Last updated: October 2026
Social anxiety (social phobia) is a strong, lasting fear of being judged or embarrassed in social situations. Unlike shyness, it doesn’t ease once you warm up, and it can affect work, friendships and daily life. It’s common and treatable. NICE recommends CBT designed for social anxiety as the first treatment, and CBT self-help is a good start.
What is social anxiety disorder?
Social anxiety disorder is the medical name for social anxiety. It’s a recognised anxiety condition, not a personality flaw. NICE describes it as a persistent fear of one or more social or performance situations that is out of proportion to the real threat.
Common triggers include meeting new people, talking in meetings, starting conversations, eating or drinking while others watch and public speaking. With social anxiety disorder, the worry is excessive before, during and after, and it starts to shape your life.
- How common is it? It’s one of the most common anxiety disorders. NICE quotes a US study estimating that 12% of adults will have it at some point in their lives.
- When does it start? Usually in the teenage years. NICE gives a median age of onset of 13.
- Does it last? Some teenagers grow out of it, but if it carries on into adulthood, the chance of it clearing without treatment is modest. Only about half of people with it ever seek treatment, often after many years.
How is it diagnosed?
There’s no blood test. A GP or therapist will ask what you fear, what you avoid and how much it affects daily life. NICE suggests two simple screening questions: do you find yourself avoiding social situations or activities, and are you fearful or embarrassed in social situations? A yes to either is a reason for a fuller assessment, which may include a short questionnaire such as the SPIN (Social Phobia Inventory).
If talking face to face feels too hard at first, say so. NICE advises services to consider a first contact by phone or online.
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View productSocial anxiety symptoms
| Type | Symptoms (NHS) |
|---|---|
| Thoughts | Worrying a lot about everyday situations such as meeting strangers, phoning, working or shopping; dreading embarrassing yourself; feeling watched and judged; fearing criticism; low self-esteem |
| Behaviour | Avoiding group conversations, eating with others, parties or phone calls; avoiding eye contact |
| Body | Blushing, sweating, trembling, nausea, a racing or pounding heart |
| Panic | Some people have panic attacks, an overwhelming rush of fear that usually lasts a few minutes. See how to stop a panic attack |
For the wider picture, including how anxiety can show up differently in women and men, see our guide to anxiety symptoms.
Shyness or social anxiety?
| Shyness | Social anxiety |
|---|---|
| Feeling a bit nervous at first, then warming up | Intense fear that doesn’t ease, before, during and after |
| Doesn’t stop you doing things | Leads you to avoid situations, affecting work, friendships or daily life |
| Passes after the event | Going over what you said for days afterwards. See how to stop overthinking |
Social anxiety vs other kinds of anxiety
| Condition | The main fear |
|---|---|
| Social anxiety | Being judged, embarrassed or humiliated by other people |
| Generalised anxiety disorder (GAD) | Worry about lots of different things, much of the time |
| Panic disorder | Regular panic attacks, often for no clear reason |
| Agoraphobia | Being somewhere it would be hard to escape or get help |
| Health anxiety | Being or becoming seriously ill. See health anxiety |
iThese can overlap. Social anxiety can also sit alongside other conditions, including autism, and some people hide it well. See high-functioning anxiety. A GP can help work out what’s going on.
What causes social anxiety?
There’s usually no single cause. It often starts in the teenage years and can be linked to a naturally anxious temperament, difficult experiences such as bullying, family patterns, and low confidence. Stress, poor sleep, caffeine and alcohol can make it worse. Alcohol in particular can leave you feeling more anxious the next day: see hangxiety.
It often travels with other problems. NICE notes that around 19% of people with social anxiety disorder also have depression and 17% a substance-use disorder, partly because some people use alcohol or drugs to get through social situations. If that sounds familiar, it’s worth mentioning to your GP: it’s common, and nobody will judge you for it.
What keeps it going is often what we do to feel safer. Avoiding situations or rehearsing every sentence brings short-term relief but stops us learning that things usually go better than we fear. CBT is designed to break that loop.
Social anxiety in women and men
Social anxiety affects both sexes, but the research shows some differences:
- Women are a little more likely to have it. In a large US survey of over 43,000 adults, lifetime rates were about 5.7% in women and 4.2% in men.
- Women tend to report more severe symptoms and more social fears, and are more likely to also have other anxiety or mood problems.
- Men are more likely to use alcohol or drugs to cope with social situations, and in that survey were more likely to fear dating.
- The course is similar for men and women, according to a 2017 review.
The same treatments work for everyone. If you’ve been using a few drinks to get through social events, you’re not alone, and it’s a good reason to talk to someone. Our guide to anxiety symptoms in women and men covers the wider signs.
