What Causes Social Anxiety

Social Anxiety: Causes and Treatment 

Social anxiety isn't just shyness. It’s not a preference for quiet nights in, or an excuse to skip the party. For millions of people, social anxiety is a crushing fear of judgment, rejection, or humiliation in social settings. It can make simple things—like ordering coffee, making a phone call, or attending a work meeting—feel impossible.

Worse, many people suffering from social anxiety don’t get help. Instead, they turn to self-medication with alcohol, drugs, or other substances to try to numb the fear. This turns an already difficult mental health issue into a dangerous cycle of anxiety and addiction. Let's break down the roots of social anxiety, how it connects to substance abuse, and what treatment options actually work.

What is Social Anxiety?

Social anxiety disorder, also known as social phobia, is one of the most common mental health disorders in the United States. It’s marked by an intense, persistent fear of being watched or judged by others. People with social anxiety often:

• Avoid social interactions or events entirely

• Worry for days or weeks before an event

• Experience physical symptoms like sweating, shaking, or nausea

• Use substances like alcohol or drugs to feel more “comfortable” in social settings

What separates social anxiety from everyday nervousness is the level of distress it causes and the impact it has on someone’s ability to function in daily life.

What Causes Social Anxiety?

Social anxiety isn’t something you just wake up with one day. It usually develops over time, especially in adolescence, and is caused by a mix of biological, psychological, and environmental factors.

1. Brain chemistry: Imbalances in brain chemicals like serotonin can affect mood and anxiety regulation. People with social anxiety often have an overactive amygdala—the brain’s fear center.

2. Genetics: If someone in your family has social anxiety or another anxiety disorder, you’re more likely to develop it.

3. Environment and experiences: Bullying, abuse, family conflict, or overcritical parenting can plant the seeds of anxiety early. Even a single traumatic public embarrassment can spark lifelong fear of similar situations.

The Link Between Social Anxiety and Substance Abuse

Many people with social anxiety turn to alcohol or drugs to manage their symptoms. These substances can dull the fear—temporarily. A glass of wine might make it easier to speak in public. A joint might make someone feel more relaxed at a party. But the comfort doesn’t last.

The problem is that substances don’t cure social anxiety—they mask it. Over time, the brain becomes reliant on the substance to feel safe, and that’s how addiction forms.

This can lead to a dual diagnosis: a person has both a substance use disorder and a mental health disorder like social anxiety. Dual diagnosis is complex and often harder to treat, because each condition fuels the other. Without treating both, recovery is unlikely to last.

Signs You May Have Social Anxiety

• You constantly worry about embarrassing yourself

• You avoid eye contact or speaking in groups

• You replay conversations in your head, looking for mistakes

• You feel physically ill before or during social events

• You rely on substances to get through social interactions

If these symptoms sound familiar, you’re not alone—and help is available.

Treatment for Social Anxiety

The good news? Social anxiety is highly treatable. With the right support, tools, and sometimes medication, people can regain control over their lives.

1. Cognitive Behavioral Therapy (CBT)

CBT is the gold standard for treating social anxiety. It teaches people how to identify and challenge irrational thoughts that fuel anxiety. Through exposure techniques, CBT also helps people gradually face their fears in a safe, controlled way.

2. Medication

In some cases, antidepressants or anti-anxiety medications like SSRIs or SNRIs can help reduce symptoms. These are especially useful for people whose anxiety interferes with daily functioning or who have a co-occurring depressive disorder.

3. Group Therapy

This might sound like a nightmare to someone with social anxiety, but group therapy allows people to share experiences in a supportive environment. It helps break the isolation and teaches social skills in a low-pressure setting.

4. Mindfulness and Relaxation Techniques

Breathing exercises, meditation, and progressive muscle relaxation can help calm the body’s fight-or-flight response. Over time, this can make anxiety symptoms more manageable in real-world situations.

5. Dual Diagnosis Treatment Programs

If someone is struggling with both substance abuse and social anxiety, they need specialized care. Dual diagnosis treatment addresses both disorders simultaneously through a combination of therapy, medication, peer support, and lifestyle changes.

Left untreated, social anxiety can lead to job loss, failed relationships, academic difficulties, isolation, and yes—addiction. But when people seek help, they discover they’re not weak. They’re not broken. They’re simply dealing with a mental health issue that can be managed with the right tools.

If you or someone you know is struggling with social anxiety and using substances to cope, don’t wait. There’s no shame in asking for help—only strength in doing so.

Life doesn’t have to be ruled by fear. You don’t need a drink or a drug to feel like yourself. You just need the right support.

If you or a loved one are struggling with mental health issues, please give us a call today at 833-479-0797.