How to tell the difference between social anxiety and autism

Understanding the difference between social anxiety and autism can be challenging because they share some similar traits. While they both can make social situations feel difficult, they’re not the same. Someone can have social anxiety disorder, autism, or both at the same time.

It’s important to know the difference between these two conditions so you can get the right care for your needs. Support for autism or social anxiety might include learning coping skills, getting an evaluation, or exploring treatment options.

What’s autism?

Autism spectrum disorder (ASD) — often called autism — is a neurodevelopmental condition that affects how you communicate, interact with others, and experience the world. Autism is a spectrum, which means each person has different strengths, challenges, and support needs.

Common characteristics of autism include:

• Differences in social communication: Trouble understanding social cues, making conversation, or building relationships

• Repetitive behaviors: Repeating movements, words, or routines, or feeling upset when routines change

• Focused interests: Having strong interests in specific topics or activities

• Sensory differences: Being more or less sensitive to sounds, lights, textures, smells, or other sensory input

Researchers ^[1] believe autism develops because of a combination of genetic and environmental factors. 

What’s social anxiety?

Social anxiety disorder (SAD) is a mental health condition characterized by an intense fear of being judged or embarrassed by other people. While many people are naturally shy, social anxiety goes beyond shyness. It can make everyday social situations feel stressful or overwhelming.

Common signs of social anxiety include:

• Fear of judgment: Worrying that other people will criticize you or think badly of you

• Avoiding social situations: Skipping conversations, parties, or other events because they make you anxious

• Physical symptoms: Blushing, sweating, shaking, a racing heart, or an upset stomach during social situations

• Ongoing worry: Spending a lot of time worrying before or after social situations

Social anxiety can develop for many reasons, including genetics, life experiences ^[2], and the way the brain responds to fear. Common triggers for social anxiety include meeting new people, speaking in front of others, or feeling like you’re the center of attention.

Key differences between social anxiety and autism

Although they can look similar, social anxiety disorder and autism are different conditions. Social anxiety is a mental health condition, while autism is a neurodevelopmental condition.

Some of the biggest differences include:

• The reason behind social challenges: People with social anxiety often avoid social situations because they fear being judged. Autistic people may communicate differently, regardless of if they’re worried about what others think.

• Fear of judgment: Fear of embarrassment or rejection is a core feature of social anxiety. It isn’t required for an autism diagnosis.

• Development: Autism is present from early childhood, even if it isn’t recognized until later in life. Social anxiety usually develops later — often during childhood or adolescence.

• Other characteristics: Autism often includes sensory differences, repetitive behaviors, and focused interests. These aren’t defining features of social anxiety.

How social anxiety and autism overlap 

Many people wonder if they have social anxiety or autism because the two conditions can look alike. 

Some key ways the two conditions overlap include:

• Avoiding social situations: People with either condition may avoid social events. Someone with social anxiety may fear being judged. An autistic person may avoid social situations because they're confusing, tiring, or overwhelming.

• Difficulty with conversations: Both may find conversations difficult. Someone with social anxiety may worry about saying the wrong thing or being judged, while an autistic person may have trouble reading social cues or knowing when to speak.

• Less eye contact: Both conditions can involve less eye contact. Someone with social anxiety may avoid it because they feel nervous or self-conscious, while an autistic person may find eye contact uncomfortable or overwhelming.

• Feeling overwhelmed: Busy social settings can feel overwhelming for both people with autism and people with social anxiety.

Because these symptoms overlap, one condition can sometimes be misdiagnosed as the other. This may be more likely in people who mask their autism symptoms — especially girls and women. It's also possible to have both autism and social anxiety, which can make diagnosis more challenging.

If you think you’ve been misdiagnosed, talk with a healthcare provider or mental health professional. A full evaluation can help determine whether you have autism, social anxiety, or both.

Can autism make social interactions more challenging?

Autism can make some social situations harder to navigate. You may have trouble reading social cues, following unspoken rules, or knowing how to respond in conversations. These differences don’t mean autistic people don’t want close relationships.

Autistic masking can also make socializing more tiring. You may copy others, rehearse conversations, or hide certain traits to fit in. Over time, this extra effort can make social situations feel stressful or exhausting.

Autism doesn’t directly cause social anxiety, but the two can occur together. Rejection, bullying, or past social struggles may make an autistic person more worried about being judged. Social challenges tied to autism can also show up even when the person isn’t feeling anxious.

Can you have both social anxiety and autism?

Yes, you can have both social anxiety and autism, and they often occur together. Research ^[3] suggests that anxiety disorders are more common among autistic people than in the general population.

When both conditions are present, social situations ^[4] may feel difficult for more than one reason. Autism may make it harder to read social cues or follow unspoken rules. Social anxiety can add fear of judgment, embarrassment, or rejection. Anxiety may also make autistic traits feel harder to manage, while past social challenges related to autism may increase anxiety over time.

Having both autism and social anxiety can vary from person to person. Someone might want to connect with others but avoid social situations because they feel confusing, overwhelming, or frightening.

Getting evaluated for social anxiety vs. autism

It may be worth getting evaluated if social challenges or anxiety are affecting your relationships, work, school, or daily life. An evaluation can also help if you’re unsure whether your experiences are related to social anxiety, autism, or both.

The evaluation may include interviews, questionnaires, and observations. For autism, a provider will also ask about childhood development, communication, sensory experiences, routines, and behavior patterns. When possible, they may get information from a parent or someone else who knew you growing up. An adult autism assessment supports looking at several sources of information ^[5] rather than relying on one test alone.

To tell the conditions apart, providers look at why social situations are difficult ^[6] and when those difficulties began. Social anxiety is mainly driven by fear of being judged or embarrassed. Autism involves broader differences in social communication and behavior that begin during development. Because the symptoms can overlap, providers also consider if both autism and social anxiety are present.

Treating social challenges and autism

Treatment depends on if someone has social anxiety, autism, or both. The goal is to reduce distress and provide support based on the person’s needs.

The most common treatment approaches include: 

• Therapy: For people with social anxiety, cognitive behavioral therapy (CBT) can help challenge anxious thoughts, reduce avoidance, and feel more comfortable in social situations.

• Medication: Some people with social anxiety may benefit from medication — especially when anxiety has a major impact on daily life.

• Autism support: Autism doesn’t need to be “cured.” Support can help with communication, sensory needs, relationships, daily tasks, or needs at work or school.

• Support for both: People with autism and social anxiety may benefit from CBT that’s adjusted to fit their needs and communication style.

Outcomes vary, but treatment and support can make a meaningful difference. People may experience less anxiety, feel more confident navigating social situations, and have a better quality of life. Remember, the goal isn’t to make an autistic person appear less autistic. It’s to help them manage challenges and build a life that works for them.

Clinician’s take

You don’t have to socialize a certain way to build meaningful relationships. Sometimes the goal isn’t to socialize more, but to find ways of connecting that feel comfortable and genuine.

Brandy Chalmers, LPC

Clinical reviewer