications anywhere in the military and the Indian Health Service if they are credentialed in Louisiana or New Mexico. Psychologists can prescribe in five states: Louisiana, New Mexico, Illinois, Iowa, and Idaho.

Professional psychologists gained prescribing privileges in New Mexico in 2002 and in Louisiana in 2004. In 2014, Illinois became the third state to grant prescribing powers to psychologists who hold appropriate training. Iowa granted prescriptive authority to psychologists in 2016, and Idaho followed suit in 2017.

In such cases, psychologists are required to receive proper training and are permitted to prescribe certain medicines used in the treatment of mental disorders.

How Much Does Therapy Cost?

There isn't an easy answer for how much therapy will cost you. The price varies depending on where you live, who you see, and your insurance. But we can give you a rough idea of what to expect. Without insurance, traditional therapy can cost anywhere from $100 to $200 per session, depending on your diagnosis and treatment. How long your session is will also influence the final price. Most online therapy services cost around $60 to $90 per session. Some platforms cost more or less, depending on the features they offer.

Does Therapy Help Social Anxiety?

Because medication alone is not enough to adequately treat social anxiety, therapy is an invaluable part of the treatment picture. Therapy gives you a safe space in which to explore your thoughts, feelings, beliefs, and origins while simultaneously learning the skills you need to make meaningful changes.

Cognitive behavioral therapy (CBT) has been found to be particularly useful in disrupting harmful emotional and behavioral patterns and replacing them with healthier alternatives. According to a study by researchers at the Johns Hopkins University Bloomberg School of Public Health, “CBT is more effective [than medication] and, unlike medication, can have lasting effects long after treatment has stopped.” Not only does CBT produce better outcomes than medication, but it also allows you to avoid unwanted side effects. Evan Mayo-Wilson, the lead author of the study, also notes, “The other issue is that drugs often stop working. With [CBT], you’re teaching people skills that they take with them after the therapy ends.” As such, Mayo-Wilson and many other mental health professionals now believe that CBT should be the first choice for the treatment of social anxiety disorder.

What is the Difference Between Having Social Anxiety Disorder and Being Shy?

Anyone can experience shyness from time to time. Having social anxiety disorder consistently interferes with or prevents you from doing everyday activities such as going to the grocery store or talking to other people. Because of this, a social anxiety disorder can negatively affect your education, career, and personal relationships. Being shy from time to time doesn’t affect these things.

In general, the three main factors that distinguish social anxiety from shyness are:

1. How much it interferes with your day-to-day life.

2. How intense your fear and anxiety are.

3. How much you avoid certain situations.

Many people with social anxiety disorder don’t try to get help or seek treatment because they think social anxiety is just part of their personality. It’s important to reach out to your healthcare professional if you’re experiencing ongoing and intense symptoms when in social situations.

What is Social Anxiety Therapy Like?

The best way to treat social anxiety is through cognitive behavioral therapy or medication -- and often both. You generally need about 12 to 16 therapy sessions. The goal is to build confidence, learn skills that help you manage the situations that scare you most, and then get out into the world. Teamwork is key in social anxiety therapy. You and your therapist will work together to identify your negative thoughts and start to change them. You'll need to focus on the present instead of what happened in the past. You might do role-playing and social skills training as part of your therapy

5 Major Kinds of Anxiety Disorders

The five major kinds of anxiety disorders are:

1. 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.

2. Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as hand washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety.

3. Panic Disorder

Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.

4. Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

5. Social Phobia (or Social Anxiety Disorder)

Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation - such as a fear of speaking in formal or informal situations, or eating or drinking in front of others - or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.

Different Types Of Social Anxiety

A person with social anxiety disorder can have a mild, moderate, or extreme form of it. Some people with social anxiety only experience symptoms with one type of situation, like eating in front of others or performing in front of others, while other people with social anxiety experience symptoms in several or all forms of social interaction. In general, the different levels of social anxiety include:

1. Mild social anxiety: A person with mild social anxiety may experience the physical and psychological symptoms of social anxiety but still participate in, or endure, social situations. They may also only experience symptoms in certain social situations.

2. Moderate social anxiety: A person with mild social anxiety may experience physical and psychological symptoms of social anxiety but still participate in some social situations while avoiding other types of social situations.

3. 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. A person with extreme social anxiety likely has symptoms in all or many types of social situations.

It’s very common to have anticipatory anxiety when facing these situations. It’s possible to fluctuate between different levels of social anxiety throughout your life. No matter which type of social anxiety you have, it’s important to seek treatment because this type of anxiety affects your quality of life.

Signs and Symptoms of Social Anxiety Disorder

When people with social anxiety have to perform in front of or be around other people, they tend to experience certain symptoms, behaviors, and thoughts. A person with social anxiety disorder can have these symptoms during specific types of social situations or they can have them in several or all social interactions.

Physical and physiological symptoms of social anxiety disorder can include:

- Blushing, sweating, shaking, or feeling your heart race in social situations.

- Feeling very nervous to the point of feeling nauseated in social situations.

- Not making much eye contact when interacting with others.

- Having a stiff body posture when you’re around other people.

- Thoughts and behaviors that can be signs of a social anxiety disorder include:

- Being very self-conscious in front of other people.

- Feeling embarrassed or awkward in front of other people.

- Feeling your mind “goes blank” and not knowing what to say to other people.

- Feeling very afraid or worried that other people will judge you negatively or reject you.

- Finding it scary and hard to be around other people, especially strangers.

- Avoiding places where there are people.

Causes of Social Anxiety

Like many other mental health conditions, social anxiety disorder likely arises from a complex interaction of biological and environmental factors. Possible causes include:

1. Inherited traits. Anxiety disorders tend to run in families. However, it isn't entirely clear how much of this may be due to genetics and how much is due to learned behavior.

