What Psychologists Say Really Works for Social Anxiety

We all experience the nerves in social situations, whether it’s the flutter of nerves you feel before giving a presentation or your heart rate increasing when meeting someone new.

But how do you know if these responses are just the occasional stomach butterflies or social anxiety?

What Social Anxiety Feels Like

Everyday tasks like going to work or school, taking phone calls, grocery shopping, or keeping appointments can feel overwhelming when you have social anxiety. You might also experience:

• Blushing
• Sweating
• Trembling
• Shallow breathing
• Rapid heartbeat
• Feeling watched or the “spotlight effect“
• Mind blanking 
• Nausea
• Dizziness
• Being extremely self-conscious
• Fearful of being criticized or rejected by others
• Avoiding situations where you might be the center of attention
• Avoiding being around other people
• Feeling anticipatory anxiety before any social event
• Mentally scrutinizing a social interaction when it’s over

“I pretty much always want to cancel and not go—it takes a lot just to get to the social part,” says Emily Taffel, 44, a mom and entrepreneur who has had social and general anxiety since childhood. “Physically, I get extremely overheated, my breathing speeds up, my heart races, I will get irritable very easily [and] in the worst scenario, it can become a full-blown panic attack.”

What Really Helps, According to Experts

The good news is social anxiety can be managed and overcome. Dr. Cook and Sosnowsky note that cognitive behavioral techniques can be helpful. Here are several approaches that actually work:

• Cognitive restructuring: This involves identifying and challenging irrational negative thoughts that fuel anxiety (cognitive distortions) and replacing them with more positive and realistic ones. For example, if you notice a negative automatic thought, like catastrophizing, jumping to conclusions, or labeling (“I’m such a bore”), take a moment to jot down evidence that challenges that belief. “You’ll likely discover the things we tell ourselves are overblown or just plain untrue,” says Sosnowsky.
• Exposure and response prevention (ERP): This CBT technique encourages people to gradually confront their fears and anxieties in a safe and controlled environment. Next, they’ll process their interaction with their therapist afterward to compare objective and subjective experiences, explains Dr. De Gannes. The more exposure a person has, the more confident they become in handling social situations, he adds.
• Eye movement desensitization and reprocessing (EMDR): Besides CBT, EMDR therapy can also be an effective tool for social anxiety, as it helps identify and work through traumatic experiences that may have led to social anxiety, says Jeanne Cross, a therapist specializing in EMDR and trauma-focused cognitive behavior therapy (TF-CBT).

Other treatment options include prescription medications, like SSRIs, SNRIs, beta-blockers, and benzodiazepines, says Dr. Daniella Marchetti, a Miami-based clinical psychologist. 

Self-Help Techniques

Medication and therapy aren’t the only treatment options for social anxiety disorder. There are other effective coping skills you can try to snap out of the fight-or-flight mode and overcome social anxiety:

• Paced breathing
• Body scan meditation
• Standing or walking barefoot on the ground
• Taking a short walk
• Holding something cold

“I write out my fears, then try to play the other side of it and remind myself most people don’t remember half of what you say because they are too absorbed in their own thoughts or anxieties,” says mental health blogger Lindsey Hall, 35.

Taffel likes to do the 5-4-3-2-1 grounding exercise. It involves naming five things you can see, four you can hear, three you can touch, two you can smell, and one you can taste.

“I also look for the weird and the whimsical,” she says. For example, look around and spot three things you’ve never seen before (the weird) and three things that are out of the ordinary (the whimsical). “By the time I cycle through, I’m usually able to smile and feel calmer,” she says.

