Need to know
A bright, hardworking student is doing poorly in his communications class. Participation counts for 25 per cent of his grade, but he hasn’t spoken up in class since the semester started because he’s worried he’ll sound stupid.
A coding whiz just built their first video game. Despite their talent and just graduating from a reputable computer science programme, they are unemployed. They haven’t applied for a job because they are terrified of going for an interview.
A five-star athlete dominates the soccer field with her quick pace and innovative playmaking. When reporters hound her after the game, she appears cold and uninterested. In reality, the reason she offers curt responses is because she is terrified of appearing arrogant.
What unites each of these people? Social anxiety. If any of these descriptions resonate with you, perhaps you too live with social anxiety. This Guide will help you understand this condition and learn how to address it.
Understand the causes of social anxiety
At its core, social anxiety is a fear of negative evaluation and rejection. When you feel socially anxious, you worry about what others think of you and hope you are making a good impression.
Like most emotions, anxiety tries to help you. Anxiety is your brain’s way of alerting you to a looming threat. Think: snake slithering up your arm. Social anxiety is designed to do the same thing: alert you to social threats. Social threats are anything that involves you being rejected, such as being made fun of or ousted from a group. When social anxiety bubbles up, it says: ‘Hey, there’s a good chance you might be rejected right now.’ To minimise the chances of rejection, you tune in to your situation. You scan the room looking for disapproving faces; you analyse how people are acting; you hyperfocus on your posture, speech and facial expressions. After this quick assessment, you try to match your behaviour to fit in and avoid rejection. Voilà! Thank you, social anxiety.
If social anxiety were a person, you could say they have good intentions. But sometimes, social anxiety gets it wrong. This happens when social anxiety sends alarm bells for social threats that are not actually there – or worse, it’s a nonstop alarm bell everywhere you go.
You might be thinking: ‘I don’t socialise much, but I’m not bothered by it. I just prefer to be alone.’ This is introversion and it’s different from social anxiety. Introversion is a personality trait that is more about your preference for socialising: how often, with whom, big or small groups, and so on. In contrast, social anxiety is about the fear of socialising. You can be introverted with or without social anxiety, and you can have social anxiety with or without introversion. Social anxiety is also different from shyness, which is when you feel some uneasiness or reservation in a social setting. It is common to feel shy occasionally, such as when you meet new people or perform in front of others. If you don’t struggle with social anxiety, you can usually adapt quickly when shyness shows up and still enjoy the social interaction.
Social anxiety gets in the way of building strong social relationships, performing to the best of your ability at school and work, and feeling comfortable in your own skin. It can also lead to other mental health conditions, such as substance abuse, depression and even suicide.
People who feel very anxious in many social situations might be struggling with social anxiety disorder (SAD). SAD involves persistent and distressing anxiety in numerous social situations, such as:
- giving a presentation;
- performing in front of others;
- interacting with strangers;
- going on a date;
- small talk; or
- eating or drinking in front of others.
When you have SAD, these everyday social situations feel like opportunities to fail. Interacting with a stranger opens the door to saying something foolish; going on a date skyrockets your chances of getting rejected; small talk could lead to an awkward silence or stumbling on your words; and eating and drinking in front of others feels like a performance where your every sip and chew is under a magnifying glass.
As a result of this anxiety, people with SAD avoid initiating or participating in social interactions – even if the situations are important to them. To be diagnosed with SAD according to formal psychiatric criteria, you must endorse each of the following symptoms:
- marked, persistent fear of social situations;
- feared social situations almost always elicit anxiety;
- fear about the situation is out of proportion to the actual threat;
- the situations are avoided or endured with intense anxiety;
- your anxiety and/or avoidance causes impairment in important life areas; and
- symptoms have been present for at least six months.
SAD is one of the most common mental illnesses in the world. Roughly 4 per cent of people around the world will meet these diagnostic criteria at some point in their lives. Based on current population estimates of 8 billion, this is roughly 320 million people!
Here’s the good news: social anxiety is very treatable. Even if social anxiety bubbles up only occasionally or impacts a single area of your life, there are effective tools to combat it.
During my years as a clinician, including a year-long rotation at Harvard Medical School’s McLean psychiatric hospital, I worked with many teens and adults with social anxiety. I was often struck by the uniqueness of each person’s situation – the origins of their social anxiety, how it showed up for them, and the ways they coped. But I was even more struck by how quickly people got better using the same tried-and-true treatment tools. Even for those with social anxiety so devastating that they were no longer leaving their home, they got better. To be clear, addressing social anxiety is no walk in the park. It takes courage to face your fears head-on. But with a little effort and support, you might be surprised by how quickly you start to feel better – and start living the life you want to live.
What to do
Identify your goals
Goals will guide you as you work through your social anxiety, so a good place to start is to think about what matters to you. Identify areas of your social life that you want to improve, such as:
- finding a romantic partner;
- making more friends;
- speaking up more in group settings;
- being more assertive; or
- meeting new people.
Reminding yourself of your ‘why’ (your goals) helps you stay motivated and keep at it.
Break unhelpful thinking habits
Social anxiety tricks you into believing that certain situations cause anxiety, but in reality, your thoughts about the situations drive your anxiety. The next step is therefore to consider and challenge your fearful thoughts.
Imagine that you’re about to meet a co-worker for lunch:
Scenario 1. You think: ‘I’m eager to get to know them better!’ When you walk into the restaurant, you feel excited. You update each other on new happenings in your lives. You leave feeling grateful.
Scenario 2. You think: ‘I have nothing interesting to say.’ When you walk into the restaurant, you feel anxious. You hold back during the conversation. You leave feeling embarrassed.
In these scenarios, the situation (lunch with a co-worker) is identical, but your thoughts about the event drastically differ. These thoughts drive your behaviour (what you said during the conversation), and your feelings during and after.
When you’re struggling with social anxiety, your social outings tend to resemble Scenario 2. You might view social events as unequivocally awful (‘Nothing went right’) or view ambiguous situations as catastrophes (‘My classmates must hate me because they didn’t include me in a group chat’).
These negative thinking patterns can occur before, during and after social situations. Even if your negative thoughts are sometimes factually correct, playing them on repeat usually just amplifies your anxiety and keeps you stuck in a cycle of avoidance. Here’s how to break them:
- Describe a social situation in which you felt anxious. Be specific by detailing who, what, when and where, such as: Party with Sarah at Bentley’s Bar on Friday night. I am standing alone in the corner sipping my drink.
- Describe your negative thoughts. I’m going to make a fool of myself.
- Question the evidence. Be honest with yourself: what data supports or contradicts your negative thoughts? Tip: recalling how you navigated similar situations in the past helps you more objectively weigh the evidence of your current situation.
Evidence that supports the thought ‘I’m going to make a fool of myself’: People have made fun of me before. Or, When I’m nervous, I have a hard time expressing myself.
Evidence that contradicts the thought ‘I’m going to make a fool of myself’: I don’t know for sure if I will do something foolish because I don’t have a crystal ball. Anything could happen. Or: I’m in control of my actions. I can choose to say or do certain things that might land well. Or: I’ve handled similar social situations well in the past.
- Generate a balanced alternative. How else could you think about this situation? Come up with balanced thoughts that take into account the evidence you listed above and what you want to achieve from the situation. Tip: be realistic. The quickest way for this to fail is by lying to yourself. I might say something awkward, which would be really embarrassing. But even if I make a few awkward comments, I could also say something funny or interesting. It’s certainly possible that I make a complete fool of myself. If that happened, it would be painful, but it wouldn’t be the end of the world. This one night doesn’t define who I am, and I’ll have other opportunities to make friends. Regardless, it’s not helpful to keep worrying about making a fool of myself – doing so will just keep me stuck in my head and make it harder to make friends tonight.
Level up your conversational skills
If you’re avoiding social interactions, your conversational skills might be a little rusty.
Levelling up your social skills is just as important as any other tactic for addressing your social anxiety because here’s the hard truth: social anxiety can actually increase the very thing you fear – rejection.
