Social Anxiety Disorder

What Happens

If you have social anxiety disorder, even common social situations can cause overwhelming fear and anxiety. You may be afraid to eat in public, meet new people, use a public restroom, or speak in front of others. You may avoid being around other people. This can affect your daily activities, including work or school.

People with social anxiety disorder may underachieve at work or at school to avoid attention or working in a group. They tend to have few friendships. They may have trouble dating or forming relationships. In severe cases, they may have other conditions (such as depressiondepression or substance use disordersubstance use disorder).

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Exams and Tests

To diagnose social anxiety disorder, your doctor will ask about your symptoms and past health. The doctor may ask other questions to see how you are doing emotionally. Blood or urine tests may also be done. They can rule out other medical conditions that can cause similar symptoms (such as hyperthyroidismhyperthyroidism).

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Treatment Overview

Treatment of social anxiety disorder includes counseling, such as cognitive behavioral therapycognitive behavioral therapy (CBT). CBT may use exposure therapy. Exposure therapy involves being guided by a professional counselor to imagine you are facing the feared situation. Treatment may also include taking medicine, such as antidepressants. Whether you need medicine depends on how much the condition affects your life.

You may not seek treatment because you feel anxious about talking to someone about it. Or you may think that you can work things out on your own. But treatment works for many people.

People who have social anxiety disorder often have depression too. They may also have substance use disorder. Your doctor may ask you questions to see if you might be using drugs or drinking too much. If so, your treatment will also need to address these conditions.

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Self-Care

Counseling and medicines are the most effective treatments for social anxiety disorder. But practicing a healthy lifestyle may also help reduce your anxiety.

• Get regular exercise.

  Start slowly so that you don't overdo it. Build up your exercise program bit by bit. Aim for at least 2½ hours a week of moderate exercise.^{footnote 1footnote 1}

• Get enough sleep.

  Try to go to bed at nearly the same time. And keep your room quiet and dark. This may reduce distractions and may help you get good sleep.

• Avoid foods and beverages that contain caffeine.

  Foods with caffeine, such as energy drinks and coffee, may make you more anxious and cause sleep problems.

• Learn and do relaxation exercises.

  These may include guided imagery and progressive muscle relaxation.

• Learn how to handle negative thoughts.

  Positive thinking can change how you feel and help you prevent or control anxiety.

• Avoid using alcohol and drugs.

  Some people use alcohol or drugs to try to gain confidence to face feared social situations. But using them can cause substance usesubstance use disorder along with social anxiety disorder.

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