If you suffer from social anxiety, you know how it feels at the exact moment the anxious thoughts start to creep in: You’re out with friends or co-workers and your heart starts racing. Suddenly you’re too overwhelmed to contribute, even a little, to the conversation.

And it’s not only in group settings that social anxiety can appear, says Pamela Larkin, a therapist who specializes in anxiety and relationships at Optimum Joy. It can be during one-on-one interactions too.

“It really does impact all spheres of someone’s life,” she says “Dating, work life, family life, and even friendships.”

Being nervous for a date or a large party, while normal, is not the same as experiencing social anxiety.