Social Anxiety

Social Anxiety Treatment — Compassionate, Evidence-Based Care

Medically reviewed by Dr. Justin Nepa, DO | Board-Certified Psychiatrist | Last updated March 28, 2026

If speaking up in a meeting fills you with dread, if you rehearse conversations for hours before making a phone call, or if you've turned down opportunities because the idea of being watched or judged feels unbearable — you may be living with social anxiety disorder.

You're not alone. Social anxiety affects 15 million American adults, making it the third most common mental health condition in the United States. And yet, many people wait over 10 years before seeking help — often because the disorder itself makes reaching out feel terrifying.

The good news: social anxiety disorder is one of the most treatable conditions in psychiatry. With the right combination of therapy and medication, most people see significant improvement — often within weeks.

Over 75% of people with social anxiety disorder who receive evidence-based treatment experience meaningful, lasting improvement in their symptoms and quality of life.

What's Covered in This Guide

What Is Social Anxiety Disorder?
Signs and Symptoms
What Causes Social Anxiety?
How Social Anxiety Is Diagnosed
Social Anxiety Treatment Options
Our Approach at Refresh Psychiatry
Telepsychiatry for Social Anxiety
Insurance and Affordability
Frequently Asked Questions

What Is Social Anxiety Disorder?

Social anxiety disorder (also called social phobia) is a chronic mental health condition characterized by an intense, persistent fear of being watched, judged, or evaluated negatively by others. It goes far beyond ordinary nervousness or shyness.

People with social anxiety experience overwhelming anxiety in everyday situations that most people take for granted — ordering food at a restaurant, introducing themselves, answering a question in class, or attending a social gathering. The fear often feels irrational even to the person experiencing it, yet they cannot simply "push through" it.

Over time, social anxiety typically leads to avoidance behaviors that progressively shrink a person's world — declining invitations, passing on promotions, avoiding eye contact, or isolating entirely. The condition often begins in the early to mid-teens but can develop at any age.

Social Anxiety vs. Shyness — Understanding the Difference

Many people confuse shyness with social anxiety disorder. While they share surface-level similarities, the differences are clinically significant:

Shyness is a personality trait. You may feel temporarily uncomfortable meeting new people but can still function normally. It doesn't prevent you from living your life.
Social anxiety disorder is a medical condition. The fear is persistent (lasting 6 months or more), disproportionate to the actual situation, and causes significant impairment in work, school, or relationships.

If social situations cause you such distress that you're changing your behavior to avoid them — skipping work events, eating lunch alone, turning down opportunities — that's not shyness. That's a treatable condition. Learn more about how anxiety differs from normal worry.

How Common Is Social Anxiety Disorder?

15 million adults in the U.S. live with social anxiety disorder. It is equally common in men and women, though men are less likely to seek treatment. The average age of onset is 13 years old.

Social anxiety is the third most common mental disorder after depression and alcohol use disorder. Despite its prevalence, only about 36% of people with social anxiety receive treatment — often because the disorder itself creates barriers to seeking help.

If you recognize yourself in any of this, you've already taken the hardest step: acknowledging that something isn't right.

Signs and Symptoms of Social Anxiety Disorder

Social anxiety manifests through a combination of emotional, behavioral, and physical symptoms. Recognizing them is the first step toward getting help.

Emotional & Behavioral Symptoms

Intense fear of situations where you may be judged
Worry for days or weeks before a social event
Fear of embarrassing or humiliating yourself
Avoiding social situations or enduring them with extreme distress
Difficulty making eye contact or speaking to strangers
Fear that others will notice you're anxious
Analyzing your "performance" after social interactions
Avoiding eating, drinking, or writing in front of others

Physical Symptoms

Blushing, flushing, or feeling hot
Rapid heartbeat or heart pounding
Sweating (especially palms)
Trembling or shaking
Nausea or stomach distress
Difficulty catching your breath
Dizziness or lightheadedness
Muscle tension, especially in the jaw and shoulders
Mind going blank mid-conversation

When to Seek Professional Help

Consider reaching out to a psychiatrist for an evaluation if:

You avoid everyday activities — work meetings, phone calls, social events — because of fear
Your anxiety feels disproportionate to the actual situation
Social fears have persisted for 6 months or longer
You've turned down jobs, relationships, or experiences because of anxiety
You use alcohol or substances to cope with social situations
You spend excessive time worrying about upcoming social interactions
Your symptoms are accompanied by depression or other mental health concerns

Social anxiety rarely goes away on its own. In fact, without treatment, it tends to intensify over time as avoidance patterns deepen. The earlier you seek help, the more effective treatment tends to be.

