Social anxiety disorder — sometimes known as social phobia — is a type of anxiety disorder that causes anxiety or fear in social settings.

Someone with this disorder has trouble talking with others, meeting new people, and attending social gatherings. They may feel anxious about others judging or scrutinizing them.

They may understand their fears are irrational, but feel powerless to overcome them.

According to the Anxiety and Depression Association of America (ADAA), around 15 million American adults have social anxiety disorder. It often starts during the teenage years.

Am I just shy?

Social anxiety is different from shyness. Shyness can make socializing, school, and work difficult, but it doesn’t disrupt life to the same extent as social anxiety. Social anxiety is persistent and overwhelming and may affect everyday activities, such as shopping for groceries.

Symptoms of social anxiety disorder

For a person with social anxiety disorder, social interaction may lead to:

blushing
nausea
sweating
trembling or shaking
a rigid body stance
difficulty speaking
feeling as if their mind goes blank
dizziness or lightheadedness
rapid heart rate

Psychological symptoms may include:

intense worry before, during, and after a social situation
avoiding social situations or trying to blend into the background if you must attend
self-consciousness and fear of doing something embarrassing
concerns that others will notice you’re stressed or nervous
feeling a need to consume alcohol to help face a social situation
missing school or work because of anxiety

Everyone feels anxious at times, but those with social anxiety have a constant fear of being judged by others or humiliated in front of them.

They may avoid all social situations, including:

asking a question
job interviews
shopping
using public restrooms
talking on the phone
eating in public

Some individuals have limited or selective anxiety. For example, they may only be anxious when eating in front of others or talking with strangers. People with severe symptoms may avoid all social settings.

What causes social anxiety disorder?

The exact cause of social anxiety disorder is unknown, but it may result from a combination of factors.

Physical, biological, and genetic factors likely play a role, according to scientists. Problems with neurotransmitter systems — chemical messengers throughout the body — may lead to imbalances in the hormones serotonin, dopamine, and glutamate. These brain chemicals help regulate mood.

Some health experts say environmental factors may contribute, but only as part of a complex interaction involving biological and genetic features.

Factors that may contribute to social anxiety disorder include a history of:

emotional, physical, or other kinds of abuse
negative interactions with peers
overcontrolling parenting styles
having an insecure attachment style

Negative experiences may lead to a type of post-traumatic stress disorder (PTSD), where social anxiety is a symptom.

Anxiety disorders can run in families, but it’s unclear whether this is due to genetic or environmental factors.

Diagnosing social anxiety disorder

There’s no medical test to check for social anxiety disorder. However, a doctor will likely use criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) to establish if social anxiety disorder is likely.

They will likely ask about:

your symptoms
your family history
other health conditions

The criteria for assessing social anxiety disorder, according to the DSM-5-TR, are:

a fear of one or more social situations that could involve scrutiny from others
having a fear of acting in a way that will lead to a negative evaluation by others or upset or offend others
when a specific situation nearly always provokes fear or anxiety
when the person either avoids the situation or attends with intense anxiety or fear
when fear is out of proportion to the threat
when fear or anxiety is persistent, usually lasting 6 months or more
when fear and anxiety disrupt daily living
when other symptoms or health conditions cannot explain the fear and anxiety the person feels

They may also wish to rule out other conditions, such as:

a substance-related issue
a personality disorder
concerns about a health issue, obesity, or a physical characteristic, such as a facial burn

Treatment for social anxiety disorder

Several treatment options can help with social anxiety disorder. How well a therapy works will vary between individuals. Some people only need one type of treatment, but others may need a combination.

A primary care doctor may prescribe treatment or refer you to a psychologist or other mental health specialist.

Options include the following:

Counseling therapy

Counseling involves talking, either one-on-one or in groups. Counseling sessions are available face to face or online.

Cognitive behavioral therapy (CBT): CBT helps you learn new ways to manage anxiety, for example, how to replace negative thoughts with positive ones.

Acceptance and commitment therapy (ACT): In ACT, people learn to use mindfulness, acceptance, and behavioral strategies to be more present and figure out how to live a value-based life despite negative feelings.

Group therapy or a support group: This approach helps you learn social skills and techniques to interact with people in social settings. Working in a group will help you see that you’re not alone and enable role-playing of practical solutions.

Exposure therapy: In this type of therapy, a healthcare professional helps you gradually face social situations rather than avoid them.

Medication

Medications can help improve your symptoms and help you function in your daily life.

Medications that can treat social anxiety disorder include:

selective serotonin reuptake inhibitors (SSRIs), such as paroxetine (Paxil) and Sertraline (Zoloft)
selective norepinephrine reuptake inhibitors (SNRIs), for example, venlafaxine (Effexor)
propanolol

SSRIs and SNRIs can take several weeks to have an effect, but propanolol is a short-acting drug that you can use when you need it.

