Social anxiety (social phobia)

Social anxiety disorder is an overwhelming fear of social situations. It can be long-lasting.

It usually starts during the teenage years. For some, it gets better as they get older. For many, it does not 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 does not go away.

It can affect your:

• relationships
• self-confidence
• everyday activities
• 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 - such as group conversations, eating with company and parties
• always worry about doing something you think is embarrassing - such as 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 - where a person is overly anxious about flaws in their appearance

When to get help for social anxiety

Talk to your GP if you think you have social anxiety, especially if it's having an 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 may have social anxiety, they will refer you to a mental health professional. The professional will assess you and talk about treatments.

Dealing with 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.

Think about 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 if the entire situation went 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. Your anxiety symptoms are not 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 gradually towards activities you fear more.

Create a list of the situations that cause you 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 can free you from unhelpful patterns of behaviour.

Supported self-help CBT

Guided self-help involves using CBT-based books or an online mental health service with some support from a therapist.

Psychotherapy

Psychotherapy involves talking about your past with a therapist. This can help to influence what happens in the present, and the choices you make.

Find out more about talking therapies

CBT is generally considered the most effective treatment. But other treatments may help if CBT does not work or you do not 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.

Antidepressant medicine

This is usually a type of medicine called a selective serotonin reuptake inhibitor (SSRI). Your GP will explain the options to you.

Find out more about antidepressants.

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

Talk 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 medicine 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.