Supporting Someone With Social Anxiety
Social anxiety disorder is intense fear of being watched or judged in social situations, strong enough that those situations are avoided or endured with dread, and lasting six months or more.
Also called: Social phobia, Social anxiety.
ICD-10 F40.1 · ICD-11 6B04
It gets mistaken for being quiet, rude or not interested.
People with social anxiety get seen as cold, aloof or unfriendly. The truth is that they are frightened, and working hard to hide it. Because it looks like a personality, almost nobody recognises it as a treatable illness. That includes the people who have it.
START HERE
The same message, two replies
Tap any reply to see what it does.
hey sorry i left the party early. i just couldnt be there anymore
Lands well
No need to be sorry. I was glad you came at all.
This removes the shame of leaving. It also notices the effort it took to turn up at all.
i kept thinking everyone could tell i was freaking out
Honestly I didn't notice. I just thought you were quiet. Want to get a coffee, just us, sometime?
This gives a real view from outside without dismissing the feeling. It also offers a smaller, easier next step.
yeah. that i can do
Lands badly
lol everyone noticed, you were so awkward
This confirms the exact fear. It will be replayed for weeks.
you just need to put yourself out there more
This is well meant. It sounds like they are not trying, when they are trying very hard indeed.
ok
nobody is even looking at you anyway
This is meant as reassurance. It dismisses the fear without testing it. It can also sound like "you are not worth looking at".
Seen. Doesn't come to the next one.
AND WHAT TO DO
If you are close to someone with social anxiety
- Do not speak for them or rescue them every time. It is kind, and it works exactly like a safety behaviour.
- Suggest smaller planned steps instead of big events. One friend, not a whole party.
- Never tease them about blushing, about being quiet, or about leaving early.
- Notice the effort. Turning up is often the hardest part of the whole evening.
- Encourage CBT designed for social anxiety. It is the treatment with the strongest evidence behind it.
MYTH CHECK
Six things people say. Two of them are true.
Answer before you read the answer. It sticks better.
Social anxiety is just being shy.
Verdict: myth.
Shyness is a trait. Social anxiety disorder is fear strong enough to shrink a life.
Many shy people are content and have close friends. Social anxiety causes real distress. It makes people avoid things they badly want.
People with social anxiety do not like people.
Verdict: myth.
Most of them want connection. Fear gets in the way.
From outside, avoiding people looks like not being interested. From inside it is usually longing and fear at the same time.
Kids will grow out of it.
Verdict: myth.
Without treatment it often lasts for years.
Social anxiety that starts in childhood tends to carry on into adult life. Early treatment works well.
The best thing is to avoid situations that cause anxiety.
Verdict: myth.
Avoiding brings relief now, and makes the fear stronger.
Every situation you avoid is a prediction that never gets tested.
People usually look much less anxious than they feel.
Verdict: true.
True.
When people with social anxiety watch themselves back on video, nearly all of them see that they came across better than they had predicted.
Dropping safety behaviours makes people like you more.
Verdict: true.
True.
In experiments, socially anxious people stopped using safety behaviours. The people they were talking to then rated them more warmly.
WHAT THE MISUNDERSTANDING COSTS
16 years — is the typical wait between social anxiety starting and a person getting any treatment.
is the typical wait between social anxiety starting and a person getting any treatment.
Part of the reason is the illness itself. Asking for help means phoning a stranger. It means sitting in a waiting room. It means describing your fears to someone who might judge you.
The other part is that it looks like a personality. People get told they are just shy, and eventually they believe it.
THE SAME ACT, TWICE
What it looks like, and what it is
Tap a card to turn it around.
Never speaks up in meetings.
They have something to say every single time. They rehearse it until the moment has passed.
Always has an excuse not to come.
They wanted to come. They spent the whole day dreading it, and then could not get out of the door.
Seems cold. Won't look at you.
They avoid eye contact because it feels like being seen straight through.
Texts instead of calling.
A phone call gives no time to plan. It also gives no way to hide a shaking voice.
Drinks a lot at parties.
They are using alcohol to get through it. That is a safety behaviour, and a risky one.
Left early without saying goodbye.
Saying goodbye means everyone turns and looks at you. Leaving quietly was the only way out.
BACKGROUND
Where the stigma comes from
It looks like personality
Quiet, awkward or cold reads as who a person is. It does not read as something they are struggling with.
It hides itself
The illness makes people avoid the exact places where it would be noticed. Clinics and honest conversations are two of them.
Confidence is prized
Schools, jobs and social media all reward being outgoing. So fear of attention gets read as weakness.
Shyness is a joke
On screen, shy characters exist to be laughed at. The real distress is almost never shown.