Imagine standing outside the school cafeteria, heart pounding, convinced that everyone inside is going to stare at you from the moment you walk through the door until you’re sitting down. Or being unable to walk into your college orientation because the thought of introducing yourself to a room full of strangers feels unbearable.
Social anxiety disorder is different from shyness or introversion. It involves an intense fear of being judged, embarrassed, rejected, or negatively evaluated by other people. When that fear begins interfering with school, work, relationships, or everyday life, it may be time to seek support. Luckily, you can learn to live a life that isn’t controlled by social anxiety.
What You’ll Learn
- What is social anxiety disorder, and how is it different from shyness?
- What are the signs and symptoms of social anxiety in teens and young adults?
- How can social anxiety affect school, relationships, work, and everyday life?
- What treatments and coping strategies can help people manage social anxiety?
- How can parents support a child or teen who is struggling with social anxiety?
Quick Read
Social anxiety involves an intense fear of being judged, embarrassed, rejected, or negatively evaluated by others. It can go beyond just a little shyness, leading to avoidance, physical symptoms, and persistent worry that interferes with school, work, relationships, and everyday activities. Social anxiety can affect children, teens, college students, and adults, and may look different depending on a person’s age and circumstances.
Treatment can help people understand the fear-avoidance cycle and gradually become more comfortable facing situations that cause anxiety. Cognitive behavioral therapy, exposure therapy, nervous system regulation, social skills training, family therapy, and other approaches may help. Parents can also support young people by validating their experiences, encouraging small manageable steps, practicing coping skills, and avoiding accommodations that reinforce avoidance.
What Is Social Anxiety Disorder?
Social anxiety disorder, sometimes called social phobia, is an anxiety disorder involving an intense fear of social or performance situations where someone may feel watched or judged. For someone experiencing social anxiety, everyday interactions can feel threatening and insurmountable.
Almost everyone feels nervous sometimes before giving a presentation, meeting new people, or walking into an unfamiliar room. Social anxiety is different because the fear is more intense, persistent, and disruptive.
According to the Diagnostic and Statistical Manual of Mental Disorders, the statistical manual criteria used to have social anxiety disorder diagnosed generally require symptoms to last at least six months and cause meaningful disruption.
Social anxiety can affect children, teens, college students, and adults. It often occurs alongside other types of anxiety, like performance anxiety or phobias. It’s also likelier to occur in people with highly sensitive nervous systems, neurodivergence, trauma, and learning disabilities.
Shyness vs. Social Anxiety
Shyness and social anxiety can look similar from the outside, but social anxiety is not just shyness or introversion. It’s an actual personality trait.
A shy teen might feel nervous when meeting new people but gradually warm up once they become comfortable. They may prefer smaller groups or need some time to feel at ease, but their shyness doesn’t necessarily stop them from doing things they want or need to do.
Social anxiety tends to involve a much stronger fear of judgment or embarrassment. It can sometimes look like extreme shyness, but the difference is the level of distress, avoidance, and how much it disrupts daily life. Someone may desperately want to go to a party, make friends, participate in class, or apply for a job, but feel unable to do so because the anxiety is overwhelming.
A few questions can help distinguish the two:
- Does the fear significantly interfere with everyday life?
- Does the person regularly avoid situations because of anxiety?
- Do they spend a lot of time worrying before or replaying interactions afterward?
- Does social anxiety keep them from school, work, friendships, dating, or activities they would otherwise enjoy?
- Do they experience physical symptoms such as a racing heart, sweating, nausea, or shaking in social situations?
What Does Social Anxiety Feel Like?
Social anxiety disorder can feel like being under a spotlight. Even when nobody is paying particularly close attention, the person experiencing anxiety may feel as though everyone is watching, noticing, and judging them through the lens of negative evaluation, which can make social interactions feel threatening.
