How to Deal With Social Anxiety

In life, we encounter situations that cause discomfort, nervousness, and stress. In some situations, some degree of anxiety is beneficial as it helps you stay focused and hit deadlines. However, some individuals experience severe social anxiety that’s persistent and debilitating to an extent that it interferes with their daily life.

In such cases, anxiety is categorized and handled as a clinical disorder. It’s important to seek professional help from Meadows Psychiatry, who’ll offer effective coping strategies and treatment to recover your self-esteem, confidence, and psychological well-being.

What Causes Social Anxiety Disorder (SAD)?

Like most mental health disorders, social anxiety arises from a complex blend of environmental and biological factors. If there’s a family history of clinical anxiety, you are 30-40% more likely to develop the condition.

However, it’s impossible to determine how much of the condition results from genetics as opposed to parenting style where parents do not show affection, are overcontrolling, and are quick to criticize.

Other Causes Include

  • Negative experiences – Children who’ve experienced trauma or undergone stressful life events can develop SAD. Examples of negative experiences include:
    • Teasing or bullying by peers
    • Emotional, sexual, or physical abuse
    • Desertion or death of a parent
    • Domestic violence or family conflicts
  • Brain structure – Research also shows a connection between the Amygdala and SAD. During fight or flight responses, the Amygdala triggers physiological changes similar to those anxiety sufferers experience. These symptoms include muscle tightening, increased heart rate, a spike in blood sugar levels, and respiratory excitement.


    When this happens, the mental focus shifts to the prefrontal cortex, a part of the brain responsible for calming the symptoms when there’s no real threat. For SAD sufferers, instead of reducing the symptoms, the prefrontal cortex amplifies the Amygdala’s activity worsening the symptoms.


Fortunately, with the help of Dr. Richard Wu at Meadows Psychiatry, you can reprogram your brain to react rationally in social situations where there’s no real danger through cognitive-behavioral therapy.

At What Age Does Social Anxiety Begin?

Social anxiety (SAD) typically begins in childhood or adolescence. On average, for adults treated for SAD, it started in their early or mid-teen years, with most having developed it by their 20’s. But there’s still a small group of adults who develop it later.

Some people can pinpoint when their disorder started and even associate it with an event. Others say they’ve always been shy, and their anxiety has been progressive but notice a significant spike when they approach or are approached by others.

Finally, some people cannot remember when they didn’t feelings of anxiety.

Symptoms of Anxiety

Physical signs that may accompany social anxiety include:

  • Rapid heart rate
  • Blushing
  • Trembling
  • Nausea or upset stomach
  • Sweating
  • Muscle tension
  • Difficulty catching your breath
  • Lightheadedness or dizziness
  • Your mind goes blank
  • Rigid body posture

Signs of Social Anxiety

Some behavioral and emotional signs that point to SAD include:

  • Being hypersensitive to criticism
  • Low self-esteem
  • Negative self-talk
  • Worrying about humiliating or embarrassing yourself
  • Intense fear of interacting with strangers
  • Fearing that others will notice your anxiety
  • Substance abuse including overindulgence in alcohol
  • Suicide attempts

What Triggers Someone with Anxiety?

Anxiety levels can peak due to certain triggers. They can be external or internal and can include sounds, emotions, sights, and smells. Specific events may also be triggering. They include:


These include musical performances, public speaking, or athletic competitions. People with social anxiety may find themselves underperforming in these situations.

Meeting new people and partying

A room with new people is a massive trigger. As such, attending a party or meeting someone for the first time can be difficult for individuals with social anxiety disorder.


Generally, dating is stressful, but for a person with social anxiety disorder, it can be an overwhelming experience. The whole dating process, including going on a first date, phone calls, and sex, are massive anxiety-inducing situations.

Using public restrooms

Bashful bladder syndrome, shy bladder, or shy kidney is the intense fear of using public restrooms without a medical diagnosis. For individuals with social anxiety disorder, the experience can be too much, resulting in difficulties in fulfilling social obligations or traveling.

Eating in front of others

A person with social anxiety disorder can have trouble eating in front of others. They are often afraid of spilling drinks on their friends or other people seeing their hands tremble while they eat.

Giving your opinion

It’s frightening being in a situation where you have to give your opinion since you are afraid they’ll judge you harshly for them.