What Causes Social Anxiety Disorder?

Social anxiety disorder develops through a complex interaction of biological, psychological, and environmental factors. Understanding these can help reduce self-blame — this is not a character flaw or a failure of willpower.

Genetic and Biological Factors

Genetics: Social anxiety runs in families. If a first-degree relative has the condition, you're 2 to 6 times more likely to develop it yourself.
Brain chemistry: Imbalances in serotonin — a neurotransmitter that regulates mood and anxiety — play a central role. This is why SSRIs are effective treatments.
Amygdala activity: Research shows that people with social anxiety have an overactive amygdala — the brain's threat-detection center — which triggers exaggerated fear responses in social situations.

Environmental and Psychological Triggers

Childhood experiences: Bullying, rejection, public humiliation, or overly critical parenting can contribute to the development of social anxiety.
Modeling: Growing up with a parent who exhibits anxious behavior in social settings can teach children to perceive social situations as threatening.
Temperament: Children who are behaviorally inhibited — naturally cautious, shy, and withdrawn in new situations — are at higher risk.
Life transitions: Starting a new job, moving to a new city, or other major life changes can trigger or worsen symptoms.

Many people with social anxiety also experience co-occurring conditions such as depression, generalized anxiety disorder, alcohol use disorder, or ADHD. A comprehensive psychiatric evaluation helps identify all contributing factors so treatment can address the full picture.

How Social Anxiety Disorder Is Diagnosed

There is no blood test or brain scan for social anxiety. Diagnosis is based on a thorough clinical evaluation by a qualified mental health professional — typically a psychiatrist or psychiatric nurse practitioner.

Your provider will evaluate your symptoms against the criteria in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), which requires:

Marked fear or anxiety about one or more social situations involving possible scrutiny by others
Fear that you will act in a way or show anxiety symptoms that will be negatively evaluated
Social situations almost always provoke fear or anxiety
Social situations are avoided or endured with intense anxiety
The fear is out of proportion to the actual threat
Symptoms have persisted for 6 months or more
Symptoms cause clinically significant distress or impairment in social, occupational, or other areas of functionin

What to Expect at Your First Appointment

We understand that scheduling a first appointment can feel like its own anxiety trigger. Here's exactly what happens, so there are no surprises:

Your comprehensive psychiatric evaluation lasts approximately 45 to 60 minutes
Your provider will ask about your symptoms, their severity, and how long they've been present
You'll discuss your medical history, family history, and any other mental health concerns
There are no tests or surprises — just an open, non-judgmental conversation
You'll receive a personalized treatment recommendation before you leave
Appointments are available in-person or via telepsychiatry — whichever feels more comfortable

Ready to take the first step?

Schedule your evaluation today — in person or from the comfort of home.

Book Your Appointment | Call (954) 603-4081

Social Anxiety Treatment Options

Social anxiety disorder is one of the most responsive conditions to evidence-based treatment. At Refresh Psychiatry, we use approaches backed by decades of clinical research and personalize every treatment plan.

Cognitive Behavioral Therapy (CBT) — The Gold Standard

Cognitive Behavioral Therapy is the most extensively studied and effective psychotherapy for social anxiety disorder. It works by helping you:

Identify the negative thought patterns that fuel your anxiety ("Everyone is judging me," "I'm going to embarrass myself")
Challenge those thoughts with evidence-based techniques
Replace them with more realistic, balanced perspectives
Gradually face feared social situations through structured exposure therapy

A meta-analysis of 101 clinical trials found that CBT produces large, clinically meaningful improvements in social anxiety symptoms. Benefits are maintained long after treatment ends — often years later.

CBT for social anxiety typically involves 12 to 16 weekly sessions. Many people notice improvement within the first month. The skills you learn — thought restructuring, relaxation techniques, gradual exposure — become tools you carry for life.

Medication Management

For moderate to severe social anxiety, medication can play a critical role — both as standalone treatment and as a complement to therapy.

