Help for Social Anxiety in the UK: Where to Start

The NHS says social anxiety is a fear that does not go away and affects everyday activities, self-confidence, relationships and work or school life. You may have social anxiety if you:

• worry about everyday activities, such as meeting strangers, starting conversations, speaking on the phone, working or shopping
• avoid or worry a lot about social activities, such as group conversations, eating with company and parties
• always worry about doing something you think is embarrassing, such as blushing, sweating or appearing incompetent
• find it difficult to do things when others are watching, as if you are being watched and judged all the time
• fear being criticised, avoid eye contact or have low self-esteem
• often feel sick, sweat, tremble or have a pounding heartbeat

The NHS adds that many people with social anxiety also have other mental health difficulties, such as depression, generalised anxiety or panic disorder. Source: NHS: social anxiety (social phobia).

The NHS says self-help can reduce social anxiety and may be a useful first step before other treatment. Its suggestions include:

• keep a diary of what goes through your mind and how you behave in social situations, to understand your anxiety better
• try relaxation techniques, such as breathing exercises
• break challenging situations into smaller parts and work on feeling more relaxed with each part
• try to focus on what people are saying, rather than assuming the worst

The NHS also points to an NHS self-help guide for social anxiety on its page.

The NHS says it is a good idea to see a GP if you think you have social anxiety, especially if it is having a big impact on your life. If the GP thinks you could have it, you can be referred to a mental health specialist for a full assessment. You can also refer yourself directly to an NHS talking therapies service without a GP referral: find your local NHS talking therapies service (England only). In Scotland, Wales and Northern Ireland, a GP is usually the first step.

The main treatments, according to the NHS, are cognitive behavioural therapy (CBT) with a therapist (on your own, in a group, or with parents or carers), guided self-help (working through a CBT-based workbook or online course with regular support from a therapist), and antidepressant medicine, usually a type called an SSRI. The NHS says CBT is generally considered the best treatment, some people need a combination, and the medicines are usually not used for children and young people. Medicine is a decision for you and your doctor.

The NHS lists these for people with social anxiety and other anxiety disorders:

• Anxiety UK
• Mind
• YoungMinds
• Triumph Over Phobia (TOP UK)
• Free and low-cost therapy: charities, workplaces, universities and training clinics.

The NHS says signs in a child can include crying or getting upset more often than usual, getting angry a lot, avoiding other children and adults, fear of going to school or taking part in classroom activities, not asking for help at school, and being very reliant on parents or carers. If you are worried about your child, speak to a GP. Treatment is similar to that for teenagers and adults, tailored to the child's age and often involving the parent or carer; medicines are not normally used. See also getting help for your child's mental health.

If you want to start sooner, choose who you see, or have longer-term support, you can see a private practitioner. Several professions work with social anxiety, and none is better for everyone. Ask about their training and experience with social anxiety and which approach they use:

• CBT therapists.
• Practitioner psychologists, such as clinical and counselling psychologists, who are on the HCPC register.
• Counsellors and psychotherapists with anxiety experience.
• Arts therapists (art, music, drama and dance movement), if putting feelings into words is hard.
• Occupational therapists, who can help when anxiety affects work, study or daily routines.

Whoever you choose, check their register and ask about fees, session length and how you will review progress together. See questions to ask before you book and how much therapy costs. On Therapist Circle, each practitioner's registration is checked when they join, and their profile shows the register and number so you can check it yourself.