Social anxiety disorder (SAD) is more than just being shy or nervous in social settings—it’s a chronic condition that makes everyday interactions feel unbearable. People with social anxiety are intensely afraid of being judged, embarrassed, or rejected in social or performance situations. These fears can affect personal and professional relationships and make simple tasks like answering the phone or ordering at a restaurant feel overwhelming.
What Causes Social Anxiety?
Social anxiety stems from a combination of the following:
- Genetics: Research suggests that some people inherit a predisposition to anxiety. For example, if a parent has social anxiety, their child is more likely to develop the disorder themselves. However, it’s unclear whether this is due to genetics or learned behaviors from the parent.
- Upbringing: Negative childhood experiences can also contribute. These might include being bullied, criticized, or experiencing trauma, such as family conflict or emotional abuse. Children raised in environments where parents are overly critical, controlling, or unaffectionate may also develop low self-esteem and fear of judgment from others.
How Do I Know If I Have Social Anxiety?
When someone with SAD faces a social situation, their anxiety may manifest in various ways, affecting how they think, feel, and behave. Here are some of the most common signs of social anxiety:
Physical Symptoms
- Pounding or racing heart when anticipating or experiencing social interactions
- Sweaty palms, underarms, and general body perspiration
- Shaky hands, trembling voice, or overall body shakes
- Shortness of breath, shallow breathing, or tight chest
- Difficulty speaking calmly
- Dizziness or lightheadedness
- Muscle tension, especially in the neck, shoulders, and back
Psychological Symptoms
- Fear of being judged or evaluated negatively by others
- A constant fear of making mistakes or doing something embarrassing
- Overanalyzing past social interactions, with a hyper-focus on anything that might have gone wrong
- Heightened awareness of every action and word
- Fear of people noticing their nervous behaviors and judging them because of it
- Difficulty concentrating during conversations, as the mind is preoccupied with self-critical thoughts and fear of judgment
Behavioral Symptoms
- Avoiding social interactions by calling in sick, declining invitations, and steering clear of busy public settings
- Staying on the sidelines in group settings, hoping to avoid being noticed
- Avoiding eye contact
- Speaking softly or mumbling
- Rehearsing conversations to minimize the risk of making a mistake or sounding awkward during the real thing
- Relying on alcohol or drugs to cope with the discomfort of social settings
Diagnosing Social Anxiety
If you feel intense fear in everyday interactions or find yourself avoiding social situations, you might wonder if you have social anxiety. The key difference between occasional nervousness and social anxiety disorder is the level of distress and interference with daily life.
If social situations cause extreme anxiety that affects your ability to work, maintain relationships, or enjoy life, consider speaking with a mental health professional. You might be diagnosed with SAD based on your symptoms, mental health history, and the extent to which fear of judgment affects your behavior and decisions.
Treatment Options for Social Anxiety
The good news is that social anxiety is treatable, and several approaches can be combined to help reduce your symptoms.
Therapy
Cognitive-behavioral therapy (CBT) is the most widely recommended treatment for social anxiety. CBT helps individuals reframe negative thoughts and challenge their irrational fears, teaching them to view social interactions more realistically.
Exposure therapy, a component of CBT, gradually exposes individuals to feared social situations in a safe, controlled environment. By facing their fears, people with SAD build confidence and learn that social interactions are not as threatening as they seem.
Medication
Medication is another effective tool for treating social anxiety, especially when combined with therapy. Here are some common types of medications prescribed for SAD:
- Selective serotonin reuptake inhibitors (SSRIs) balance serotonin levels in the brain, which can reduce anxiety symptoms by regulating mood more effectively. Commonly prescribed SSRIs include sertraline (Zoloft) and fluoxetine (Prozac).
- Benzodiazepines are fast-acting anti-anxiety medications that help during specific, high-anxiety situations. They are typically prescribed for acute anxiety or panic attacks rather than long-term use due to the risk of dependence. Examples include alprazolam (Xanax) and diazepam (Valium).
- Beta-blockers are often used to manage the physical symptoms of social anxiety, such as rapid heartbeat and shaking. They are particularly helpful for performance situations like public speaking. Common beta-blockers include propranolol (Inderal) and atenolol (Tenormin).
Lifestyle Changes
In addition to therapy and medication, certain lifestyle changes can help manage social anxiety. Regular exercise, mindfulness practices like meditation, and a healthy diet support good mental well-being. In addition, gradually stepping out of your comfort zone and engaging in social activities helps reduce anxiety over time.
How to Get Help
If you or a loved one is struggling with social anxiety, professional support can make all the difference. A mental health provider can prescribe the right combination of therapy, medication, and lifestyle changes based on your needs. Overcoming social anxiety is possible with persistence and help from Mindwell Urgent Care. We understand how isolating social anxiety can be. That’s why we offer patient-centered, compassionate care to help you navigate your mental health journey. We make same-day and next-day urgent care available for immediate support when you need it most. Whether you prefer in-person visits at our Dallas clinic or telepsychiatric appointments from anywhere in Texas and beyond, our board-certified providers are ready to help you regain control. Schedule an evaluation today and take the first step toward feeling more confident in social situations.