SSRIs (First-Line Treatment)

Selective Serotonin Reuptake Inhibitors are the most commonly prescribed and best-studied medications for social anxiety disorder:

Sertraline (Zoloft) — FDA-approved for social anxiety; well-studied with a favorable side-effect profile
Paroxetine (Paxil) — FDA-approved for social anxiety; often effective for severe cases
Fluvoxamine (Luvox) — FDA-approved for social anxiety; sometimes preferred for patients with co-occurring OCD
Escitalopram (Lexapro) — Commonly used off-label with strong supporting evidence

SSRIs typically take 4 to 6 weeks to reach full therapeutic effect. Your psychiatrist will start at a low dose and adjust gradually based on your response. Learn more about our medication management approach.

SNRIs

Venlafaxine (Effexor XR) is an FDA-approved SNRI for social anxiety that works on both serotonin and norepinephrine. It may be recommended if SSRIs alone aren't providing sufficient relief.

Beta-Blockers for Performance Anxiety

Propranolol and other beta-blockers are commonly prescribed for performance-specific social anxiety — situations like public speaking, presentations, or musical performances. They work by blocking the physical symptoms of anxiety (racing heart, shaking hands, trembling voice) without affecting cognition. They are taken as needed, typically 30 to 60 minutes before the feared situation.

Benzodiazepines (Short-Term, Limited Use)

Medications like clonazepam may be prescribed short-term for severe social anxiety while waiting for SSRIs to take effect. Due to risk of dependence, they are not recommended as long-term treatment. Your provider will discuss risks and benefits openly.

Pharmacogenomic Testing

Not sure which medication is right for you? Pharmacogenomic testing analyzes your DNA to help predict which medications your body is most likely to respond to — and which may cause side effects. This can reduce the trial-and-error process and get you to effective treatment faster.

Combined Treatment — Therapy + Medication

Research consistently shows that combining CBT with medication produces the best outcomes for social anxiety disorder — superior to either approach alone, particularly for moderate to severe cases.

Medication provides symptom relief that makes it easier to engage in therapy. Therapy provides lasting skills that remain even after medication is discontinued. Together, they create a powerful, synergistic treatment approach.

Lifestyle Strategies That Support Recovery

While not replacements for professional treatment, these evidence-informed strategies can complement your care:

Regular exercise — 30 minutes of moderate exercise, 3-5 times per week, has been shown to reduce anxiety symptoms
Mindfulness meditation — Mindfulness-Based Stress Reduction (MBSR) shows promising results for social anxiety
Sleep hygiene — Poor sleep worsens anxiety; maintaining consistent sleep habits supports treatment outcomes. Read about managing insomnia
Limiting caffeine and alcohol — Both can worsen anxiety symptoms. Learn about the relationship between alcohol and mental health
Social skills practice — Structured, gradual exposure to social situations with professional guidance

Our Approach at Refresh Psychiatry

At Refresh Psychiatry and Therapy, we believe that effective treatment starts with understanding you as a whole person — not just your diagnosis.

Personalized Treatment Plans

Every patient's social anxiety is different. Some people fear public speaking but are comfortable one-on-one. Others struggle with all social interactions. Some have mild symptoms; others haven't left their home in months. Your treatment plan is built around your specific fears, your goals, and your life.

Board-Certified Providers Who Specialize in Anxiety

Our team includes board-certified psychiatrists and psychiatric nurse practitioners with extensive experience treating anxiety disorders. Every provider is trained in current evidence-based approaches and committed to creating a warm, non-judgmental environment.

Same-Week Availability

We know that waiting weeks for an appointment is especially difficult when anxiety is the issue. We work to offer appointments within days, not months. Check our current availability.

Why Telepsychiatry Works for Social Anxiety

For people with social anxiety, the experience of seeking treatment can itself trigger the condition. Traveling to an office, sitting in a waiting room with strangers, and meeting a new provider face-to-face may feel overwhelming.

Telepsychiatry removes those barriers.

Studies show that telehealth-delivered CBT and medication management for anxiety disorders produce outcomes comparable to in-person treatment. For social anxiety specifically, telepsychiatry may even have an advantage — patients report feeling safer and more open in their own environment.

With Refresh Psychiatry's telepsychiatry services, you can:

Meet with your psychiatrist from your home, office, or any private space
Avoid the added stress of commuting and waiting rooms
Access the same quality of care as an in-person visit
Continue treatment seamlessly when traveling or relocating within our service states
Schedule around your life — including evening and weekend options

Telepsychiatry is available for all services including initial evaluations, medication management, and follow-up appointments.

Social anxiety shouldn't stop you from getting help for social anxiety.

Start your treatment from home with a secure, private telepsychiatry appointment.

