Exercise as an adjunct intervention for social anxiety disorder: a mini-review

Social anxiety disorder (SAD) is a common and often persistent mental health condition that typically emerges during adolescence and is associated with marked functional impairment. Although cognitive-behavioral therapy and selective serotonin reuptake inhibitors remain first-line treatments, many individuals experience incomplete response, poor tolerability, stigma-related concerns, or limited access to care. Against this background, exercise has attracted increasing interest as a low-cost, accessible, and scalable adjunctive intervention, although adherence and accessibility may vary across populations. In this mini-review, we synthesize current evidence on the role of physical activity and structured exercise in the management of SAD. Available findings suggest that higher levels of physical activity are generally associated with lower social anxiety symptoms, while emerging intervention studies indicate that aerobic exercise, climbing, and group-based exercise programs may confer psychological benefit. Exercise may complement mainstream therapies through partially overlapping yet distinct pathways, including enhancement of self-efficacy, resilience, body image, and social engagement, as well as modulation of cognitive bias, neuroplasticity, and stress-related physiological processes. Potential applications in adolescents, individuals with autism spectrum disorder and comorbid social anxiety, and performance-related anxiety contexts also warrant attention. However, the current evidence base remains limited by small samples, heterogeneous interventions, insufficient long-term follow-up, and a lack of large randomized controlled trials in clinically diagnosed SAD, and much of the available evidence derives from non-clinical or subclinical populations. Overall, exercise should be considered a promising adjunct rather than a replacement for established treatments, and future research should prioritize mechanism-informed, precision-based, and implementation-oriented intervention models.