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Understanding Friendship Anxiety — and 7 Ways to Overcome It

Daniel Z. Lieberman, MD

Reviewed by Daniel Z. Lieberman, MD

Written by Hadley Mendelsohn

Updated 04/30/2025

Anxiety disorders are incredibly common, affecting nearly 20 percent of American adults annually — and many forms of anxiety are particularly prevalent in adolescent and young adult women.

Whether or not you’ve been officially diagnosed with a condition like generalized anxiety disorder (GAD), panic disorder, or social anxiety disorder (SAD), anxiety symptoms can get in the way of maintaining friendships, leading to what's known as friendship anxiety.

It’s no secret that anxiety can make meeting new people difficult, but friendship anxiety can also put a strain on existing friendships and connections.

The good news is that with appropriate treatment, it’s usually possible to gain more control over your mental health and prevent high anxiety levels from affecting your social relationships.

Below, we explore how anxiety impacts friendship and offer strategies for easing social stress and enjoying time with friends more comfortably.

While it’s not an official anxiety disorder like social anxiety, friendship anxiety is a common experience that involves extreme worrying about platonic dynamics and friendships.

If you frequently feel stressed out or worried about what kind of friend you are, or if you find yourself overthinking friendships and every little social interaction (even with your best friends), then you might be experiencing friendship anxiety. In fact, you may have even found yourself here because you searched “anxiety about friends not liking me.”

While there is a lot of overlap between social anxiety (or social phobia) and friendship anxiety, the latter tends to be less broad and only applies to interactions with friends.

Common Anxiety Symptoms

Friendship anxiety symptoms can be similar to those of GAD and SAD, but they usually bubble up around friendship specifically. Some common symptoms can include:

  • Feeling on edge, agitated, irritable, or restless

  • Difficulty focusing or feeling like your mind is going blank

  • Difficult-to-control feelings of worry and ruminating, especially on interactions with friends

  • Feeling fatigued quickly and often

  • Anxious thoughts like fear of losing friends or being rejected 

  • Needing constant reassurance from friends

  • Physical symptoms, like muscle tension, blushing, and sweating

The severity of social anxiety symptoms varies. Some people can control symptoms with the right techniques, while for others, they can lead to panic attacks.

Let’s look at some of the ways anxiety can affect platonic relationships, plus ways to manage social and friendship anxiety. 

Anxiety can affect your friendships in lots of ways. Below, we’ve shared seven ways that severe or persistent feelings of anxiety can get in the way of developing and maintaining friendships.

1. Meeting New People Might Be Challenging

It’s common to have a persistent fear of social situations, such as performing in front of others or meeting new people.

This fear can lead to physical symptoms like a racing heart and emotional symptoms like fear of judgment or embarrassment. These can make meeting new friends difficult, even if you think you’ll be compatible with someone.

2. Opening Up in Conversation Can Be Difficult

Friendship anxiety can also make building trust a big challenge.

Even if you’ve met someone and overcome the initial barriers to friendship, the idea of keeping up a conversation — or worse yet, starting one on your own — could feel daunting.

You may notice that you speak softly and avoid eye contact, even among friends. You might tremble or sweat when your friends ask you something completely innocent. These physical symptoms can worsen your anxiety.

Overall, this persistent worry can make what others think of as short and simple conversations feel like high-stakes obstacle courses to you.

3. You May Rely on Others to Initiate

You might rely on your friends to set up social engagements instead of taking the initiative yourself.

This might happen because you feel fatigued or find it difficult to focus. Alternatively, you may worry about feeling rejected if your friends don't respond to your invitation or aren't available when you are.

4. You Might Question the Strength of Your Friendships

Social and friend anxiety often involves a persistent fear that people judge you negatively. When a friend or new acquaintance doesn’t contact you for a few days or takes longer than expected to get back to you, it’s easy to question the state of that friendship.

One study found that people with SAD typically gave lower scores for perceived “friendship quality” than friends who were also asked to rate the quality of their friendships.

In other words, the participants with social anxiety perceived their friendships more negatively, even though their friends typically rated them as having strong friendships.

5. Some Social Activities Might Feel Off Limits

If certain situations, like crowded spaces, trigger your anxiety, you might find yourself instinctively avoiding specific social events and gatherings.

For example, some people have phobias of being part of a large crowd, spending time in open spaces, or being away from home by themselves. These fears might cause you to withdraw from friendships and other relationships.

