Shyness and social anxiety is thought by experts to exist on a continuum, however, efforts to cope with this anxiety challenge can be extremely disabling. For many, social anxiety symptoms leads to avoidance of situations as well as using and abusing substances in an effort to cope. The co-occurrence of substance abuse, particularly alcohol abuse, is common among people who have social anxiety disorder according to the Anxiety and Depression Association of America.

Many diagnosed with this anxiety disorder begin to rely on alcohol as a coping mechanism to relieve social discomfort. While individuals may not experience full relief from their symptoms by using alcohol or drugs, they may experience enough relief to enable them to get through difficult social situations, which is reinforcing. Some studies report that the average lifetime prevalence of alcoholism among individuals with social anxiety disorder, as well as depression, may be as high as 20 percent. Many mental health professionals and addiction specialists would argue that this number is low.