Social Anxiety Disorder
Social anxiety disorder involves persistent fear of being judged or embarrassed in social or performance situations. It goes beyond ordinary shyness when avoidance or distress substantially limits daily life.
Key takeaways
- Fear may centre on speaking, eating, meeting people or being observed and can cause blushing, trembling, sweating or a blank mind.
- Assessment considers duration, avoidance, panic, depression, autism, substances and physical causes of prominent symptoms.
- Cognitive behavioural and exposure-based therapy can build lasting skills; medicines may support care but are not a substitute for assessment.
Catalogue matches do not diagnose social anxiety or indicate that an antidepressant is suitable.
What keeps social anxiety going?
Avoidance reduces anxiety briefly but prevents corrective experience, while intense self-monitoring magnifies normal sensations. Safety behaviours may also reinforce the belief that a situation is dangerous. Treatment works with these cycles at a manageable pace.
When might medicine be considered?
An antidepressant such as paroxetine may be considered for persistent impairment, often alongside therapy. Benefits take time and must be balanced against interactions, withdrawal effects, sexual adverse effects and mood changes; see antidepressants.
When to seek urgent care
Seek urgent mental-health help for suicidal thoughts, self-harm risk or inability to meet basic needs. New chest pain, fainting or severe breathing difficulty should receive physical assessment rather than being assumed to be anxiety.
Related articles
Understand why daily SSRI or SNRI treatment and short-term anxiety medicines have different roles, timelines, risks and review questions.
Read guide