Do you suffer from the physical symptoms of social anxiety when in public? Do even intimate gatherings cause you to tense up, sweat, stammer, and feel like you’re not in control? Are you constantly afraid that these physical symptoms are visible to others?

Today’s Q&A isn’t brought to us by anyone specific because it’s something that hundreds of people I’ve worked with bring up all the time: How to deal with noticeable physical anxiety symptoms.

Dealing with the physical symptoms of social anxiety can be a vicious self-perpetuating cycle.

When we get anxious, we suffer the symptoms, then we get even more anxious because we think people are noticing. In fact, it can even cause major phobias, which then make the cycle even worse!

When we think that people are going to notice the results of our anxiety, we freak out because we believe that they’ll think we’re weak; they’re going to assume we’re a loser; they’re not going to want to work with us or date us—we’re loading judgements onto our symptoms.

Without even questioning it, we just assume the worst and swallow the judgement, hook, line, and sinker. At that point, we will do ANYTHING to rid ourselves of the problem.

One client I was working with had an issue with blushing: he got really red any time he spoke up at work, and it had become such a “thing” for him that he just stopped contributing his thoughts on the job. We worked together for a couple months, but all he wanted to do was make it disappear. In fact, he actually researched surgeries to remove the problem!

Now, let’s step back for a moment and look at this realistically. Does anyone think that a quick-fix solution this drastic is going to help the underlying problem in the long run?


All of the built-up anxiety inside you isn’t just going to evaporate into thin air . . . if you remove its outlet in one form, it’s just going to find another.

What you need to do is deal with the underlying anxiety—not its symptoms. Instead, however, we allow ourselves to believe that the symptom is the problem, and then we get even more anxious worrying about that.

Nowhere is this more evident than in erectile dysfunction. Often, the issue with this problem is cardiovascular, stemming from poor diet, lack of exercise, obesity, bad circulation, or all of the above. What doctors have also found, however, is that anxiety can play a huge role, as well: it happens once when we’re not feeling well (or whatever the cause), and from then on, we become a bundle of stress every time we get in an intimate situation.

What we resist persists.

In other words, you can’t freak out about something and still expect the symptoms to disappear.

So, how do we deal with the problems associated with stress while addressing the underlying issue? Acceptance.

– Yeah, I blush . . . so what?
– Yeah, I sweat a lot . . . so what?
– Yeah, I stammer sometimes . . . so what?

Who cares if these things pop up for you every now and then? They pop up for everyone! Do you really think someone is going to base their entire perception of you on the fact that you’re blushing? All other things aside, they probably wouldn’t even notice.

Think about it: you strike up a conversation with a coworker who is a little red in the face but who, otherwise, seems fine—you might simply think he’s hot or that he just walked up a flight of stairs. At worst, you might ask about it to make sure the person is OK, and he might say, “Yeah, I blush sometimes. Anyway. . . .”

No big deal.

What’s noticeable is if he’s acting like a scared, nervous mess on top of it—that’s when we might start to worry about him.

Just because you are projecting this horrible judgement of yourself doesn’t mean everyone else is doing the same.

The real issue is determining where that internal judgement is stemming from so that we can begin to deal with that.

When did you start to judge yourself so harshly for your anxiety and its symptoms? Did you get teased as a kid or have one really bad experience with it at some point?

For one of my clients, his issues with eye contact began when he got accused of staring at a woman in an elevator. In truth, he was just dealing with a lot of stress in his life and had “blanked out” on her face while thinking about it (which is perfectly normal).

Most serious anxiety issues can be pinpointed to one moment in time (or a collection of similar moments). In fact, these symptoms often start during stressful times in our lives because obsessing over them allows us to hyper focus on something other than the discomfort in our lives.

So, step one in approaching this issue is to figure out the root cause and give yourself some compassion. Step two is to take that compassion and let it evolve into acceptance.

Fact: we are always our own worst critics.

Nobody is going to be as harsh on you as you are, so you need to take a cue from the people around you and let go of that judgement.

The root of self-love is self-acceptance, but you will never get there until you let go of your obsessive judgements and tell yourself, “It’s OK.” If you have dealt with self-acceptance issues for a long time, then a good place to start might be with my program, Confidence University ( or my podcast, Shrink for the Shy Guy. These tools offer step-by-step instructions on diving deep into self-acceptance so that you can learn to let go of the old stories that aren’t serving you.

Once you can get to that place, your anxiety symptoms will start to become a non-issue. At that point, you will either continue to deal with those symptoms or not . . . but you won’t be held captive by them.

What issues do you have with acceptance of both yourself and your anxiety symptoms? How would you judge someone else with the same physical indicators? When we learn look at the underlying anxiety, we can finally begin to move past it and get on with our lives in a productive and prosperous manner. This is what I hope for you and what I know you have the power to achieve.

Until we speak again, may you have the courage to be who you are and to know on a deep level that you’re awesome.

Dr. Aziz