For someone experiencing social anxiety disorder, however, these feelings can be much more intense. The fear of being judged, embarrassed or getting something wrong can become overwhelming, making situations that others might take for granted feel extremely difficult.
Social anxiety disorder, sometimes referred to as social phobia, can affect people of all ages. It often develops during adolescence or early adulthood and, without appropriate support, can have a significant impact on relationships, education, work and overall wellbeing.
Caroline Clare, consultant forensic psychologist at Cygnet Health Care, explains what social anxiety is, how it can affect daily life and the steps that can help people manage it.
What is social anxiety disorder?
Social anxiety is more than simply being shy or lacking confidence. It involves an intense fear of social situations, particularly those in which someone feels they might be observed, evaluated or judged by others.
Social anxiety disorder used to be referred to as social phobia and is about the level of intensity of worry that someone can experience that is triggered by social situations, so it’s quite focused on how a person is seen in social situations.
For example, they might be worried about how other people view them or might be judging them, and that can lead to a lot of embarrassment and self-consciousness.
Someone experiencing social anxiety might spend considerable time worrying about an upcoming conversation, replaying something they have said or anticipating that others will notice their nervousness.
These worries can become difficult to manage and may lead people to avoid situations they fear, even when they would like to take part.
The key distinction between everyday nervousness and social anxiety disorder is the intensity of the fear and the extent to which it affects someone’s ability to live their life as they wish.
Recognising the signs of social anxiety
Social anxiety can affect people in different ways, and its symptoms are not always immediately obvious to others.
Emotional and psychological signs may include:
- Persistent worry about being judged, criticised or embarrassed.
- Feeling self-conscious or ashamed in social situations.
- Overthinking conversations or interactions before and afterwards.
- Dreading social events or situations where attention might be focused on them.
- Feeling overwhelmed by the prospect of meeting people or speaking in public.
There can also be physical symptoms as the body responds to feelings of fear and anxiety. These might include a racing heart, sweating, blushing, trembling, nausea or stomach discomfort.
Social anxiety can affect sleep, particularly when someone spends a lot of time worrying about social situations or anticipating difficult interactions.
Recognising these signs can be an important first step towards understanding what is happening and seeking appropriate support.
How can social anxiety affect everyday life?
When social anxiety becomes overwhelming, people may begin avoiding situations that trigger their fears.
This might mean turning down invitations to meet friends, avoiding telephone calls, finding it difficult to attend appointments or feeling unable to participate confidently at school or work.
Over time, avoidance can become a pattern. While withdrawing from a situation may provide temporary relief, it can also make the prospect of facing a similar situation feel increasingly difficult.
Social anxiety and relationships
Social anxiety can also affect relationships. Someone may worry so much about saying the wrong thing or being judged that they struggle to express themselves, initiate conversations or maintain friendships.
For young people, these difficulties can be particularly challenging during a period of life when friendships, education and developing independence are so important.
It is important to remember that avoiding social situations does not necessarily mean someone is uninterested in other people. They may want to participate but feel unable to manage the anxiety they experience.
Understanding this distinction can help families, friends and professionals respond with patience and support rather than assuming someone is simply being withdrawn or uncooperative.
When should someone seek support?
It is worth seeking help when anxiety begins to interfere with everyday activities, relationships, education, work or general wellbeing.
If you begin to notice physical health difficulties such as heart palpitations, feeling sweaty, feeling sick before or during the social situations, or notice that even short social interactions leave you feeling very drained and very fatigued afterwards, this might suggest that you would benefit from some extra support.
People do not need to wait until their anxiety becomes unmanageable before asking for help. Speaking to a GP or mental health professional can help them better understand their experiences and explore the options available.
For parents and carers concerned about a young person, creating a safe space to talk without judgement can also make a difference. Listening to their concerns, acknowledging how difficult things feel and encouraging them to seek help can be valuable first steps.
What support can help with social anxiety?
There are several approaches that can help people understand and manage social anxiety. The right support will depend on the individual, their symptoms and how anxiety is affecting their life.
1. Understanding triggers and symptoms
An important starting point is identifying which situations trigger anxiety and recognising how it affects thoughts, feelings and physical responses.
This awareness can provide a foundation for developing practical strategies to manage anxiety.
2. Cognitive Behavioural Therapy (CBT)
CBT is an established psychological treatment for social anxiety disorder. It can help people recognise unhelpful patterns of thinking, understand how these influence their feelings and behaviour, and develop alternative ways of responding to challenging situations.
With appropriate support, people can learn to question their fears and build confidence in their ability to manage social interactions.
3. Taking small, manageable steps
For some people, a graded exposure approach can be helpful. This involves gradually working towards situations that trigger anxiety, beginning with small, achievable steps rather than attempting to tackle the most difficult situations straight away.
We might get someone to identify the situations that they’re avoiding that create most anxiety and then set out some very small achievable steps to get them to start tolerating those better, alongside giving them some coping techniques to help with that situation.”
The aim is to help people build confidence at a manageable pace, with support and strategies in place to make difficult situations feel more achievable.
4. Relaxation and grounding techniques
Breathing exercises, mindfulness and grounding techniques can also support people when anxiety feels overwhelming. These approaches may help someone recognise what they are experiencing and feel more able to manage their immediate response.
In some cases, a GP may also consider medication as part of an individual’s treatment plan.
What to remember
Social anxiety can be isolating, particularly when the fear of being judged makes it difficult to talk about what is happening. But people do not have to navigate these feelings alone.
Understanding the signs, recognising when anxiety is affecting everyday life and accessing appropriate support can all help people work towards greater confidence and wellbeing.
The aim is not to dismiss someone’s fears or expect them to overcome anxiety overnight. It is to understand their individual experiences and help them take manageable steps towards the life they want to lead.
With the right support, social anxiety can become more manageable, helping people feel better equipped to navigate relationships, everyday activities and opportunities that matter to them.
This guide has been reviewed by Caroline Clare – Consultant Forensic Psychologist
Caroline has extensive experience supporting adults with a range of complex needs, with a particular interest in trauma-informed care.