Getting Help for Social Anxiety Disorder at College


Getting Help for Social Anxiety Disorder at College

Meeting new people and developing friendships is an important part of college. Many people experience some degree of nervousness or awkwardness in relating with unfamiliar people such as professors, classmates, students in the dorm and other acquaintances. They may consider themselves to be «shy.

» But we now know that many «shy» people actually have «Social Anxiety Disorder.» Individuals who struggle with Social Anxiety Disorder experience a level of anxiety and fear about social situations that goes beyond minor or temporary feelings of discomfort.

Social Anxiety Disorder (SAD) is characterized by intense self-consciousness and embarrassment in social settings. People with SAD have intense, overwhelming fears of being watched or judged by others. Physical symptoms of anxiety, such as blushing, perspiring, and shaking are common.

These feelings and physical sensations often lead the person with SAD to become anxious for days or even weeks before social events. Social Anxiety Disorder is not equivalent to shyness.

Un shyness, Social Anxiety Disorder is persistent, intense fear and anxiety that does not diminish in social situations and that greatly interferes with the ability to function academically, socially, and at work.

People who struggle with SAD often avoid activities such as speaking in class, joining clubs or sports teams, attending parties, initiating romantic relationships, and approaching professors.

Some SAD sufferers avoid eating in public, writing in front of others, or using a public restroom as they fear scrutiny and feeling ashamed in these situations. Prevalence rates for Social Anxiety Disorder range from 2-13%. The overwhelming anxiety associated with SAD often begins during the teenage years, and may follow shyness and fear as a child. SAD frequently co-occurs with other mental health disorders, including other types of anxiety disorders, depression and substance abuse. SAD often occurs in more than one family member, and probably is caused by a combination of life experience and heredity.


Many people who struggle with Social Anxiety Disorder avoid seeking psychological treatment. The symptoms of the disorder lead SAD sufferers to fear many interpersonal situations, including counseling. This is unfortunate, as SAD can be effectively treated with therapy, or a combination of therapy and medication.

Counseling for SAD typically involves examining and changing the negative and self-defeating thoughts that are part of the disorder. These thoughts are usually irrational, and treatment helps the client understand that his or her fears are exaggerated and unrealistic.

For example, if a person has a great fear of speaking in class, the therapist will explore the client’s fears about what would happen (e.g. “I’m going to stammer and my voice will shake,” “People will think I’m stupid”). The therapist helps the client in substituting more positive, realistic beliefs (e.g. “People are concerned with the class, not with me.

” “It is perfectly acceptable to not know all the answers.”). The therapist might also assist the client in using and practicing social skills, such as making appropriate eye contact, smiling, and asking questions to get to know others better.

Another way counseling may help is in exploring social experiences earlier in life that may have contributed to the client viewing interactions with others as frightening or potentially humiliating. Many college students have had negative experiences during elementary, middle or high school years.

When facing a new social situation, the individual with SAD may come to expect a repetition of negative, uncomfortable experiences with others. Therapy investigates the client’s assumptions about social interactions, such as the expectation that others will be judgmental or critical, or the excessive need for others’ approval. The client in treatment for SAD learns to develop different, more realistic expectations about social situations.


Research has shown that Selective Serotonin Reuptake Inhibitor (SSRI) medications, (e.g. Prozac, Zoloft, Paxil, Luvox) help to reduce symptoms of Social Anxiety Disorder. These drugs usually take from between 3 to 12 weeks to begin working.

The SSRI medications are usually used for at least 6 to 12 months and withdrawn slowly. Short-acting anti-anxiety medications (e.g.

Ativan) can also help with short-term relief from Social Anxiety Disorder symptoms, but are less desirable for long term use than the SSRI’s because of the risk of becoming “habituated” (needing to take more of the drug to achieve the same effect).

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Getting Help for Social Anxiety Disorder at College

Starting college comes with bittersweet anticipation for most students. It’s considered a rite of passage into adulthood and with this milestone comes independence, exploration and personal development.

Some see the social parts of college life as the driving force to enroll. Keg parties, fraternity or sorority life and meeting new people is, to some, as important as academics.

For those who struggle with anxiety, though, leaving for college can fill them with apprehension.

