If being around other people fills you with dread — afraid you will be judged, embarrassed, or watched — that is not “just being shy,” and you are not alone. Social anxiety disorder is common, it is well understood, and it responds very well to treatment. You are welcome here.

What social anxiety disorder is

Social anxiety disorder is an intense, lasting fear of social or performance situations in which you might be judged or scrutinized — speaking up, meeting new people, eating in front of others, or being the center of attention. It affects about 7% of U.S. adults in a given year, and roughly 12% at some point in life (National Institute of Mental Health, n.d.). It often starts young and, untreated, can quietly shrink a person’s world.

Signs and symptoms

• Strong fear of being embarrassed, judged, or rejected.
• Avoiding social situations, or enduring them with intense distress.
• Physical signs — blushing, sweating, trembling, racing heart, or a shaky voice.
• Dreading an event for days or weeks beforehand, and replaying it afterward.

It is more than shyness when the fear is intense, lasts six months or more, and gets in the way of work, school, or relationships.

How it is understood and evaluated

A careful, caring history is how we understand your experience and tell social anxiety apart from ordinary shyness, panic disorder, or generalized anxiety. You can share at your own pace — and yes, it is completely okay to start that conversation by telehealth from somewhere you feel safe.

Brief screening (96127)

To understand your symptoms and track your progress, we use brief, validated questionnaires — administered, auto-scored, and documented on the CNS Vital Signs platform and billed under code 96127 (brief emotional/behavioral assessment) — including the GAD-7 and, for children and teens, the Social Anxiety Scale for Children and Adolescents (Spitzer et al., 2006; CNS Vital Signs, n.d.). Each takes only a few minutes.

How it is treated — and how we approach it at OhanaPsych

The strongest evidence supports cognitive behavioral therapy (CBT) — especially individual CBT with gradual, supported exposure — as the best initial treatment for social anxiety disorder (Mayo-Wilson et al., 2014). Medication also helps, alone or alongside therapy: SSRIs and SNRIs have the most consistent evidence, with paroxetine, sertraline, and venlafaxine commonly used (Mayo-Wilson et al., 2014; Melaragno, 2021).

We hold this work with aloha and patience, with the goal of restoring lōkahi (balance and harmony) so connection feels possible again and your world can open back up. We coordinate care with your therapist and primary-care team.

Getting care by telehealth

Telehealth can be especially welcome for social anxiety, since you can begin from a private, comfortable place of your own. Some parts of care — such as certain controlled medications — still follow the federal Ryan Haight Act and DEA rules and may call for an in-person step; we will tell you clearly if that applies to you.

Lasting access by telehealth

As we complete the final stages of becoming a Rural Health Clinic (RHC), telehealth for mental-health care is here to stay with us. Under Medicare’s rural-health rules, RHCs are permanently authorized to provide behavioral and mental-health care by telehealth — including into your home, anywhere in Hawaiʻi — not under the temporary flexibilities that expire and must be renewed. For our patients, that means dependable, lasting telehealth access to the care you need.

Wherever you live, OhanaPsych is your statewide practice. We provide care across the entire state of Hawaiʻi by telehealth, reaching every island — Hawaiʻi Island, Maui, Oʻahu, Kauaʻi, Molokaʻi, Lānaʻi, and Niʻihau. If you would rather be seen in person, you have that option at our offices in Hilo and Honolulu.

When to reach out

You do not need to be in crisis to reach out — new patients are welcome. Call (808) 777-9460 or start your request online.

If you or someone you love is thinking about suicide or self-harm, get help right away. Call or text the 988 Suicide & Crisis Lifeline (call or text 988, or chat at 988lifeline.org). In Hawaiʻi, Hawaiʻi CARES is available by calling or texting 988, or at 808-832-3100 / 800-753-6879. In a life-threatening emergency, call 911.

Medically reviewed by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner, OhanaPsych / Ohana Care Clinic.
Last reviewed: June 28, 2026. Citations verified: June 28, 2026.

This page is general health education from OhanaPsych. It is not a substitute for a personal evaluation by a qualified clinician who knows your situation, and reading it does not create a provider–patient relationship. If you think you may have a mental health condition, reach out to us or another licensed provider. In an emergency, call 911.

References

CNS Vital Signs. (n.d.). CNS Vital Signs computerized rating instruments. https://www.cnsvs.com/WhitePapers/CNSVS-RatingInstruments.pdf

Mayo-Wilson, E., Dias, S., Mavranezouli, I., Kew, K., Clark, D. M., Ades, A. E., & Pilling, S. (2014). Psychological and pharmacological interventions for social anxiety disorder in adults: A systematic review and network meta-analysis. The Lancet Psychiatry, 1(5), 368–376. https://doi.org/10.1016/S2215-0366(14)70329-3

Melaragno, A. J. (2021). Pharmacotherapy for anxiety disorders: From first-line options to treatment resistance. Focus, 19(2), 145–160. https://doi.org/10.1176/appi.focus.20200048

National Institute of Mental Health. (n.d.). Social anxiety disorder. https://www.nimh.nih.gov/health/statistics/social-anxiety-disorder

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092