Social Anxiety Disorder in Adults: Signs, Complications, and Treatment Options

Have you ever had trouble mustering up the nerve to leave the house before an important occasion? Or felt your heart race as you’re standing at the doorway to what is supposed to be a fun event? Perhaps your mind has gone completely blank during an important presentation that you’ve practiced and know by heart. If any of this sounds familiar, you may be experiencing social anxiety disorder.

Before assuming anything, however, it helps to slow down and look at the bigger picture. Do you always feel this way in social situations, or was it an isolated incident? If these feelings are persistent, support and guidance from a mental health professional can provide insight and relief.

This page can help you understand what social anxiety disorder is, how it shows up in adults, and what kinds of support are available. It will discuss:

  • What social anxiety disorder is and how it develops
  • The most common symptoms of social phobia in adults
  • How to recognize fear of social situations vs everyday nervousness
  • The causes and risk factors of adult anxiety disorders
  • Effective social anxiety treatment programs
  • Long-term social anxiety coping skills
Man clutching his head in a public place, struggling with social anxiety disorder in adults

What Is Social Anxiety Disorder?

When anxiety goes unaddressed or untreated for years, it can begin to shape your habits and patterns and become a disorder. This means that your brain chemistry, bodily responses, and reactions start disrupting your daily life. 

Social anxiety, sometimes called “social phobia”, is when you feel unable to cope in social situations. For some people, this may happen only in specific circumstances, but for others, almost any type of social gathering can trigger fear or discomfort. 

The good news is that even though social anxiety can feel inescapable, it is a highly treatable condition. With the right coping skills, therapy, and support, you can learn to manage your anxiety and enjoy social situations again (or for the very first time).1

Types of Social Anxiety

Social anxiety can come in many forms, and although there are differences, they all center around discomfort in social situations. Symptoms often emerge in childhood, continue through teenage years, and carry into adulthood. They can be difficult to break, but many people see meaningful improvement with time and treatment. 

The following are the different types of social anxiety:

  • Generalized Social Anxiety Disorder 

    • This causes ongoing anxiety and worry about all social situations and interactions.2
  •  

  • Non-generalized Social Anxiety Disorder

    • This usually involves a specific type of social situation or trigger
  •  

  • Social Phobias

    • These are usually centered around particular situations, such as:
      • Fear of public speaking
      • Performance anxiety
      • Eating in public
      • Using public restrooms

If you are experiencing any of these challenges and are not already working with a psychiatrist or mental health professional, consider reaching out. It may be daunting at first, but facing and resolving anxiety can dramatically improve your life. 

Signs and Symptoms of Social Anxiety Disorder

Many people feel shy in social settings or awkward around people they don’t know, but social anxiety goes far beyond typical nervousness. The fear can be so overwhelming that even thinking about an upcoming event or gathering causes enormous distress. Some people with social anxiety disorder may even feel physically ill at the thought of a social event.

Some of the key signs of social anxiety disorder are:1

  • Fear of judgment or embarrassment
  • Obsessive worrying
  • Fear of talking with strangers
  • Anxiety before an event
  • Rumination
  • Avoiding speaking or participating
  • Expecting the worst possible outcomes in social situations
  • Fear that others will notice you being anxious
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What Causes Social Anxiety Disorder in Adults?

As explained above, social anxiety disorder often begins in childhood, is further developed in adolescence, and becomes deeply ingrained in early adulthood. In many cases, it forms when the brain labels particular social experiences as “negative,” and these interpretations get reinforced over time. 

In addition to difficult or embarrassing social experiences, your genes, brain, environment, and personality can all impact your stress and anxiety levels. These situations are interpreted negatively by the brain, which tries to protect you from perceived threats in the future. Unfortunately, the protection your brain provides isn’t always helpful. 

Here is how some of the risk factors for developing social anxiety work:

  • Genetic predisposition
    • Your immediate family and those related to you may have social anxiety, which can be passed down.

  • Brain chemistry
    • Differences in the way the brain processes stress, fear, and social cues can alter its functioning and contribute to anxiety.3

  • Environmental factors
    • A negative experience in a social situation can make you naturally worried about going through something similar again. 

  • Personality Traits
    • Our personalities can also shape our behavior and create patterns of thought, emotions, and actions.

Commonly Co-Occurring Conditions With Social Anxiety Disorder

Social anxiety often appears alongside other mental health conditions. In many cases, these issues develop earlier in life, and social anxiety becomes more noticeable later on. Some of the most common co-occurring conditions include: 

If you have already been diagnosed with one of these conditions and you are also struggling with social interactions, speak with your treatment provider. A clear social anxiety diagnosis can help guide more effective support. 

