Social Anxiety Disorder and Social Phobia Symptoms, Self-Help, and Treatment
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Many people get nervous or self-conscious on occasion, like when giving a speech or interviewing for a new job. But social anxiety disorder is more than just shyness or occasional nerves. If you have social anxiety disorder, your fear of embarrassing yourself is intense — so intense, in fact, that you may go to great lengths to avoid situations that would trigger it. The good news is that many effective treatments and self-help strategies can help you overcome the symptoms of social anxiety and reclaim your life.

What is social anxiety disorder (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’ll be watched or evaluated by others. These social situations may be so frightening that you get anxious just thinking about them or go to great lengths to avoid them.

Underlying social anxiety disorder 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.

Although it may feel like you’re the only one with this problem, social anxiety disorder is actually quite common. Many people struggle with these fears. But the situations that trigger the symptoms of social phobia can be different.

Some people experience anxiety in most social and performance situations, a condition known as generalized social anxiety disorder. For other people with social phobia, anxiety is connected with specific social situations, such as speaking to strangers, eating at restaurants, or going to parties. The most common specific social phobia is fear of public speaking or performing in front of an audience.

Triggers for social anxiety disorder (social phobia)

The following situations are often stressful for people with social anxiety disorder:

Meeting new people
Being the center of attention
Being watched while doing something
Making small talk
Public speaking
Performing on stage
Being teased or criticized
Talking with “important” people or authority figures
Being called on in class
Going on a date
Making phone calls
Using public bathrooms
Taking exams.
Eating or drinking in public
Speaking up in a meeting
Attending parties or other social gatherings

Signs and symptoms of social anxiety disorder (social phobia)

Just because you occasionally get nervous in social situations doesn’t mean you have social anxiety disorder, or social phobia. Many people are shy or self-conscious — at least from time to time — 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 disorder, 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.

Psychological symptoms of social anxiety disorder (social phobia)

Intense worry for days, weeks, or even months before an upcoming social situation.
Extreme fear of being watched or judged by others, especially people you don’t know.
Excessive self-consciousness and anxiety in everyday social situations.
Fear that you’ll act in ways that that will embarrass or humiliate yourself.
Fear that others will notice that you’re nervous.
Avoidance of social situations to a degree that limits your activities or disrupts your life.

Physical symptoms of social anxiety disorder (social phobia)

Pounding heart or tight chest
Shaky voice
Rapid breathing
Sweating or hot flashes
Upset stomach, nausea
Dry mouth
Trembling or shaking
Muscle tension
Blushing
Dizziness, feeling faint
Clammy hands
Twitching

Social anxiety disorder (social phobia) in children

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

Getting help for social anxiety disorder (social phobia)

While it may seem like there’s nothing you can do about the symptoms of social anxiety disorder (social phobia), in reality, there are many things that can help. The best treatment approach for social anxiety disorder varies from person to person. You may find that self-help strategies are enough to ease your anxiety symptoms, or you may need professional help as well, such as therapy or medication. But whatever your approach, you can overcome your social anxiety if seek the help you need and make a commitment to treatment.

Lifestyle changes for social anxiety disorder (social phobia)

While lifestyle changes alone aren’t enough to overcome social anxiety disorder, they can support your overall treatment progress. The following lifestyle tips will help you reduce your overall anxiety levels and set the stage for successful treatment:

Avoid or limit caffeine. Coffee, tea, caffeinated soda, energy drinks, and chocolate act as stimulants that increase anxiety symptoms.

Drink only in moderation. You may be tempted to drink before a party or other social situation in order to calm your nerves, but alcohol increases your risk of having an anxiety attack.

Quit smoking. Nicotine is a powerful stimulant. Smoking leads to higher, not lower, levels of anxiety.

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

Medication for social anxiety disorder (social phobia)

Medication is sometimes used to relieve the symptoms of social anxiety, but it’s not a cure for social anxiety disorder or social phobia. If you stop taking medication, your symptoms will probably return full force. Medication is considered most helpful when used in addition to therapy and other self-help techniques that address the root cause of social anxiety disorder.

Three types of medication are used in the treatment of social anxiety disorder (social phobia):

Beta blockers – Beta blockers are used for relieving performance anxiety. They work by blocking the flow of adrenaline that occurs when you’re anxious. While beta blockers don’t affect the emotional symptoms of anxiety, they can control physical symptoms such as shaking hands or voice, sweating, and rapid heartbeat.

Antidepressants – Antidepressants can be helpful when social anxiety disorder is severe and debilitating. Three specific antidepressants—Paxil, Effexor, and Zoloft—have been approved by the U.S. Food and Drug Administration for the treatment of social phobia.

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

Therapy for social anxiety disorder (social phobia)

Of all the treatments available, cognitive-behavioral therapy (CBT) has been shown to work the best for treating social anxiety disorder, or social phobia. Cognitive-behavioral therapy 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.

Cognitive-behavioral therapy 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.
Other cognitive-behavioral techniques for social anxiety disorder include role-playing and social skills training, often as part of a therapy group.

