Dr. Julie DiMatteo is a clinical psychologist board certified in Behavioral and Cognitive Therapy by the American Board of Professional Psychology (ABPP). She is the co-founder of CBT Specialists, a private group practice in North Jersey specializing in evidence-based treatment of anxiety disorders, OCD, depression, trauma, and women's mental health. Dr. DiMatteo is also a board member and the research coordinator for the National Social Anxiety Center (NSAC), an organization dedicated to providing and fostering effective evidence-based services for those struggling with social anxiety.
Article4 min read
Are You Suffering From Social Anxiety? Here's How to Tell
- Julie DiMatteo PhD ABPP
- Zach Pacha LISW
- Holly Scott MBA MS LPC
- Suma Chand PhD
- Oct 1, 2025
- 4
Social anxiety disorder is a notoriously under-recognized, under-diagnosed, and under-treated mental health condition, especially among women. Many women navigate social anxiety in silence, often dismissing their symptoms as mere shyness or everyday nerves. What makes it so tricky to pinpoint? If you’ve spent years managing social anxiety on your own, it’s easy to downplay the impact it has on your life. But when fears of social interactions—along with the physical and emotional symptoms they trigger—start limiting your personal, professional, or social opportunities, it’s time to explore relief options and prioritize your well-being.
What Is Social Anxiety Disorder (SAD)?
Social anxiety disorder, or SAD, is a mental health condition characterized by an intense and persistent fear of social situations. This fear stems from anxiety about being judged, embarrassed, or humiliated in front of others to the extent that it interferes with daily life.
SAD can be triggered by a combination of genetic predisposition, biological factors, and environmental influences. It often begins during adolescence, around the age of 13, but can also appear in younger children.
Social Anxiety Disorder Symptoms
- Extreme shyness
- Intense fear of being embarrassed or humiliated
- Aversion to social interactions
- Few or no social or romantic relationships
- Difficulty participating in classes or meetings
- Refusal to speak in group settings
- Physical symptoms like blushing, sweating, shaking, heart palpitations, nausea, or dizziness before or during social interactions
How Is Social Anxiety Treated?
- Cognitive behavioral therapy (CBT): This research-based therapy involves changing the way you perceive social interactions and situations.
- Mindfulness training: Developing mindfulness skills can help you stay present in social settings instead of giving in to anxious thought patterns.
- Acceptance and commitment therapy (ACT): ACT involves learning to accept the thoughts and feelings you can’t control and disconnect from past and future worries to focus on the current moment.
- Medication: SSRIs, or antidepressants, have been proven effective in treating SAD when combined with ongoing therapy.
Quiz: Do I Have Social Anxiety… or Something Else?
Normal Anxiety vs. Social Anxiety Disorder
You’ve probably experienced run-of-the-mill anxiety if you felt shy before walking into a room full of strangers, anxious before asking your boss for a raise, or jittery on your way to a blind date. Social anxiety disorder amplifies these normal worries into insurmountable fears that interfere with daily life. Someone with social anxiety might decline an invitation to a loved one’s birthday party, turn down a hard-earned promotion because it requires public speaking, or come up with an excuse to avoid dinner plans out of fear of embarrassment and rejection.
Social Anxiety vs. Shyness
While social anxiety is often confused with simple shyness, the two differ greatly in intensity. Shy people tend to experience mild effects that ease as they become more comfortable over time. Those with social anxiety, on the other hand, suffer from relentless symptoms that cause social impairment and isolation. Social anxiety is more likely to be mistaken for shyness in women, resulting in frequent missed diagnoses.
Social Anxiety vs. OCD
SAD and OCD are both anxiety disorders that can trigger similar symptoms and aversions, such as the fear of saying the wrong thing in public. The key difference lies in how each disorder responds to logic. Someone with social anxiety could use logic to come to the conclusion that no one will judge or reject them if they say the wrong thing, resolving the negative thought. A person battling OCD, on the other hand, is aware that their intrusive thoughts are not logical but is still unable to eliminate them. OCD tends to respond better to a combination of exposure therapy and CBT.
Social Anxiety vs. Agoraphobia
Social anxiety disorder and agoraphobia can trigger similar types of fears and even occur simultaneously in the same person. They diverge in that SAD is triggered by fears surrounding social situations and other people. while agoraphobia revolves around fears of physical places. In fact, someone with agoraphobia may find their symptoms are alleviated by the presence of a companion, while a person struggling with social anxiety will likely find the opposite to be true.
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