Social anxiety disorder: symptoms, causes and treatment

Social anxiety disorder (also known as social phobia) is an anxiety disorder characterized by an intense fear of being judged, embarrassed, criticized, or negatively evaluated in social situations. People with social phobia disorder often worry that they will say or do something awkward, appear nervous, or be rejected by others.

Although social anxiety is sometimes confused with shyness, the two are not the same. Shyness is a personality trait, while social anxiety disorder involves persistent fear and avoidance that can interfere with work, relationships, education, and daily life. In more severe cases, social situations may even trigger a panic attack.

People with social phobia often experience a combination of anxious thoughts, physical symptoms, self-consciousness, and safety behaviours. Over time, avoiding feared situations can strengthen the anxiety and make it harder to feel confident in social settings. In practice, many people I work with don’t just fear embarrassment, they fear being seen as inadequate. This often makes social situations feel much more threatening than they objectively are.

Social anxiety does not always look like avoidance or visible nervousness. Some people appear confident and capable on the outside, while internally dealing with constant self-monitoring, pressure to perform, and fear of being judged. This pattern is known as high-functioning social anxiety. Because they continue to function well, many people do not recognize it in themselves. If you often feel tense, overthink social situations, or feel drained afterward despite performing well, this may be worth exploring further.

On this page, you will learn what social anxiety disorder is, how it develops, how the underlying causes and maintaining factors work, and which treatment options can help reduce social phobia.

What is social anxiety disorder?

Social anxiety disorder is a type of anxiety disorder where someone experiences a strong and ongoing fear of social situations. These are situations where other people might watch, judge, or form an opinion about them. The fear is often linked to worries about doing or saying something embarrassing, looking anxious, or being seen in a negative way. If you recognize yourself in this, you’re not alone, this is something many people struggle with, even if it’s not always visible.

Common situations that trigger social phobia include speaking in groups, meeting unfamiliar people, making phone calls, eating in public, or being the center of attention. In these situations, people with social anxiety often experience strong self-consciousness, anxious thoughts, and physical symptoms such as blushing, sweating, trembling, or a racing heart.

Although many people feel nervous in social situations from time to time, social phobia goes beyond normal nervousness. The anxiety is more intense, lasts longer, and often leads to avoidance or enduring situations with significant distress. Over time, this can affect confidence, relationships, work, and overall quality of life.

To cope with this anxiety, people often rely on safety behaviours, such as avoiding eye contact, rehearsing conversations, staying quiet, or seeking reassurance. While these strategies may reduce anxiety in the short term, they often maintain or even strengthen the anxiety over time.

This creates a self-reinforcing pattern in which thoughts, physical symptoms, and behaviours all interact with each other. This pattern is often referred to as the social anxiety cycle, and it plays a key role in how social phobia develops and persists.

The social anxiety cycle explained

Social phobia is often maintained by a self-reinforcing pattern in which thoughts, physical symptoms, and behaviours continuously influence each other. This is known as the social anxiety cycle.

In this cycle, a social situation triggers anxious thoughts (e.g., “I will embarrass myself”), which lead to physical symptoms such as sweating, blushing, or a racing heart. These symptoms increase self-consciousness and reinforce the belief that something is wrong.

To cope with this discomfort, people often use safety behaviours (such as avoiding eye contact or staying quiet) or avoid the situation altogether. Although this reduces anxiety in the short term, it prevents new learning and keeps the anxiety in place.

Over time, this cycle strengthens itself, making social situations feel increasingly threatening and difficult to handle.

Example: how social phobia can develop

This cycle is one of the main reasons why social anxiety persists over time. The following example illustrates how social anxiety can gradually develop and become self-reinforcing: