Feeling anxious in certain social situations is normal. Perhaps you are attending a party where you don’t know many people and feel uneasy about making small talk with strangers. Or, you have a presentation to give at work and worry about “sounding like an idiot.” Or, you are going on a date and worry that your date may find you boring or unattractive. 

Its Not Easy

Being judged, negatively evaluated, or rejected by others can be unpleasant and hurtful and, understandably, we feel anxious about this possibility. A social anxiety disorder differs from the periodic anxiety one may experience about certain social situations in that it is a clear, intense, and persistent fear of social situations, and anxiety is not only experienced in social situations but interferes with daily behaviors and functioning. For example, it may be difficult to talk to people at school or work. 

Avoiding Social Situations

Social anxiety differs from other anxiety disorders in that it refers to people who specifically avoid or fear social situations. People with social anxiety disorder often overemphasize the extent that others are observing them or negatively evaluating them, which can make it difficult to form and maintain effective relationships. 

Additional symptoms of social anxiety disorder include:

• Fear and anxiety about one or more social situations in which a person is exposed to possible judgment/criticism from others. 

• The person fears they will act anxious/exhibit symptoms of anxiety that will be negatively judged by others.

• Social situations cause fear or anxiety, are avoided, and/or endured with fear/anxiety.

• Fear/anxiety is disproportionate to the actual threat posed by the social situation.

This Psychology Today article provides an overview of social anxiety disorder. 

Physical Symptoms May Exist

Since many of the features of social anxiety disorder involve being negatively evaluated, judged, or criticized by others, those with the disorder may feel sensitive to criticism, have difficulty speaking up and asserting themselves, and/or experience feelings of inferiority. Physical symptoms of anxiety such as blushing, sweating, trembling, shaky voice, rapid heart rate, or feeling sick to one’s stomach, also make it challenging to talk or perform in front of others. For example, those with a social anxiety disorder often believe that others will see that they are anxious when speaking and judge them as “weak” or “incompetent” because of their anxiety. 

Evidence-Based Treatment

Cognitive behavior therapy (CBT) is an evidence-based treatment for social anxiety. CBT involves learning skills to think and behave differently in anxiety-provoking social situations to feel less anxious and fearful. For example, if you are giving a presentation and think, “Everyone will see that I am anxious and think I am incompetent,” this thought will fuel your anxiety. Instead, if you remind yourself, “I may be anxious and that is okay. I can have anxiety and still give an effective presentation,” your anxiety will likely decrease. CBT may also involve practicing social skills which helps boost social confidence, along with exposure therapy. Exposure therapy involves systematically confronting, rather than avoiding, anxiety-provoking social situations to lessen anxiety over time. 

How To Seek Therapy

Acceptance and commitment therapy (ACT) can also be helpful for social anxiety. ACT skills, such as mindfulness and learning to create mental space from unhelpful thoughts, can be used in conjunction with CBT techniques to create more options for how to manage anxious thoughts. Further, exposure therapy is emotionally challenging because it involves confronting anxiety. Exploring one’s values and sources of meaning can be useful in highlighting the personal benefits of exposure and reducing avoidant behavior. For example, if you value professional growth and learning yet your social anxiety hinders your ability to speak up at work, anxiety is interfering with your larger values. So, practicing speaking up will not only decrease anxiety over time, it is a values-based behavior. 

To learn more about therapy for social anxiety, please contact us here at CBTDenver. CBTDenver is proud to be the the Denver regional clinic of the National Social Anxiety Center (NSAC). NSAC is dedicated to promoting the highest quality, evidence-based psychotherapy services to people with social anxiety.