Social Anxiety Treatment, From Home
Social anxiety disorder is an intense fear of being judged, embarrassed, or found lacking in social situations, strong enough to trigger physical symptoms (blushing, sweating, shaking, a blank mind) and persistent enough to shape decisions. It is different from shyness. Shyness is a temperament, while social anxiety disorder is a pattern of avoidance that costs you things: the meeting where you stayed silent, the class you dropped, the promotion you did not pursue, the relationships that never got past hello.
There is a specific irony in social anxiety care: the condition that makes it hardest to sit in a waiting room and talk to a stranger is treated by sitting in a waiting room and talking to a stranger. Telehealth removes that first wall.
Generalized vs. Performance-Only
Social anxiety comes in 2 broad patterns, and the distinction changes treatment.
It can look like
Generalized social anxiety spans most social situations: conversations, meetings, eating in public, being observed.
Performance-only anxiety is confined to specific situations like public speaking or presentations, while ordinary socializing is fine.
Treatment
How Social Anxiety Is Treated
For generalized social anxiety, first-line treatment is an SSRI or SNRI, cognitive behavioral therapy, or both. Sertraline, paroxetine, and venlafaxine ER have FDA approval for the condition, with effects typically building over 4 to 8 weeks. CBT for social anxiety, particularly with graded exposure, has some of the strongest psychotherapy evidence in the anxiety literature.
For performance-only anxiety, a beta blocker such as propranolol, taken before the specific event, blunts the physical cascade: the racing heart, the shaking hands, the tremor in your voice. It is an off-label but long-established approach; it is not sedating and is not controlled. For many people whose anxiety lives entirely on stages and in boardrooms, it is the right-sized tool.
What the first weeks look like
With Siggy
How Siggy Treats Social Anxiety
Intake and a video visit from wherever you are comfortable, an honest sort between generalized and performance patterns, and a matching plan: daily SSRI/SNRI treatment, situational propranolol, therapy referral, or a combination. Follow-ups are scheduled through the adjustment window via video; no waiting room required.
Structured intake
Answer clinically structured questions with Siggy, on your own time. Free, private, and reviewed by a clinician.
Video visit in days
Meet a licensed prescriber via video — days from intake, not months. Diagnosis and plan, decided together.
Treatment, same day
If medication is right, it goes to your pharmacy the same day, with follow-ups scheduled inside the adjustment window.
FAQs.
- Is medication really necessary, or should I just push through?
- Avoidance tends to grow, not shrink, without intervention. Whether the right intervention is medication, therapy, or both depends on your pattern; that is a 1-visit conversation, not a life sentence.
- Does propranolol make you calm or foggy?
- Neither. It blocks the adrenaline symptoms (heart rate, tremor) without sedation or cognitive effects, which is why it is used before performances rather than daily.
- Can social anxiety be treated entirely online?
- Yes, and for this condition online care is arguably better suited, not worse: lower barrier to the first visit, exposure practice happens in your real life, and follow-ups do not require a commute.
If you are having thoughts of suicide or self-harm, call or text 988 (Suicide & Crisis Lifeline) now. Siggy is not an emergency service.