You may start with a low dose and gradually increase your prescription to avoid side effects. If you’re dissatisfied with one medication, the doctor may offer an alternative.

Healthcare professionals can explain the benefits and risks and help you decide which treatment is right for you.

Home remedies

Home and natural remedies can support the treatment recommended by your doctor.

Tips to address stress and anxiety include:

using breathing exercises
using mindfulness and meditation
exercises, such as yoga and tai chi, to help manage stress
avoiding caffeine and other stimulants
establishing a regular sleep routine
learning about anxiety and its effects
finding a trusted person to talk with honestly, such as a friend, therapist, or family member
knowing the signs and when to seek help
getting regular exercise and eating a balanced diet to boost your overall sense of well-being

Try these grounding techniques

Grounding techniques can distract your mind from intrusive thoughts and relieve your stress. Here are some examples:

touching household items, water, or ice, and focusing on their textures or guessing their colors
moving your body or taking a short walk
counting down or doing math in your head
listening to music, or turning it off and focusing closely on the ambient sounds around you
describing your surroundings in detail until you feel calm
listing some people, objects, or activities in your life that bring you joy
being kind to yourself, repeating phrases that encourage you, like “You’re having a rough time, but you’ll make it through.”

Outlook and complications

According to the ADAA, over one-third of people with social anxiety don’t seek help until they have had symptoms for at least 10 years. Individuals may not see their discomfort as a mental health issue and may not realize that help is available.

Without treatment, social phobia can affect:

achievement at work and in studies
social interaction
relationships
self-esteem
quality of life

Additionally, up to 90% of people have another condition alongside social anxiety, such as:

depression
alcohol misuse
thinking about or attempting suicide

Counseling therapy, lifestyle changes, and medication can help many people cope with social anxiety and other mental health issues.

If you find yourself thinking of suicide, you are not alone — there are resources available to help you. We include some of them here:

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
Not in the United States? Find a helpline in your country with Befrienders Worldwide.
Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Frequently asked questions

What are the symptoms of social anxiety?

People with social anxiety either avoid or feel very anxious in social settings. They may blush, sweat, tremble, avoid others, stand rigidly, avoid eye contact, or find it hard to talk. They may not know why they feel anxious, but it’s usually due to a fear of being judged or offending another person.

What is the main cause of social anxiety?

Experts don’t know exactly why it happens, but an imbalance in brain chemicals may play a role. Life events may contribute, such as a history of abuse or growing up in a household with a controlling parenting style. However, health experts believe these are unlikely to be the only factors.

How can I overcome social anxiety?

It’s important to seek medical help as soon as possible, as other complications may arise if a person lives with social anxiety disorder for a long time. Counseling, medication, and lifestyle remedies are all options. Social anxiety disorder seems to respond well to a combination of counseling and antidepressants, such as SSRIs and SNRIs.

Summary

It’s important to remember that if you are experiencing social anxiety, it is not happening because of anything you are doing or any decision you are making. You are living with a condition that you did not choose for yourself, and there are tools available that may help you live a less anxious life.

People with social anxiety disorder feel fearful or anxious in social situations. The feeling may be so overwhelming that they avoid socializing and may avoid school, work, shopping, and other places where interaction may occur.

You may fear that someone will judge you, or you will offend someone, or somehow humiliate yourself, but the threat is unlikely to be real. Medication, counseling, and lifestyle remedies can help you manage symptoms and improve your quality of life.

Chu A, et al. (2023). Selective serotonin reuptake inhibitors. https://www.ncbi.nlm.nih.gov/books/NBK554406/
Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR). (n.d.). https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787
Norton AR, et al. (2017). The role of environmental factors in the aetiology of social anxiety disorder: A review of the theoretical and empirical literature. https://www.cambridge.org/core/journals/behaviour-change/article/role-of-environmental-factors-in-the-aetiology-of-social-anxiety-disorder-a-review-of-the-theoretical-and-empirical-literature/95A253CA5E3F40E0CA14CF3DA3590133
Rose G, et al. (2022). Social anxiety disorder. https://www.ncbi.nlm.nih.gov/books/NBK555890/
Serotonin and norepinephrine reuptake inhibitors (SNRIs). (n.d.). https://screening.mhanational.org/content/serotonin-and-norepinephrine-reuptake-inhibitors-snris/
Social anxiety disorder (n.d.). http://www.adaa.org/understanding-anxiety/social-anxiety-disorder
Social Anxiety Disorder: More Than Just Shyness. (2022). https://infocenter.nimh.nih.gov/sites/default/files/2022-02/social-anxiety-disorder-more-than-just-shyness.pdf

This article originally appeared on Healthline. © 2025 Healthline Media LLC. All rights reserved. Our website services, content, and products are for informational purposes only. Healthline Media does not provide medical advice, diagnosis, or treatment.

What Is Social Anxiety Disorder and What Can I Do About It?

More about Anxiety