Schedule Telepsychiatry Visit | Call (954) 603-4081

Insurance and Affordability

Social anxiety disorder is a recognized medical condition with an ICD-10 diagnosis code (F40.10), and treatment is covered by most health insurance plans.

Refresh Psychiatry is in-network with:

Aetna
United Healthcare
Cigna
UMR
Oscar

We also offer competitive self-pay rates for patients without insurance or who prefer private payment. Our team can help verify your insurance benefits before your first appointment so there are no surprises.

Frequently Asked Questions About Social Anxiety Treatment

What is the best treatment for social anxiety disorder?

The most effective treatment is a combination of Cognitive Behavioral Therapy (CBT) and medication. CBT — particularly exposure therapy — is considered the gold standard. SSRIs like sertraline (Zoloft) and paroxetine (Paxil) are FDA-approved first-line medications. Research consistently shows that combined treatment produces better outcomes than either approach alone.

What medications are used to treat social anxiety?

FDA-approved medications include SSRIs (sertraline, paroxetine, fluvoxamine) and the SNRI venlafaxine (Effexor XR). Beta-blockers like propranolol are used for performance-specific anxiety. Benzodiazepines may be prescribed short-term. Your psychiatrist will work with you to find the right medication and dosage through our medication management program.

Can social anxiety be cured permanently?

Social anxiety disorder is highly treatable, and many people achieve lasting remission. CBT teaches skills that continue working long after therapy ends. Studies show that 50-65% of patients who complete a full course of CBT experience significant, sustained improvement. Early treatment leads to better long-term outcomes.

What is the difference between social anxiety and being shy?

Shyness is a personality trait — mild discomfort that doesn't impair functioning. Social anxiety disorder is a medical condition involving intense, persistent fear lasting 6+ months that causes significant distress and avoidance. The key difference is functional impairment — social anxiety interferes with work, school, and relationships in ways shyness does not.

Do I need a psychiatrist or therapist for social anxiety?

Many people benefit from both. A psychiatrist prescribes and manages medications; a therapist provides CBT and talk therapy. At Refresh Psychiatry, we offer comprehensive care including medication management and therapy referrals. For mild cases, therapy alone may suffice. For moderate to severe social anxiety, combined treatment is recommended.

How long does social anxiety treatment take?

CBT typically involves 12 to 16 weekly sessions, with many patients noticing improvement within 4-6 weeks. SSRIs take 4 to 6 weeks for full effect. Treatment duration varies — some people do well with a focused course, while others benefit from ongoing support.

Can social anxiety be treated without medication?

Yes. CBT alone is effective for mild to moderate social anxiety. Exposure therapy, social skills training, and mindfulness interventions can all produce meaningful improvement. For moderate to severe cases, combining therapy with medication typically produces the best results.

Does insurance cover social anxiety treatment?

Yes. Social anxiety disorder (ICD-10: F40.10) is a recognized medical condition covered by most plans. Refresh Psychiatry accepts Aetna, United Healthcare, Cigna, Humana, Avmed, UMR, and Oscar. We can verify your benefits before your first visit.

Can social anxiety be treated through telepsychiatry?

Yes. Telehealth-delivered treatment for social anxiety is as effective as in-person care. It can be especially beneficial because it removes the stress of office visits. Refresh Psychiatry offers telepsychiatry across Florida.

What happens at a first appointment for social anxiety?

Your first visit is a comprehensive evaluation lasting 45-60 minutes. Your provider asks about symptoms, history, and goals in a non-judgmental conversation. You'll receive a personalized treatment plan before you leave. Appointments are available in-person or via telepsychiatry.

Take the First Step Toward Relief

Living with social anxiety can feel isolating — like you're the only one struggling with something everyone else handles effortlessly. But you're not alone, and you don't have to keep living this way.

Social anxiety disorder is treatable. With the right combination of therapy, medication, and support, most people experience significant improvement — and many achieve full remission.

At Refresh Psychiatry, we've helped thousands of patients reclaim their confidence, their relationships, and their lives. We're ready to help you, too.

You deserve to live without fear holding you back.

Book your evaluation today — in person at any of our 16 locations, or from the comfort of home via telepsychiatry.

Schedule Your Appointment

Or call us at (954) 603-4081

Most insurance accepted | Same-week availability

Related Resources

Medical Disclaimer: This page is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment of any medical condition. If you are experiencing a mental health emergency, call 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.

Schedule online. It's easy, fast and secure.

BOOK AN APPOINTMENT

Telepsychiatry Services in Davie, Florida