Treatment options

Many individuals that do have social anxiety disorder do not seek treatment. Those that do choose to change their life and actively seek treatment, have several options offered to them. The most popular means of treatment is drug therapy. It is used most commonly because it gives quick and moderately successful results. Such effective drug classes used to treat S.A.D. include: selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), benzodiazepines, and beta blockers (blood pressure medication). Although drug therapy is successful in relieving many people’s anxiety, they still exhibit the continued irrational thought process in social situations. Psychotherapy is the other treatment option which has been shown in some studies to offer individuals long term successful results because it addresses their maladaptive thought processes and works towards restructuring their thought processes. Psychotherapy is usually offered through individual consultations with a psychotherapist or in a group setting led by a therapist.

Hope you are finding my blog helpful

Hi everyone! I hope you find my blog informative. I am planning on releasing a self help book on social anxiety disorder. I am going to keep putting information on my blog and will put a link to purchase my book when it is all published. Thank you all for your support and continue the hard work. God bless you. Nick

SAD diagnosed

In understanding how serious this disorder is, it is important to recognize the symptoms and seek out some sort of treatment as soon as possible to improve lifestyle. The Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV), describes social phobia as an intense, irrational, and persistent fear of being scrutinized or negatively evaluated by others (American Psychiatric Association, 1994). However, to meet the diagnosis for this disorder, the symptoms must be severe enough to cause significant distress or disability (Bruce & Saeed, 1999).
The DSM-IV gives a list of diagnostic criteria for social anxiety disorder. The following are the criteria according to the DSM-IV that must be met for a diagnosis of social phobia. First, there must be a marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to the possibility of scrutiny by others (American Psychiatric Association, 1994). The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing to them. In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults (American Psychiatric Association, 1994). Also, exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a panic attack (American Psychiatric Association, 1994). In children, the anxiety may be expressed by crying, tantrums, freezing, or running away from social situations with unfamiliar people (American Psychiatric Association, 1994). In many cases, the person with S.A.D. recognizes that the fear is excessive or unreasonable. In children, this feature may be absent. The feared social situations are avoided or else are endured with intense anxiety or distress (American Psychiatric Association, 1994). The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, social activities, or relationships. In order for individuals under 18 years of age to be diagnosed, the duration of the previous listed symptoms must exist at least six months (American Psychiatric Association, 1994). The fear or avoidance cannot be due to the direct physiologic effects of a substance (e.g., drug abuse or a medication) or a general medical condition and is not better accounted for by another mental disorder (American Psychiatric Association, 1994). In social phobia, fear and avoidance typically develop into a vicious cycle that can become severely distressing, debilitating, and demoralizing over time (Bruce & Saeed, 1999).

What is social phobia? (continued)

Another serious complication of social phobia is that of alcoholism. Alcohol is commonly utilized in an attempt to decrease anxiety and allow the individual to tolerate the feared social situation. In approximately 85% of the people with both social phobia and alcohol abuse, the social phobia preceded the alcohol problem (Jacobson, 2001). Social anxiety makes the treatment of alcoholism more difficult. People with S.A.D. are likely to resist group therapy or self-help meetings like Alcoholics Anonymous. I have to admit that I used alcohol in college when placed into social situations. It allowed me to be relaxed around my peers and to open up to them. I felt like I had no inhibitions and I could really act like myself around others. This is a dangerous situation because you then feel like you need to use alcohol whenever you are around others. Pretty soon you will find yourself being dependant on alcohol and having a major problem on your hands. Don’t fall into this situation because it is hard to get out of. Not only is alcoholism a common complication of social phobia but there are also many co morbid disorders that people may have along with S.A.D. Depression is one such disorder that is very common in persons with S.A.D. Many believe depression is a secondary effect from S.A.D. and that the social anxiety is the cause of it. There are studies that have found that children with social anxiety have more severe kinds of depression, more relapses, more suicidal ideation, and more suicide attempts than depressed people without the co morbid illness. We can’t conclude that social anxiety precedes other illnesses but we can say it is a predictor of future psychiatric illness. Tobacco abuse is yet another serious addiction found in concordance with S.A.D. Kids with social anxiety on average start smoking later than their peers but tend to smoke more and become nicotine dependent more rapidly and more often. As with alcohol, kids may use the nicotine to help relieve anxiety symptoms.