2. Brain structure. A structure in the brain called the amygdala (uh-MIG-duh-luh) may play a role in controlling the fear response. People who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations.

3. Environment. A social anxiety disorder may be a learned behavior — some people may develop significant anxiety after an unpleasant or embarrassing social situation. Also, there may be an association between social anxiety disorder and parents who either model anxious behavior in social situations or are more controlling or overprotective of their children.

Risk Factors of Having Social Anxiety

Several factors can increase your chances of developing a social anxiety disorder, including:

1. Negative life experiences 

Children who are teased, bullied, rejected, ridiculed, or humiliated may be more likely to develop a social anxiety disorder. Family conflict, trauma, abuse, or other negative life events may also be linked to the condition.

2. New social or work demands 

Meeting new people, giving a speech, or having to make an important presentation at work may trigger social anxiety disorder symptoms.

3. Having an appearance or condition that attracts attention 

Facial disfigurement, stuttering, tremors due to Parkinson’s disease, and other conditions can make people feel self-conscious and may trigger social anxiety disorder.

4. Shy temperament 

Children who are shy, timid, withdrawn, or restrained when dealing with new situations or people may have an increased risk of developing the disorder. People who have social anxiety disorder commonly say they were extremely shy as children. (However, social anxiety disorder and shyness are not the same things.)

Treatments for Social Anxiety

A number of treatments are available for social anxiety. The main options are:

1. Cognitive Behavioural Therapy (CBT)

This is a therapy that helps you identify negative thought patterns and behaviors, and change them; this can be done with just you and a therapist, in a group, or with your parents or carers.

2. Guided Self-Help

This involves working through a CBT-based workbook or online course with regular support from a therapist.

3. Support Groups

Many people with social anxiety find support groups helpful. In a group of people who all have a 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. 

4. Antidepressant Medicines

These are usually a type of medicine called a selective serotonin reuptake inhibitor (SSRI), such as escitalopram or sertraline; are usually not used to treat people under the age of 15. CBT is generally considered the best treatment, but other treatments may help if it does not work or you do not want to try it. Some people need to try a combination of treatments.

Prevention of Social Anxiety Disorder

There’s no way to completely prevent social anxiety disorder, but these techniques can help you reduce anxiety symptoms:

1. Get help as soon as possible. Anxiety can be more difficult to treat if you delay seeking treatment.

2. Start journaling. Keeping a record of your thoughts and experiences can help you and your healthcare provider figure out what’s causing your symptoms and what makes you feel better.

3. Figure out your priorities. Carefully manage your time and energy, and spend time doing things you enjoy.

4. Avoid unhealthy substance use. Using alcohol and drugs, as well as caffeine or nicotine, can cause anxiety or make it worse. But quitting can also cause anxiety. If you’re addicted to any substances, look for a doctor, treatment program, or support group that can help.

What to Expect from Anxiety Therapy

A common misunderstanding about therapy is that you'll immediately start to feel better. Sometimes this is the case. But much of the time, you feel worse before you start feeling better. Surprisingly, feeling worse is often a sign of progress. And if you think about it, that makes sense.

When you make the decision to enter into therapy, it's often because you haven't been able to work through your anxiety on your own. Therapy involves exploring your anxiety and the reasons behind it in a deeper, more meaningful way. This can cause a temporary spike in your anxiety.

Therapy should never be thought of as a quick fix. It's a process that's unique to each individual. The type of therapy you need, the skills, that you learn, and how long you're in therapy depends entirely on the type of anxiety you have and the severity of your symptoms.

It's important to understand that though the process won't always feel good, it will be completely worthwhile in the end.

How to Make the Most Out of Social Anxiety Therapy

Trying to make a change can be a challenge. Anxiety therapy is no exception. However, if you are persistent, you should see improvement. Here are a few ways to make the most of your therapy—and actually see some results:

- Don't pretend to be OK

- Ask questions

- Tell your therapist anything and everything

- Do the work outside your sessions

- Focus on your goals

- Practice healthy lifestyle choices

- Make sure you have a social support system

- Reduce stress in your life that makes your anxiety worse

In this way, you can see that putting in an effort and being present throughout the therapy process will have the biggest impact on how well it works for you.

How to Find an Anxiety Therapist

When looking for a therapist for social anxiety disorder (SAD), you should seek someone who specializes in treating this specific mental health concern.

Although the process of finding an anxiety therapist will not be easy, the benefits of entering into therapy with a qualified professional are great. Below are some steps to help you find an anxiety therapist in your area.

1. Contact Your Insurance Provider

If you plan to use your insurance to pay for therapy, you may need to select a therapist who is part of your insurance plan. The best first step is to contact your insurance provider for a list of therapists that are in your plan's network. Once you have the list, narrow it down to those who provide treatment specifically for anxiety disorders and SAD.

2. Pick up the Phone

If there is a large clinic in your area, they likely have therapists on staff that treat anxiety disorders. If you are comfortable, call their offices and ask whether anyone on staff treats SAD.

3. Search Online

There are a number of online directories to connect you with therapists near you. Sources like the American Psychological Association's ​Psychologist Locator or the Anxiety and Depression Association of America's Find a Therapist Directory are great because you can click on different filters to find therapists that meet your criteria. Both websites also provide resources for people living with anxiety.

4. Shop Around

Once you have located a therapist and gone to your first few sessions, remember that your treatment process is still unfolding. Even though a therapist may be trained to treat SAD, they may not be a good fit for you.

Sources:

NIHM

Cleveland Clinic

NHS

Wikipedia

Very Well Mind

CNET

Mayo Clinic

HHS

Everyday Health

Bridges To Recovery

WebMD

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.