Spotlight on social anxiety: what you need to know

Can social anxiety be treated?

Yes, there are effective treatments available.

The main treatment recommended for social anxiety is Cognitive Behavioural Therapy (CBT). This usually involves doing a course of between eight and twenty weekly sessions focusing on:

• Cognitive work, such as identifying and testing unhelpful thoughts and avoiding reliance on "safety behaviours" like avoiding eye contact or hiding behind your phone
• Exposure, or gradually facing up to situations you would usually avoid, sometimes via virtual reality, so the brain learns the situation is safer than expected
• Skills practice, such as social skills training where needed, and relapse-prevention planning

Antidepressant medications such as SSRIs/SNRIs can also be used, alone or in combination with therapy, when people struggle with severe social anxiety.

For people whose main issue is performance situations, another option is to take a beta-blocker such as propranolol before the event to reduce physical symptoms such as sweating and palpitations.

5 social anxiety coping techniques

There are lots of ways to manage social anxiety. But they don't all work for everybody. What you need is to find techniques that work for you.

Here are five things you can try.

1. Remind yourself that everyone feels anxious sometimes and that we all make mistakes. It can help to develop some personal affirmations you can repeat before going into an anxiety-inducing situation (e.g., "This feeling is temporary; it will pass." Or "I belong here, and my thoughts and feelings have value.")
2. Manage the situation. If you feel uncomfortable addressing large groups, for example, try to arrive early at work meetings or gatherings so you can greet the other participants one by one
3. Avoid so-called safety behaviours Try not to use alcohol or other props to hide behind. They are only likely to make things worse over time
4. Breathe. Box breathing (in through your nose for four seconds, hold for four seconds, out through your mouth for four seconds, hold for four seconds) can help to clear your mind and keep stress at bay. Or try the 4-7-8 technique (in through your nose for four seconds, hold for seven seconds, out through your mouth for eight seconds) if you're feeling panicky
5. Listen. Focusing on what other people are saying can take your mind off your own struggles, while feeling better informed can make you more confident about joining in

BACP member and psychotherapist Louise Tyler has this advice: "Make peace with your social anxiety. Everyone you see is simply 'surviving' the social situation the best way they can. Most people are too focused on themselves to notice what you or others are doing.

"While some may appear more confident, it doesn't mean they're not feeling anxious too. The key is learning to quiet your anxiety, so it doesn't overwhelm you."

Social anxiety signposting dos and don'ts

If you notice a friend, family member or colleague struggling socially, you may be able to help them by sharing clear, gentle recommendations designed to help them overcome their symptoms. Known as signposting, it's imperative that such communications are delicately handled and judgement-free.

Do

• Make your advice optional and focused on their needs
• Aim to listen more than you speak
• Offer practical support such as staying with them at an event
• Share clear, concrete options for external support and treatment (e.g., NHS Talking Therapies, Mind, or their GP)
• Respect their decision about how to move forward

Don't

• Diagnose their condition or use labels such as "social anxiety" unless they do
• Minimise their feelings (e.g., "It's not a big deal.")
• Pressure them or draw attention to them in a social situation (e.g., "Speak up! No one can hear you!")
• Jump in with advice they've probably heard before
• Promise quick fixes and permanent solutions