What is Social Phobia (continued)

When people with S.A.D. approach social situations or sometimes just imagine approaching them, they experience intense anxiety. These individuals often exhibit physical symptoms such as shortness of breath, excessive sweating, tremors, and rapid heart beat (Jefferson & Moore, 2004). In some cases, people with this disorder may be able to endure these symptoms and follow through with the situation. In other cases, however, the symptoms are so overwhelming that these individuals may refuse to continue the actions because of their acute fear. In extreme cases, they may even experience a full-blown panic attack. Individuals with social phobia are often so affected by the disorder that it can complicate many aspects of their life depending on the subtype of the phobia, the patient’s occupation, or the social demands placed upon them (Jacobson, 2001). For example, one with a phobia of public speaking may refuse a promotion for a new position that could involve giving public speeches. Some people with the fear of urinating in public rest rooms may choose not to be away from home for long periods. Anxiety and autonomic symptoms may, in fact, impair performance to the point where it is inept (Jacobson, 2001). For example, a patient phobic about writing in public may tremble so much that their handwriting becomes illegible.

What is Social Phobia? Continued

Social anxiety disorder typically begins during childhood with a mean age of onset between 14 and 16 years and is sometimes preceded by a history of social inhibition or shyness in younger years (JCP, 2001). This is of course just an average age. Social phobia can develop later in life or earlier.
There are two subtypes of social phobia, namely generalized and circumscribed (non-generalized). The generalized subtype describes a person that experiences anxiety in numerous situations such as meeting new people, answering questions in class, or interacting socially at all(Jefferson & Moore, 2004). In “Tina’s” case, she suffered from generalized subtype. The circumscribed subtype is characterized by a fear of acting foolishly in only very specific situations (Jefferson & Moore, 2004). The most common type of circumscribed social phobia is the fear of public speaking. Don’t you remember those people back in school that were terrified when the teacher said that everyone had to do a speech in front of the whole class. For these people, doing a speech in front of others is literally a nightmare. Other common feared social situations include: fear of trembling when writing in public, fear of choking when eating in public, or being unable to urinate when others are present (Jefferson & Moore, 2004). Regardless of the subtype, it is not so much the act itself that is feared, but rather, it is the doing of the act in public which arouses the fear (Jefferson & Moore, 2004). In terms of treatment, the generalized subtype is by far the harder subtype to treat.

What is Social Phobia? continued part 3

There are many other theories around how S.A.D. evolves. Many believe that this is a disorder caused through environmental exposure and is a learned behavior. Some researchers believe that individuals develop S.A.D. after experiencing a particular negative social experience in their life. After the encounter of the negative event, these individuals relate that negative experience to any general social experience they encounter in the future. They become very anxious in social situations, fearing that the previous negative social experience will occur again. The result of this is a change in behavior through the avoidance of social situations altogether.
Sometimes, through therapy, people diagnosed with social phobia can recall a specific traumatic incident that sparked their anxiety and irrational thought process. Through my experience, I could specifically nail down one incident from my childhood that ignited my behavior. I was in kindergarten when this occurrence happened. I remembered that I would always get excellent comments on all my work. But one day, my teacher announced to the class that I actually got something wrong on some sort of project. Many of my classmates made fun of me the rest of the day. This sounds like a very benign event and shouldn’t have had such an effect on my life but it really did. The rest of my life I was known as the quiet or shy kid that never talked. I hated more than anything when someone would say that to me. I will get more into this discussion on how I would deal with this in the chapter with my self help tips.
Attachment specialists attribute that another possible cause of S.A.D. may be an effect of not developing an adequate bond with one’s primary caretaker as a child. Researchers state that these children grow up lacking self-regulatory skills to calm, focus, and soothe one’s self in situations perceived as stressful or chaotic.