Dr. Tim O’Connor, MD
Psychiatrist
Most people have felt nervous before giving a presentation, meeting new people, or walking into a room where they do not know anyone.
Most people have felt nervous before giving a presentation, meeting new people, or walking into a room where they do not know anyone.Â
Social Anxiety Disorder involves more than occasional nervousness.
For individuals with social anxiety, everyday interactions can become a source of significant distress. Conversations, meetings, classes, social events, and even routine activities may trigger intense fear of embarrassment, criticism, rejection, or judgment from others.
If social anxiety has begun affecting your relationships, work, education, or quality of life, treatment may help.
Learn more about our anxiety treatment in North Carolina or schedule an appointment now.
Social Anxiety Disorder, sometimes called social phobia, is characterized by an intense fear of being judged, criticized, embarrassed, or negatively evaluated by others.Â
The fear often extends beyond public speaking or large groups. Some individuals experience anxiety during conversations, eating in public, meeting new people, participating in meetings, or performing routine tasks while being observed.
Many people recognize that their fear is disproportionate to the actual situation. The challenge is that insight alone is often not enough to reduce the anxiety.
Over time, the anticipation of social situations can become as distressing as the situations themselves.
Social Anxiety Disorder can affect the way a person thinks, feels, responds physically, and behaves in social situations. While everyone experiences occasional nervousness, social anxiety often creates a pattern of fear and avoidance that extends beyond a single interaction and begins affecting daily life.
The symptoms can vary from person to person. Some individuals notice the physical symptoms first, while others become more aware of the constant worry before or after social interactions. Many people experience a combination of emotional, physical, and behavioral symptoms.
Many people with social anxiety recognize that avoiding uncomfortable situations provides temporary relief. The challenge is that avoidance often reinforces the anxiety, making social situations feel even more intimidating the next time they arise.
Shyness and social anxiety are not the same thing.
Some people are naturally reserved, quiet, or cautious in unfamiliar social situations. Those traits do not necessarily indicate a mental health condition.
Social Anxiety Disorder involves a level of fear and avoidance that begins interfering with daily functioning.
A shy person may feel uncomfortable during a presentation and still complete it.
Someone with Social Anxiety Disorder may avoid opportunities, relationships, classes, meetings, or career advancement because the fear feels overwhelming.
The distinction is not whether someone feels nervous. The distinction is how much that fear affects their life.
There is no single cause of Social Anxiety Disorder.Â
Like other mental health conditions, researchers believe it develops through a combination of biological, psychological, and environmental influences.
Potential contributing factors include:
Individuals with a family history of anxiety disorders may have an increased likelihood of developing social anxiety.
Some individuals appear naturally more sensitive to social evaluation, uncertainty, or criticism.
Bullying, humiliation, rejection, chronic criticism, and other difficult social experiences may contribute to the development of social anxiety.
Over time, avoidance can reinforce anxiety by preventing individuals from gathering evidence that feared outcomes are less likely than they imagine.
Social anxiety is often misunderstood because many individuals become skilled at hiding it.
People dealing with social anxiety disorders can develop ways of masking their symptoms which can make the impact less obvious.
Social anxiety can affect:
If someone is avoiding social situations because of anxiety, they have fewer opportunities to build relationships that can support career advancement, personal growth, and life satisfaction.
Over time, these patterns can lead to a life that becomes smaller than a person would like it to be.
Social Anxiety Disorder is highly treatable.
Several evidence-based approaches have demonstrated effectiveness. While these treatments differ in their techniques, many share an important principle: gradually helping individuals confront the situations they fear rather than avoiding them.
Although avoidance often provides temporary relief, approaching feared situations in a safe, structured, and supportive way is what allows anxiety to become more manageable over time.
Cognitive behavioral therapy (CBT) is an often-used therapy and is considered one of the most effective treatments for social anxiety.Â
This approach helps individuals identify patterns of thinking and behavior that contribute to anxiety while developing practical strategies for responding differently to feared situations.
Many treatment plans involve gradually approaching situations that trigger anxiety in a structured and supportive manner rather than avoiding them.
Exposure-based therapies are used to treat several anxiety disorders, while a specialized form called Exposure and Response Prevention (ERP) is considered the gold-standard treatment for Obsessive-Compulsive Disorder (OCD).Â
The goal is to help individuals build confidence in their ability to tolerate anxiety and reduce the avoidance patterns that often keep it going.
For some individuals, medication may be a helpful component of treatment.
A psychiatrist can help determine whether medication may be appropriate based on symptoms, treatment history, and treatment goals. Â
When anxiety has become particularly disruptive or traditional outpatient treatment has not provided enough support, a Mental Health Intensive Outpatient Program (IOP) may be beneficial.Â
An IOP provides several hours of structured treatment each week while allowing individuals to continue living at home and maintaining many of their daily responsibilities.
At Advaita Integrated Medicine, we understand that social anxiety is about more than feeling nervous around people.
It can affect relationships, career opportunities, education, confidence, and a person’s willingness to engage with experiences that matter to them.
Our team provides:
We serve individuals throughout North Carolina, including Raleigh, Cary, Chapel Hill, and surrounding communities.
Avoiding situations that create anxiety can feel helpful in the short term. Unfortunately, avoidance often allows anxiety to continue expanding over time.
Treatment can help you develop new ways of responding to anxiety, build confidence in social situations, and engage more fully with the relationships, opportunities, and experiences that matter to you.
Contact Advaita Integrated Medicine to learn more about therapy and psychiatry services for Social Anxiety Disorder in North Carolina.
If you are experiencing thoughts of self-harm, suicidal thoughts, or a mental health emergency, call 911, go to your nearest emergency room, or contact the 988 Suicide & Crisis Lifeline by calling or texting 988.
Sources: National Institute of Mental Health (NIMH), Anxiety & Depression Association of America (ADAA).
Psychiatrist
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Psychiatric Physician Assistant
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