What causes social anxiety?

Social anxiety is more than just occasional nerves.

Social anxiety definition: the NHS defines social anxiety as ‘A fear that does not go away and affects everyday activities, self-confidence, relationships and work or school life.’¹

What is social anxiety? 

Social anxiety can be defined as a fear of social situations. Social anxiety disorder is when this fear is long-lasting, profound and has a negative effect on your overall quality of life.

These situations could be something specific, such as eating in public.

They could also be something more general like making new friends, socialising, talking in front of a group, speaking up during a meeting or even talking on the phone.

Feeling a flutter of nerves isn’t unusual when faced with a stereotypically ‘scary’ social situation like a job interview, presentation, ceremony or first date. Feeling mildly nervous in situations like these is perfectly normal and doesn’t necessarily mean you have social anxiety.

Social anxiety symptoms

Symptoms of social anxiety include:

• ongoing worry about certain aspects of daily life which include interactions with others, going to school, college or work
• rapid heartbeat, sweaty palms and shortness of breath when you’re facing a social situation
• stuttering in your speech during a social situation when you don’t usually stutter
• feeling hyper-aware of being watched while in a social situation or in public. This can include feelings of paranoia and feeling afraid to carry out normal activities like eating or walking
• feelings of inferiority and wanting to disappear in social situations

What causes social anxiety?

Social anxiety causes aren’t always clear. However, mental health researchers have identified that it usually develops during adolescence, which is a time you come into contact with lots of new people. This is a critical stage in your social development when you are forming relationships with others and navigating school, friendships and activities.² Therefore, social anxiety often has its roots in childhood and adolescence and could stem from a negative experience such as being bullied or feeling humiliated at school.³

What triggers social anxiety?

Social anxiety can strike at any time, particularly when in public or when dealing with other people. Usually, people who experience it have a particular set of triggers which are related to their individual fears.

For example, the following can trigger social anxiety:

• having to start a conversation
• being in a group setting with people you don’t know very well
• being required to volunteer your ideas
• having to complain about poor service
• having to make small talk
• making a phone call
• giving constructive criticism, for example to an employe
• using a public toile

For people with social anxiety, even just thinking about some of these tasks can trigger an upsetting narrative in your head. For example, you may start imagining the potential worst-case scenario for the above situations.

Simply thinking about a social or public situation may also trigger negative self-talk, such as that ‘nobody wants me there’ or telling yourself you’re stupid for being afraid. Difficult as it may be to believe, these are all symptoms of social anxiety and do not mean that your fears are in any way founded.

What should you do about social anxiety? 

Social anxiety can have a serious effect on your life and shouldn’t be dismissed as just being ‘shy’ or ‘awkward’.

There are things you can do to help alleviate your social anxiety. In some cases, people with social anxiety see a great improvement in their confidence and ability to handle social situations without those nasty symptoms rearing their heads.

However, social anxiety treatment isn’t a quick fix by any means. Just as the development of social anxiety doesn’t happen in an instant, you can’t magic it away overnight.

One of the best-studied and most-recommended treatments for social anxiety is cognitive behavioural therapy (CBT). This is a type of talking therapy which helps people examine their negative patterns of thinking and challenge these patterns before they become a vicious cycle of negative thoughts.⁴ If you’re ready, CBT is a practical way to help manage social anxiety and has produced some excellent results in studies.^{5 6 7} After the initial assessment period, you'll start working with your therapist to break down problems into their separate parts. To help with this, your therapist may ask you to keep a diary or write down your thought and behaviour patterns.⁸

Other methods you can try to help with social anxiety:

• Be prepared. It might feel a little contrived at first, but if you know you’re going into a social setting where you don’t know people, come prepared with a few opening lines to initiate conversation. These could be as simple as introducing yourself, or asking a question such as, “Do you know what time the food will be served?”

Often breaking the ice is the most difficult part, and once you’ve actually begun communicating with people, it gets easier.

• Find an ally. There’s nothing wrong with feeling anxious, especially if it’s a typical high-pressure situation. Admitting, “I’m feeling a little nervous” can be a good way to develop a kinship with people, for example at a work event.

Nobody will think less of you, and it can actually be a good way to bond with someone as they may be feeling nervous, too.

• Rationalise. When was the last time that making small talk led to you being rejected or insulted? It’s actually extremely unlikely that your worst fears around social situations will come true. And the ironic thing is, even if they do, the fear of the situation is much worse than the situation itself happening.

And what shouldn’t you do about social anxiety?

Drink alcohol 

Many people find themselves using alcohol as a crutch when they experience social anxiety.

In the short term, people can be fooled into thinking alcohol works very well against social anxiety. A drink might seem to offer confidence and melt away those fears that were preventing you from enjoying your social experience.

However, this is an illusory technique. All alcohol does is artificially lower your inhibitions and give you less control over what you do and say. To someone with social anxiety, this is sure to lead to extra worry the next day.⁹

Think of confidence like a muscle. It needs to be built up slowly but surely. Using alcohol as a crutch means you’ll never develop your social muscle and give it the chance to be as strong as it could be.

Avoid social situations

Social anxiety disorder causes sufferers to withdraw from situations which trigger their anxiety. Temporarily, this can provide relief.

However, avoiding the situations which make us anxious won’t help your recovery.

Putting ourselves in a situation that causes serious worry, anxiety or panic can be an incredibly uncomfortable experience. But avoiding them completely, while effective in the short term, will simply reinforce the belief that these situations are something to be afraid of.

Getting gradual exposure to situations that make us afraid is the way to go.¹⁰

Don’t underestimate baby steps. You don’t have to suddenly be the life and soul of the party or be able to run a meeting without breaking a sweat.

To start with, try low-risk moves such as:

• accepting a social invitation you’d usually decline
• make a phone call instead of sending an email or text
• make a pledge that the next time your order is wrong, politely let the restaurant or café know
• promise yourself that next time you have an idea or opinion at work, don’t stay silent
• try making small talk with the person behind you next time you’re in a long queue

It’s advised by the NHS to speak to your GP if you think you might be experiencing social anxiety disorder. You may be certain that you have it based on your symptoms, but only a GP or mental health professional can diagnose you properly.

Last updated: 31 July 2020

 

2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447508/ 3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627045/ 4 https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/ 5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016703/ 6 https://pubmed.ncbi.nlm.nih.gov/10846306/ 7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610618/ 8 https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/how-it-works/ 9 https://adaa.org/understanding-anxiety/social-anxiety-disorder/social-anxiety-and-alcohol-abuse 10 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594210/