Imagine you’re on a date, and you’re worrying about the dreaded awkward silence. Before the date, you generate a list of conversation topics and rehearse some answers. When you get to the date, you’re trembling with fear about the conversation dying. You pepper your date with questions. They are speaking and then pause, and you jump in to squash the silence – and you accidentally interrupt them. You do this a few times. The conversation has a staccato flow.
Your date might misinterpret your behaviour and think that you want to dominate the conversation or feel like you don’t care what they have to say. Of course, these interpretations are not true, but your social anxiety is telling them otherwise.
Here’s how to improve three social skills that will help build your social confidence:
Initiating a conversation shows someone you’re interested in them and what they have to say. But you might be worried that you don’t know what to say or how to say it. You can take the pressure off: there is no secret codeword to start a conversation.
Instead of perseverating on how to start a conversation, focus on why you are starting it. What are you hoping to gain from the conversation? From there, decide on your opening volley. It’s often easiest to keep it simple. Aim for areas of common ground, such as a recent cultural event, a shared experience, or, yes, the weather.
Reading the room
Knowing how to read the room will help you navigate all types of social situations, including knowing when and how to jump into a conversation.
For example, in Western cultures, eye contact generally conveys interest. Is someone gazing at you to show interest in what you’re saying, or are their eyes drifting to the surrounding environment (perhaps indicating boredom) or their watch (indicating they might want to wrap it up)? Similarly, an open body posture, warm smile or nodding head might indicate that they are interested in you or your conversation, whereas a closed-off stance or frown might indicate a lack of interest.
An important caveat here: people’s moods and interest are not always decipherable, and you don’t want to hyper-analyse a person’s every muscle movement. Rather, use a person’s body language as a general guide for determining whether you should initiate and continue a conversation or redirect your efforts elsewhere.
Asking good questions
Asking good questions is key to keeping the conversation going. Try the AAA method:
- Attend: aim to be an ‘active listener’ – what are the main topics the person is mentioning? Are there certain topics that they seem excited about or want input on?
- Answer: when they stop speaking, show them you were listening by responding to something they said. It is usually better to respond to a main point instead of a tangential detail, but don’t worry about picking the ‘correct’ thing to respond to (this doesn’t exist). Pick whatever feels easiest or most natural to you.
- Ask: follow up with a question to show that you want to learn more about them. The question could be a simple follow-up (‘What was your favourite part of your trip?’) or something more personal (‘How did you feel when they said that to you?’). The AAA method is one tool to ask good questions, but it is not meant to be formulaic. It doesn’t matter if you lose track of the conversation (some people like to ramble!). If you are caught up on remembering every word a person said, you’ll probably sound distracted or inauthentic when it’s your time to speak. The most rewarding conversations are usually those that flow naturally. The idea here is to do your best to listen and respond to the main gist of what someone is saying.
Exposure: do the things that scare you
Exposure involves intentionally and repeatedly engaging in the social situations that you fear. Think about exposures as behavioural experiments to test out whether your dreaded Worst Case Scenario will come true. Spoiler alert: exposures work by showing you that your Worst Case Scenario probably won’t happen and that the situations you dread are probably not as bad as you thought.
One frustrating part about social anxiety is that it’s rarely cured with a one-and-done exposure. Instead, you have to keep practising. The more exposures you do, the better you will feel.
To get started, list all the social situations that make you anxious, such as:
- messaging someone on a dating app;
- introducing myself to a stranger;
- attending a work happy hour by myself;
- raising my hand in class; or
- giving a co-worker critical feedback.
Don’t filter; write down as many situations as come to mind.
Next, rate each situation from 0 (no anxiety) to 100 (maximum anxiety), and then rank-order each from least to most anxiety-provoking. When it comes to choosing your first attempt at exposure, start with one of the situations that is lower on your anxiety thermometer; later, work your way up the list gradually.
For each exposure, follow the step-by-step process below.
Before your exposure:
- Identify your biggest fear(s). What are you most afraid will happen in this specific situation? This could be something like being told you are stupid or getting laughed at.
- Make a plan. Where will you do the exposure? With whom? Sort out some details ahead of time, and then schedule a time to do the exposure. Planning makes it more likely that you’ll follow through.
