Social anxiety

It is December, the wedding season, and the invitations keep coming: a holud on Friday, a reception at the club on Saturday. Mitu, an illustrator whose work sells out at every Dhaka art fair, has drafted three messages saying she cannot come. Before any client call she rehearses her two sentences until her mouth goes dry, and on the way home she replays them, looking for the moment everyone noticed.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding social anxiety

Some people simply prefer quiet company, and that is temperament. Social anxiety is different: an intense, lasting fear of being watched, judged or embarrassed, strong enough to make people avoid ordinary situations or endure them in real distress. It often begins in adolescence, and because so much of life involves other people, it can quietly shape study, careers and friendships.

How common is social anxiety?

Social anxiety is one of the anxiety disorders, which together affected 470 million people worldwide in 2023, WHO estimates; the figure covers all anxiety disorders, not social anxiety alone. Half of all mental health conditions begin by the age of 18, WHO notes.

Signs and symptoms of social anxiety

• Strong fear before everyday situations: meetings, phone calls, eating in front of others
• Blushing, trembling, sweating or a racing heart in company
• Avoiding these situations, or getting through them with great effort
• Going over conversations afterwards, looking for mistakes
• Feeling sure that others will notice your anxiety and think less of you

Treatment for social anxiety

Cognitive behavioural therapy has the most evidence of any psychological treatment for anxiety disorders, according to WHO, and in social anxiety it helps people test their fears gradually and kindly, in real situations, until the feared outcomes stop seeming likely. For some people, medication helps alongside therapy.

What getting better can look like

Mitu’s progress is measured in ordinary rooms: a question asked on a client call, a lunch at the gallery opening. One winter evening she goes to the holud in yellow, stays for the music, and does not replay the night on the drive home.

Common questions about social anxiety

What is the difference between shyness and social anxiety?

Shyness, or a preference for quiet company, is temperament. Social anxiety is an intense, lasting fear of being watched, judged or embarrassed, strong enough that people avoid ordinary situations such as meetings, phone calls or eating in front of others, or get through them in real distress. It often begins in adolescence.

Can social anxiety be treated without medication?

Often, yes. Cognitive behavioural therapy has the most evidence of any psychological treatment for anxiety disorders, according to WHO, and in social anxiety it helps people test their fears gradually, in real situations, until the feared outcomes stop seeming likely. Some people also benefit from medication alongside therapy, a decision made with a doctor.

When to see a psychiatrist

If fear of other people is narrowing your choices at work, in study or in friendship, it is worth exploring. Help can begin with a single conversation.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.

Sources

• World Health Organization, “Mental disorders” fact sheet, 11 September 2026
• World Health Organization, “Anxiety disorders” fact sheet, 15 September 2026
• World Health Organization, “Child and adolescent mental and brain health”