6. You Might Worry That You’re Missing Out

Fear of missing out, or FOMO, is the apprehension that others are doing fun, fulfilling activities without you. As you can probably guess, FOMO — and conversations about FOMO — surged with the rise of social media.

FOMO can make many anxiety symptoms worse, including feelings of loneliness and social inferiority. You may notice this problem more if you’re prone to anxiety and spend a lot of your time on TikTok, Instagram, or other social media platforms. 

7. Sometimes, You May Just Cancel Plans

Anxiety severity can vary widely. For some, it’s an occasional issue that might make it harder to meet new people or speak publicly. For others, it’s pervasive and intense, causing panic attacks and a feeling of impending doom.

If you have a severe anxiety disorder, you might feel the need to avoid social situations entirely when your symptoms become a significant problem for you. 

In short, anxiety can lead you to avoid spending time with friends, which can weaken friendships and connections in the long term. 

Everyone experiences friendship anxiety sometimes. But if your anxiety is starting to get in the way of your ability to connect with friends, meet people, or maintain your existing relationships, it’s important to take action. 

The good news is that most anxiety disorders, including social anxiety, can be treated with a mix of professional help and simple adjustments to your habits and lifestyle. 

1. Talk to a Mental Health Professional About Anxiety Treatments

If you think you have a clinical anxiety disorder, such as GAD or SAD, one of the most important things you can do is to have a conversation with a mental health provider. For example, a psychiatrist can assess your symptoms and, if appropriate, suggest medication and/or therapy.

Many people with anxiety disorders benefit from antidepressants, anti-anxiety medications, and therapies like cognitive-behavioral therapy (CBT) for anxiety.

This type of therapy involves learning different methods of challenging negative and irrational thought patterns that fuel your anxiety or come up when you’re anxious. 

Both medication and therapy take time to work, but many people find they significantly reduce anxiety symptoms. In turn, this can make it easier to maintain friendships, romantic relationships, and family bonds.

If you feel ready to take the next step, we offer online psychiatry, where you can connect with a provider and access personalized care from the privacy and comfort of your home.

2. Practice Healthy Habits to Control Anxiety Symptoms

Sometimes, simply changing your habits can make the symptoms of anxiety easier to deal with. You can try to add exercise to your day, practice mindfulness meditation, or perform breathing techniques, which can all be great tools for managing stress and anxiety.

Our guide to mental health coping skills shares simple but effective wellness techniques that you can use to gain more control over your feelings and limit the effects of anxiety on your social life. 

3. Tell Your Friends You Have Anxiety

Sometimes, the easiest way to deal with friendship anxiety is to tell your friends how you feel. Consider letting your friends know that you have anxiety and might occasionally struggle with things like keeping plans or maintaining eye contact during conversations. 

There’s no need to go into detail unless you want to. Simply explaining why you might feel uneasy can help your friends understand and support you rather than judge you negatively.

4. Remember That You’re Not Alone

Have you ever spent time around your friends and worried they were secretly judging you? You probably weren’t the only one — in fact, your friends might have had similar worries that people were secretly judging them.

Remember that anxiety disorders are common. Some of your friends may also experience anxiety or related mental health issues, providing a common ground for bonding.

5. Work On Self-Acceptance

When you feel anxious around others, it’s easy to look at a natural social butterfly and wish you could be like that person.

Remember that everyone is different, and you don’t need to compare yourself to someone you think is “successful” at making friends. There’s no perfect level of sociability, and feeling anxious isn’t a sign that you’re less capable of being a good friend.

Instead, work on cultivating your self-esteem. This will help you embrace who you are, which can, in turn, lessen your anxiety in social situations. It’s all part of your journey.

6. Pay Attention to the Signs of Depression

Anxiety and depression frequently develop at the same time. In fact, research suggests that between 20 and 70 percent of people with SAD also develop depression at some point in life.

Like with anxiety, many of the symptoms of depression can affect your social life and make it more difficult to maintain friendships.

Some of these symptoms might make it harder to keep in touch with friends or make anxiety reactions more severe when they occur. The good news is that there are many effective treatment options for depression, too. 

Feelings of anxiety — even if you haven’t actually been diagnosed with a specific type of anxiety condition — can be overwhelming. But there are ways to take action.

Here’s what to keep in mind about friendship anxiety and how anxiety disorders can impact your friendships:

  • Persistent anxiety can impact your ability to connect with people and maintain friendships. While it’s not an official diagnosis like social anxiety, friendship anxiety is a common experience that involves extreme worrying about platonic dynamics and friendships.

