Social anxiety can get better.
Fear of being judged is one of the most common mental health problems. It usually starts in the teens and rarely goes away on its own. Well-tested help exists, and you can start some of it this week, on your own.
- Learn what keeps it going
The loop of avoiding, checking yourself and replaying.
- Work through a self-help book
Books based on CBT help on their own.
- Do a guided online program
Online CBT with a little help from a therapist.
- See a therapist, or ask about medication
Therapy made for social anxiety works best.
Most people can start at step 1 or 2 without anyone else. How to choose a step
Where is it hardest for you?
Each page explains why that situation is hard and gives small steps to try.
What happens in your body and mind
Four things research is clear about
- It is common.
About 4 in 100 people worldwide have social anxiety disorder at some point in life. In some countries, such as the United States, it is closer to 12 in 100.
- It starts early.
Half of all cases start by about age 14. Very few start after 25.
- It rarely goes away on its own.
Without treatment, most people still have it years later.
- Treatment works.
Therapy made for social anxiety helps most people who complete it. See what helps
Best-tested options
Rated by how well they have been tested. How we rate evidence
- Cognitive therapy for social anxiety (CT-SAD)
A form of CBT made for social anxiety. You and a therapist test your fears with experiments, drop safety behaviours and practise focusing outward. It has the strongest evidence of any treatment for social anxiety.
- Self-help books
You work through a book based on CBT, doing the exercises in real life. Books helped in trials, and they help more when someone checks in with you along the way.
- SSRIs and SNRIs
Daily antidepressant medicines, such as sertraline, escitalopram, paroxetine or venlafaxine. They are the best-tested medicines for social anxiety and clearly beat placebo, but symptoms often return after stopping.
- Virtual reality exposure therapy
You wear a headset and practise feared situations, such as a meeting or a talk, with a therapist guiding you. Inside a course of therapy, it works about as well as practising in real life.
- Group CBT
You meet weekly with a small group of people who also have social anxiety, and practise feared situations together. It helps clearly, but individual therapy made for social anxiety has done better in comparisons.
- Internet CBT
You work through online lessons and exercises, usually with a therapist checking in by message. Guided programmes work about as well as face-to-face therapy in several trials.
Practise in virtual reality
VR lets you face a meeting, a party or an audience step by step, with a therapist or at home. Inside therapy, it works about as well as practising in real life.
Helping someone else
For parents, partners, friends and therapists.