Social anxiety: symptoms, treatment and therapy
Updated · Editorial principles and sources
In brief
Social anxiety disorder is a common anxiety disorder. It is not an exaggerated form of shyness but a disorder that can significantly limit work, study and social life. It is treatable, and cognitive behavioural therapy has strong research evidence in its treatment.
What is social anxiety?
Social anxiety disorder is a common anxiety disorder. The person strongly fears situations where they are the focus of others' attention or evaluation. The fear is out of proportion to the situation and often leads to avoidance. Only a professional can assess whether it is a disorder.
Feared situations
Performing or speaking in groups
Meeting new people
Talking on the phone
Eating in public
Job interviews and meetings
Shopping or returning items
The vicious cycle of social anxiety
- Anticipation: You stress about the situation in advance and imagine the worst scenario
- In the situation: Body anxiety symptoms (blushing, trembling), attention shifts to self-monitoring
- Post-event processing: You analyze the situation afterwards and focus on "mistakes"
- Avoidance: You start avoiding similar situations, which reinforces the fear
Effective treatments
Cognitive Behavioral Therapy (CBT)
CBT is a well-researched treatment for social anxiety disorder. You learn to identify and challenge negative thoughts, drop safety behaviours and face feared situations gradually.
Group therapy
Group CBT can suit social anxiety well, because the group offers a natural setting to practise social situations. Sharing experiences can reduce shame and isolation.
Exposure therapy
Exposure is a core part of CBT. Feared situations are faced in small steps with the therapist's support. Experiencing that the feared situation is not dangerous can reduce anxiety.
Self-help, medication and cost
- According to the Finnish Current Care guideline, the lifetime prevalence of social anxiety disorder in international studies of people over 18 was 4.0%.
- Self-help: for mild nervousness, approaching feared situations in small steps, breathing exercises and recognising thought patterns may be enough. If the fear has lasted for years and avoidance has become established, guided support is usually needed.
- Medication: antidepressants are the first-choice drug treatment for social anxiety disorder and are effective both on their own and alongside therapy. Medication is considered for example when the fear is strong, comes with depression or other anxiety, or therapy alone is not enough. A doctor assesses the need individually.
- Cost: care through public health care, occupational health and student health care is often free or low-cost, but waiting times vary. You pay for private psychotherapy yourself unless Kela grants rehabilitation psychotherapy.
Source: Current Care guideline, Anxiety disorders (in Finnish)