Going Out Into the World: Exploring Treatments for Social Anxiety Disorder

Social Anxiety Disorder (SAD) is the inhibitive fear of being publicly judged, humiliated, embarrassed, and criticized. Not only does it affect life quality and relationships, and hinder academic and professional progress, but, if left alone for too long, can also lead to other mental health issues like depression and body dysmorphic disorder; even suicide.

However, perseverance and professional assistance of a mental health specialist can easily help treat SAD, with the most effective treatment options being:

1-Psychotherapy:

Psychotherapy, particularly Cognitive Behavioural Therapy (CBT), has been proven to be the most effective, long-term solution for social anxiety. SAD-specific CBT involves educating an individual on their condition and changing their thoughts, beliefs and behaviours related to social situations. Therapy usually consists of 12-16 sessions (though some may require it for much longer) and can be conducted both individually and in groups. A step-wise CBT course usually comprises of:

• Getting a better understanding of your condition to help form a clear picture of the problems that require solving
• Identifying the fear and anxiety-fueling thinking styles that you most engage in and challenging their hold on you.
• Replacing suspicion with rationality, e. questioning yourself on your over-exaggerated thoughts every time a social situation ends badly.
• Freeing yourself from the thought that your symptoms are visible and open to judgment for others by switching focus from yourself to what’s actually happening around you.
• Making an exposure hierarchy in which you gradually work up to your most feared situations by slowly exposing and accustoming yourself to smaller anxiety-inducing activities

2-Medication:

The following medications are commonly prescribed alongside psychotherapy as a temporary measure to help control the physical and emotional symptoms of SAD:

• Antidepressants, specifically SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), are primary SAD medications that work to elevate depressive moods by increasing brain serotonin levels. However, they are initially prescribed in low doses to minimize side effects like headaches, nausea, and sleep issues, and usually require a few weeks to months for full effect.
• Anti-Anxiety Medications help control anxiety-specific symptoms like fast heart rate, panic attacks, and nervousness. Despite a faster acting time, anti-anxiety medications like Benzodiazepines are only prescribed to older adults for very short time periods due to their addictive nature.
• Beta-Blockers bar the stimulating effect of epinephrine/adrenaline to reduce physical anxiety symptoms like sweating, tremors, and increased heart rate. Commonly prescribed for Performance Anxiety, they are only meant for situational use and not recommended for general SAD treatment.

Note: Medications are generally bypassed when treating SAD in children. 

3-Support Groups:

Similar to group psychotherapy, joining a support group comprised of people also suffering from social anxiety can help you come to better understand your condition and overcome your fears by sharing and receiving honest, unbiased opinions on your view of others and how others view you.

4-Breathing Control:

Hyperventilation (rapid shallow breathing) and panic attacks are a common occurrence with SAD that not only lead to other physical symptoms, but also increase avoidance of related social situations and places for fear of a recurrence. Therefore, to escape from this restrictive cycle, learn and practice breathing exercises that focus on slow breathing in the event of an anxiety attack.

5-An Anti-Anxiety Lifestyle:

Lifestyle adaptations are a necessary accompaniment to medical and professional treatment. The following measures may help reduce overall anxiety:

• Avoid or limit coffee and all other caffeinated stimulants including soda and energy drinks to one serving a day.
• Inactivity breeds depression and anxiety, so exercise for at least 30 minutes a day and incorporate physical activity into your daily routine.
• Boost your moods and anxiety-management abilities by adding sufficient omega-3 foods into your diet. Examples include fatty fish, flaxseed, and walnuts.
• Quit smoking to avoid nicotine stimulation.
• Sleep deprivation fuels anxiety. So make sure to consistently get 6-8 hours of sleep every day.

Most people with anxiety struggle solitarily with the condition for years due to the fear of being viewed as ‘weird’ or ‘abnormal’ by others, when that is definitely not the case. Do not hesitate to reach out for help if you or a loved one suffers from social anxiety.

You can also book an appointment with a top psychiatrist in Lahore, Karachi and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your mental health concerns.