What Does Social Anxiety Feel Like, and How Is It Different Than Being Shy or Introverted?
Key takeaways:
Social anxiety disorder causes intense fear about being judged or feeling like you might embarrass yourself around others.
Shy or introverted people may not feel comfortable in social situations, but it’s not the same as having social anxiety disorder.
Talk therapy, medication, and support groups can help with social anxiety disorder.
Many people are excited to be invited to parties. But shy people, introverts, and people with social anxiety disorder may not be — all for different reasons.
Shy people and introverts might prefer to avoid social events. On the other hand, people with social anxiety disorder can experience debilitating fear at even the thought of being around other people.
Read on to learn more about social anxiety disorder and how it differs from shyness and introversion.
What is social anxiety disorder?
Social anxiety disorder is a mental health condition that causes overwhelming fear and anxiety about social situations. The condition used to be referred to as social phobia.
More specifically, social anxiety disorder leads you to fear:
Being judged or scrutinized (examined closely)
Having others see how afraid you feel
Feeling embarrassed or humiliated
Being rejected by other people
Situations like making small talk or eating in front of other people may cause extreme anxiety. Eventually you may avoid social situations altogether because you’re so afraid. The fear and anxiety may also get in the way of work and friendships.
Some ways you may notice these signs in your interactions include:
Feeling extremely self-conscious, awkward, or embarrassed
Avoiding eye contact
Talking in a small, quiet voice
Having difficulty talking with people you don’t know
Wishing you could speak more comfortably with strangers
Finding ways to avoid being around other people
Social anxiety disorder can cause physical signs, too. These can include:
Sweating or trembling
A rapid or pounding heartbeat
Trouble concentrating
Nausea
Some people only experience social anxiety disorder when they’re expected to perform. This is often referred to as performance anxiety. Examples include speaking or performing in public and taking a test.
How do I know it’s not shyness or my introversion?
Some people mistake shyness or introversion for social anxiety disorder, but they aren’t interchangeable. Not all people with social anxiety disorder consider themselves shy or introverted.
Shyness is a trait, not a mental health condition. Shy people may feel uncomfortable in social situations when they don’t know the people they’re with. They might worry that others will judge them. Yet their fears don’t stop them from doing all social activities.
Introversion is also a personality trait. Introverts prefer to spend time by themselves. They aren’t necessarily shy, even though they may choose to be alone. Many introverted people even enjoy social events — they just might need lots of alone time to recharge afterward.
Can shyness lead to social anxiety?
Shyness doesn’t lead to social anxiety disorder for most people.
It is possible for children who are very shy to develop social anxiety disorder as they get older. This doesn’t happen to all shy children. In fact, only half of adults with social anxiety disorder say they were shy as kids.
How do I get a social anxiety disorder diagnosis?
If you’re concerned you may have social anxiety disorder, talk to your healthcare provider or a mental health professional. They can assess your concerns and make a diagnosis depending on your symptoms.
To do this, a provider will likely ask:
Your history with social interactions
Your comfort level and fear in social situations
Whether or not you avoid social events
If you experience physical symptoms at social events like a racing heartbeat or sweaty palms
Your provider might also recommend a physical exam and blood tests. These can help rule out any medical conditions that might be contributing to your anxiety.
Social anxiety disorder treatments, therapies, and medications
People with social anxiety disorder may benefit from psychotherapy, medication, support groups, or a combination of these treatment options.
Psychotherapy for social anxiety disorder
One of the best treatments for social anxiety disorder is cognitive behavioral therapy (CBT). CBT helps you learn new ways to manage scary thoughts and feelings about social interactions. Your therapist may also recommend exposure therapy, which is a type of CBT.
During exposure therapy, you start to face your social fears one at a time. Each exposure will get a little harder as you practice new skills to cope with your anxiety. Over time, you’ll learn you can handle social situations, even when you feel anxious.
Some other types of therapy may be used to treat social anxiety disorder. These can include:
Mindfulness-based stress reduction (MBSR)
Medication for social anxiety disorder
Your provider may suggest medication for your social anxiety disorder symptoms. Antidepressant medications — specifically SSRIs and SNRIs — are usually recommended first.
The FDA has approved four medications to treat social anxiety disorder. These include:
Depending on your symptoms, your provider might recommend other options. This could include:
Other antidepressants
Anti-anxiety medication
Beta blockers (like propranolol)
It may take a few weeks to notice a difference when you first start taking medication. For many people, a combination of medication and therapy will be most helpful for social anxiety disorder. You and your provider will work together to create a treatment plan.
Social anxiety disorder support groups
Discussing social anxiety disorder with others who have the condition may be helpful. It might sound scary to go to a group with other people. But everyone there can understand what you’re going through.
There are different types of groups for social anxiety disorder. Some are peer support groups. These are run by people who also have the condition. Together, you talk about the challenges you face and support each other.
Therapy groups are usually run by a licensed mental health professional. These groups often focus more on treatment for social anxiety disorder. You might learn and practice CBT skills, for example.
You can learn more about how to find social anxiety support groups here.
The bottom line
Social anxiety disorder is a mental health condition. Being shy or introverted, on the other hand, is simply an aspect of your personality. Some people with social anxiety disorder may be shy, but not always. If you think you have social anxiety disorder, talk with a healthcare provider. Therapy or medication treatment options can help you better manage anxiety about social situations. This may help you live life more fully or reach your potential, personally and professionally.
Why trust our experts?
References
American Psychological Association. (n.d.). Acceptance and commitment therapy (ACT).
American Psychological Association. (n.d.). Cognitive behavior therapy (CBT).
American Psychological Association. (n.d.). Interpersonal psychotherapy (IPT).
American Psychological Association. (n.d.). Introversion.
American Psychological Association. (n.d.). Performance anxiety.
Anxiety & Depression Association of America. (2015). Clinical practice review for social anxiety disorder.
Anxiety & Depression Association of America. (2022). Social anxiety disorder.
Blanco, C., et al. (2013). The evidence-based pharmacotherapy of social anxiety disorder. International Journal of Neuropsychopharmacology.
Cox, B. J., et al. (2005). Psychiatric correlates of childhood shyness in a nationally representative sample. Behaviour Research and Therapy.
Dalrymple, K. L., et al. (2013). When does benign shyness become social anxiety, a treatable disorder? Current Psychiatry.
Heiser, N. A., et al. (2003). Shyness: Relationship to social phobia and other psychiatric disorders. Behaviour Research and Therapy.
National Institute for Health and Care Excellence. (2013). Social anxiety disorder: Recognition, assessment and treatment.
National Institute of Mental Health. (2018). Anxiety disorders.
National Institute of Mental Health. (2022). Social anxiety disorder: More than just shyness.
Social Anxiety Institute. (n.d.). DSM-5 definition of social anxiety disorder.
Substance Abuse and Mental Health Services Administration. (2016). Table 16, DSM-IV to DSM-5 social phobia/social anxiety disorder comparison. DSM-5 Changes: Implications for Child Serious Emotional Disturbance.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
