What Is Social Anxiety & How Does It Feel?

Many people experience some anxiety in certain social situations, such as going to a job interview or giving a speech at a wedding. It is normal to expect to feel nervous or worried about such situations.

However, for people who experience social anxiety, these anxious feelings can occur in most or all social situations. The anxiety can be so intense that it negatively affects their life.

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you are concerned that you may have social anxiety disorder or another mental health condition, please consult a qualified healthcare provider.

What is Social Anxiety?

Social anxiety disorder, also known as social phobia, is an anxiety disorder characterized by intense fear and anxiety in social situations.

They may experience social anxiety in many areas of life, such as at school, at work, at social events, and when out in public. 

Individuals may find social situations so distressing that they might avoid or escape them, so they do not have to face their fears.

Below is a list of some of the social situations that someone with social anxiety disorder may find challenging:

• Public speaking
• One-on-one conversations
• Social events, e.g., parties
• Meeting new people
• Making phone calls
• Job interviews
• Giving presentations
• Work meetings
• Eating or drinking in front of people
• Talking to authority figures

Signs Of Social Anxiety

People with social anxiety may experience a combination of cognitive, behavioral, and physical signs.

Cognitive signs

Cognitive signs of social anxiety are usually negative beliefs, biases, and thoughts about oneself or social situations, and can include the following: 

• Intense anxiety during social situations
• Fear of talking to strangers
• Fear of situations where there is the possibility of being negatively judged
• Fear that others will notice the anxiety
• Fear of physical sensations associated with anxiety
• Overthinking social interactions after they have ended
• Misreading people’s emotions as social rejection

Behavioral signs

Behavioral signs of social anxiety are the actions performed by the socially anxious individual as a result of their anxiety, including: 

• Avoiding speaking
• Avoiding being the center of attention
• Leaving or escaping social situations
• Using safety behaviors (e.g., scrolling on a phone)
• Missing school or work

Physical signs

Physical signs of social anxiety are those which are typically experienced before, during, and after a social situation; usually, sensations typically experienced during the fight or flight response, including:

• Blushing
• Sweating
• Rapid heartbeat
• Nausea
• Feeling breathless
• Light-headedness
• Muscle tension

These signs will not be the same for everyone who experiences social anxiety, as some may experience only a few, whilst others may experience a lot more. It is important to keep in mind that social anxiety can be unique to every person. 

What Does Social Anxiety Feel Like? 

Below are some quotes from experts and individuals who have experienced social anxiety, who describe what it really feels like.

What does an expert say?

Therapist Angela Dierks describes how she has encountered clients with social anxiety who experience a lot of shame:

‘Very often, somebody with social anxiety is not very shame-resistant. They’re very shame-prone. They’re very likely to experience the (signs of) flushing cheeks and going red in the face as being deeply shameful.’

Dierks goes on to explain how egocentricity (the excessive focus on oneself) plays a big role in many people with social anxiety:

‘You become quite egocentric when you are anxious… there’s this sense that the whole world is paying attention to you, that people are paying intense attention to you. That people notice every single emotion that you might be experiencing… The truth is often that most people wouldn’t notice. They don’t know exactly what’s going on for you. They may not even be that interested.’

Personal experiences of social anxiety

In a study by Mohammadi et al. (2019), one participant described how restricting social anxiety can feel: 

‘When I am in stressful situations I can’t speak or move, it is like I am in a cage.’

People who have experienced social anxiety often describe feeling powerless or unworthy in social situations: 

‘I think something makes me most vulnerable in these situations and that is I don’t feel worthy enough.’

From Mohammadi et al. (2019)

This feeling was shared by Kate when she described her personal experience: 

‘but I think that’s a lot of what social anxiety is is feeling out of control and like you don’t have the power in a conversation or don’t have the power to hold a conversation.’

Likewise, individuals who experience social anxiety may find ways to cope that involve putting in more effort than may be necessary into navigating social situations, as described by Ryan: 

‘My social anxiety really stemmed from not knowing what to say. And I found that I would be planning dialogue in my head before having a conversation with somebody. And I would always try to be like two or three steps ahead of the conversation.’

