Social anxiety disorder, or social phobia, is a type of anxiety disorder where the patient has extreme fear in social situations. The Mayo Clinic notes that patients with social anxiety have immense difficulty interacting in public, which results in poor social skills. Symptoms of social anxiety include low self-esteem, fear of being judged, difficulty making eye contact, shaky voice and excessive worry about embarrassing oneself. Treatment options for social anxiety include psychotherapy and medication, and the two are often combined.
Psychotherapy
The goal of psychotherapy is to identify the cause of the patient's anxiety, help her change these behaviors and introduce group interactions. The Mayo Clinic notes that cognitive behavioral therapy, or CBT, improves social anxiety symptoms in 75 percent of patients. During cognitive behavioral therapy, the therapist works with the patient, helping her discover the underlying reasons for her social anxiety. Once the cause has been pinpointed, the therapist and patient will work toward changing the negative behaviors. Over time, the patient will be able to developing coping mechanisms to control her anxiety.
Psychotherapy may also include group therapy or exposure therapy, where the patient gradually tackles her fears. The Mayo Clinic states that during exposure therapy, the therapist and patient may engage in role playing, thus strengthening the patient's social skills. In the Helpguide.org article, "Social Anxiety Disorders and Social Phobias," the authors add that the patient may participate in acting out scenarios, or may be videotaped to observe her own actions.
SSRIs and SNRIs
The first choice in medication for social anxiety is selective serotonin reuptake inhibitors (SSRIs), according to the Mayo Clinic. SSRIs reduce the symptoms of social anxiety by increasing the amount of serotonin in the patient's brain. Examples of SSRIs are paroxetine, sertraline, fluvoxamine and fluoxetine. Selective serotonin and norepinephrine reuptake inhibitors (SSNRIs or SNRIs) are another first choice for social anxiety. Like SSRIs, SSNRIs increase the levels of serotonin, as well as a second neurotransmitter---norepinephrine.
Other Medication Options
The Mayo Clinic notes that other medication options for social anxiety are benzodiazepines and beta blockers. Benzodiazepines, like diazepam, are an anti-anxiety medication that acts upon the GABA receptors in the brain. The GABA receptors, however, are the same receptors that alcohol acts upon; therefore, benzodiazepines can become habit forming. When prescribed, benzodiazepines are given as a short-term medication for social anxiety. Another option is beta blockers, like propranolol; beta blockers are a heart medication and are prescribed off-label for the physical symptoms of social anxiety.
