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Mental health Condition

Social anxiety

Social anxiety disorder is one of the most common anxiety conditions, affecting around 1 in 10 people at some point in their lives. It involves an intense fear of social situations — not just shyness — driven by a deep concern about being judged, embarrassed or humiliated. It can significantly limit careers, relationships and daily life, but responds very well to therapy.

See therapies that may help

What is Social anxiety?

Social anxiety disorder (also called social phobia) is characterised by an intense, persistent fear of social situations in which you might be scrutinised, judged or embarrassed. It goes well beyond ordinary shyness — the anxiety is disproportionate to the actual threat, is recognised as excessive by the person experiencing it, and significantly interferes with daily functioning.

Common feared situations include speaking in public, meeting new people, eating or drinking in front of others, using public toilets, writing in front of others, or any situation where you feel you might be the centre of attention. The fear is not of the situation itself but of what others might think — that you will say something stupid, blush, sweat, or otherwise embarrass yourself.

Social anxiety often begins in adolescence and, without treatment, tends to be chronic. It is frequently misunderstood as introversion or lack of confidence, when in reality it involves significant distress and avoidance that goes far beyond preference for quieter social settings.

Signs and symptoms

Signs of social anxiety include:

  • Intense fear or dread of social situations in advance (anticipatory anxiety)
  • Avoidance of social situations, or enduring them with intense distress
  • Physical symptoms in social situations: blushing, sweating, trembling, racing heart, nausea
  • Fear of being watched, judged or evaluated negatively by others
  • Post-event processing — replaying social interactions afterwards and focusing on perceived mistakes
  • Difficulty making eye contact or speaking when expected
  • Fear of eating, drinking or writing in public
  • Significant impact on work, relationships or social life

How therapy can help

CBT is the most evidenced treatment for social anxiety and is recommended by NICE. The CBT model for social anxiety addresses the specific maintaining factors — including self-focused attention, safety behaviours and post-event processing — that keep social anxiety going.

Key elements of treatment include:

  • Shifting attention from internal self-monitoring to the external social environment
  • Dropping safety behaviours (the things you do to prevent feared outcomes, which paradoxically maintain the anxiety)
  • Behavioural experiments — testing feared predictions in real social situations
  • Video feedback — using video to challenge distorted self-image

Other helpful approaches include:

  • Acceptance and commitment therapy (ACT) — building willingness to engage in social situations despite discomfort
  • Mindfulness-based therapy — reducing self-focused rumination
  • Hypnotherapy — working with the subconscious drivers of social fear
  • Group therapy — particularly powerful for social anxiety, as the group itself becomes the exposure context

Seeking help

Social anxiety is one of the most underreported and undertreated anxiety conditions — many people assume it is just "who they are" rather than a treatable condition. If social fear is limiting your career, relationships or quality of life, therapy can make a substantial difference.

CBT for social anxiety works best when delivered by a therapist experienced in the specific CBT model for social phobia — not all CBT therapists have this specialisation. It is worth asking specifically about their approach to social anxiety before beginning.

Therapies that may help with Social anxiety

Showing 12 therapies linked to Social anxiety.

Therapy Evidence Notes
Cognitive Behavioural Therapist
strong

CBT helps identify and challenge the fearful thoughts about being judged that drive social anxiety, while gradual exposure builds confidence in feared situations.

Counsellor
strong

Talking through social fears with a counsellor offers a safe space to explore where avoidance comes from and to practise facing everyday social situations.

EMDR Practitioner
strong

EMDR can reprocess distressing memories of humiliation or rejection that often underpin social anxiety, reducing their emotional charge in present situations.

ISTDP Practitioner
strong

ISTDP works to uncover and release the buried emotions and defences behind social avoidance, helping you feel less guarded around other people.

Mindfulness Practitioner
strong

Mindfulness teaches you to notice anxious thoughts and bodily sensations before social situations without being swept up in them, easing the urge to avoid.

Psychotherapist
strong

Psychotherapy explores the deeper roots of social fear, such as early experiences of criticism or shame, helping reshape how you relate to others.

Arts Therapist
moderate

Arts therapy provides a non-verbal way to express social fears and self-consciousness when words feel difficult, best used alongside appropriate professional care.

Biofeedback Practitioner
moderate

Biofeedback helps you recognise and calm the physical signs of anxiety, like a racing heart, before social situations; it works best as a support to professional care.

EFT Practitioner
moderate

EFT pairs tapping on acupressure points with focusing on social fears; it may offer supportive relief but evidence is limited and it should not replace professional care.

Hypnotherapist
moderate

Hypnotherapy uses focused relaxation to ease anticipatory anxiety before social events; it can be a supportive aid, though evidence is limited and not a substitute for professional care.

NLP Practitioner
moderate

NLP offers techniques aimed at reframing the inner dialogue behind social fear; this is a complementary approach with limited evidence and not a replacement for professional care.

Regression Therapist
moderate

Regression therapy revisits early experiences thought to shape social fear; this is a complementary approach with limited evidence and not a substitute for professional care.

Frequently asked questions

Is social anxiety the same as shyness?

No — shyness is a personality trait involving mild discomfort in social situations that does not significantly impair functioning. Social anxiety disorder involves intense fear, significant avoidance, and meaningful impact on daily life, career and relationships. The distinction matters because social anxiety is a treatable condition, not a fixed personality characteristic.

What triggers social anxiety?

Social anxiety is typically triggered by situations involving potential scrutiny or evaluation by others — public speaking, meeting new people, being observed doing tasks, or any situation where embarrassment feels possible. The underlying fear is of negative evaluation and its consequences.

Can social anxiety be completely overcome?

Many people achieve substantial or complete recovery from social anxiety through CBT. The key is not just reducing anxiety levels but changing the behaviours (avoidance, safety behaviours) and thinking patterns (self-focused attention, post-event processing) that maintain it. This requires committed engagement with the exposure components of treatment.

Does medication help social anxiety?

SSRIs are recommended by NICE for social anxiety disorder and can reduce symptoms enough to make engaging with therapy easier. They are most effective when combined with CBT rather than used alone, as medication does not address the maintaining factors that keep social anxiety going.

How long does treatment for social anxiety take?

A standard course of CBT for social anxiety runs 12–16 sessions. Progress depends significantly on willingness to engage in behavioural experiments between sessions — social anxiety improves through doing, not just understanding. Group CBT programmes can be highly effective and are sometimes available through IAPT.