The Difference Between Social Anxiety & Social Anxiety Disorder
Most of us experience moments of shyness, tension, nervousness, or anxiety around social events. Sometimes it can be as simple as butterflies in the stomach when expecting to meet new people at a party.
Physical reactions such as these signal that the situation is important enough to want to make a good impression. When our bodies are activated in this way, we are often galvanized into action (Weissman & Mendes, 2021).
However, the mild nervousness and shyness of social anxiety every now and again must not be confused with social anxiety disorder.
Social anxiety disorder, sometimes referred to as social phobia, is a type of clinical anxiety disorder whereby an individual’s persistent fear of being watched or judged by others impedes everyday functioning.
Individuals with this disorder may ruminate on planned social events weeks in advance and may actively avoid social situations completely. The disorder can be so intrusive and cause such distress to individuals that even simple tasks, such as buying groceries or visiting family, are impossible to do (Stein & Stein, 2008).
To be diagnosed with social anxiety disorder by a qualified mental health professional, individuals may experience several criteria as outlined by the Diagnostic Statistical Manual of Mental Disorders (American Psychiatric Association, 2013).
A persistent fear of social situations in which the individual fears being exposed to the scrutiny of others, or the fear of acting in a way that will be embarrassing or humiliating
Avoiding social situations or enduring them with intense fear or anxiety
The fear or anxiety is not proportional to the actual threat posed by the social situation.
The fear or anxiety is so intense that it affects normal functioning.
Lasting for six months or more
The fear, anxiety, or avoidance is not because of a medical condition, substance use, or other mental disorder.
In these instances, the help of a therapist is needed. Let’s look at the symptoms of social anxiety to clarify where the line should be drawn.
Symptoms of Social Anxiety
The symptoms of mild social anxiety can be easy to identify: sweaty palms, a racing heart, shortness of breath, worrying, a racing mind, and butterflies in the stomach.
These are fairly generic symptoms that occur when the autonomic nervous system (ANS; our fight-or-flight system) becomes activated (Cannon, 1932), and the body is flooded with epinephrine (adrenaline).
Couple this with a decrease in gamma-aminobutyric acid (a main inhibitory neurotransmitter), which for most individuals is turned down during social situations, and you may feel tense and anxious. This activation happens when an event or situation is seen as stressful, whether the perception is accurate or not.
While chronic stress is extremely detrimental to the body — because of the continuous activation of the ANS (McEwen & Stellar, 1993) — mild stress can actually be helpful in enhancing performance (Kofman et al., 2006) and spurring action.
Usually when this happens, the parasympathetic nervous system (PNS) activates in order to counter the activation of the ANS, by releasing hormones that downregulate the mind and body and help us relax (Sapolsky, 2004).
So when tackling mild social anxiety, the key is to activate the PNS. Below, we will outline useful techniques to activate the parasympathetic nervous system.
Given that we can all feel the effects of social anxiety at one time or another, how can we actively tackle such feelings? And how do we cope in stressful environments, such as work?
Coping with social anxiety at work
When those familiar feelings of anxiety emerge at work, individuals face a tough decision: to struggle ahead in silence or take a timeout. Ideally, this is the ability to step away and take a few minutes to apply grounding techniques, as an example. More on that below.
It is strongly recommended that all organizations and employers build supportive cultures where individuals feel able to take such a break. While discussions of mental health in the workplace are fortunately now more commonplace, there is still some way to go to normalize the pervasiveness of anxiety in the human experience.
Strategies for reducing workplace anxiety
To calm anxious feelings at work, individuals can tap into several key techniques that should help to turn things around quickly.
The primary aim here is to activate the PNS. When feeling anxious, it is hard to feel grounded. The mind is spiraling with unhelpful thoughts.
Grounding techniques work by helping the mind focus on the body and the present moment. This can help you feel calmer and more centered.
Below are three highly effective types of grounding techniques.
The breath is miraculous! By simply concentrating on breathing, the nervous system can be actively downregulated, and within no time at all, anxious moments may dissipate.
One example is to breathe in for four seconds, hold the breath for four seconds, and breathe out slowly over a count of eight seconds. There are many variations of this breathing technique, but essentially, breathing out for longer than breathing in helps slow a racing heart.
Touching the body can be an excellent way to soothe and calm the nervous system, particularly areas that are not associated with anxiety. This includes rubbing your earlobes or elbows, which cannot themselves hold tension or anxiety in them.
Touch is powerful; it is often used in therapeutic settings for the very purpose of relieving anxiety and has also been effective in reducing pain.
When feeling anxious, individuals should try to distract the mind from worrying. An alternative and equally effective technique to breathing exercises is to focus on counting.
Counting can be particularly powerful when paired with observation of the surroundings. A popular example is to find five things that can be seen, four things that can be felt, three things that can be heard, two things that can be smelled, and one thing that can be tasted.
When doing this exercise, try to be as specific as possible and provide lots of detail with what is sensed.
It’s so intimidating in fact, that researchers often use the notion of having to speak in public to induce individuals into stressful states during experiments (see Kirschbaum et al., 1993).