  • Friendship and social anxiety might make it harder to open up, build trust, and follow through on activities that maintain relationships. You might also unnecessarily ruminate about social interactions and doubt the strength of close friendships.

  • Many symptoms of anxiety are treatable with changes to your daily lifestyle. You also have medication options such as antidepressants and therapy options like CBT. It’s important to seek professional help if you experience consistent and overwhelming anxiety.

It’s tough to feel friendship anxiety, especially when it starts to interfere with your social life and self-esteem. Remember, the fact that you’re here indicates you care about your friends, which makes you a pretty great friend already.

Even more good news? A mental health professional can help you through those feelings and manage your worries and anxious emotions about friendship.

Our psychiatric services can help you start the journey to rebuilding your social and friendship confidence and enjoying greater interpersonal relationships.

12 Sources

  1. Curtiss JO, et al. (2021). Cognitive-Behavioral Treatments for Anxiety and Stress-Related Disorders. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475916/
  2. Gupta MA, et al. (2021). Fear of missing out: A brief overview of origin, theoretical underpinnings and relationship with mental health. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283615/
  3. Kalin NE. (2020. The Critical Relationship Between Anxiety and Depression. Retrieved from https://psychiatryonline.org/doi/10.1176/appi.ajp.2020.20030305
  4. MedlinePlus. (2023). Anxiety. Retrieved from https://medlineplus.gov/anxiety.html
  5. Mitsui NO, et al. (2022). Antidepressants for social anxiety disorder: A systematic review and meta‐analysis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773641/
  6. National Institute of Mental Health. (2024). Anxiety Disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders
  7. National Institute of Mental Health. (n.d.). Any Anxiety Disorder. Retrieved from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
  8. National Institute of Mental Health. (2024). Depression. Retrieved from https://www.nimh.nih.gov/health/topics/depression
  9. National Institute of Mental Health. Mental Health Medications. (2023). Retrieved from https://www.nimh.nih.gov/health/topics/mental-health-medications#part_149861
  10. National Institute of Mental Health. (2022). Social Anxiety Disorder: More Than Just Shyness. Retrieved from https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness
  11. Rodebaugh TH, et al. (2014). Self and Friend’s Differing Views of Social Anxiety Disorder’s Effects on Friendships. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227963/
  12. Teo AL, et al. (2013). The role of social isolation in social anxiety disorder: A systematic review and meta-analysis. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0887618513000571
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Daniel Z. Lieberman, MD

Dr. Daniel Z. Lieberman is the senior vice president of mental health at Hims & Hers and of psychiatry and behavioral sciences at George Washington University. Prior to joining Hims & Hers, Dr. Lieberman spent over 25 years as a full time academic, receiving multiple awards for teaching and research. While at George Washington, he served as the chairman of the university’s Institutional Review Board and the vice chair of the Department of Psychiatry and Behavioral Sciences.

Dr. Lieberman’s has focused on , , , and to increase access to scientifically-proven treatments. He served as the principal investigator at George Washington University for dozens of FDA trials of new medications and developed online programs to help people with , , and . In recognition of his contributions to the field of psychiatry, in 2015, Dr. Lieberman was designated a distinguished fellow of the American Psychiatric Association. He is board certified in psychiatry and addiction psychiatry by the American Board of Psychiatry and Neurology.

As an expert in mental health, Dr. Lieberman has provided insight on psychiatric topics for the U.S. Department of Health and Human Services, U.S. Department of Commerce, and Office of Drug & Alcohol Policy.

Dr. Lieberman studied the Great Books at St. John’s College and attended medical school at New York University, where he also completed his psychiatry residency. He is the coauthor of the international bestseller , which has been translated into more than 20 languages and was selected as one of the “Must-Read Brain Books of 2018” by Forbes. He is also the author of . He has been on and to discuss the role of the in human behavior, , and .

Education

  • 1992: M.D., New York University School of Medicine

  • 1985: B.A., St. John’s College, Annapolis, Maryland

Selected Appointments

  • 2022–Present: Clinical Professor, George Washington University Department of Psychiatry and Behavioral Sciences

  • 2013–2022: Vice Chair for Clinical Affairs, George Washington University Department of Psychiatry and Behavioral Sciences

  • 2010–2022: Professor, George Washington University Department of Psychiatry and Behavioral Sciences

  • 2008–2017: Chairman, George Washington University Institutional Review Board

Selected Awards & Honors

  • 2022: Distinguished Life Fellow, American Psychiatric Association

  • 2008–2020: Washingtonian Top Doctor award

  • 2005: Caron Foundation Research Award

Publications

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