Avoiding other people from time to time is normal. But if you isolate yourself out of fear of embarrassment or rejection, you may have social anxiety disorder.
Charissa Chamorro, PhD
In this Q&A, Charissa Chamorro, PhD, a Mount Sinai clinical psychologist, explains how to know if you might have social anxiety disorder and what you can do to be more confident around others.
“Treatment isn’t about getting rid of anxiety—it’s about learning you can feel anxious and still engage meaningfully. The more you approach instead of avoiding, the more confidence you build,” says Dr. Chamorro, Assistant Clinical Professor, Psychiatry, Icahn School of Medicine at Mount Sinai.
What is the difference between being shy and having social anxiety disorder?
Social anxiety disorder is a diagnosable mental health condition. Shyness is considered a personality trait that can be shaped by temperament and experiences. While shyness usually involves mild discomfort in social settings, social anxiety involves a persistent, intense fear of being judged, embarrassed, or rejected.
Unlike shyness, social anxiety interferes with your life. If you avoid situations you actually want to be part of or cancel plans because of discomfort, you may have social anxiety disorder.
What causes social anxiety disorder?
The causes are thought to be a combination of biological and environmental factors, but not necessarily due to bullying or poor parenting. Some people are more prone to anxiety, and experiences like negative social feedback can reinforce that.
What are signs I might have social anxiety disorder?
- Avoiding social interactions: Not just avoiding parties, but isolating yourself at work or having a hard time starting conversations with co-workers.
- Going blank in conversations: You may blame yourself—thinking, “Why can’t I think of something to say?”—but this can be part of your body’s fight, flight, or freeze response to anxiety.
- Over-apologizing and deferring to others instead of stating your own preferences: People with social anxiety often seek social approval.
- Rumination: Replaying past conversations, focusing on something you think went wrong, or feeling that you were really embarrassing. Thinking about social interactions is normal, but if it causes distress and is hard to control, you may have social anxiety.
- Perfectionism: Feeling that you have to know the perfect thing to say before you can speak.
- Hiding behind your phone in public: Not for work or enjoyment, but to avoid engaging with others.
How can I become more confident in social situations?
Here are three tips you might find useful:
- Remind yourself that everyone feels awkward sometimes. That normalizes the experience and helps you feel less alone.
- Vocalize your feelings. For example, if you’re giving a speech, you might say, “I’m feeling nervous because I really want this to go well.” Naming it can disarm others and help you feel more confident.
- Reframing your thoughts can build confidence. Instead of telling yourself, “I’m so awkward,” tell yourself, “A part of me feels anxious, and that’s okay. I’m going to do my best.” Coaching yourself with more balanced, supportive thoughts can make a difference.
How can a mental health professional help me with social anxiety?
Social anxiety is highly treatable, and cognitive behavioral therapy (CBT) is the gold standard. CBT helps you identify thoughts contributing to anxiety and use cognitive restructuring to examine them.
How does a therapist use cognitive behavioral therapy to treat social anxiety?
I would ask you to recall positive social experiences to challenge self-critical thoughts, like “I can never connect with people.” Cognitive behavioral therapists work on helping you create more balanced thoughts—for example, “Sometimes I feel awkward, but I’ve also connected with others before.”
Therapists also assign gradual behavioral exposures—small tasks like ordering coffee and making eye contact with the cashier, then building up to things like attending a party. The goal is to break the cycle of avoidance and create opportunities to approach social situations.
Are there medications that treat social anxiety?
CBT is often very effective, but if symptoms remain or access is limited, medication may be a helpful additional support. Depending on how severe your anxiety is—especially if generalized anxiety is also present—we may refer you to a psychiatrist to discuss medication options.
What happens if I continue to avoid social situations?
Avoidance makes anxiety stronger. When you avoid a social situation, anxiety goes down short-term, but you don’t get the chance to learn that you can manage it.
Treatment isn’t about getting rid of anxiety—it’s about learning you can feel anxious and still engage meaningfully. The more you approach instead of avoiding, the more confidence you build.