Are you extremely afraid of being judged by others?
Are you very self-conscious in everyday social situations?
Do you avoid meeting new people?
If you have been feeling this way for at least six months and these feelings make it hard for you to do everyday tasks—such as talking to people at work or school—you may have a social anxiety disorder.
Social anxiety disorder (also called social phobia) is a mental health condition. It is an intense, persistent fear of being watched and judged by others. This fear can affect work, school, and your other day-to-day activities. It can even make it hard to make and keep friends. But social anxiety disorder doesn’t have to stop you from reaching your potential. Treatment can help you overcome your symptoms.
(Images created by, Emily Carlson)
When having to perform in front of or be around others, people with social anxiety disorder tend to:
Social anxiety disorder sometimes runs in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain are involved in fear and anxiety. Some researchers think that misreading of others’ behavior may play a role in causing or worsening social anxiety. For example, you may think that people are staring or frowning at you when they truly are not. Underdeveloped social skills are another possible contributor to social anxiety. For example, if you have underdeveloped social skills, you may feel discouraged after talking with people and may worry about doing it in the future. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.
First, talk to your doctor or health care professional about your symptoms. Your doctor should do an exam and ask you about your health history to make sure that an unrelated physical problem is not causing your symptoms. Your doctor may refer you to a mental health specialist, such as a psychiatrist, psychologist, clinical social worker, or counselor. The first step to effective treatment is to have a diagnosis made, usually by a mental health specialist.
Social anxiety disorder is generally treated with psychotherapy (sometimes called “talk” therapy), medication, or both. Speak with your doctor or health care provider about the best treatment for you. If your health care provider cannot provide a referral, visit the NIMH Help for Mental Illnesses web page at www.nimh.nih.gov/findhelp for resources you may find helpful.
A type of psychotherapy called cognitive behavioral therapy (CBT) is especially useful for treating social anxiety disorder. CBT teaches you different ways of thinking, behaving, and reacting to situations that help you feel less anxious and fearful. It can also help you learn and practice social skills. CBT delivered in a group format can be especially helpful. For more information on psychotherapy, please visit www.nimh.nih.gov/health/topics/psychotherapies.
Many people with social anxiety also find support groups helpful. In a group of people who all have 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. You can also learn how others with social anxiety disorder approach and overcome the fear of social situations.
There are three types of medications used to help treat social anxiety disorder:
Anti-anxiety medications are powerful and begin working right away to reduce anxious feelings; however, these medications are usually not taken for long periods of time. People can build up a tolerance if they are taken over a long period of time and may need higher and higher doses to get the same effect. Some people may even become dependent on them. To avoid these problems, doctors usually prescribe anti-anxiety medications for short periods, a practice that is especially helpful for older adults.
Antidepressants are mainly used to treat depression, but are also helpful for the symptoms of social anxiety disorder. In contrast to anti-anxiety medications, they may take several weeks to start working. Antidepressants may also cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects that you have.
Beta-blockers are medicines that can help block some of the physical symptoms of anxiety on the body, such as an increased heart rate, sweating, or tremors. Beta-blockers are commonly the medications of choice for the “performance anxiety” type of social anxiety.
Your doctor will work with you to find the best medication, dose, and duration of treatment. Many people with social anxiety disorder obtain the best results with a combination of medication and CBT or other psychotherapies.
Don’t give up on treatment too quickly. Both psychotherapy and medication can take some time to work. A healthy lifestyle can also help combat anxiety. Make sure to get enough sleep and exercise, eat a healthy diet, and turn to family and friends who you trust for support.
For basic information about these and other mental health medications, visit www.nimh.nih.gov/health/topics/mental-health-medications. Visit the Food and Drug Administration’s website (www.fda.gov/) for the latest information on warnings, patient medication guides, or newly approved medications.
To learn more about social anxiety disorder, visit:
For more information on conditions that affect mental health, resources, and research, visit the NIMH website (www.nimh.nih.gov).
The Substance Abuse and Mental Health Services Administration (SAMHSA) provides this online resource for locating mental health treatment facilities and programs. The Mental Health Treatment Locator section of the Behavioral Health Treatment Services Locator lists facilities providing mental health services to persons with mental illness. Find a facility in your state at findtreatment.samhsa.gov/. For additional resources, visit www.nimh.nih.gov/findhelp.
(NIMH does not provide specific medical advice or treatment recommendations or referrals; our materials may not be used in a manner that has the appearance of providing such information.)
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