What Causes Social Anxiety?

The exact causes of social anxiety are not fully understood, but there are several factors that may contribute to its development.

Overall, social anxiety is likely caused by a combination of genetic, environmental, and biological factors.

Can I inherit social anxiety from my family?

Genetics may play a role, as individuals with a family history of anxiety disorders are more likely to develop social anxiety. The closer the genetic relationship (e.g., parent or sibling), the higher the risk (Heimberg et al., 2014).

What are some possible biological causes of social anxiety?

Studies have suggested that imbalances of the neurotransmitters serotonin and dopamine could play a role in developing social anxiety.

One study, for instance, found that there was increased serotonin and dopamine activity in brain regions associated with fear (amygdala) and rewards (nucleus accumbens), with greater activity being correlated to symptom severity (Hjorth et al., 2019).

Imaging studies have demonstrated that those with social anxiety disorder demonstrated selective activation of their amygdala when exposed to fear-relevant stimuli (Birbaumer et al., 1998) or showed differing patterns of amygdala activation during aversive conditioning (Schneider et al., 1999).

Can environment and life events cause social anxiety?

Environmental influences also play a role. Stressful life events, such as challenges at work, school, or traumatic experiences, may trigger onset.

Early learning experiences are important as well: children raised in overly critical, controlling, or protective households may be more likely to develop anxiety.

Parents who are themselves anxious may unintentionally pass on these worries, modeling social fears for their children.

“I was raised in a family full of tension and stress that were beyond my ability to manage.”
— Interview extract from Mohammadi et al. (2019)

Many people with social anxiety recall being shy or withdrawn as children. Bullying or abuse can reinforce this vulnerability, making social fears more persistent.

Finally, social isolation and loneliness have also been linked to the development of social anxiety (Eres et al., 2023).

How Is Social Anxiety Disorder Diagnosed?

Mental health professionals diagnose social anxiety disorder using standard criteria, most often from the DSM-5 or ICD-11.

These frameworks describe the condition as a persistent and intense fear of being judged in social situations, lasting at least six months, and significantly interfering with daily life.

The diagnostic process usually begins with a clinical interview. A professional asks about when symptoms began, how often they occur, and how they affect areas such as school, work, or relationships.

A physical exam may also be conducted to rule out medical issues that could mimic or worsen anxiety symptoms.

To support the interview, clinicians sometimes use structured questionnaires, such as the Liebowitz Social Anxiety Scale (LSAS) or the Social Phobia Inventory (SPIN).

These tools are not diagnostic on their own, but they help measure the severity of symptoms and track changes over time.

Part of the process involves differential diagnosis—distinguishing social anxiety from other conditions with overlapping features, such as generalized anxiety disorder, depression, body dysmorphic disorder, or autism.

This ensures that the difficulties are best explained by social anxiety disorder rather than another mental health condition.

What Keeps Social Anxiety Going?

Social anxiety often persists because people overestimate the likelihood that something will go wrong and the cost of what might happen if it does.

For example, when giving a presentation, someone may believe it is very likely they will stutter (probability) and that classmates will laugh or judge them harshly if it happens (cost). These thoughts heighten anxiety and can trigger physical symptoms like trembling, blushing, or nausea.

Many individuals also worry about the visibility of these symptoms, fearing they will appear anxious, boring, or incompetent, which in turn reinforces the cycle (Hofmann et al., 2010).

Research shows perfectionism plays a role as well. Those with perfectionistic tendencies set unrealistically high standards, criticize themselves harshly, and fear negative evaluation, which can intensify social anxiety (Ferber et al., 2024).

Attempts to project an image of flawlessness often backfire, increasing self-consciousness and fueling more anxiety.

Other maintaining factors include:

• Hypervigilance to “social threats”
• Negative self-beliefs
• Fear of “social catastrophe”
• Self-focused attention
• Avoidance and safety behaviors
• Concerns about how others perceive them
• Deeply held core beliefs

Avoidance Behaviors

People with social anxiety often cope by avoiding feared situations — such as meeting new people, speaking in groups, or attending school or work.