Common emotional and cognitive social anxiety disorder symptoms include:
- Intense fear of embarrassment or rejection
- Worry about saying or doing the wrong thing
- Feeling self-conscious about appearance, behavior, or the way you speak
- Going blank during conversations or when called on
- Believing other people think you’re awkward, stupid, weird, or unlikeable
- Spending hours replaying conversations afterward
- Worrying for days before an upcoming social event
The Physical Symptoms of Social Anxiety Disorder
The physical response to social anxiety can be intense. Physical symptoms of social anxiety include a pounding heart, sweating, blushing, shaking, nausea, dizziness, shortness of breath, or faintness.
Specific behaviors often develop in response to the anxiety, particularly avoidance behaviors. A teen might do everything they can to avoid answering questions in class, sit on the edge of a group, hide behind their phone, skip parties, or ask someone else to speak for them. A young adult might avoid making phone calls, networking, interviewing, or speaking up for themselves.
The hardest part about social anxiety is that it can shrink down a young person’s world. The things they want to do may be right there in front of them, but extreme fear and anxiety symptoms keep getting in the way. The more they avoid the things they’re afraid of, the more powerful the fear becomes. That fear/avoidance cycle keeps building, which ultimately makes life smaller.
Examples of Social Anxiety in Teens and Young Adults
Social anxiety looks different depending on someone’s age, environment, and unique triggers.
Some common things that can lead to or amplify social anxiety or avoidance in social interactions include:
- Raising their hand or answering questions in class
- Introducing themselves to new people
- Eating or drinking around other people in social settings
- Joining group activities
- Trying out for a team or club
- Giving presentations or performing
- Talking to teachers, coaches, or other adults
- Going to parties or social events
- Being photographed, recorded, or posted online
- Dating or talking to someone they like
For college students and young adults, social anxiety might show up in new ways, like:
- Avoiding orientation or campus events
- Struggling to meet roommates or make friends
- Staying on the periphery of class or group participation
- Putting off phone calls or emails
- Avoiding job interviews or networking
- Feeling unable to speak up at work
- Avoiding dating or new relationships
- For some people with social anxiety, the intense anxiety that leads to avoidance can mean missed career opportunities, underperformance at work, and an unemployment rate that is three times higher for those with social anxiety disorder.
If any of these signs of anxiety feel intimately familiar, reaching out for help is a good idea.
How Is Social Anxiety Treated?
There’s no magic way to turn anxiety off, but professional support through talk therapy and other approaches can help people understand the cycle of fear and avoidance and gradually become more comfortable doing the things anxiety has been telling them to avoid.
- Cognitive Behavioral Therapy (CBT) is a primary treatment for social anxiety. As a core part of CBT, cognitive therapy helps people recognize anxious thought patterns, challenge distorted beliefs, question assumptions about how other people see them, and develop more balanced ways of thinking.
- Exposure therapy is often incorporated into CBT. Rather than forcing someone into their biggest fear all at once, exposure involves gradually approaching situations that cause anxiety. That might mean saying hello to a classmate, attending a club meeting for a few minutes, or eventually giving a presentation. Facing your fears in a slow and controlled way helps you learn that you can overcome them and do things in spite of being afraid.
- Nervous system regulation and resilience are crucial skills in learning to live the life you want. You won’t always be able to stay cool, calm, and collected in scary situations, and that’s okay (and normal). Nervous system resiliency means learning to understand your body and nervous system and respond appropriately when you’re in distress.
- Other therapeutic approaches, including social skills training, group therapy, Acceptance and Commitment Therapy, DBT-Informed Skills, and family therapy, can all also help you build self-confidence, trust, and self-compassion.
- Medication may be recommended for some people, particularly when symptoms are moderate or severe. A psychiatrist or other qualified medical professional can help determine whether medication is appropriate. Treating social anxiety disorder may include selective serotonin reuptake inhibitors, which are commonly prescribed. In some cases, beta blockers may help control physical symptoms in performance situations, while benzodiazepines may provide rapid relief but carry addiction risks.
Lifestyle adjustments, relaxation techniques, and support groups can also complement treatment for some people. If you suspect you or a loved one is experiencing symptoms of social anxiety, reach out to your primary care doctor or a mental health professional to find the right route for care and support.
