In the worst cases, anxiety about the approval of others can blow up into a debilitating fear, a diagnosable psychological condition called “allodoxaphobia.” Even if it doesn’t become a mental illness, worrying about the opinions of others can lower your basic competence in ordinary tasks, such as making decisions. When you are thinking about what to do in a particular situation—say, whether to speak up in a group—a network in your brain that psychologists call the “behavioral inhibition system” (BIS) is naturally activated, which allows you to assess the situation and decide how to act (with a particular focus on the costs of acting inappropriately). When you have enough situational awareness, the BIS is deactivated and the “behavioral activation system” (BAS), which focuses on rewards, kicks in. But research from 2013 shows that concern about the opinions of others can keep BIS active, impairing your ability to take action. If you always leave an interaction kicking yourself over what you should have said—but didn’t—it may indicate that you are being unduly influenced by concern over what others think.

One reason we fear others’ opinions is because negative assessments can lead to shame, which is the feeling of being deemed worthless, incompetent, dishonorable, or immoral—and thus, given the weight we place on others’ opinions, feeling this way about ourselves. Fearing shame makes sense, because research clearly shows that feeling it is both a symptom of and a trigger for depression and anxiety. People will go to a lot of effort to avoid shame, which can explain behaviors such as virtue signaling on social media and giving money to strangers.