- Set an achievable goal. Identify one thing you want to accomplish during the exposure. Pick an objective behaviour, such as ‘ask two questions’ or ‘invite them to coffee’. Avoid goals based on feelings (eg, ‘don’t get anxious’) because they are difficult to measure and don’t tell you whether an exposure was successful. You can feel very anxious and have a successful interaction! You also want to avoid goals about other people’s perceptions (eg, ‘appear smart’) because you’re not a mind reader and never really know what others think.
During your exposure:
- Monitor and eliminate what psychologists call ‘safety behaviours’. Safety behaviours are subtle things you do to feel more comfortable and avoid facing your fears head-on, such as checking your phone to avoid having a conversation, tightly gripping a drink to occupy trembling hands, or averting eye contact to avoid getting asked a question. Sometimes, people use substances such as alcohol or cannabis to feel more comfortable in social situations. For example, the phrase ‘liquid courage’ refers to the increased social confidence people feel when they drink alcohol. Using substances to feel less anxious can facilitate a problematic pattern where a person increasingly feels like they need substances to participate or enjoy a social situation. For exposures to work, you must fully encounter the situation – which means dropping your safety behaviours. If not, you teach yourself that you can get through the situation only if you avoid certain aspects of it.
After your exposure:
- Debrief. Answer two questions. First, did your biggest fear come true? Majority of the time, it won’t (or you simply don’t have enough evidence to determine if it did!). Second, what did you learn from the situation? Jot down a few insights. You might find, for example, that you felt less anxious than you anticipated or that you enjoyed some moment(s) of the interaction. Over time, as you repeat these exposures, you will ‘unlearn’ the terrifying aspects of socialising and ‘relearn’ new ones – including how wonderful social interactions can be.
- Reward yourself. You were brave enough to face your fears, and you’re probably a bit exhausted from it. You’ve earned a treat. Pick a reward that’s reinforcing as an extra dose of motivation for your next exposure.
- Plan for the next exposure. Keep up the momentum by planning for the next exposure. Avoidance is anxiety’s best friend – the longer the gap between exposures, the harder it will be to get going again. Make exposure a habit. And if you’re really struggling to get going with these exposure exercises, jump to the Learn More section below for some additional tips.
In sum, you can successfully tackle your social anxiety with three strategies: brushing up your conversational skills, catching and correcting your unhelpful thinking habits, and intentionally participating in scary social situations. As you work through your social anxiety, be sure to remind yourself why you’re doing this – and what your life might look like on the other side of your efforts.
Key points – How to overcome social anxiety
- Understand the causes of social anxiety. At its core, social anxiety concerns a fear of rejection. When you feel socially anxious, you worry about what others think of you and hope you are making a good impression.
- Identify your goals. Identify areas of your social life that you want to improve, such as making more friends or speaking up in meetings – these goals will guide you as you work through your social anxiety.
- Break unhelpful thinking habits. Your negative thoughts about social situations drive your anxiety. Question the evidence for these thoughts and generate a more balanced perspective.
- Level up your conversational skills. Three social skills can improve your social confidence: starting conversations, reading the room, and asking good questions.
- Exposure: do the things that scare you. Gradually and systematically participate in different social situations so you can practise socialising, learn that your Worst Case Scenario probably won’t happen, and enjoy the beauty of social relationships.
Overcoming exposure roadblocks
Intentionally putting yourself in anxiety-provoking social situations (practising ‘exposures’) is key to overcoming social anxiety but, as I said before, it can often be challenging (and scary!) to get going. Let me help you get ahead of some of the common roadblocks that people encounter when doing exposures so you’ll be prepared when they arise.
- Roadblock 1: you don’t know how to do the exposure.
Try an imaginal exposure, where you vividly imagine the feared situation. Walk through exactly how the situation could go and what you could say and do. Go through a few iterations so you’re prepared for whatever comes up. This helps you practise facing your fears in a safer environment and generate ideas for when you do the exposure in real life.
- Roadblock 2: you feel too anxious to start the exposure.