Indeed, public speaking is the ultimate trigger for social anxiety because it involves purposefully exposing oneself to the opinions and judgments of others.
Overcoming public speaking anxiety
To prepare for an upcoming speech, public-speaking anxiety can be overcome similarly as other stressful events: by focusing on strategies to calm the nervous system.
Tips and strategies for delivering a confident speech
1. Prepare well
Practice, practice, practice! This might be an obvious tip, but by rehearsing the speech more confidence is built about delivering the speech.
This confidence can help offset some of the nervousness experienced.
2. Manage breathing
Engage in breathing exercises before delivering the speech. As mentioned earlier, slowing down breathing is a simple yet powerful way to downregulate the body.
When feeling those familiar anxiety symptoms before giving a speech, practice slow, deep breaths. Pair this with any of the aforementioned grounding or relaxation techniques to amplify the benefits and bring you back into the present moment.
3. Burn energy
Harness some of that nervous energy and take action. Do star jumps or jumping jacks before the speech to blow off steam. During the speech, individuals can move around and gesture to consume even more nervous energy.
4. Visualize success
Before the event, spend a few minutes visualizing the delivery of a successful speech or presentation. Imagine the audience responding positively and see yourself feeling calm and collected.
Can You Overcome Social Anxiety? 3 Techniques
If you recognize yourself as someone who often experiences social anxiety and are wondering what other steps you can take to reduce the frequency and/or intensity of these experiences, the key resides in being proactive.
If we simply do nothing and then try desperately to reduce anxiety when it rears its head in a stressful moment, we may very well be ill prepared to manage it effectively.
Given that it is not possible to avoid stressful events, the focus should be to learn how to better cope with them. By building internal resources, a stressful event can be navigated with ease.
Below are three preventive practices that will help build all-important psychological resources, such as resilience, positive coping, positive emotions, and self-esteem.
The benefits of regular exercise to both physical and mental health are well documented (Penedo & Dahn, 2005).
By acting as a protective buffer against disease and psychological distress, exercise is one surefire way to bolster internal resources. Exercise boosts the experience of positive emotions, which in turn helps accrue psychological resources (see the broaden-and-build theory of positive emotions; Fredrickson, 2001).
Mindfulness is another superpower that can help stock up internal resources. If engaging in a regular practice, users can expect a cascade of positive outcomes, including reduced depressive and anxious symptoms and increased positive mood, compassion, and resilience (Gu et al., 2015).
Even 10 minutes a day of mindfulness practice can drastically improve both physical and psychological functioning.
The beauty of mindfulness is that it does not have to be practiced as a formal meditation. Rather, it can take many forms, including mindfulness walking or listening to music.
Experiment with different mindfulness activities to find the best-suited format for you or your clients.
Sometimes, in order to counteract anxiety, you might want to look more closely at patterns of thinking. Given that activation of the autonomic nervous system and symptoms of anxiety occur because we interpret an event as stressful, it stands to reason that interpretations may not always be on point.
When this happens, engaging with Cognitive-Behavioral Therapy (CBT) can be a real game changer. CBT is often employed as a treatment for anxiety and works by challenging thinking patterns and helping individuals shift their mindsets.
Useful CBT techniques include writing down thoughts and then gently challenging the veracity of them, and learning positive coping mechanisms such as cognitive reframing.
Self-Help Exercises for Managing Social Anxiety
To aid your client in finding tools that will help them manage their social anxiety, the following self-help worksheets can be instrumental in helping them find coping mechanisms or understand their anxiety better.
Observing Anxiety Mindfully
This worksheet helps clients identify and observe how anxiety feels in the body.
Clients are encouraged to explore the different sensations that arise in the body when thinking about a stressful social situation.
Once the sensations have been observed, clients are encouraged to accept and sit with the feelings and sensations of anxiety from a place of nonjudgment, as with any mindfulness practice.
Lastly, clients are invited to use visualization to further tap into self-compassion and recognize the transient nature of anxiety.
The Anxiety Record is an effective worksheet that allows a client to capture step by step what happens when they experience anxiety.
The first step is to identify the stressor, before noting down anxious feelings and whether thoughts are helpful or realistic.
The client is then invited to identify more helpful thoughts when facing anxious moments and ways to regain a sense of control when feeling carried away with anxious thoughts.
Mindfulness has a powerful impact on building coping skills, and it also enhances the ability to sit with discomfort without getting swept away by feelings.
3 Books About Social Anxiety
If you are interested in learning more about social anxiety, the following three books provide excellent reading. These three were chosen because of their practical nature and the fact that they are grounded in science.
1. How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety – Ellen Hendriksen
Dr. Hendriksen is a clinical psychologist specializing in overcoming anxiety so that individuals may lead a more authentic life.
How to Be Yourself takes real-life stories of situations where individuals have experienced social anxiety and weaves in a compelling narrative that outlines why social anxiety persists and the science behind it.
The book offers tangible, practical ways to rewire our brain so we can break free of the shackles of social anxiety.
