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U.S. Department of Health and Human Services • National Institutes of Health

National Institute of Mental Health

Always Embarrassed:

Social Phobia

(Social Anxiety Disorder)

National Institute of Mental Health

Anxiety Disorders

People with anxiety disorders feel extremely fearful and unsure. 

Most people feel anxious about something for a short time now and 

again, but people with anxiety disorders feel this way most of the time. 

Their fears and worries make it hard for them to do everyday tasks. 

About 18% of American adults have anxiety disorders. Children also 

may have them. 

Treatment is available for people with anxiety disorders. Researchers 

are also looking for new treatments that will help relieve symptoms.

This booklet is about one kind of anxiety disorder called social phobia. 

Some people also call it social anxiety disorder. For information about 

other kinds of anxiety disorders, please see the end of this booklet.

Social Phobia
Social Phobia 

Social phobia is a strong fear of being judged by others 

and of being embarrassed. This fear can be so strong that it 

gets in the way of going to work or school or doing other 

everyday things. 

People with social phobia are afraid of doing common 

things in front of other people; for example, they might be 

afraid to sign a check in front of a cashier at the grocery 

store, or they might be afraid to eat or drink in front of 

other people. All of us have been a little bit nervous, at one 

time or another, about things like meeting new people or 

giving a speech. But people with social phobia worry about 

these and other things for weeks before they happen.

Most of the people who have social phobia know that they 

shouldn’t be as afraid as they are, but they can’t control their 

fear. Sometimes, they end up staying away from places or 

events where they think they might have to do something 

that will embarrass them. That can keep them from doing 

the everyday tasks of living and from enjoying times with 

family and friends. 

Most people who have social phobia

know they shouldn't be as afraid 

as they are, but they can't control 

their fear.

 
s o c i a l p h o b i a 

This is a list of common symptoms. 

People with social phobia:

• are very anxious about being with other people.

• are very self-conscious in front of other people; that is, 

they are very worried about how they themselves will act.

• are very afraid of being embarrassed in front 

of other people.

• are very afraid that other people will judge them.

• worry for days or weeks before an event where other 

people will be.

• stay away from places where there are other people.

• have a hard time making friends and keeping friends.

• may have body symptoms when they are with other 

people, such as: 

 blushing, 

heavy sweating, 

trembling, 

nausea, and 

having a hard time talking. 
 n a t i o n a l i n s t i t u t e o f m e n t a l h e a l t h 

When does social phobia start?

Social phobia usually starts during the child or teen years, usually 

at about age 13. A doctor can tell that a person has social phobia 

if the person has had symptoms for at least six months. Without 

treatment, social phobia can last for many years or a lifetime.

Is there help?

There is help for people with social phobia. The first step is to go 

to a doctor or health clinic to talk about symptoms. People who 

think they have social phobia may want to bring this booklet 

to the doctor to help them talk about the symptoms in it. 

The doctor will do an exam to make sure that another physical 

problem isn’t causing the symptoms. The doctor may make a 

referral to a mental health specialist.

Doctors may prescribe medication to help relieve social phobia. 

It’s important to know that some of these medicines may take 

a few weeks to start working. In most states only a medical 

doctor (a family doctor or psychiatrist) can prescribe medications. 

Treatment can help people with 

social phobia feel less anxious 

and fearful.
s o c i a l p h o b i a 

The kinds of medicines used to treat social phobia are listed below. 

Some of these medicines are used to treat other problems, such 

as depression, but also are helpful for social phobia:

• antidepressants,

• anti-anxiety medicines, and

• beta blockers.

Doctors also may ask people with social phobia to go to therapy 

with a licensed social worker, psychologist, or psychiatrist. 

This treatment can help people with social phobia feel less 

anxious and fearful.

There is no cure for social phobia yet, but treatments can give 

relief to people who have it and help them live a more normal 

life. If you know someone with signs of social phobia, talk to 

him or her about seeing a doctor. Offer to go along for support.

To find out more about social phobia, call 1-866-615-NIMH 

(1-866-615-6464) to have free information mailed to you.
 n a t i o n a l i n s t i t u t e o f m e n t a l h e a l t h 

Who pays for treatment?

Most insurance plans cover treatment for anxiety disorders. 

People who are going to have treatment should check with 

their own insurance companies to find out about coverage. 

For people who don’t have insurance, local city or county 

governments may offer treatment at a clinic or health center, 

where the cost is based on income. Medicaid plans also may 

pay for social phobia treatment.

Why do people get social phobia?

Social phobia sometimes runs in families, but no one knows for 

sure why some people have it, while others don’t. When chemicals 

in the brain are not at a certain level it can cause a person to 

have social phobia. That is why medications often help with the 

symptoms because they help the brain chemicals stay at the 

correct levels. 

To improve treatment, scientists are studying how well different 

medicines and therapies work. In one kind of research, people 

with social phobia choose to take part in a clinical trial to help 

doctors find out what treatments work best for most people, or 

what works best for different symptoms. Usually, the treatment 

is free. Scientists are learning more about how the brain works

so that they can discover new treatments.
s o c i a l p h o b i a 

“In school I was always 

afraid of being called on, 

even when I knew the 

answers. When I got a job, 

I hated to meet with my 

boss. I couldn’t eat lunch 

with my co-workers. 

I worried about being 

stared at or judged, and 

worried that I would 

make a fool of myself. 

My heart would pound, 

and I would start to 

sweat when I thought 

about meetings. The 

feelings got worse as 

the time of the event 

got closer. Sometimes 

I couldn’t sleep or 

eat for days before 

a staff meeting.” 

“I’m taking medicine 

and working with 

a counselor to cope 

better with my fears. 

I had to work hard, but 

I feel better. I’m glad I 

made that first call to 

my doctor.”

Personal story
 n a t i o n a l i n s t i t u t e o f m e n t a l h e a l t h 

For More Information on 

Social Phobia and Other Anxiety Disorders

Visit the National Library of Medicine’s 

MedlinePlus www.nlm.nih.gov/medlineplus

En Español, http://medlineplus.gov/spanish

For Information on Clinical Trials for 

Social Phobia and Other Anxiety Disorders

NIMH Clinical Trials Web page

www.nimh.nih.gov/studies/index.cfm

National Library of Medicine Clinical Trials Database

www.clinicaltrials.gov

Information from NIMH is available in multiple formats. 

You can browse online, download documents in PDF, 

and order paper brochures by mail. You can order NIMH 

publications online at www.nimh.nih.gov. If you do not 

have Internet access, please contact the NIMH Information 

Center at the numbers listed below.

For Further Information

National Institute of Mental Health

Science Writing, Press, & Dissemination Branch

6001 Executive Boulevard

Room 8184, MSC 9663

Bethesda, MD 20892-9663

Phone: 301-443-4513 or 

1-866-615-NIMH (6464) toll-free

TTY: 301-443-8431

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FAX: 301-443-4279

E-mail: nimhinfo@nih.gov

Web site: www.nimh.nih.gov
 

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u.s. Department of Health and Human Services

National Institutes of Health

NIH Publication No. 07-4678

Revised 2007