Social Anxiety Disorder - Diagnosis and Treatment

Diagnosis

Doctors usually start by doing a physical exam to check if health problems or medications might cause anxiety symptoms.

They’ll then talk with you about your symptoms, including:

How much it affects your daily life
How often you feel anxious
What types of social situations trigger the anxiety

You might fill out self-report forms that ask about your feelings, habits, and what triggers your anxiety.

To officially diagnose social anxiety disorder, doctors look at the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. According to these guidelines, symptoms should typically last at least 6 months and include:

DSM-5 Criteria for Social Anxiety Disorder
Ongoing, strong fear about being judged or embarrassed in social settings
Staying away from stressful situations, or facing them with major anxiety
Fear levels are greater than what the situation should normally cause
Anxiety gets in the way of daily activities like school or work
The symptoms aren’t better explained by another health issue or substance use

These steps help doctors tell social anxiety apart from other conditions.

Treatment

Talking with a therapist is a key step for managing social anxiety. One of the most common approaches is cognitive behavioral therapy (CBT). CBT helps you spot and change negative thoughts and habits that make anxiety worse.

CBT might include:

Noticing anxious thoughts as they come up
Practicing how to react in social settings with less fear

Common therapy methods:

Type	What it Focuses On
Cognitive restructuring	Changing negative thoughts
Exposure therapy	Facing feared situations
Social skills training	Practicing social actions

Therapists often use role-playing to build social skills. Exposure therapy, which means facing feared situations bit by bit, is another important part.

You can do CBT one-on-one or in a group. Many people find that regular sessions lower their anxiety and help them feel more comfortable in public.

Medicines can help many people control their symptoms, especially if therapy alone isn’t enough. Doctors usually start with low doses and slowly increase them to avoid side effects.

Frequently recommended medicines:

Selective Serotonin Reuptake Inhibitors (SSRIs): Helps more serotonin stay in your brain to boost mood and lower anxiety.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Raises both serotonin and norepinephrine to improve mood and focus.

You might need to wait several weeks to see if the medicine helps. Doctors usually recommend giving it time before making any changes.

Some people need other options to manage their symptoms.

Other Antidepressants: Doctors sometimes try different types to find what works best with the fewest side effects.
Anti-Anxiety Drugs: These can calm anxiety fast, but they may cause drowsiness and can be habit-forming, so doctors only use them short-term.
Beta Blockers: These block adrenaline’s effects, like a racing heart or shaky hands. Beta blockers can help with things like public speaking but aren’t for everyday use.

Safety Note: Always work closely with your doctor when taking these medicines. Sticking with your treatment plan really matters. It can take time—sometimes weeks or more—to see real changes, whether you’re doing therapy or taking medication.

Some tips to help you stay on track:

Go to all your appointments.
Take your medicine as directed.
Set small goals for facing social situations.
Tell your doctor about any changes or concerns.

For some people, symptoms fade and they can eventually stop medicine with their doctor’s help. Others might need treatment longer to keep symptoms from coming back.

Complementary and Other Approaches

Some individuals try herbal remedies or supplements for anxiety. Research is mixed, and safety isn’t always clear.

Before you try anything new:

Talk to your doctor first.
Check for possible interactions with your current medicine.
Remember, herbal remedies shouldn’t replace proven treatments like CBT or prescription meds.

Everyday Steps and Self-Help Strategies

A lot of people find it helpful to use everyday habits to manage social anxiety. You can use these along with advice from your doctor or therapist.

Healthy Lifestyle Habits

Small changes in your daily routine can make a real difference.

Healthy Habit	Reason It Helps
Physical activity	Reduces tension, boosts mood
Better sleep	Improves focus and lowers stress
Nutritious diet	Keeps energy and mood steady
Avoid alcohol	Prevents mood swings
Less caffeine	Lowers jittery feelings

Stay Active: Activities like walking or stretching can calm your nerves.
Get Enough Sleep: A steady sleep schedule supports your mental health.
Eat Balanced Meals: Nutritious foods help keep your energy up.
Cut Back on Alcohol and Caffeine: Both can make anxiety worse, so it helps to limit them.