What Can Parents Do to Help Young People Overcome Social Anxiety?
Family support and encouragement makes a big difference in a young person’s ability to navigate challenges. It’s easier said than done, though. For parents, one of the hardest parts of social anxiety is knowing when to encourage a child to push through discomfort and when to give them a break. Here are some good places to start.
Listen and take anxiety and mental health seriously
The first thing to do is take your child’s anxiety seriously. Telling a teen to “just relax” or “stop worrying about what everyone thinks” won’t make the fear disappear. Always listen and validate what your teen is saying first, before trying to problem-solve or come up with solutions.
Encourage and support them
Accommodating avoidance can unintentionally reinforce the anxiety. Sometimes it feels like a bit of a balancing act to make sure your kid feels seen and heard while also encouraging them to take small, manageable steps toward something scary.
Don’t jump right into trying to do every anxiety-inducing thing at once. Work with your child to figure out one or two behaviors they want to prioritize. You can say something like: “I know this feels really uncomfortable. You don’t have to feel completely confident before you try it. Let’s figure out one tiny step that feels doable.”
Brainstorm small steps to take
Together, brainstorm some small ways to lean toward the discomfort, and celebrate effort and courage. Going to the store for 20 minutes counts. Asking one question in class counts. Making the phone call, even while nervous, counts.
Practice coping skills together
Before or after trying something that feels scary, try practicing simple coping skills together, such as jumping up and down, shaking, dancing, breathing, or focusing on something you can see, hear, or feel.
For teens whose anxiety is significantly affecting school, it’s a good idea to work with counselors, teachers, or other school staff to identify appropriate supports and accommodations.
Therapy for Anxiety and Mental Health Disorders at PrairieCare
Social anxiety shouldn’t keep someone from being capable of making friends, going to college, finding meaningful work, dating, speaking up, or feeling comfortable around other people. With the right support, people can gradually build confidence and learn that anxiety doesn’t have to make their decisions for them.
If you’re a parent watching your child struggle, you don’t have to wait until things become unbearable to reach out for help. And if you’re a young adult recognizing yourself in this article, asking for support can be the first step toward getting more of your life back.
At PrairieCare, we provide mental health care for children, teens, young adults, and families, with treatment options ranging from outpatient therapy to higher levels of care when needed across Minnesota. Care may involve a mental health professional and, when appropriate, clinical psychiatry support as part of an individualized treatment plan.
To get started, get in touch with us to complete a care questionnaire or speak with our intake team at 952-826-8475. We’ll help you figure out your next right steps, whether that’s coping tools you can practice at home, more robust family, or therapy.
FAQs
What causes social anxiety?
- Social anxiety doesn’t have one single cause. Risk factors can include a complex interaction of biological and environmental factors, including temperament, genetics, trauma, perfectionism, and environmental factors; symptoms often begin in childhood or the teenage years.
What does social anxiety feel like?
- Social anxiety can involve intense fear of being judged or embarrassed, along with physical symptoms such as a racing heart, sweating, shaking, nausea, or feeling like you might faint.
What’s the difference between shyness and social anxiety?
- Shyness may make social situations uncomfortable, but social anxiety is one of several anxiety disorders and mental disorders, not merely shyness, and it involves more intense fear and avoidance that can interfere with everyday life, relationships, school, or work.
How can social anxiety be treated?
- Cognitive behavioral therapy (CBT), including gradual exposure to feared situations, is a common treatment for social anxiety. Depending on the person’s needs, treatment may also include other forms of therapy, social skills practice, family support, or medication, and planning may need to account for other anxiety disorders, panic attacks, substance abuse, and substance use disorders.
When should I seek help for social anxiety?
- Consider reaching out when anxiety symptoms or avoidance is interfering with school, work, friendships, activities, or other parts of daily life. Earlier support can help prevent avoidance from becoming more entrenched in a social anxiety disorder.