2. Overcoming Social Anxiety and Shyness: A Self-Help Guide Using Cognitive Behavioural Techniques – Gillian Butler
If you are looking for a self-help guide that takes individuals through the techniques of CBT as a pathway to reduce social anxiety, this book by Dr. Gillian Butler, a cognitive therapist and clinical psychologist, is for you.
Chock-full of practical strategies, the reader can work through the book at their own pace and by the end should feel armed to the teeth with solutions for fending off social anxiety.
For more information on Goyder’s work, check out this popular TEDx Talk.
The surprising secret to speaking with confidence
Helpful Resources From PositivePsychology.com
PositivePsychology.com has a plethora of useful resources for anyone interested in learning more about coping with social anxiety.
Below, you will find several worksheets for learning to cope with anxiety. Completing these exercises proactively can help ensure better navigation of anxiety, inducing in social situations.
Stressors and Resources
The aim of this worksheet is to help clients identify key sources of stress and anxiety, and outline strategies or resources that can deal with them.
This worksheet is extremely helpful because it also identifies past, present, and anticipated sources of stress and anxiety. After completing this worksheet, clients should have a greater awareness of their triggers and the strategies that work best for them in social situations.
Coping Skills Inventory
The Coping Skills Inventory worksheet introduces six common and widely used coping skills that can be used when facing social anxiety.
The client is guided in selecting the most appropriate coping skill that will work for them in a given social situation. Identifying coping strategies before a stressful event is an excellent way to build self-awareness and those all-important internal resources.
For more informative and practical articles on anxiety and coping, you may enjoy this selection of articles:
If you’re looking for more science-based ways to help others manage stress without spending hours on research and session prep, check out this collection of 17 validated stress management tools for practitioners. Use them to help others identify signs of burnout and create more balance in their lives.
A Take-Home Message
Social anxiety is a pervasive human experience and one we can all expect to encounter every now and again.
Whether we are at work, out with friends, or with family, some social events can and will trigger our fight-or-flight response.
Because life is fraught with stressful life events, trying to avoid them at all costs is not realistic or sustainable. Rather, it is better to be proactive in engaging in practices and techniques that will help us better cope with stress and anxiety as and when we need to.
Physical symptoms can include an elevated heart rate, shortness of breath, sweaty palms, and feeling dizzy. Psychological symptoms can include feelings of panic or dread, rumination on negative thoughts, and a difficulty focusing on the here and now.
Is social anxiety a mental illness?
Social anxiety is not a mental illness. It is healthy and normal to experience mild physiological activation from time to time when faced with situations or tasks outside of our comfort zone. Often, low levels of anxiety are adaptive and can help us perform better. Only when social anxiety becomes intrusive to daily functioning, can social anxiety disorder be considered, as identified by the DSM-5.
How common is social anxiety?
Anxiety is highly prevalent worldwide, with about 309 million individuals experiencing an anxiety disorder in 2019 (World Health Organization, 2022). Since many individuals experience activated nervous systems in the face of social stressors, it is fair to say that social anxiety is extremely commonplace.
What causes social anxiety?
The activation of our autonomic nervous system causes social anxiety, which kicks into gear when a situation is perceived as stressful. The brain floods the body with adrenaline to prepare for action, and it is this adrenaline that causes many of the physical symptoms of social anxiety.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Cannon, W. B. (1932). The wisdom of the body. Norton.
Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56(3), 218–226.
Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review, 37, 1–12.
Kirschbaum, C., Pirke, K. M., & Hellhammer, D. H. (1993). The ‘Trier Social Stress Test’—A tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology, 28(1–2), 76–81.
Kofman, O., Meiran, N., Greenberg, E., Balas, M., & Cohen, H. (2006). Enhanced performance on executive functions associated with examination stress: Evidence from task-switching and Stroop paradigms. Cognition & Emotion, 20(5), 577–595.
McEwen, B. S., & Stellar, E. (1993). Stress and the individual: Mechanisms leading to disease. Archives of Internal Medicine, 153(18), 2093–2101.
Penedo, F. J., & Dahn, J. R. (2005). Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Current Opinion in Psychiatry, 18(2), 189–193.
Sapolsky, R. M. (2004). Why zebras don’t get ulcers: The acclaimed guide to stress, stress-related diseases, and coping (3rd ed.). Henry Holt and Company.
Stein, M. B., & Stein, D. J. (2008). Social anxiety disorder. The Lancet, 371(9618), 1115–1125.
Weissman, D. G., & Mendes, W. B. (2021). Correlation of sympathetic and parasympathetic nervous system activity during rest and acute stress tasks. International Journal of Psychophysiology, 162, 60–68.
World Health Organization. (2022). Mental disorders. Retrieved June 15, 2023, from https://www.who.int/news-room/fact-sheets/detail/mental-disorders.
About the author
Kirsty Gardiner, Ph.D. is a Social Psychologist with a passion for using research to power social change. She holds a doctorate in Psychology, a masters in Applied Positive Psychology, and is a registered chartered Psychologist with the BPS. On completing her Ph.D. she taught on the MAPPCP programme for several years. Currently, she is based in the UK as the Research Director at Ardent - a DEI consultancy.