Social anxiety disorder (SAD)—also known as social phobia—is a common but often overlooked mental health condition that causes intense fear and distress in social situations. From making eye contact to speaking in public or meeting new people, individuals with SAD may experience severe anxiety that affects their daily life, relationships, and quality of life.
At CBT Baltimore, we specialize in evidence-based treatments for social anxiety disorder, helping individuals overcome fear, build confidence, and reconnect with the world around them.
What Is Social Anxiety Disorder?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), social anxiety disorder is characterized by an intense fear of social or performance situations in which a person may be judged, embarrassed, or scrutinized. This fear is persistent and can interfere with work, school, or personal relationships.
Although shyness is common, SAD goes far beyond typical nervousness—it’s a diagnosable mental health disorder with real consequences if left untreated.
Symptoms of Social Anxiety Disorder
The symptoms of social anxiety disorder affect both the body and mind. They may occur during or in anticipation of social interactions or when performing in front of others.
Emotional and Behavioral Symptoms
- Fear of being judged or humiliated
- Avoidance of social situations, like parties or meetings
- Difficulty speaking to new people
- Negative thoughts and self-doubt
- Heightened self-consciousness
Physical Symptoms
- Increased heart rate
- Tremors, sweating, or blushing
- Nausea or dizziness
- Trouble speaking
- Upset stomach or shortness of breath
These symptoms may be especially severe in settings like public restrooms, presentations, or even casual conversations.
Risk Factors and Causes
The causes of social anxiety are complex and may include:
- Genetic predisposition
- Environmental factors (e.g., bullying, family conflict)
- Childhood experiences of embarrassment
- Overactivity in brain areas related to the fear response
Adolescents are particularly vulnerable, as SAD often begins during the teenage years—a developmental period where social evaluation is heightened.
People with SAD may also have an increased risk of developing other mental health disorders, such as:
- Panic disorder
- Depression
- Substance abuse
- Other anxiety conditions
Organizations like the National Institute of Mental Health (NIMH) and NIH continue to study the biological and psychological underpinnings of SAD.
Diagnosis and Assessment
A diagnosis is typically made by a mental health professional, such as a therapist, psychologist, or psychiatrist. At CBT Baltimore, we use structured interviews, questionnaires, and clinical evaluations to assess the severity and impact of SAD.
We may collaborate with primary care providers to rule out a medical condition or other health concerns, and always approach care with sensitivity and confidentiality.
Treatment Options for Social Anxiety Disorder
The good news is that social anxiety disorder is treatable. At CBT Baltimore, we offer a range of interventions tailored to each client’s needs.
1. Cognitive Behavioral Therapy (CBT)
CBT is the most effective, first-line treatment for SAD. It helps people recognize distorted beliefs, challenge negative thoughts, and gradually face feared situations.
Our approach often includes:
- Exposure exercises to build confidence in real-world situations
- Thought-challenging techniques to reduce self-conscious thinking
- Social skills training to improve communication and self-expression
2. Medication Options
When symptoms are moderate to severe, pharmacological treatments may be recommended in conjunction with therapy:
- SSRIs (e.g., sertraline) – commonly used antidepressants that reduce anxiety
- SNRIs – helpful for some individuals with overlapping conditions
- Beta-blockers – reduce physical symptoms like sweating or trembling in performance situations
- Benzodiazepines – fast-acting for short-term use; not typically first-line due to side effects and dependency concerns
All medication plans are coordinated with a licensed psychiatry provider or prescribing health care provider.
3. Supportive Therapies
- Talk therapy: Create a safe space to explore fears and social history
- Support groups: Connect with others facing similar challenges
- Self-help tools: Journaling, mindfulness, and guided audio programs
- Relaxation techniques: Breathing exercises, progressive muscle relaxation, and meditation
Our holistic care integrates the best of both psychotherapy and lifestyle support to create lasting change.
Social Anxiety vs. Shyness
While shyness is a personality trait, social anxiety disorder is a chronic condition that causes significant impairment in functioning. Here’s how they differ:
| Feature | Shyness | Social Anxiety Disorder |
|---|---|---|
| Commonality | Very common | Affects ~7% of U.S. adults annually |
| Triggers | New or unfamiliar settings | Most or all social interactions |
| Duration | Temporary | Persistent, lasting 6+ months |
| Impact | Mild discomfort | Disruption to work, school, and relationships |
If social discomfort is interfering with your daily life, it may be time to speak with a mental health professional.
How CBT Baltimore Can Help
At CBT Baltimore, our experienced clinicians offer individualized treatment plans rooted in compassion and backed by science. We combine CBT, exposure therapy, and skills-based coaching to help clients:
- Reduce social avoidance
- Improve mental health
- Build resilience in social and professional settings
- Reconnect with loved ones and communities
We also collaborate with primary care and psychiatry providers to offer integrated care when needed.
Let’s Tackle Social Anxiety Together
If fear of social situations is holding you back, you don’t have to face it alone. CBT Baltimore provides the tools and support you need to move forward with confidence. Our team is here to help you regain control, restore balance, and improve your quality of life.
Schedule a Session
Contact us to learn more about therapy for Social Anxiety Disorder, or feel free to request a session.