Lifestyle Changes

One thing to keep in mind with any form of anxiety is that it can be managed from the “neck down,” says Sosnowsky. Simple lifestyle tweaks that can help you tackle social anxiety include:

• Eating a balanced diet: Dr. Stanford suggests cutting back on processed foods and sugar as they can negatively affect your mood. Consider eating more whole grains, fruits, veggies, nuts, seeds, and fatty fish.
• Prioritizing movement: Regular exercise, like running, biking, tai chi, or even just a walk, can help calm your mind and ease anxiety, says Dr. Stanford. “Yoga helps me a lot to ground myself before going to something,” shares Hall. 
• Getting more probiotics: A study found that eating probiotic-rich foods (like yogurt, cottage cheese, and kimchi) is linked to fewer symptoms of social anxiety.
• Limiting caffeine and alcohol: Some people turn to alcohol to lessen their anxiety, but it can actually worsen symptoms over time, says Dr. Marchetti. “Caffeine can cause and worsen anxiety, as well,” she adds.
• Getting enough sleep: According to a 2023 study, sleep deprivation can lower mood, make it difficult to manage emotions, and may worsen anxiety symptoms. Try to keep a consistent sleep schedule and get seven to eight hours of sleep every night.

Small Daily Steps to Build Confidence

When you have social anxiety, it can feel tempting to cancel plans. But doing so only reinforces your anxiety and avoidance behaviors, says Dr. Cook. Here are six strategies to try instead:

• Start small: Start with small, simple interactions in controlled settings. Like saying “Have a good day!” to the barista or cashier as you leave. Similarly, if mingling for the entire happy hour fills you with dread, aim to strike up just one conversation before heading home, suggests Sosnowsky.
• Arrive early: “Getting to an event early to scope out the space and be there before a lot of other people arrive helps me,” says Taffel.
• Rehearse conversations: “I also practice conversation questions and talking points before going somewhere so that I don’t feel anxious trying to think of things to say,” shares Taffel. You can also try role-playing with a therapist or in a social skills group to better manage anxiety in real-life situations. 
• Use body language: Practicing body language skills like making eye contact, maintaining a relaxed posture, and a firm handshake may help you feel more confident in social situations. 
• Play to your strengths: “I try to avoid social moves that will make me feel more awkward,” says Hall. Whether it’s humor, kindness, great listening skills, or something else, playing to your strengths in social situations can make it easier to connect with others, enjoy the interactions, and avoid anxiety triggers. Similarly, stick to topics you’re confident in.
• Be kind to yourself: “Social anxiety gets us so caught up in our own heads—worried that people are judging us—when in reality, others are preoccupied with their own thoughts,” says Dr. Cook. So let go of self-criticism and give yourself grace if you do goof up. 

Building and Maintaining Relationships

Even though it may feel daunting, it’s possible to make new connections and build meaningful relationships despite having social anxiety. Here’s how to get started:

• Challenge the fear of judgment: Recognize negative thoughts for what they are—just thoughts. In reality, people are more likely to think about what others think of them than about you.
• Ask open-ended questions: This can help redirect attention to the other person, allowing you to feel more at ease and engage more fully in the conversation. “If there are people you know at an event, think about their interests and prepare a few questions to help pave the way for conversation,” suggests Dr. Marchetti.
• Find common ground: This could be similar life experiences, professions, food preferences, or shared hobbies. You can use these shared interests and experiences as talking points for future conversations and build meaningful connections. 
• Stay in touch: If making a phone call feels overwhelming, start with texts to check in or share updates. 
• Schedule catch-ups: Planned interactions can feel less anxiety-inducing than spontaneous ones. Choosing a familiar setting, like your favorite coffee shop, can also help you feel more in control. Making plans and following through shows the other person that you’re interested in developing the relationship and willing to put in the effort. 
• Say yes to invitations: Instead of turning down the invite, Dr. Marchetti suggests planning in advance for the event to reduce anxiety. For example, you can practice small talk topics, pick the outfit, and come up with an exit plan to politely excuse yourself if it feels too overwhelming. If possible, you can also look up the menu online and decide what you want to order beforehand.
• Avoid comparisons: “I can’t tell you how often I hear clients talk about their most charismatic, extroverted friend when discussing their own anxiety,” says Sosnowsky. The truth is, these people represent a very small minority. Remember, you don’t need to have the most outgoing personality to thrive in socializing, notes Sosnowsky.
• Join a support group: Dr. Marchetti suggests joining a support group for people with SAD to connect with others with shared experiences, develop healthy coping techniques, and practice social skills.