Therapy for Anxiety Disorders

Social anxiety treatment in Rockville is available in the form of psychotherapy and medication. Cognitive behavioral therapy (CBT) is a common method of psychotherapy for anxiety disorders. CBT teaches you coping skills that’ll help you manage emotional and physical symptoms that develop when you’re in social situations.

These techniques help you remain calm in the moment and teach you how to gracefully navigate blunders like mispronouncing someone’s name in public without getting overwhelmed.

Generally, CBT includes several techniques, although treatment doesn’t always involve all of these techniques.

  • Psychoeducation

Understanding the psychological components of your social anxiety will help you understand the beliefs that cause you to avoid social situations and make your anxiety worse.

The therapist can also:

    • Explain how the technique works to reduce anxiety
    • Provide reassurance that the anxiety symptoms you’re experiencing are normal for the disorder and treatable
    • Offer additional information on how some strategies work and their effectiveness
  • Cognitive restructuring

This technique is all about testing your cognitive distortions and negative thought patterns that manifest in social scenarios. It may include:

    • Overgeneralization
    • Emotional reasoning
    • Mental filtering
    • catastrophizing

Identifying these patterns is a key step in restructuring them. Dr. Richard Wu, D.O from Meadows Psychiatry will walk you through an imagined or past situation to help you gain insight into the distorted thought patterns and identify alternative thought processes. Restructuring often involves realistic or neutral thinking.

  • Systematic desensitization

This exposure therapy helps you confront social situations you fear, starting with those that are least dreadful. This situational exposure technique also involves learning relaxation exercises that you can use to soothe or ground yourself.

  • Behavioral experiments

The goal is to:

    • Determine unhelpful self-monitoring or safety behaviors
    • To check and test your negative self-beliefs as well as worst-case predictions

Experimenting might involve attending social gatherings and having small talk with strangers instead of hiding in a corner. And in your next therapy session, you review if the experience was as you’d predicted. Alternatively, it can be done through role-plays.

  • Attention training

This technique is all about shifting focus from yourself to other people. Focusing on yourself prevents you from picking up on the real reaction of other people, which reinforces negative self-beliefs.


Some medications can help reduce symptoms depending on your anxiety disorder and whether you exhibit physical or mental problems. For instance:

  • Some anti-depressants can treat anxiety disorders
  • You may get a buspirone prescription
  • You may receive a prescription for beta blockers or sedatives for short-term symptom relief.

Can Social Anxiety Be Cured?

Generally, individuals with social anxiety disorder respond well to treatment, be it CBT, medication, or both. Some people may be on symptom-managing medication for the rest of their lives, while others need psychological therapy or medication for a short time.

Without effective treatment, social anxiety disorder can result in a decline in performance at work, relationship quality, and quality of life. Some may even develop alcohol use disorder or depression.

Home and Lifestyle Remedies for Social Anxiety Disorder

Despite needing a qualified psychotherapist to manage or treat your disorder, you can use the following tips to control trigger symptoms:

  • Get sufficient sleep
  • Acquire stress reduction skills
  • Eat a balanced diet
  • physical exercise or being physically active
  • Avoid alcohol
  • Avoid or reduce caffeine intake
  • Participate in social events through people you’re comfortable around


In addition to the above, you can consider practicing some not-so-overwhelming situations like:

  • Making eye contact and returning greetings
  • Giving compliments
  • Showing an interest in other people
  • Calling a friend and making plans

The Difference Between Social Anxiety Disorder and Social Phobia?

Until 1994, social phobia was described as the persistent fear or anxiety one experienced when one performed before people. However, in the Diagnostic and Statistical Manual of Mental Disorders, the name was changed to social anxiety disorder and expanded to include the anxiety and fear of being watched and judged by others in all social situations.

What’s The Difference Between Agoraphobia and Social Anxiety Disorder?

Agoraphobia refers to feelings of helplessness or losing control in specific situations, but not always because of other people. Whereas social anxiety disorder is caused by what other people might think about you.

Get Help and Treatment from Meadows Psychiatry

Although you can manage social anxiety with some self-help tools and with support from friends, it may not be enough. You’ll need help from a mental health professional like Meadows Psychiatry to receive evidence-based coping strategies and treatment.

It’s better to get treatment sooner than later to prevent it from getting worse and crippling your everyday life. Schedule an appointment or call us at (301) 298-9900.