They are moving away from the comfort of family and friends to a place of uncertainty, where interacting with strangers is inevitable. The college environment places heavy demands on social performance.

Making new friends, group projects, class presentations and everyday interactions with people can be challenge.

Managing Social Anxiety as a College Student

It’s important to remember there are three parts to social anxiety: thoughts; feelings or emotions; and behaviors. These connect and feed on each other:

“I have the thought that I’m not going to make any new friends because of my social anxiety.”

“I feel fear and anxiety in anticipation of meeting my roommate.”

“I won’t go to the dorm meet-and-greet because I’m going to feel anxious.”

The key is to try to separate and counter them. By avoiding social situations, we miss out on the chance to test our anxiety-fueled beliefs. If those beliefs aren’t countered, we’re bound to continue feeling fear and anxiety. Try to act in line with what you want from your college experience instead of giving into your beliefs and emotions.

Long-Term Strategies for Having a Successful College Experience with Social Anxiety

  1. The goal is avoidance reduction, not anxiety reduction.  No one s feeling fear and anxiety. But when we avoid situations because of it, the anxiety is in control. Trying things that seem impossible can help change our beliefs.

    We all remember how nervous we were on the first day of middle school but, by the end of the year, it was much easier.

  2. Create a hierarchy.  Compile a list of social interactions important for you to conquer, ordering it from easiest to hardest.

    Focus on getting comfortable with the easier activities, saying hello to your dorm neighbors, before moving on to harder items on your list, such as joining a club where you don’t know anyone.

  3. Practice, practice, practice. Exposing yourself to challenging social interactions will only get easier if you keep doing it.

    learning a musical instrument or foreign language, skill and confidence come with practice.

  4. Debrief your experiences.  After each social interaction, ask yourself, “What can I learn from this?” to determine if your belief about the situation actually happened.

    Often, we find anxiety was strongest in anticipation of the event. Other times, we do find our worry came to pass. Either way, debriefing is a chance to learn from the situation so you’re more prepared for the next one.

Short-term Tips for Success Despite Social Anxiety

  • Touch base with your new roommate, if you can, before leaving for school. This will show you’re eager to meet and help you begin to feel comfortable with them.
  • Reach out to any acquaintances going to the same college and, if possible, meet them before you leave. A familiar face on campus will help reduce feeling isolated and alone.
  • Attend as many orientation events as you can; they’re created to help meet new people. Set realistic expectations, though; meeting one or two new people is more manageable than trying to meet everyone.
  • Set goals, such as initiating introductions. Share three things about yourself and ask two questions of the other person.
  • Join clubs that focus on things of interest or that are familiar to you. Clubs related to your major can be helpful, while religious organizations can be welcoming and friendly.
  • Arrive to class early and try to sit in the same spot each time; others will ly do the same routine. That familiarity helps build relationships. Start by making eye contact and smiling at people you recognize. Add a ‘hello’ the next time.
  • When assigned a group project, try using non-verbal communication to let people know you want to work with them. Then invite them by saying, “Hey, would you to pair up?”
  • For class presentations, practice what you want to say, but don’t memorize it, which will give you a false sense of confidence. Use notes and PowerPoint to guide you.
  • While tempting to head home on the weekends, try to stay on campus as much as you can.

Celebrate Your Successes    

Learning to manage your social anxiety is any other skill; we get better with practice.

Don’t despair if you have setbacks. Acknowledge and reward your successes. Keep going if you face challenges and ask for help if you seem to be stuck or are experiencing extreme or debilitating anxiety.

Check out the campus counseling center as a resource. Regional clinics of the National Social Anxiety Center can also be a help. Each of those has psychotherapists trained to help with social anxiety.

The National Social Anxiety Center is a national association of regional clinics with certified cognitive therapists specializing in social anxiety and anxiety-related problems. We have compassionate therapists who can help you to reduce social anxiety.

Currently, we have regional clinics in San Francisco, District of Columbia, Los Angeles, Pittsburgh, New York City, Chicago, Newport Beach / Orange County, Houston / Sugar Land, St.

