Social Anxiety in Adults: Why It Happens and How to Overcome It

While it is normal to feel anxiety on a rollercoaster, or before a big presentation, living with social anxiety disorder goes far beyond occasional nerves. Adults with this condition can feel intense, persistent, and disruptive anxiety that impacts their daily life.

At Wellington Counseling Group, with locations in Chicago and Northbrook, we frequently work with adults who have struggled with social anxiety disorder for years. Though often mistaken as shyness or introversion, social anxiety is a diagnosable condition that requires care. Thankfully, it is also highly treatable with many effective evidence-based resources to help.

What Is Social Anxiety Disorder?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), social anxiety disorder involves intense fear and anxiety related to social or performance situations. The fear usually centers around being judged, embarrassed, or negatively evaluated by others.

Symptoms of social anxiety disorder include:

• Avoiding social situations such as parties, meetings, or speaking in public
• Worrying for days or weeks before an event
• Difficulty making eye contact or starting conversations
• Physical symptoms of anxiety like blushing, sweating, trembling, or nausea
• A constant fear of saying or doing the “wrong” thing

Social anxiety can look different for different people—some feel it in all social settings, while others are situation specific, like public speaking or eating in front of a group.

Why Does Social Anxiety Happen?

People with social anxiety often have a pattern of negative thoughts about themselves and how others perceive them. These beliefs may stem from:

• Genetics or a family history of anxiety
• Traumatic or embarrassing social experiences in childhood or adolescence
• Underlying issues with self-esteem or perfectionism

Associations in the brain begin to develop over time, associating social situations with danger, and triggering the fight-flight-freeze response. While in this emotional state, it can feel safer to withdraw or avoid social situations altogether, leading to issues in daily life.

Short-Term and Long-Term Effects

In the short term, avoiding social situations can bring immediate relief. Skipping a party, staying quiet in meetings, or declining a phone call may ease anxiety in the moment, but that relief often comes at a cost—missed opportunities for connection, increased self-criticism, and a growing sense of isolation. Avoidance can also make everyday interactions feel even more intimidating over time.

Left unaddressed, social anxiety can have long term effects. It may interfere with relationships, limit career growth, and contribute to depression, substance use, and chronic stress. The longer avoidance patterns continue, the more deeply they can become ingrained.

The good news? Social anxiety disorder is treatable. With the right support—through therapy, medication, or a combination—you can learn to manage symptoms, break the cycle of avoidance, and build confidence in social situations.

How to Treat Social Anxiety Disorder

Treatment typically includes a combination of therapy, medication, and lifestyle changes. The approach depends on the severity of symptoms and your individual goals.

1. Therapy

There are a number of therapy approaches, including Cognitive Behavioral Therapy (CBT), that treat social anxiety disorder, helping individuals:

• Identify and challenge negative thoughts
• Develop realistic beliefs about social situations
• Build practical coping skills while facing fears over time

Therapy can provide insights and skills for long-lasting change.

2. Medication

In some cases, Selective Serotonin Reuptake Inhibitors (SSRIs) or other anti-anxiety medications are prescribed to reduce symptoms and improve quality of life. These can be especially helpful when used alongside therapy.

Speak to a mental health professional to determine if medication is right for you.

3. Support Groups and Social Practice

Support groups offer a safe space to share experiences, practice social interactions, and reduce feelings of isolation. For instance, practicing exposure-based exercises can help retrain the brain’s response to social triggers and reduce the fight-flight-freeze response.

Over time, what once felt overwhelming can become more manageable—and possibly even enjoyable.

Building Confidence, One Step at a Time

If you live with social anxiety, know this: you’re not alone. Many adults manage these challenges daily, even if it’s not visible from the outside. The key is to take things one step at a time.

Start small:

• Set manageable, achievable, and scalable social goals
• Focus on self-compassion instead of self-criticism
• Celebrate progress—even the small actions 

If you’re feeling stuck, talk to someone. Working with a therapist can help you navigate setbacks, reframe old beliefs, and build new thought and behavior patterns.

Final Thoughts

Social anxiety disorder is more than nervousness—it’s a treatable condition that deserves understanding and support. You don’t have to keep avoiding situations or hiding your discomfort. With the right tools, you can move out of fear toward connection, confidence, and emotional freedom. If you’re ready to take the next step, contact Wellington Counseling Group to schedule a session in Chicago or Northbrook. Our experienced team is here to help you build the skills and insight to feel more at ease in your own skin—and in the world around you.