Social Anxiety Disorder

Social Anxiety Disorder is a mental health condition characterized by intense fear or anxiety in social situations where you might be observed, evaluated, or judged by others. It goes beyond ordinary shyness or nervousness—it involves persistent, overwhelming anxiety that interferes with work, relationships, and daily activities. People with social anxiety often recognize their fear is excessive, yet feel powerless to control it.

What is Social Anxiety Disorder?

Social Anxiety Disorder involves intense fear of social situations in which you might be scrutinized or negatively evaluated by others. This fear is disproportionate to any actual threat and causes significant distress or impairment in your life. The anxiety can be triggered by a wide range of social interactions, from formal presentations to casual conversations, eating in public, or simply being observed by others.

What distinguishes social anxiety from normal nervousness is its intensity, persistence, and impact on your life. You might avoid social situations entirely, endure them with intense distress, or spend excessive time worrying before and ruminating afterward about how you were perceived. The fear of embarrassment, humiliation, or rejection becomes so powerful that it shapes decisions about work, relationships, and opportunities.

Social anxiety often begins in childhood or early adulthood, though many people don't seek treatment until it has significantly impacted their careers or relationships. You may have developed elaborate strategies to hide your anxiety or avoid triggering situations, leading others to underestimate your struggle. Despite appearing successful or capable on the surface, you may live with constant anxiety about social interactions and harsh self-criticism about your performance.

Social anxiety can be generalized, occurring across most social situations, or more specific, such as performance anxiety that occurs primarily when speaking or performing in front of others. Both forms can be equally debilitating and both respond well to treatment.

Signs and Symptoms

In social situations, you may experience:

• Intense fear of being judged, embarrassed, or humiliated

• Worry about others noticing your anxiety symptoms

• Fear of offending others or saying something wrong

• Extreme self-consciousness and feeling "on stage"

• Fear that your mind will go blank

• Difficulty making eye contact

• Speaking quietly or hesitantly

• Blushing, sweating, trembling, or rapid heartbeat

• Nausea or upset stomach

• Muscle tension or feeling frozen

Avoidance behaviors may include:

• Declining invitations or opportunities that involve social interaction

• Avoiding speaking up in meetings or classes

• Staying quiet in groups or letting others speak for you

• Arriving late or leaving early to minimize social contact

• Using alcohol or substances to cope with social situations

• Choosing careers or roles that minimize social exposure

• Avoiding eye contact or physical proximity to others

• Over-preparing or rehearsing for social interactions

Before and after social situations:

• Anticipatory anxiety days or weeks before an event

• Extensive mental rehearsal of what you'll say or do

• Difficulty sleeping before social events

• Ruminating afterward about mistakes or awkward moments

• Harsh self-criticism about your performance

• Reviewing conversations repeatedly to check for errors

• Catastrophizing about consequences of perceived failures

Impact on daily life:

• Difficulty forming or maintaining friendships

• Challenges in romantic relationships or dating

• Limited career advancement due to avoiding visibility

• Missing opportunities that require social interaction

• Isolation or loneliness despite wanting connection

• Low self-esteem or sense of inadequacy

• Depression related to social limitations

My Approach to Treatment

I provide comprehensive treatment for social anxiety disorder, helping individuals reduce anxiety, challenge self-limiting beliefs, and build confidence in social situations.

Comprehensive Assessment: I provide thorough psychiatric evaluations that explore the situations triggering your social anxiety, the history and development of your symptoms, avoidance patterns and safety behaviors, impact on work, relationships, and quality of life, and co-occurring conditions such as depression, generalized anxiety, or ADHD that may complicate the picture.

Evidence-Based Psychotherapy: Cognitive Behavioral Therapy is highly effective for social anxiety disorder. I incorporate CBT approaches that help you identify and challenge anxious thoughts about social situations, reduce avoidance and safety behaviors that maintain anxiety, gradually face feared situations in a controlled way, develop social and communication skills when needed, and build self-compassion and realistic self-evaluation. The goal is to help you see that your feared outcomes are unlikely and that you can handle social situations even when anxious.

Medication Management: Several medications can effectively reduce social anxiety symptoms. SSRIs and SNRIs are first-line treatments that reduce overall anxiety levels over time. Beta-blockers may be helpful for performance anxiety or situational use. Benzodiazepines are occasionally used short-term but carry risks of dependence. I work collaboratively with you to determine whether medication would be beneficial and, if so, which option is most appropriate for your situation.

Addressing Core Beliefs: Social anxiety often stems from deeply held beliefs about yourself, others, and social situations—beliefs like "I'm fundamentally flawed," "Others are harshly critical," or "Making mistakes is catastrophic." We work together to identify and challenge these core beliefs, developing more balanced and compassionate perspectives that allow you to take social risks without excessive fear.

Building Skills and Confidence: Treatment may involve practicing assertive communication, developing conversation skills, learning to tolerate uncertainty and imperfection, building resilience to criticism or rejection, and cultivating self-compassion and acceptance. As you practice these skills and face feared situations, you build evidence that you're more capable than anxiety tells you and that social situations are more manageable than they seem.

Holistic and Contextual Care: I understand social anxiety within the context of your life, culture, and values. Some social anxiety may reflect cultural differences, neurodivergence, or realistic concerns about discrimination or judgment. Treatment is tailored to your specific goals and circumstances, honoring what matters to you while helping you live more freely. I collaborate with therapists or other providers when beneficial.

Long-Term Freedom: The goal of treatment is not just symptom reduction but genuine freedom to pursue meaningful relationships, career opportunities, and life experiences without being controlled by fear. With treatment, most people experience significant improvement and many recover completely, building confidence and social connections they never thought possible.

Getting Started

If social anxiety is limiting your life or preventing you from pursuing meaningful goals and relationships, I offer comprehensive psychiatric evaluations and evidence-based treatment to help you overcome fear and build confidence.

To schedule an appointment, please call or email my practice. I look forward to helping you move from anxiety to freedom in social situations.