How to overcome social anxiety: a step-by-step plan
These steps follow the principles of the CBT that NICE recommends. Start on your own, with a self-help guide or with a therapist. Small and regular beats big and rare.
| Step | What to do | Why it helps |
|---|---|---|
| 1. Map your fears | List the situations you find hard and rate each one from 0 to 10. Note what you fear will happen. | Turns a vague dread into something specific you can work on |
| 2. Spot your safety behaviours | Notice what you do to get through: rehearsing sentences, avoiding eye contact, gripping a drink, staying on your phone, leaving early, drinking first. | They feel protective but stop you learning that you would cope without them |
| 3. Shift your attention outwards | Practise focusing on the other person, what they’re saying and the room around you, rather than on how you look or sound. | Watching yourself closely tends to make you feel more noticeable than you are |
| 4. Test your predictions in small steps | Pick something low on your list. Before, write what you think will happen. Do it, dropping one safety behaviour. After, write what actually happened. | This is how CBT tests fearful beliefs. Over time, the evidence builds up |
| 5. Stop the after-event replay | When you catch yourself picking over a conversation, ask: what’s the evidence? What would I say to a friend? Then do something absorbing. | Replaying the worst moments keeps the memory distorted |
| 6. Use a structured CBT self-help guide | Work through a free NHS guide (see below) a little each week. | NICE recommends CBT-based supported self-help if you don’t want face-to-face CBT |
| 7. Get therapy if you’re stuck | Self-refer or see your GP (details below). | CBT built for social anxiety is the most effective treatment |
Free CBT self-help to start with
- The NHS self-help guide on social anxiety from Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust.
- NHS inform’s social anxiety self-help guide.
- NHS Every Mind Matters for short anxiety exercises.
Getting therapy without waiting for a GP
- England: refer yourself to NHS Talking Therapies. You need to be registered with a GP and aged 18 or over (16 in some areas). Social anxiety is one of the conditions it treats.
- Scotland: start with your GP practice. NHS inform also has free CBT-based self-help guides and apps.
- Wales: you can sign up for SilverCloud, a free online CBT programme through NHS Wales, without a GP referral, or see your GP.
- Northern Ireland: start with your GP.
8 ways to cope day to day
- Don’t avoid everything. Avoidance keeps anxiety going. Small, regular steps, as the NHS suggests, shrink it.
- Breathe slowly before and during. See box breathing.
- Ground yourself in the moment, for example by naming five things you can see.
- Focus outwards on what others are saying, not on how you’re coming across.
- Prepare a few questions or topics in advance.
- Keep a diary of situations, thoughts and feelings, so you can see your progress.
- Be kind to yourself. Social anxiety often goes hand in hand with low self-esteem. Talk to yourself as you would a friend.
- Look after the basics: sleep, movement and regular meals. If your body feels on edge, try these ways to calm down quickly.
Parties, work events and Christmas
Office parties, family gatherings and nights out can make the run-up to Christmas the hardest weeks of the year. If the dread starts days before, see anticipatory anxiety.
At parties and Christmas do’s
- Arrive early, when it’s quieter, rather than walking into a full room.
- Bring a friend or agree a “check-in” signal.
- Give yourself a role: helping with drinks or taking photos.
- Plan your exit time so it feels manageable.
- Alternate drinks with water or choose alcohol-free. Alcohol can feel like a confidence boost on the night but often makes next-day anxiety worse.
- Schedule recovery time the next day.
At work
- Meetings: aim to speak once, early, even just to agree with a point. The longer you wait, the bigger it feels.
- Presentations: practise out loud, ideally to one trusted person first. Focus on the message, not on how you look.
- Phone calls: jot down two or three points first, then make the call straight away.
- Talk to your manager if you feel able to. If social anxiety has a substantial, long-term effect on daily life, it may count as a disability under the Equality Act 2010, which means your employer should consider reasonable adjustments.
For the wider pressures of the season, see Christmas stress.
