The Best Ways to Treat Social Anxiety Disorder

Social anxiety disorder is a common mental health condition that can have a major impact on your life. It is much more than being shy or introverted. 

Social anxiety disorder is a persistent fear of being judged by other people — to such a degree that it can limit your activities. You or someone you know may have social anxiety disorder. It affects 12% of people in their lifetimes. 

It is possible to treat social anxiety disorder so you can feel more confident in social situations. Learn about the best treatments for social anxiety disorder and what you can do to manage social anxiety from home.

What is social anxiety disorder?

Social anxiety disorder is an ongoing fear of being embarrassed, judged, or criticized by other people. 

The fear can cause so much distress that it may: 

• Impact or limit your activities

• Decrease your quality of life 

• Limit your ability to have healthy relationships 

• Affect your ability to reach your full potential in school or at work 

Social anxiety can cause many symptoms in social situations, including:

• Having a fast heart rate

• Blushing or sweating

• Feeling nauseated

• Trembling

• Avoiding eye contact

• Speaking with a soft voice

• Finding it difficult to speak

• Feeling self-conscious or embarrassed

• Avoiding certain situations or places

Social anxiety disorder often occurs with other mental health conditions. These conditions may include depression, generalized anxiety, and substance use. Symptoms often start in childhood or adolescence, and it affects more women than men. 

Some people may only have social anxiety when they have to perform, such as when they have to give a speech or toast. This is a type of social anxiety disorder called performance anxiety.

Causes of social anxiety disorder

Social anxiety disorder — like other mental health conditions — likely happens because of a combination of genetics and environment. For some people, it may start after they experience an embarrassing event. Others may learn or inherit it from a parent.

Other risk factors for developing social anxiety include:

• Having a family history of social anxiety

• Experiencing bullying or teasing as a child

• Having a history of childhood trauma

• Taking on new responsibilities with more public performance or speaking

Social anxiety disorder treatment

There are many treatment options for social anxiety disorder, including therapy and medications. The right treatment for you will depend on many factors, such as:

• The severity of your symptoms

• Your other health conditions

• Your preferences

If you experience social anxiety symptoms in many situations, you may want to try a combination of medication and therapy. When symptoms are associated with one type of situation — such as public speaking — you may do well with therapy alone.

The first step in treating social anxiety is getting a diagnosis. It’s important to discuss your concerns and symptoms with a healthcare provider. They will help you understand your treatment options. 

Is there a cure for social anxiety disorder?

Social anxiety disorder is a chronic condition and cannot be “cured.” But you can manage your symptoms and get a lot better with treatment. Everyone’s situation will be different. 

For some people, symptoms can last for a brief period of time. Other people may need ongoing support through therapy and medication to manage their social anxiety. 

Therapy for social anxiety disorder

Psychotherapy can be an effective treatment for social anxiety disorder. Sometimes, it’s the only treatment you need. Therapy can help you learn:

• New skills to handle social situations that cause fear

• Healthy habits that can lower your anxiety overall

• New ways to think through situations that make you anxious

The most effective type of therapy for social anxiety disorder is cognitive behavioral therapy (CBT). It helps you identify and change thoughts that make you more anxious in social situations. You’ll also learn how your thoughts, emotions, and actions affect each other. 

As part of CBT, your therapist may use several techniques to help with social anxiety. Ones that can be especially helpful include: 

• Exposure therapy: In exposure therapy, you will intentionally put yourself in situations that cause anxiety. The goal is to practice new ways to manage your fear. Your therapist will help you go slow, first with imaginary exposures and then with real-life exposures. This helps you become more confident and comfortable in social situations.

• Cognitive restructuring: This is a CBT skill that helps you identify and change negative thought patterns that contribute to anxiety. For example, you may have negative thoughts like, “People don’t like me” or “I am going to embarrass myself.” Cognitive restructuring will help you learn to replace them with more helpful thoughts, such as, “I have some good friends that like to do things with me” or “People have said that I have some good ideas.”

• Social skills training: Social skills training can help build your confidence around other people. You will practice role-playing and rehearsing to use your new skills in specific situations.

Social anxiety disorder medications

Your provider may also recommend prescription medications for social anxiety disorder. The best medication for you will depend on different factors. Factors include the type and frequency of your symptoms and any other health conditions you may have.