Treatment Options for Social Anxiety Disorder

If you or someone you love is being negatively affected by social anxiety, such as losing a job, missing important events, or experiencing other significant setbacks, professional support can help. There are various treatment options for social anxiety disorder that have been proven to be effective. 

Your care plan will depend on your personal history and how much your anxiety is currently impacting your life. Talk therapy, medication, and other evidence-based treatments can all produce positive results, with a combination of these approaches often the best solution for severe cases.

Treatment may include approaches such as the following:

Psychotherapy

Often referred to as “talk therapy”, psychotherapy helps you understand your thought patterns, behaviors, and emotional responses – and where they come from. Once you recognize these patterns, you will be in a stronger position to change the ones that are harming your well-being or relationships.  

Cognitive behavioral therapy for social anxiety (CBT) is one of the most common treatment approaches because it helps you recognize the relationship between your thoughts and actions. Exposure therapy can also be used alongside CBT to help you gradually face feared social situations. With time, these repeated experiences can build confidence, reduce anxiety, and show you that you can overcome your fears.

Medication

In more severe cases of anxiety, medication may be used to help you return to normal daily functioning. Medications vary in strength, and most are not intended for long-term anxiety treatment. Always consult with a doctor about how a medication may affect you and how it fits into your overall care plan. Medications that can potentially provide support for social fear include:

  • Antidepressants
    • These can be used for several conditions, but are often helpful with anxiety disorders and depression, which often co-occur.
      • Selective serotonin reuptake inhibitors (SSRIs). These are typically the first antidepressants used for social anxiety.
      • Serotonin and norepinephrine reuptake inhibitors (SNRIs). These are another type of antidepressant, sometimes used when SSRIs aren’t effective.

  • Beta blockers
    • Used to minimize the physical effects of anxiety, such as a racing heart or palpitations.

  • Anti-anxiety medications
    • These can offer rapid relief during an acute anxiety attack, but they are not intended to be used long-term or on a daily basis.4

Residential Treatment for Anxiety

If you have had a long struggle with anxiety, a residential treatment program may be the best option. Staying at an inpatient facility will provide you with 24/7 professional support, a structured environment, and targeted social withdrawal treatment to help you change unhelpful routines and build healthier habits. Inpatient facilities are often particularly beneficial for people who struggle with the self-discipline needed to break negative cycles. 

Find Anxiety Treatment Programs

A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Anxiety support is a phone call away – call 866-478-4383 to learn about our current treatment options.

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Long-Term Social Anxiety Coping Skills

Anxiety is something many people all over the world deal with, and while this may sound discouraging, it means there is a wealth of proven strategies that can help. Here are some of the most effective ways to manage anxiety wherever you are to support your long-term recovery: 

Self-Care

Self-care is often misunderstood. It doesn’t require spending money, but simply taking care of the basics. This includes getting enough sleep, eating a well-balanced diet, spending time in natural light, and getting enough exercise and water.

Exposure Practice

This involves approaching anxiety-triggering social situations in small, manageable steps. Little by little, exposure practice can help lessen your fear and increase your confidence.

Mindfulness & Meditation

These practices help your mind relax, enable you to stay present, and let the thoughts pass you by instead of taking you over. 

Grounding

  • 333 Rule
    • Identify three things you can see, three sounds you can hear, and move three different parts of your body.
  •  
  • 54321 Rule
    • Notice five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste

 

AMFM: Supporting People with Social Anxiety Disorder

If you or someone you love is experiencing social anxiety or has already received a diagnosis, reaching out for professional support can make a meaningful difference. A Mission for Michael has a team of compassionate, highly trained professionals who are dedicated to helping people work through anxiety at every stage. Our programs include educational resources, support groups, community groups, and opportunities to build self-compassion. All of this is designed to guide you towards long-term recovery. 

Don’t let another day go by waiting for things to change on their own. You deserve the support and evidence-based care that can help you regain control over your life. Reach out to our team today, and we can help you take the first steps towards recovery.

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  1. Mayo Clinic. (n.d.). Social anxiety disorder (social phobia): Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561
  2. Mayo Clinic. (n.d.). Generalized anxiety disorder: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803
  3. National Institutes of Health (US). (2007). Information about mental illness and the brain. NIH Curriculum Supplement Series. https://www.ncbi.nlm.nih.gov/books/NBK20369/
  4. Cleveland Clinic. (2025, October 23). Social anxiety disorder (social phobia). https://my.clevelandclinic.org/health/diseases/22709-social-anxiety

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