Treatment
Social anxiety responds well to treatment, even after many years. NICE recommends for adults:
| Treatment | What it involves | When it’s used |
|---|---|---|
| Individual CBT for social anxiety | One-to-one therapy built for social anxiety (the Clark and Wells or Heimberg models). Up to 14 to 16 sessions over about 4 months, with practice between sessions | First choice for adults |
| Supported self-help | A CBT-based workbook used over 3 to 4 months, with about 3 hours of support in total from a practitioner, in person or by phone | If you’d rather not have face-to-face CBT |
| Medicines | An SSRI antidepressant, usually escitalopram or sertraline, prescribed and reviewed by a GP or specialist | If you don’t want CBT, or alongside CBT if it has only partly helped |
| Short-term psychodynamic therapy | A talking therapy adapted for social anxiety | If you don’t want CBT or medicines. NICE notes it is less effective |
A few things NICE does not routinely recommend for social anxiety disorder: group CBT in preference to individual CBT, mindfulness-based or supportive therapy on their own, and medicines such as benzodiazepines. Medicines aren’t routinely offered to children and young people.
iIf you’re prescribed an SSRI, your GP should see you early on to check how you’re getting on, and sooner if you’re under 30. Don’t stop or change a prescribed medicine without talking to them first.
Where supplements fit (and where they don’t)
No supplement is a treatment for social anxiety, and NICE recommends none. CBD isn’t a treatment for social anxiety either. CBT and the steps above are where to put your energy. If you’re curious, the research is still early: see what the research on CBD and anxiety shows, and our guide to magnesium and anxiety.
Some adults like a steady daily routine alongside their other steps. Our Flow CBD Oil combines broad spectrum CBD with ashwagandha and maca, for daytime use. Ashwagandha and maca are herbs with no authorised health claims. Our Magnesium Glycinate Sleep Complex is an evening drink with magnesium bisglycinate and citrate, L-theanine and botanicals. Magnesium contributes to normal psychological function.
Check before you take them
Our products are for adults (18+) only. We don’t recommend our products during pregnancy or breastfeeding. Flow contains ashwagandha, so avoid it if you have a liver condition, a thyroid condition or an autoimmune condition, and check with your GP or pharmacist first if you take any medicine, including antidepressants or other medicines for anxiety.
The FSA’s 10mg a day figure is precautionary advice rather than a legal limit, set while longer-term safety research continues. At Evopure we think it is a very cautious figure, and many adults use more. If you go above it, increase slowly, and check with your GP or pharmacist first if you take any medication.
When to get help
iSee a GP if social anxiety is affecting your work, relationships or daily life, or if you’re relying on alcohol to cope. There’s no need to wait until it’s severe. In England, you can also refer yourself to NHS Talking Therapies.
If you need help now
If you feel you can’t cope, or you’re having thoughts of harming yourself, call Samaritans free on 116 123, any time. In England, call NHS 111 and choose the mental health option. In Scotland, call NHS 24 on 111 and choose the mental health option, or Breathing Space on 0800 83 85 87 (evenings and weekends). In Wales, call 111 and press 2. In Northern Ireland, call Lifeline on 0808 808 8000. If your life or someone else’s is at risk, call 999 or go to A&E.
Related guides
- How to deal with anxiety: the complete guide.
- Stress symptoms and how they differ from anxiety.
- If a few drinks for confidence at a party leave you feeling rough the next day, our guide to getting over a hangover covers what actually helps.
- If you’re considering supplements, read what the research says about natural supplements for anxiety first.
- If what you notice is less fear of judgement and more feeling overwhelmed by noise and busy rooms, read about being a highly sensitive person.
- Wondering about supplements? Our guide to ashwagandha for anxiety covers the evidence honestly, and why it is not a replacement for therapy.
- Our calming gifts guide suggests presents that don’t put someone in the spotlight.
Sources 17
- NHS. Social anxiety (social phobia).
- NICE. Social anxiety disorder: recognition, assessment and treatment (CG159). Recommendations and context.
- NHS inform. Social anxiety disorder.
- NHS. Find NHS Talking Therapies for anxiety and depression.
- NHS. Where to get urgent help for mental health.
- NHS. Panic disorder.
- NHS. Every Mind Matters: anxiety.
- Welsh Government. NHS 111 press 2 for urgent mental health support.
- mygov.scot. Get support for mental health.
- nidirect. Mental health emergency: if you’re in crisis or despair.
- GOV.UK. Definition of disability under the Equality Act 2010.
- Mayo-Wilson E et al (2014). Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. Lancet Psychiatry.
- Xu Y et al (2012). Gender differences in social anxiety disorder: results from the national epidemiologic sample on alcohol and related conditions. Journal of Anxiety Disorders.
- Asher M et al (2017). Gender differences in social anxiety disorder: a review. Clinical Psychology Review.
- Betsi Cadwaladr University Health Board. SilverCloud: free online mental health therapy.
- NCCIH. Ashwagandha.
- Balban MY et al (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine.
This guide is general information, not medical advice. Evopure makes Flow CBD Oil and the Magnesium Glycinate Sleep Complex. We don’t recommend our products during pregnancy or breastfeeding.