There are several types of medications that can treat social anxiety:

• Selective serotonin reuptake inhibitors (SSRIs) are usually the first-choice medication for social anxiety disorder. SSRIs, which are a type of antidepressant, are also effective for clinical depression and generalized anxiety.

• Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another type of antidepressant. These can be helpful for depression and anxiety and may also help with social anxiety disorder.

• Beta blockers like propranolol may be used off label to manage physical anxiety symptoms such as a fast heart rate, tremors, or sweating. You can take them about an hour before an event that causes performance anxiety, such as giving a speech. Beta blockers can help calm your anxiety so you can better participate in important activities.

• Benzodiazepines can be helpful to take as needed for anxiety. Importantly, these types of medications have serious risks and side effects. People can build up a tolerance to them, and they can lead to dependence. Benzodiazepines can also lead to death in overdose or when combined with alcohol or other substances.

• Some other medications that may help treat social anxiety include hydroxyzine (Atarax) and buspirone (Buspar). Healthcare providers often add buspirone to SSRIs or SNRIs, and you can take them 2 to 3 times a day to lessen anxiety symptoms. Hydroxyzine is an antihistamine that you can take as needed for anxiety symptoms. 

Keep in mind that it can take time to find the right medication. You might have to try several different types before you find the right one. It’s important to discuss these medication options with your healthcare provider. 

Social anxiety disorder support groups

Support groups can be helpful for social anxiety. They can help you connect with others who are going through similar experiences. You may be able to openly talk about your fears, learn coping skills from others with social anxiety, and practice role-playing. 

Perhaps most importantly, support groups can remind you that others feel the same way as you, and you are not alone. Groups may happen in person or online.

To get started with a support group, consider:

• Asking your therapist if they know of any social anxiety support groups in your area or online 

• Checking out Social Anxiety Support, an online forum to connect people who have social anxiety disorder

• Looking on Meetup and searching for “social anxiety” to find groups near you

• Using the Anxiety and Depression Association of America (ADAA) search tool for specific support groups

• Searching the National Social Anxiety Center for classes and therapy-based support groups

• Practicing by taking public speaking classes or joining a Toastmasters club

How to overcome social anxiety from home

There are some ways to manage social anxiety from home in addition to other treatments. For example:

• Gradually expose yourself to more social activities with small and positive experiences.

• Find ways to relax before social activities, such as with exercise or meditation.

• Remember that many other people feel the same way you do.

• Practice talking to people in all situations, such as at a store or with a coworker.

• Prepare for social events by role-playing certain situations and conversations.

• Be prepared with questions and conversation topics before social events.

• Consider apps that can help you manage anxiety symptoms.

• Look for classes or creative ways to interact with other people, such as acting or comedy classes. 

Are there natural ways to overcome social anxiety?

There may be some other natural ways to help you manage your social anxiety. These include: 

• Mindfulness exercises, such as meditation or yoga

• Aerobic exercise, such as running or biking

• Healthy sleep habits, since social anxiety can make it hard to sleep

• Supplements such as kava, passionflower, or magnesium that have little evidence to support their benefits but may still be worth trying

• Cannabidiol (CBD), which has shown some benefits for social anxiety disorder

Where can I find healthcare providers for social anxiety disorder?

The first step if you need social anxiety disorder treatment is to get an evaluation and diagnosis. Many people may start by talking with their primary care provider. You can also reach out directly to a mental health provider in your area or via telehealth.

These databases may be a good place to start your search for a mental healthcare provider: 

• Good Therapy

• Therapy Den

• Psychology Today

• QPoC Therapist Directory

• Gaylesta (for LGBTQ therapists)

• InnoPsych (for BIPOC therapists)

• Open Path Psychotherapy Collective (for low-cost therapy)

You can also call SAMHSA for more resources near you at 1-800-622-HELP (4357).

Why trust our experts?

Written by:

Christina Palmer, MD

Christina Palmer, MD, is a board-certified family physician with a special interest in chronic care management, women’s health, mental health, and preventive care. She has over 10 years of experience in primary care research, innovation, and practice.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

India B. Gomez, PhD

India B. Gomez, PhD, is a licensed clinical psychologist with a certificate in Latin American Family Therapy. She completed her doctoral education at the California School of Professional Psychology/Alliant International University.

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