Ask a therapist: Understanding Social Anxiety Disorder

Social Anxiety Disorder (also called Social Phobia) is a mental health condition that affects many young people. It can be a really stressful experience, but with the right support and strategies, there are lots of ways to manage it.

We asked clinical psychologist Nasalifya Namwinga to answer your common questions about Social Anxiety Disorder, and to share her expert tips and advice.

Download the transcript of this video.

What is Social Anxiety Disorder?

Most people know what it’s like to feel shy, nervous or a bit uncomfortable in social situations. But, as Nasalifya points out, Social Anxiety Disorder is more than this. ‘Social Anxiety Disorder is when you have a really intense fear of being judged or embarrassed in social situations.’

This fear can impact your everyday social life. Or it can stop you from doing the things you usually enjoy, like hanging with friends or going to school. In fact, it can make doing anything in public really stressful – from catching a bus or eating in front of others at a restaurant, to just saying ‘hi’ to someone.

Around 8 per cent of Australians experience Social Anxiety Disorder at some point. So, while it might feel scary and isolating at times, you’re not alone if you’re experiencing it.

What causes Social Anxiety Disorder?

There’s no single cause of Social Anxiety Disorder. As Nasalifya explains, a mix of different influences and factors can increase your risk of experiencing it. These might include past traumatic experiences (e.g. being teased or bullied), which can shape how you feel in social situations. Your genetics can also play a part, especially if anxiety disorders and other mental health conditions run in your family. 

It’s common to experience Social Anxiety Disorder alongside mental health conditions (e.g. depression), as well as other conditions such as autism and ADHD. 

There are also everyday pressures that can heighten your anxiety, such as: 

• school challenges

• study and exam stress

• friendship issues

• big life changes and transitions (e.g. moving schools or family changes)

• social media pressures (e.g. feeling the need to compare yourself with others).

As Nasalifya says, humans are wired for connection, so our brains are always scanning for social threats. But with Social Anxiety Disorder, it’s like your brain cranks up the volume and makes social situations feel way more intense. 

It can be reassuring to know that this is just how the brain works sometimes. The good news is, there are ways to dial things back so that social situations feel a lot more manageable. 

How do I know if I have Social Anxiety Disorder?

Social Anxiety Disorder can show up in different ways, but there are some of the common signs to look out for.

Download the transcript of this video.

Emotional and psychological signs

• Intense fear of social situations (especially unfamiliar ones)

• Worrying excessively about embarrassing yourself

• Fear of being judged negatively by others

• Worrying that others will notice your anxiety

• Feeling pressured to do things ‘right’ in social situations

• Feeling self-conscious around others and anxious when you’re the centre of attention

• Replaying how you acted in a social situation over and over again in your mind afterward (called ‘rumination’)

Behavioural signs

• Avoiding public speaking, group activities or small talk

• Trying to keep quiet or not draw attention to yourself

• Not doing things you want to do because you feel anxious

• Finding excuses to leave or avoid social gatherings

Physical signs 

• Racing heart or chest tightness

• Sweating, trembling or feeling dizzy

• Nausea or stomach issues

• Blushing or stammering when speaking

• Feeling that your mind has gone blank

You might have noticed a few – or even many – of these signs. You might also find they flare up if you are already feeling stressed or are going through big changes in your life. Recognising the signs can help you to understand what’s going on and figure out ways to manage it.

What are some ways I can manage Social Anxiety Disorder?

Nasalifya recommends managing Social Anxiety Disorder by using both in-the-moment strategies and long-term ones.

In-the moment strategies:

• Use breathing and grounding techniques. The 4-7-8 breathing technique or the 5-4-3-2-1 grounding technique can help you to feel calmer and more present. 

• Shift your focus outward. Instead of worrying about how you come across, try to focus on what the other person is saying or just ask them heaps of follow-up questions.

• Challenge negative thoughts. If you catch yourself thinking, ‘Everyone’s judging me’, reframe it as: ‘Most people are focused on themselves, and I’m doing my best.’ Get more tips for talking yourself up. 

Long-term strategies:

• Take small steps. Start with low-stakes social situations and build up your comfort level over time. As each step gets a bit easier, move onto something more challenging.

• Try journalling. This is a helpful way to explore your thoughts and to identify patterns in how you feel. Give the Morning Pages technique or gratitude journalling a go, or jot down convo starters you can try out with a friend. 

• Look after the basics. Stick to a regular sleep routine, build up your mindfulness practice, and try to eat healthily and get some exercise. These foundational habits can help you to manage anxiety in the long run.

• Celebrate wins (big or small). Whether it’s saying ‘hi’ to a neighbour or finally making that call you’ve been putting off, every step counts. Track your progress and remind yourself that these small moments add up.

When should I seek professional help for Social Anxiety Disorder?

It can be hard to know when to reach out. But if your anxiety is disrupting your daily life, or it’s stopping you from doing things you would usually enjoy, it’s a sign to explore support options.

Of course, the idea of doing this can be pretty anxiety-inducing, as it involves lots of social interactions. But, as Nasalifya says, you don’t have to do it alone.

When you’re ready to seek help for Social Anxiety Disorder, you could start by talking to a GP. They can help to assess your symptoms, rule out any underlying medical conditions, and offer you some solid advice on how to manage your anxiety. 

A GP can also refer you to a mental health professional such as a psychologist. They can help you to unpack what might be driving your anxiety and guide you through Social Anxiety Disorder treatment strategies and options. These can include the following:

• Cognitive behavioural therapy (CBT). CBT helps you to identify and change unhelpful thought patterns and behaviours. It’s proven to be a really helpful therapy option for people with Social Anxiety Disorder. 

• Exposure therapy. This involves gradually facing feared social situations in a safe and structured way. It helps you to reduce anxiety over time.

• Mindfulness and relaxation techniques. These are about managing anxious thoughts and physical symptoms through things like breathing exercises, meditation and grounding techniques. Check out these mindfulness exercises from headspace.

• Medication. For some cases, your GP or psychiatrist may prescribe antidepressants or another medication to treat Social Anxiety Disorder.

You can also access professional support online or over the phone with a GP or mental health professional via telehealth. If you’re looking to connect with a trained professional immediately, you can use these services:

• Lifeline – call 13 11 14, text 0477 13 11 14 or use the Lifeline online chat.

• Kids Helpline – call 1800 55 1800 or use the Kids Helpline online chat.

• 13YARN – call 13 92 76 or visit the 13Yarn website.

Can I find support online for managing Social Anxiety Disorder?

There are plenty of ways to find support online. As Nasalifya says, it’s a great way to explore coping strategies and to connect with others at your own pace (without heaps of pressure). Here’s where you can start:

• Check out online resources about how to manage anxiety and stress or different types of anxiety disorders.

• Chat online with a trained peer worker via ReachOut PeerChat – it’s free, anonymous and totally confidential.

• Jump onto the ReachOut Online Community to connect with others and share experiences in a safe space. 

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