Whether your goal is to overcome social anxiety before specific events, like presentations or parties, or you’re seeking help for social anxiety disorder, there are several strategies to consider. If your social anxiety is persistent or getting in the way of living the life you want to live, Dr. Chapman recommends working one-on-one with a therapist.
Here, experts share common strategies for overcoming social anxiety.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is a type of treatment that examines one’s thoughts, feelings and actions, focusing on changing patterns that lead to difficulty with functioning. All three experts say that this is an especially effective way to overcome both social anxiety and social anxiety disorder. “The therapist will peel back the layers of the fear in regards to the thoughts and behaviors causing it. We connect the thought process to the behaviors and integrate new behaviors to change the thought behind the fear,” explains Chestnut.
“With CBT, you teach the client what social anxiety is and [help pinpoint] where their fears are coming from,” says Dr. Chapman. For example, if someone’s fear is that they’ll embarrass themself, “then the therapist helps the person replace those thoughts with evidence-based thoughts,” he explains. “What is the evidence that you will make a fool of yourself?” Typically, he says, the evidence is not there. Even if something embarrassing did happen in the past, Dr. Chapman says the person will see that they are still okay; it wasn’t the end of the world.
Experts agree that actually engaging in social situations and overcoming the associated fear is part of CBT. This part of CBT is called exposure therapy—an example of what this can look like, according to Dr. Chapman, is outlined below:
CBT exposure therapy for social anxiety:
- Imaginal exposure: Before actually engaging in a social setting, the therapist will talk with the client about what it will be like. They may ask the client to visualize the social environment and acknowledge any anxious feelings that arise. Together they can talk through how the client will behave in the social setting and handle any anxious feelings.
- Low-risk fear exposure: The therapist will task the client with being in a social setting that only makes them feel mildly uncomfortable. This may include going to the grocery store or to the movies. In some cases, the therapist may go with the client to be there for social support and to see how they act in the social setting.
- Medium-risk fear exposure: Once the client has been successful in a low-risk fear exposure, the therapist will ask them to be in a social setting where they feel slightly more uncomfortable. Likely, the therapist will have the client do this several times in several different settings before moving up the fear hierarchy to a new setting.
- High-risk fear exposure: Once the client has navigated the medium-risk fear exposure social settings without feeling overly anxious, the therapist will ask them to engage in a social setting that would have been highly uncomfortable for them at the beginning of their treatment. But because the client will have had success in the low- and medium-risk fear exposure social settings, these settings should now only make them mildly uncomfortable.
Psychodynamic Therapy
Psychodynamic therapy is another treatment that has been shown to be effective for social anxiety disorder. This type of therapy focuses on the psychological roots of emotional suffering, according to the American Psychological Association.
Psychodynamic therapy utilizes self-reflection and self-examination, as it’s characterized by the idea that a person’s unconscious thoughts and perceptions are developed during childhood, later influencing their behavior. The goal of this type of therapy is to help you recognize and understand those deep-rooted feelings.
Studies have found psychodynamic therapy to be effective for treating social anxiety disorder, both in the short-term and long-term, and some research has found it to be comparable to CBT in terms of efficacy.
Building a Support System
“Having a support system is important for any kind of mental health condition someone may be experiencing, social anxiety included,” says Halstead. She explains that experiencing social anxiety can feel isolating, and opening up to people you trust can be difficult, but ultimately it can be beneficial to see first-hand that your loved ones want to support you.
Dr. Chapman adds that he often has clients with this condition attend a support group with other people with social anxiety disorder. “It actually works as a part of exposure therapy because a support group is in its nature a social setting,” he says. “It’s an extremely safe place to open up about your experience because you know the others there are experiencing it too.”
The best way to find a support group near you is to ask a local therapist or research social anxiety support groups in your area. The Anxiety and Depression Association of America also has a search tool to locate support groups, including ones that meet virtually.
Mindfulness-Based Stress Reduction
One very small study in the journal Emotion found that mindfulness-based stress reduction may help people with social anxiety disorder, as those who engaged in a breath-focused attention task showed improvement in anxiety and depression symptoms and self-esteem. Taking slow, deep breaths—which is often done during mindfulness-based stress reduction—helps lower cortisol levels (known as the “stress hormone”), which leads to feeling more calm. For this reason, even simply taking several deep breaths before an anxiety-inducing social situation may help someone feel less anxious.
Having Healthy Habits in Place
Regularly exercising, eating nutrient-rich foods and getting consistent, good sleep can all play a supportive role in reducing social anxiety. “Exercise has a profound effect on managing anxiety in general because the body is experiencing the same arousal response during exercise as with anxiety [an increase in heart rate],” says Dr. Chapman. “This makes experiencing that arousal response [in social situations] less threatening.” To his point, studies have found regular exercise to be an effective clinical treatment for people with anxiety.
In terms of diet, Dr. Chapman explains that the mind and gut are intricately connected. Eating a diet full of nutrient-rich foods and minimizing processed food consumption has been scientifically linked to reducing anxiety.
Lastly, as anyone who has ever missed out on a good night’s sleep knows, being tired makes everything worse—including anxiety. “If you don’t get enough sleep, cortisol levels rise, which can make you more anxious,” says Dr. Chapman. Aim for between seven and nine hours of sleep a night.
Medication
There are times when someone with social anxiety disorder may want to consider prescription medication, says Halstead—for example, if you’ve tried CBT and are still struggling, considering a prescription medication may be something to talk about with your doctor. “The most common type of medication prescribed for social anxiety disorder are [selective serotonin reuptake inhibitors] SSRIs,” she says.