School, university and social anxiety

Why school and university are hard

Social anxiety usually begins young. A study that combined 42 studies found that about half of people with it had it before age 14, and 87.5% before age 25. So school and university are often where it first shows, at a time when you cannot avoid people.

Places to study are full of the situations social anxiety fears most:

• Being called on in class, or reading out loud.
• Seminars and tutorials, where speaking counts towards your mark.
• Presentations.
• Group projects, where you have to message, meet and agree with people you do not know.
• Eating in the canteen or dining hall.
• Asking a teacher or lecturer for help.
• Shared housing, where you may avoid the kitchen until everyone is asleep.

When you are anxious in class, you tend to focus on yourself: your face, your voice, what you will say. That leaves less attention for the lesson and makes it harder to think of an answer. What keeps social anxiety going explains the loop.

It can affect your studies. In a study of 8,192 young people in Norway, those who screened positive for social anxiety were less likely to finish upper secondary school by age 21: their chance was 14 percentage points lower. They were also a little less likely to go on to higher education: 87% compared with 92%.

What people with social anxiety often do

• Sit at the back and never speak.
• Skip seminars, presentations or lessons with group work.
• Do all the work in a group project to avoid having to talk about it.
• Eat alone, or skip meals.
• Never go to office hours or ask for help.
• Drop out, or switch to a course with less contact.

Avoidance gives relief today and makes the next time harder.

Small steps to try

This is an example exposure ladder: steps you face on purpose, easiest first. Repeat each step a few times before moving up.

1. Arrive a few minutes early and sit somewhere more central than usual.
2. Say hello to the person next to you, and ask one question about the course.
3. Email a teacher or lecturer a question, then go to see them in person about the next one.
4. Answer a question in a small class or seminar. A short answer is fine.
5. Ask a question in a large class or lecture.
6. Eat in the canteen, first alone, then with someone from your course.
7. Speak at a group-project meeting, such as suggesting who does what.
8. Give a presentation, using short notes instead of a full script.

If you have a presentation coming up, public speaking has a ladder just for that.

Support at school or university

Many students struggle and few get help. In World Health Organization surveys of college students in many countries, about 1 in 5 had a mental health condition of any kind in the past year. In 83.1% of them, it began before they started college. Only 16.4% got treatment.

Most universities have a counselling service, and many have a disability or wellbeing office. Names and rules vary by country. These offices can sometimes arrange support, such as presenting to a smaller group first. Use support that helps you take part, not support that lets you avoid everything. Avoiding all presentations may help this term but keeps the fear for later.

When to get more help

If anxiety is making you miss classes, fall behind or think about dropping out, get help now rather than after exams. The best-tested therapy is cognitive therapy for social anxiety. Online CBT fits around a timetable, and gains can last: in a Swedish study that followed people for five years, most of the improvement from online CBT was still there.

If you are a parent of a child who refuses to go to school, see school refusal.