Louis, Phoenix, South Florida, Silicon Valley / San Jose, Dallas, Des Moines, San Diego, Baltimore, Louisville, Philadelphia, Montgomery County, Maryland / Northern Virginia, Long Beach, Staten Island, North Jersey, Brooklyn, and Santa Barbara.

Contact our national headquarters at (202) 656-8566 or visit our Regional Clinics contact page to find help in your local area.


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Anxiety in College Students: Signs, Symptoms & Treatments

Getting Help for Social Anxiety Disorder at College

Living away from home for the first time (and perhaps feeling homesick), managing difficult course work and schedules, increased social pressures, independent self-care routines, the pressure to succeed on your own, and financial responsibilities are all stressors that make college students more vulnerable to anxiety.

If a student is having a difficult time adjusting to one or more aspects of college life, they may find themself feeling down and experiencing anxious thoughts.

These thoughts usually include negative self-talk, self-doubt, worry, cycles of obsessing about various outcomes, and many other self-critical thoughts.

As these thoughts continue to escalate, there is a possibility that the student will start to become more anxious and possibly isolate themself to avoid being exposed.

Even if the student knows that many of their peers are also dealing with school stress, personal experience with anxiety can cause them to feel isolated and alone due to the severity of the symptoms, especially if it is the first time. It is always a good idea to speak to someone if anxiety is impacting you.

Signs of Anxiety in College Students

Anxiety in college students is more than just feelings of nervousness or worry. The symptoms that can present during this time tend to be debilitating, and without the right interventions can have a long-lasting impact on the student, even beyond the college years.

Some signs of anxiety to watch out for include:2

  • Nervousness or unease
  • Inability to maintain focus
  • Uncontrollable worry
  • Sleep disturbances or insomnia
  • Missing classes or assignments
  • Isolation from family, friends, and classmates
  • Changes in eating habits
  • Cycles of negative thoughts

Anxiety vs. Normal Stress Responses

Stress is a part of life and everyone struggles with worries and anxiety at times. However, when the reactions to the stress begin to overtake normal functioning, that is when stress can turn into anxiety.

Specific Types of Anxiety Common Among College Students

The presentation of symptoms in college students can differ greatly as everyone is impacted by anxiety related to their own unique experiences. There are various types of anxiety that are common, yet not diagnosed as separate disorders.

The following are some specific types of anxiety and the corresponding symptoms that identify each category:

  • Anticipatory Anxiety: Anticipatory anxiety is characterized by increased anxiety and panic about events that are expected to happen in the future, such as an upcoming exam or meeting with a professor.
  • Separation Anxiety: Separation anxiety can leave students feeling lonely or isolated, missing their familiar connections. It can stunt the social growth and development of community in students. When students are not open to engaging in activities on campus with their peers, they become more isolated and therefore feel an even greater impact of the separation.
  • Test Anxiety: Test anxiety can have both physical and mental manifestations such as racing heart and inability to concentrate, often resulting in a heightened sense of panic or excessive fear, even when the individual is adequately prepared for the exam.
  • Social Anxiety: Social anxiety is an intense fear or anxiety of social situations. During the college years, there are added pressures to engage in social situations related to educational coursework and outside of academia. Peer pressure is heightened during this time and presents added pressures related to experimenting with drugs, alcohol, sexual situations, and academic dishonesty.3

When to Seek Professional Help

Anxiety and the worries that come along with it may not go away on their own. You should contact your doctor if the symptoms of anxiety are interfering with your relationships, academics, or other parts of your life as a college student.

You should seek help if your fear, worry, or anxiety is upsetting to you, is difficult to control, or if you think that your symptoms may be linked to another underlying health condition. It is always important to seek professional help if you have thoughts of self-harm or suicide.

many mental health conditions, the earlier that you begin to treat anxiety, the easier it will be to learn the coping mechanisms and find the best treatment options for your situation. Allowing the symptoms to progress over time may cause more emotional and physical discomfort and disturbances to your life.3

In many instances, untreated anxiety can lead to heightened stress and possibly even panic attacks. These episodes can be very frightening for the individual and sometimes can even be mistaken for a heart attack due to the intensity.

