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Social anxiety (social phobia)

Social anxiety disorder, also called social phobia, is more than shyness. It's an intense fear that doesn't go away.

Social anxiety disorder is a long-lasting and overwhelming fear of social situations.

It usually starts during the teenage years. For some, it gets better as they get older. For many, it doesn't go away on its own.

It can be very distressing and have a big impact on your life. But there are ways to help you deal with it.

Symptoms of social anxiety

Social anxiety is more than shyness. It's an intense fear that doesn't go away.

It can affect your:

  • everyday activities
  • self-confidence
  • relationships
  • work or school life

Many people worry about social situations from time-to-time. Someone with social anxiety feels very worried before, during and after them.

You may have social anxiety if you:

  • dread meeting strangers, starting conversations, speaking on the phone, working or shopping
  • avoid or worry a lot about social activities - group conversations, eating with company, and parties
  • always worry about doing something you think is embarrassing - blushing, sweating or appearing incompetent
  • find it difficult to do things when others are watching
  • fear criticism, avoid eye contact or have low self-esteem
  • often have symptoms such as feeling sick, sweating, trembling or heart palpitations
  • have panic attacks

Many people with social anxiety also have other mental health issues, such as:

  • depression
  • generalised anxiety disorder
  • body dysmorphic disorder

When to get help for social anxiety

It's a good idea to see your GP if you think you have social anxiety, especially if it's having a big impact on your life. It's a common problem and there are treatments that can help.

Asking for help can be difficult. Your GP will be aware that many people struggle with social anxiety and will try to put you at ease.

Your GP will ask you about your feelings, behaviours and symptoms.

If they think you could have social anxiety, they will send you to a mental health specialist. There you will have a full assessment and talk about treatments.

How you can overcome social anxiety

Social anxiety can be difficult to deal with but there are things you can try yourself. There are also effective treatments and support groups that can help you.

Self-help might not cure your social anxiety, but it may reduce it. You might find it a useful first step before trying other treatments.

Understand your anxiety

Try to understand more about your anxiety. Think about what goes through your mind and which social situations you find the most difficult and how you act in these situations. This will help you get a clearer idea of the specific areas or triggers that are most difficult for you.

Beliefs and assumptions

Evaluate your beliefs and assumptions about a situation. Ask yourself could they be unrealistic ones. For example, when you feel a social situation went badly. Ask yourself did the entire situation go badly or just part of it. Think if there are any facts to support this or if you're assuming the worst.

Move your attention

Try to pay attention to people, things, sounds, sights outside of you. Remember that your anxiety symptoms aren't as obvious as you might think and fear.

Do activities you would normally avoid

This can be tough at first. Start with small targets and work towards more feared activities gradually. Create a list of the situations that cause you to experience anxiety. From the most terrifying situation all the way down to a situation that causes only a little anxiety.

Treatments for social anxiety

Several treatments are available for social anxiety.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) helps you manage problems by thinking more positively. It frees you from unhelpful patterns of behaviour.

Supported self-help CBT

CBT-based books or an online mental health service with some support from a therapist.

Antidepressant medication

This is usually a type of medicine called a [selective serotonin reuptake inhibitor] (SSRI). Discuss with your GP who can explain the options to you

Psychotherapy

Talking about how your past can influence what happens in the present, and the choices you make.

CBT is generally considered the most effective treatment. But other treatments may help if it doesn't work or you don't want to try it. Some people need to try a combination of treatments.

Treatment group

Social Anxiety Ireland runs a fourteen-week cognitive behavioural programme in Dublin.

Visit socialanxietyireland.com for more information.

Social anxiety in children

Social anxiety can also affect children.

Signs of social anxiety in a child include:

  • crying more than usual
  • frequently complaining of feeling unwell - nausea, headaches, dizziness
  • having frequent tantrums before a social event or activity
  • avoiding interaction and eye contact with other children and adults
  • fear of going to school or taking part in classroom activities or events
  • not asking for help at school
  • being very reliant on their parents or carer

Speak to your GP if you're worried about your child. Your GP will ask you about your child's problems and talk to them about how they feel.

Treatments for social anxiety in children are like those for teenagers and adults. The use of medication depends on the age of the child and the severity of their experience of social anxiety.

Therapy will depend on your child's age and will often involve help from you. You may get training and self-help materials to use between sessions. It may also take place in a small group.

Content supplied by the NHS and adapted for Ireland by the HSE.

Page last reviewed: 23/09/2018
Next review due: 23/09/2021

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