yes, it takes a lot of hard work on your end. therapeutic work, medication management if you feel its necessary, going way out of your comfort zone

I don't think it does. But there are coping mechanisms. Like I have to be in the right mood in order to put myself out there. Self care and makeup really helps me feel confident enough to do it. I think it's all about not caring what people think of you, and knowing that you are worthy of communication from others. I'm working so hard on myself, trying to get out of this horrible friendless zone. Having a good humor helps. Don't be afraid to lol sometimes, even at sad and depressing stuff.