Group therapy for social anxiety disorder 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 confident in your social abilities, and your anxiety will lessen.

Social anxiety disorder treatment #1: Reducing physical symptoms of anxiety

Many changes happen in your body when you become anxious. One of the first changes is that you begin to breathe quickly. Overbreathing throws off the balance of oxygen and carbon dioxide in your body — triggering additional physical anxiety symptoms such as dizziness, a feeling of suffocation, increased heart rate, and muscle tension. Learning to slow your breathing down can help you bring your physical symptoms of anxiety back under control.

Practicing the following breathing exercise will help you decrease the physical symptoms of anxiety and stay calm:

Sit comfortably with your back straight and your shoulders relaxed. Put one hand on your chest and the other on your stomach.
Inhale slowly and deeply through your nose for 4 seconds. The hand on your stomach should rise, while the hand on your chest should move very little.
Hold the breath for 2 seconds.
Exhale slowly through your mouth for 6 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.
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.

Social anxiety disorder treatment #2: Challenging negative thoughts

Social anxiety sufferers have negative thoughts and beliefs that contribute to their anxiety. If you have social anxiety disorder, or social phobia, you may find yourself overwhelmed by thoughts like:

“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, either through therapy or on your own, is one effective way to reduce the symptoms of social anxiety disorder.

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.

Unhelpful thinking styles involved in social phobia

In particular, 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. 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.

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

In order to reduce self-focus, pay attention to what is happening around you, rather than monitoring yourself or focusing on symptoms of anxiety in your body:

Look at other people and the surroundings.
Really listen to what is being said (not to your own negative thoughts).
Don't take all the responsibility for keeping conversations going – silence is OK, other people will contribute.

Social anxiety disorder treatment #3: Gradually facing your fears

One of the most helpful things you can do to overcome social anxiety disorder, or social phobia, is to face the social situations you fear rather than avoid them. Avoidance keeps social anxiety disorder going. It prevents you from becoming more comfortable in social situations and learning how to cope. In fact, the more you avoid a feared social situation, the more frightening it becomes.

While it may seem impossible to overcome a feared social situation, you can do it by taking it one small 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 social phobia “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 will 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.

Beating social phobia by building better relationships

Actively seeking out and joining supportive social environments is another effective way of tackling and overcoming social phobia. The following suggestions are good ways to start interacting with others in positive ways:

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.

This is me

Me too. I can't stand eating in front of other people, and spend days feeling ill if I know I have any kind of social engagement coming up. I'm extremely self-conscious, which can make my job as a college teacher pretty painful at times.

Hi Dan and welcome to Ofear

I hope we can offer you the help and support you need.

When I was younger I was quite overweight and found it difficult eating in front of others due to being so self conscious but I'm a lot better now. Do you have to stand up in front of students on a daily basis?

Thanks for the welcome jonny

Jonnyjonny_uk Wrote:Do you have to stand up in front of students on a daily basis?

Pretty much, yes.

I usually get around the discomfort by convincing myself that, as far as my students are concerned, I don't really exist as a person. They're not interested in me, just the subject.

That usually works but, if happens on occasion, a student asks me a question about me, I just crumble. Those times are excruciating.

You're really brave for being able to face your phobia like that Dan and respect for that. I spent the first 6 weeks of my time here in Moscow teaching and even without social phobia it was absolutely terryfying lol!!

Could advice for others though that find themselves faced in a similar situation.

i am a social phobic smad
i cant go to school anymore, i spend all day in my room alone and because i of the phobia i cant even have a teacher home school me, so i do school over the internet.

oh and good on you dan, for facing your fear like you do _cheesygrin::

This is my first time on this site. Its still weird to think that other people struggle everyday with the same things i do. I always thought that it was all in my head that im crazy why cant i just go to the register and pay for this myself?? Im on prozac now. I find if helps relax me somewhat but i still have trouble with meeting new people, especially those my age or younger. I can eat in front of people but not without wiping my face after every bite because im so paranoid ill have something on my face. I have only worked 1 job for 3 yrs now, im too scared to interview anywhere else. I work alone so it makes it easier. I want to go back to school but ill never be able to. The thought alone scares the heck outta me. Anyone have any suggestions on what else my help me?

Hi cats meow and welcome to Ofear

Everyone has things that work well and things that don't work so well. There's a lot of resource on this site and plenty of people to share their experiences and I'm sure they'll introduce themselves and their ideas.

Good that you have a job as some people even find that too difficult. Everyone has their own way of being and I'm sure you can bring as much advice here to others as you can get from them.

Hiya thecatsmeow3024 and a very warm welcome to Ofear

I hope we can give you all the support and advice you need.

John

OMG I have that too!!!
I really don't know why but being around people make me feel depressed :cry: maybe because I wish I was someone else, I envy them and their normal lives. They take things for granted but they don't know how hard some things(like taking a shower) are for some of us...
And being around people makes me sweat a lot! that's another problem of mine! Whatcha gonna do right? except to suck it up. My hands always sweat when I'm nervous, some people want to shake your hands and I have to dry my sweaty hand on my jeans... how embarassing.
Well I guess that's all for now...