It's a MMOA lot of players have social anxiety. Triggers can be different for each though. Some will be more uncomfortable in a 24 man surrounded by lots of other player but okay in a light party where they're only dealing with 3 others. Others will be the opposite and feel safer in the 24 man as a random face lost in the crowd compared to being in the light party where they might feel that there's more attention paid directly to them and their actions.
I know it's a MMO. But MMO doesn't mean you must do content in groups with large numbers of people. It only means a lot of people are likely to be online at the same time.
Someone with anxiety might be playing to do things with friends and they're fine when they're only with those friends. Bring strangers into the group, and their anxiety may start being a problem. They are usually still able to do the content with strangers but it will be stressful and that stress frequently leads to feeling exhausted.
Exhaustion is a personal problem. MSQ content can be cleared while anxious but if the person doesn't like being anxious they have the option of playing something else.
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