Feeling shy? Or is it something more?
It is common to feel nervous or unsure in social situations. Many people describe themselves as “shy.” For some, however, these feelings are more intense, more frequent, and begin to interfere with daily life, relationships, school, or work. When this happens, it may be more than shyness.
Social Anxiety Disorder
Social Anxiety Disorder (SAD), also known as Social Phobia, is the most common anxiety-related condition. Research suggests that about 12% of people in the United States will experience it at some point in their lives. Symptoms most often begin in childhood, and in about 95% of cases, the condition is fully developed by late adolescence.
Without treatment, Social Anxiety Disorder often continues across the lifespan. It can be highly limiting and can affect nearly every area of life. It is associated with increased risk of depression and suicidal thoughts, and can lead to lower performance or underachievement in school and at work.
Importantly, people living with Social Anxiety Disorder are not simply “too shy,” and they do not need to be outspoken, very confident, or highly assertive to improve. Effective support focuses on helping them feel safer, more skilled, and more at ease in the situations that matter to them.
Social anxiety in everyday life
Most of our daily activities involve other people—at home, at school, at work, and in the community. Individuals with Social Anxiety Disorder do not only worry about how strangers see them. They also worry about how friends, colleagues, teachers, or family members perceive them.
To cope, they may:
- Speak very quietly
- Avoid eye contact
- Constantly monitor their face for signs of blushing or “hot spots”
- Decline invitations or avoid social situations altogether
Over time, these strategies can reduce anxiety in the short term, but they often keep the fear going and limit opportunities for connection and growth.
Feeling self-conscious
You may notice that you feel very self-conscious when meeting new people, walking into a room, or even waiting at a bus stop. You might “see yourself from the outside,” imagining that you are turning red, shaking, or looking awkward. You may feel more comfortable in colder seasons because it is easier to “hide” under layers of clothing. You might apologize for “having a cold” when you fear your nose or face has turned red.
If these experiences feel familiar, you are not alone—and support is available.
How therapy can help
There are several evidence-based therapies that can help with Social Anxiety Disorder.
- Exposure-based therapy
This approach supports you in gradually entering social situations that feel challenging, in a planned and collaborative way. Over time, repeated, supportive practice helps reduce fear and build confidence. You learn that you can tolerate discomfort and that feared outcomes are often less likely or less severe than expected.
- Cognitive Behaviour Therapy (CBT)
CBT helps you notice and understand the thoughts, images, and predictions that feel most intense for you in social situations—your “hottest” thoughts. Together with your therapist, you test these predictions through structured experiments and make small, purposeful changes in behaviour. This can reduce self-focus, increase flexibility, and help you experience social interactions in a new way.
When social anxiety is linked to past experiences
Sometimes social anxiety is closely connected to events earlier in life, such as being bullied, criticized, or reprimanded in front of others. When this happens, memories or vivid images of these events may replay in your mind, including images of how you believe you looked or behaved at the time.
These memories and images can be addressed directly in therapy. Approaches such as trauma-focused CBT or EMDR (Eye Movement Desensitization and Reprocessing) can help process these experiences, reduce their emotional impact, and support you in relating to them in a more compassionate, balanced way.
What to expect from treatment
The overall goal of therapy is to help you feel:
- Better resourced and supported
- More skilled in managing anxious thoughts and physical sensations
- More comfortable experimenting with new behaviours in social situations that you choose or need to attend
Therapy is a collaborative process. You and your therapist work together to set goals that matter to you, track progress over time, and adjust the plan as your needs change. Many people with Social Anxiety Disorder experience significant improvement with structured, evidence-based care.
How CMAP Health can support you
Our multidisciplinary team of psychologists, psychotherapists, and psychiatrists offers evidence-based treatments for Social Anxiety Disorder, including Cognitive Behaviour Therapy (CBT), exposure-based approaches, and trauma-focused therapies such as EMDR where appropriate. We use measurement-based care to monitor symptoms and functioning over time, so you can see your progress and stay engaged in the process.
If social anxiety is affecting your relationships, education, work, or everyday life, you do not have to manage it alone. With the right support, change is possible.
References
Clark, D.: Update on Social Anxiety Disorder (lecture), Audio Digest Psychology, Vol. 8, Issue 6, March 21, 2019.
About the Author
Kirstine Postma, CPsych, Clinical Director
Kirstine Postma is a UK-trained Clinical Psychologist with over 20 years of professional experience. She provides psychological assessment and evidence-based interventions for a wide range of concerns, including post-traumatic stress, anxiety, mood difficulties, and certain personality-related challenges. She offers Cognitive Behavioural Therapy (CBT), EMDR, and several other scientifically supported therapies.