Exposure and Gradual Practice

Taking things step by step helps ease social anxiety.

Try simple activities, like saying hello or making eye contact.
Set small goals, such as eating out with a friend or asking for help in a store.
Practice often: The more you try, the more confident you’ll feel.

Building Social Skills

Planning ahead for social moments can help.

Read the news or think up questions to ask before joining a conversation.
Focus on your good qualities to boost your confidence.
Try friendly gestures, like giving a compliment or making a short call to a friend.

Relaxation and Coping Approaches

Some techniques can help you handle physical stress.

Use deep breathing or relax your muscles to stay calm.
Remind yourself that most people don’t notice small social mistakes.
Keep track of how often feared events actually happen—it’s usually less than you expect.

Avoid Harmful Coping

Alcohol might seem to help at first, but it can make anxiety worse later. It’s best to skip or limit it to protect your peace of mind.

With steady habits and gentle practice, a lot of people find they feel more at ease in social situations.

Ways to Manage and Find Help

People with social anxiety can use different strategies to cope. Staying in touch with family and friends builds a support system.

Tip	How It Helps
Talk to others	Strengthens connections
Join support groups	Reduces isolation
Practice hobbies	Calms the mind
Face challenges	Prevents avoidance behavior

Joining support groups—online or in person—can help you feel less alone.

Enjoyable hobbies or calming activities offer relaxation and help manage symptoms. Group activities that build speaking or communication skills can boost confidence too.

Positive habits make managing anxiety easier and can lower the chance of relapse.

Getting Ready for Your Visit

Getting ready ahead of time can make your health visit smoother and less stressful. Here are a few steps to consider before seeing a doctor or therapist:

Write down situations that make you anxious or that you’ve avoided, especially if they affect your daily life.
List your symptoms and how long they’ve lasted. Include anything that might seem unrelated.
Note big life events or changes that happened around the time your symptoms started.
Gather your medical history, including both physical and mental health diagnoses.
Make a list of all medicines and supplements. Include names and doses for everything you take.
Prepare questions for your provider to help guide your appointment.

Bringing a trusted friend or family member might also help—they can remember details and give support.

Sample questions to ask:

Question	Reason to ask
What could be causing my symptoms?	To understand the possible reasons for how you feel.
Are other explanations possible?	To make sure all options are considered.
How will you check what is wrong?	To know more about the screening and diagnosis method.
Should I see a mental health expert?	To find out if a specialist visit is needed.
Is my condition short-term or long-term?	To plan for the future and set expectations.
What treatment choices exist?	To learn about possible next steps.
Will treatment help me feel better in social situations?	To ask about the chance of improvement.
Am I at risk for other mental health issues?	To be aware of other concerns to monitor.
Are there materials or websites I can read?	To get reliable and clear information outside the visit.

You don’t have to stop at these questions. Ask anything else that’s on your mind during your visit.

What Your Provider Will Likely Ask You

When you visit, your healthcare provider will probably ask a bunch of questions. They want to really understand your symptoms, how they affect your daily life, and whether anyone in your family has dealt with something similar.

Some questions you might hear:

Has fear of embarrassment ever made you skip group activities?
Do you usually avoid being the center of attention?
Is worrying about looking foolish one of your biggest concerns?
When did you first start noticing these symptoms?
Are there certain situations that make things worse?
Does anything make your feelings better, or maybe even harder to handle?
How does this issue affect your work, school, or relationships?
Do you still feel anxious even when you’re alone?
Has someone in your family experienced similar feelings or struggles?
Do you have any medical diagnoses in your history?
Have you ever gotten help or treatment for mental health before? If yes, what actually helped?
Have you had any thoughts of self-harm or hurting others?
Do you drink alcohol or use recreational drugs? If so, how often?

Try to answer as openly and honestly as you can. That way, your provider can figure out the best plan for you, whether that means more screening or maybe a referral to a specialist.

Social Anxiety Disorder – Diagnosis and Treatment