Social anxiety: When it’s more than just feeling shy

Getting up in front of a crowded room to deliver a big presentation or going on a first date with someone you barely know, can make just about anyone feel nervous. For those living with social anxiety disorder, those emotions can be debilitating. According to the National Institute of Mental Healthanxiety has now surpassed depression as the “common cold” of mental health disorders in the United States. Jerry Davis, Ph.D., clinical programs manager, Parkview Behavioral Health, explains this mental health condition, the symptoms and common treatment options.
The facts

According to the National Institute of Mental Health, an estimated 19.1 percent of adults will experience an anxiety disorder in the past year. There is a higher prevalence in women (23.4 percent) than in men (14.3 percent).

About this disorder

One of the more common anxiety disorders is social anxiety or sometimes referred to as social phobia. Individuals who suffer from this mental illness will have a marked fear of social or performance situations and they often expect to feel embarrassed, judged, rejected or fearful of offending others. Social anxiety is not the same as shyness. It is a fear that causes more distress and interferes with normal social functioning.

Symptoms may include:
  • Feeling highly anxious about being with other people and having a hard time conversing with others.
  • Feeling self-conscious in front of other people and worried about feeling humiliated, embarrassed, rejected or fearful of offending others.
  • Being afraid that other people will judge them.
  • Worrying for days or weeks before a social gathering.
  • Staying away from places where there are other people.
  • Having a difficult time making friends and keeping friends.
  • Blushing, sweating or trembling around other people.
  • Feeling nauseous or sick to your stomach in social settings.

Research supports the importance of healthy, social relationships. Social anxiety, if not addressed, can significantly impact human development, social connections and your overall happiness. If ignored, this disorder can lead to a pattern of avoidance of interpersonal relationships sometimes referred to as avoidant personality disorder.


Treatment for social anxiety is similar to treatment for several of the anxiety disorders. Cognitive-Behavioral Therapy (CBT) has shown the most promise. CBT typically addresses both the behavioral aspects of the disorder and the cognitive dimension.

Some of the behavioral treatments would include:

  • Deep diaphragmatic breathing
  • Progressive muscle relaxation
  • Exposure therapy.

Exposure therapy involves facing your fears in small successive steps while practicing deep breathing and other distracting techniques. The cognitive treatment portion of CBT normally focuses on thought disturbances and thought stopping or cognitive restructuring. In this practice you learn to evaluate the rationality of the negative thoughts that contribute to your anxiety, and replace them with more positive and rational thoughts.

Mindfulness and meditation, as well as medication, can also be helpful in the treatment of social anxiety. 

if you or someone you know is experiencing debilitating social anxiety, or for more on available resources, call the Parkview Behavioral Health HelpLine at (260) 373-7500 or 800-284-8439. The HelpLine is available 24 hours a day, 7 days a week.

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