While this brings short-term relief, it reinforces anxiety in the long run by preventing individuals from testing their fears or gaining positive experiences.

Avoidance can limit personal and professional opportunities, lower self-esteem, and contribute to isolation or depression.

When unavoidable social situations arise, anxiety may feel even more overwhelming due to a lack of practice and preparation.

Steps Toward Reducing Avoidance

Overcoming avoidance is a gradual process, and small steps can make a meaningful difference. Helpful strategies include:

• Start small: Choose a mildly uncomfortable situation rather than the most intimidating one.
• Set achievable goals: Break larger challenges (e.g., giving a presentation) into smaller steps, such as practicing with a friend.
• Notice patterns: Keep track of when avoidance shows up and what thoughts fuel it.
• Reward progress: Acknowledge even minor efforts, such as attending a social event briefly.

These steps don’t eliminate anxiety overnight, but over time they can build confidence and reduce the cycle of avoidance.

Safety Behaviors

When avoidance isn’t possible, individuals may rely on safety behaviors to ease discomfort. These include speaking quietly, planning dialogue in advance, avoiding eye contact, wearing inconspicuous clothing, or using alcohol and drugs.

Although they may reduce anxiety temporarily, safety behaviors maintain the cycle by preventing people from discovering that feared outcomes rarely occur.

Over time, reliance on these strategies can worsen anxiety and even create new problems, such as embarrassment from alcohol use.

Like avoidance, safety behaviors shift focus inward and away from genuine engagement, reinforcing self-consciousness and missed opportunities for growth.

Steps Toward Reducing Safety Behaviors

Letting go of safety behaviors can feel challenging, but gradual changes help individuals test fears and build confidence. Some useful approaches include:

• Experiment gradually: Try easing up on one safety behavior at a time, such as maintaining brief eye contact or speaking slightly louder.
• Test predictions: Notice what actually happens when a safety behavior is reduced — outcomes are often less negative than expected.
• Shift focus outward: Concentrate on the conversation or activity, rather than monitoring how you appear.
• Reflect afterward: Write down what went well to counter anxious thoughts and reinforce progress.

These small experiments can help reveal that feared consequences are often unlikely, reducing reliance on safety behaviors over time.

How Is Social Anxiety Treated?

Research shows that the most effective approaches for social anxiety disorder often combine psychological therapies, lifestyle strategies, and, in some cases, medication.

Therapies

Mental health professionals frequently recommend cognitive-behavioral therapy (CBT), which helps individuals identify and reframe negative thought patterns.

A related method, exposure therapy, involves gradually and safely facing feared social situations to reduce avoidance and build confidence over time.

Other approaches, such as mindfulness-based strategies and social skills training, have also shown benefits.

Lifestyle Approaches

Complementary strategies, such as relaxation techniques (e.g., deep breathing, meditation), regular exercise, and adjustments like improving sleep or reducing caffeine and alcohol intake, may support recovery.

These methods are often used alongside therapy rather than as stand-alone treatments.

Medication

In some cases, clinicians may prescribe medications to help manage symptoms. For example, selective serotonin reuptake inhibitors (SSRIs) are commonly studied for social anxiety, while beta-blockers are sometimes used for performance-related anxiety.

These options are tailored to individual needs and always managed by qualified healthcare professionals.

Support Systems

Support groups, whether in-person or online, can also provide encouragement and a sense of connection.

Treatment plans are often individualized, combining different approaches based on severity, goals, and preferences.

Frequently Asked Questions

Do you need mental health support?

USA

If you or a loved one are struggling with symptoms of an anxiety disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline for information on support and treatment facilities in your area.

1-800-662-4357

UK

Contact the Samaritans for support and assistance from a trained counselor: https://www.samaritans.org/; email jo@samaritans.org .

Available 24 hours a day, 365 days a year (this number is FREE to call):

116-123

Rethink Mental Illness: rethink.org

0300 5000 927

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