Anxiety is accompanied by a host of physical sensations such as a racing heart, trembling, muscle tension and sweating. Relaxation techniques can reduce the discomfort and intensity of these physical symptoms before you enter a social interaction. Here are three relaxation techniques:
Paced breathing. Anxiety causes fast, shallow breathing. Paced breathing is a surprisingly effective and quick way to reduce anxiety. Slowly inhale through your nose for five seconds, then slowly exhale through your mouth for five seconds. Try six to eight cycles of paced breathing. When you breathe in, fill up your stomach with air (not your chest) so it expands like a balloon. When you breathe out, imagine slowly deflating the balloon.
Progressive muscle relaxation. This technique involves slowly alternating between tensing and relaxing specific muscles. Make a fist by squeezing your hand tightly. Notice the tension in your hand. After five seconds, slowly open your fist and notice the tension leaving your hand. Repeat this process with different muscles.
Engage your senses. The ‘54321’ technique engages your five senses to shift your focus away from negative thoughts and to the present moment. Name 5 things you see, 4 things you feel, 3 things you hear, 2 things you smell, and 1 thing you taste. You can also try extreme changes in your senses, such as changing your body temperature drastically by dipping your face in ice-cold water. This can slow your heart rate and calm you down.
- Roadblock 3: you completed some exposures, but you don’t feel less anxious.
Remember: it takes repetition and consistency for exposures to work. Change is not linear; your anxiety, motivation and exposure progress will all fluctuate. Unsteady progress does not mean you are not improving. Setbacks are an inevitable part of the road to getting better.
When you lose motivation, remind yourself why you are doing this work. Anchor yourself to your values. What is important to you? What gives you a sense of purpose and meaning? What do you want your life to look like?
When you feel discouraged, practise realistic self-compassion. Treat yourself fairly and embrace yourself with kindness – just like you would a loved one.
- Roadblock 4: you need support
Working on your mental health can feel isolating, and exposure is hard work. Asking for help is a sign of courage, not weakness. Try recruiting help from a friend or family member. They can help you plan an exposure, model one for you, or even do an exposure with you.
It might also be helpful to work with a mental health professional who can be a consistent source of support and guide you through the exposure process. You could also consider trying group therapy, where you work together on exposures and other social anxiety tools with a small group of people who also struggle with anxiety. If you feel like you could benefit from medication, which can also be helpful for anxiety, consider a consultation with a psychiatrist or your primary care physician.
Links & books
In my TEDx talk ‘Why You Feel Anxious Socializing (and What to Do About It)’ (2022), I busted three myths about social anxiety and explained why this condition is rising across the globe. I also offer practical tips for being your most authentic self in any social situation.
The book Managing Social Anxiety, Workbook: A Cognitive-Behavioral Therapy Approach (3rd ed, 2019) by Debra Hope, Richard Heimberg and Cynthia Turk is a helpful resource that provides detailed psychoeducation and practical steps for overcoming social anxiety based on the principles of cognitive behavioural therapy. The book takes a deeper dive into some of the topics discussed in this Guide and includes user-friendly worksheets to challenge automatic thoughts and engage in an exposure.
The second edition of the book The Shyness and Social Anxiety Workbook for Teens: CBT and ACT Skills to Help You Build Social Confidence (2022) by Jennifer Shannon is a well-researched and practical book that helps teens make real social connections by overcoming their social anxiety. The book also includes tips to build self-compassion and navigate the world of social media, perfectionism, and social comparisons.
The US-based National Social Anxiety Center provides access to psychotherapy services to treat social anxiety. Their website highlights the latest research on social anxiety disorder (SAD), and prioritises increasing public awareness and the de-stigmatisation of social anxiety.
The website of the Anxiety and Depression Association of America offers numerous resources, including webinars, blogs and videos, for understanding and managing SAD, and includes links for online peer-support groups and finding a therapist.
The US-based Andrew Kukes Foundation for Social Anxiety is an organisation that aims to improve the diagnosis and treatment of SAD. Their website is especially helpful because it provides resources for people who want to learn ways to support a loved one who is struggling with social anxiety.
Toastmasters International is a global organisation with a local club-based structure that teaches conversational, public speaking and leadership skills. Each club typically includes around 20 members and meets weekly.