Anxiety ยท October 14, 2026
Social Anxiety Disorder: Signs, Causes, and Treatment
By Kathie Bolles, PMHNP-BC
Social anxiety disorder is more than shyness: it is a persistent, intense fear of being watched, judged, or embarrassed in social situations. The NIMH reports that an estimated 7.1% of U.S. adults experienced it in the past year, and it can interfere meaningfully with work, school, and relationships. The good news is that it is treatable: cognitive behavioral therapy (CBT), including exposure-based work, is the first-line psychotherapy, and SSRIs or SNRIs are first-line medications. At Mynd Works Psychiatry in Austin, Texas, an anxiety evaluation can clarify whether social anxiety is part of the picture and how to approach treatment.
What is social anxiety disorder?
Per the NIMH, social anxiety disorder involves marked anxiety or fear in situations where a person may be scrutinized or judged, such as conversations, meeting new people, speaking, or eating in front of others. The fear feels uncontrollable and often leads to avoidance.
Physical symptoms such as blushing, sweating, a racing heart, or stomach upset commonly accompany the fear. People may worry about an upcoming situation for weeks in advance, and the avoidance can quietly shrink a person's life over time.
How common is social anxiety disorder?
Social anxiety is one of the most common anxiety disorders. The NIMH estimates that 7.1% of U.S. adults experienced it in the past year, that it affects 8.0% of women and 6.1% of men, and that about 12.1% of adults experience it at some point in their lives.
Despite how common it is, many people assume it is just their personality and never seek treatment. Social anxiety can coexist with depression or other anxiety disorders, which is one reason a careful evaluation is valuable.
What does social anxiety feel like in daily life?
It might show up as dread before meetings, avoiding phone calls, rehearsing conversations, declining invitations, or feeling on edge throughout a social event. Over time, avoidance protects the anxiety in the short term but makes it stronger and more persistent.
This pattern can interfere with careers, relationships, and everyday tasks in Austin and anywhere else. The work of therapy is not to eliminate nervousness, but to reduce the fear and avoidance so that life stops shrinking.
How is social anxiety treated?
Cognitive behavioral therapy, particularly with gradual exposure to feared situations, is the first-line psychotherapy and helps people identify and change the negative thoughts and avoidance that keep the disorder going. Where support adds value, psychotherapy at Mynd Works can focus specifically on these patterns.
SSRIs and SNRIs are the first-line medication options when medication is part of the plan, and combining therapy with medication is often recommended for moderate to severe cases. Treatment is decided collaboratively after an evaluation, never from a one-size-fits-all script.
How does an evaluation at Mynd Works work?
The evaluation is a conversation about your symptoms, when they started, what situations are hardest, and how anxiety affects your functioning. Measurement-based tools help track severity over time so progress is visible rather than guessed at.
From there, the clinician builds a personalized treatment plan, which may include therapy, medication, or both, with clear next steps. You can request a consultation to start, in person in Austin or by telehealth where clinically appropriate.
Common questions
Is social anxiety the same as being shy?
No. Shyness is a personality trait. Social anxiety disorder involves intense fear and avoidance that cause significant distress and interfere with daily life, work, or relationships.
Can therapy alone treat social anxiety?
Yes. CBT, and particularly exposure-based therapy, is a first-line treatment and can be highly effective on its own. Some people benefit from adding medication, and the right combination is decided with your clinician.
Does Mynd Works treat social anxiety in Austin?
Yes. Social anxiety is among the conditions Mynd Works evaluates and treats, with care available in person in Austin or by secure telehealth where clinically appropriate.