How Anxiety Is Treated on College Campuses

Due to the high prevalence, most college campuses have specialized services in place which are also convenient to access and are usually low cost or free to students. Campus mental health counselors are well prepared to treat anxiety and they are also able to refer students to the health center for a medication evaluation if indicated.

While it is highly treatable, only about one-third of the population seeks treatment for anxiety.4

Some specific ways that anxiety is treated are:

  • Therapy: In therapy, you will explore the struggles that you are facing and develop a plan to help you learn to cope with your specific symptoms of anxiety in a healthy way. Some therapy techniques for treating anxiety include cognitive behavioral therapy and exposure therapy.
  • Medication: Medications are sometimes used to treat anxiety and prevent episodes of severe symptoms. A medical doctor or a psychiatrist can complete an evaluation and determine if medication will be used in your treatment plan.
  • Exercise: Scientists have found that regular participation in aerobic exercise has been shown to decrease overall levels of tension, elevate and stabilize mood, improve sleep, and improve self-esteem. About five minutes of aerobic exercise can begin to stimulate anti-anxiety effects.5
  • Natural Remedies: Natural remedies for anxiety, yoga, meditation, mindfulness practice, good nutrition, support groups, and spirituality can all aid in the treatment of anxiety.

How to Get Help

Campus counseling centers are a great first step, as they are available to provide assessments, treatments, and referrals for the college community’s mental health needs.

Contact the counseling center to schedule an appointment for an evaluation to help determine a course of treatment.

The mental health provider will be able to discuss your needs and work with you to develop a specific treatment plan to address the symptoms of anxiety and how it is impacting your life.

What Resources at My University Can Help?

College campuses are equipped with many resources to assist with your mental health needs. Becoming familiar with the services that are available at your school is especially important. The types of support services found on college campuses are typically similar, however what they are called and the exact services provided may vary.

Resources for mental health support on a college campus typically include:

  • Campus Counseling Center: Therapy services, community referrals, online assessments, group programming, and mental health educational and outreach services.
  • Health and Wellness Center: Ambulatory care, primary care services, health education and wellness programs.
  • Student Support Groups: Usually run by a mental health professional. On many campuses, support groups are available both in-person and online.
  • Campus Police: Responsible for safety, security, and upholding the laws. Police are trained to respond to mental health crises when they arise.

Do Universities Make Accommodations for Students with Anxiety?

Colleges are required to provide assistance and accommodations to students who are diagnosed with a mental health disorder according to Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973.6 Some examples of these accommodations include, but are not limited to, additional testing time, audio recordings of lectures and books, and additional time to complete assignments.

In order to qualify for accommodations due to a mental health diagnosis, an application must be submitted through the school’s disability office. This process can begin once the student receives their acceptance letter or at any point during their educational experience.

Colleges have different documentation requirements, however, most require a letter from a doctor or mental health professional who is qualified to make a diagnosis, assessments supporting the diagnosis, relevant treatment data, and records of functional limitations requiring accommodations.6

Coping With Anxiety as a College Student

Some helpful strategies to ensure that you are addressing your anxiety and making sure not to worsen the symptoms might include:

  • Eating well-balanced meals
  • Exercising regularly
  • Learning ways to better manage stress
  • Getting a healthy amount of sleep
  • Learning breathing exercises and grounding techniques
  • Working with a therapist who uses evidence-based treatment for anxiety
  • Connecting with other people who understand what you are going through
  • Learning about your anxiety—seek books, articles, blogs from experts in the field. Giving your symptoms a name and taking the time to understand your thoughts and reactions reduces the power that they have over you. If it’s test anxiety, find better ways to feel prepared.

What to avoid:

  • Trying to hold it in and keeping it to yourself
  • Using alcohol or drugs to cope with anxiety
  • Telling yourself to “get over it” or minimizing the impact
  • Ignoring physical reactions to anxiety

How Parents Can Help Their Anxious College Student

When your child is struggling with anxiety, it is important to remember that they will need support to help overcome it.

Here are some things that you can do to help your college-aged child without enabling them:

  • Talk to your child about their anxiety
  • Provide a safe space to listen to their concerns
  • Help your student remember times when they were able to achieve their goals despite feeling anxious
  • Connect your student with local mental health providers and resources


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