Shyness, Social Anxiety, and the Hidden Toll of Coping with Alcohol: A NYC Therapist’s Perspective
Shyness and social anxiety may seem like harmless personality quirks—common, even endearing—but for many, they signal something deeper and more debilitating. While mental health experts understand these traits to exist on a continuum, social anxiety disorder (SAD) can silently disrupt the lives of high-functioning individuals who, on the outside, seem calm, capable, and composed. Underneath the surface, however, lies a storm of self-consciousness, anticipatory dread, and the desperate need to escape perceived scrutiny.
And for too many, that escape is found at the bottom of a glass.
When Social Anxiety and Substance Use Collide
According to the Anxiety and Depression Association of America (ADAA), individuals with social anxiety disorder are significantly more likely to misuse substances—particularly alcohol—as a way to manage distressing social situations. Alcohol becomes more than just a social lubricant; it becomes an adaptive strategy for surviving the unbearable.
For many, alcohol serves three roles at once:
Disinhibitor, reducing feelings of fear or shame in social environments
Mask, allowing individuals to perform without revealing inner discomfort
Self-soother, momentarily quieting the nervous system and inner critic
While it may provide short-term relief, this cycle is inherently self-reinforcing—and dangerous. Social avoidance increases, tolerance builds, and the original anxiety remains untreated, often worsening over time. This is the crux of what makes co-occurring social anxiety and substance use so insidious: each condition masks and fuels the other.
The Hidden Epidemic of Co-Occurring Social Anxiety and Addiction
Many studies estimate that the lifetime prevalence of alcohol use disorder among individuals with social anxiety disorder ranges from 20–30%, though clinicians working in urban environments—particularly in NYC—report seeing this number much higher in practice. In fact, many individuals presenting with alcohol misuse are only later diagnosed with social anxiety disorder after therapeutic rapport allows for deeper exploration.
This overlap is especially common among:
High-functioning professionals, who feel pressure to “keep it together” at all costs
Creative and performance-based fields, where visibility is currency but also a trigger
College students and young adults, navigating identity and intense social exposure
Women and femme-identifying clients, who may face compounded shame or gendered expectations around appearance, likability, and competence
Substance use—particularly alcohol and benzodiazepines—becomes a culturally accepted way to "manage" anxiety, masking the severity of the distress. Unfortunately, many clients come to therapy after years of feeling they had a character flaw or “just weren’t good at people.” In truth, they were never given the chance to understand or treat the actual root cause.
What Drives Social Anxiety Isn’t Just Fear of Rejection
One of the most misunderstood aspects of social anxiety is that it’s not only about fearing judgment. Many clients fear positive attention just as much—sometimes more—than negative evaluation. Being noticed, praised, or promoted can feel equally unsafe. Why?
Because social anxiety isn’t just cognitive—it’s somatic, relational, and often trauma-rooted. Past experiences of humiliation, neglect, bullying, or emotional invalidation leave deep imprints on the nervous system. Over time, the body learns to anticipate danger in visibility, even in moments of success.
This creates a push-pull experience: the desire to connect paired with the terror of being seen.
How Therapy Helps Break the Anxiety-Addiction Loop
Treating co-occurring social anxiety and substance use requires a trauma-informed, multidimensional approach. At Holistic Therapy & Wellness NY, we offer therapy that addresses both the symptom and the source, through modalities that honor the complexity of the human experience.
Our integrative framework includes:
Cognitive Behavioral Therapy (CBT): To reframe distorted beliefs about self-worth and social risk
Eye Movement Desensitization and Reprocessing (EMDR): To process social trauma and reduce emotional charge around triggering memories
Somatic and Nervous System Therapies: To regulate fight-flight-freeze responses and help the body feel safe in social contexts
Attachment-Based and Relational Therapy: To repair internal working models of trust, vulnerability, and self-expression
Addiction-Informed Psychotherapy: To address the function of substance use, reduce shame, and create alternative coping strategies
The goal is not simply to stop drinking or reduce anxiety—it’s to help clients feel safe enough to be seen, without numbing or hiding.
A Note for High-Achieving New Yorkers
In a city that rewards charisma, performance, and resilience, it’s easy to overlook social anxiety and substance use until things begin to unravel. But these struggles are more common than most people realize. If you feel exhausted from performing, isolated in your success, or reliant on alcohol to show up, you are not alone—and this is not your fault.
With the right support, you can heal the wounds that keep you stuck in cycles of avoidance and self-medication. Therapy offers not just tools—but a new way of relating to yourself and others, grounded in authenticity rather than fear.
About Holistic Psychotherapy & Wellness Manhattan
Kimberly Seelbrede, LCSW is a New York State licensed Psychotherapist, EMDR Practitioner and Couple Therapist with a private practice in New York City, Montana and virtually. As a wellness psychotherapist and holistic consultant, she has received advanced, extensive training in Trauma Therapy, Psychoanalytic Psychotherapy, Internal Family Systems (IFS), Eye Movement Desensitization Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Somatic Experiencing (SE), and Nutrition & Integrative Medicine For Mental Health. She is passionate about honoring the exquisite interplay of the mind-body connection. Kimberly Seelbrede specializes in anxiety & mood disorders, trauma and women’s mental health. She brings over 20 years of counseling, coaching, and healing experience to her holistic practice and transformational work.
In addition to online therapy for anxiety, depression, trauma and relationship struggles, Holistic Psychotherapy & Wellness offers a wide variety of online services to fit the needs of busy professionals. New Yorkers often lead fast-paced and complex lives, which makes work-life balance and managing career, family and social obligations a challenge. Psychotherapy and wellness practices provide the support to help clients cultivate resources, resilience and enhanced emotional health, as well as uncover conflicts and obstacles that may interfere with having the life they desire.
Women’s Mental Health Perimenopause & Menopause
Curated Lifestyle Interventions Protocols