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Exploring Treatments for Social Anxiety Disorder

Social anxiety disorder is the most common of anxiety disorders., It is an intense fear and discomfort in social situations that impede a person's ability to function in their daily life. Doing simple things like meeting new people, making a good impression at job interviews, or going out with friends becomes highly challenging if not impossible.

If you have been diagnosed with or suspect you might have social anxiety disorder, it is helpful to know about the various social anxiety disorder treatment options available to you.

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Social Anxiety Can Be a Challenge

People think of social anxiety as a form of shyness. But it is much more than that. Human beings need social experiences, and many people with social anxiety experience a considerable amount of sadness and depression as a result of their isolation. For those that are looking for relief, take my free 7-minute anxiety test now.

This article will discuss several social anxiety treatments, with information that includes:

  • The risks and rewards of different types of therapy
  • Common prescription-only drugs
  • Herbal supplements that some people use as a treatment.
  • Positive lifestyle changes, and more.

Social anxiety is treated over time, and each person requires an approach tailored to their needs.

Types of Therapy

Cognitive behavioral therapy, or CBT, is often the first line of defense in treating social anxiety disorder. When using CBT to treat social anxiety, positive results are expected within a 16-session period, usually occurring over the course of 16 weeks or 4 months. CBT is divided into several subgroups, including exposure therapy, exposure therapy with cognitive restructuring and cognitive restructuring without exposure, and social skills training.

Cognitive behavioral therapy essentially means changing your cognition how you think in order to alter your behavior, or how you act. The goal of this type of therapy is to work with the client to find out what unhelpful beliefs and thought patterns are underlying their anxiety surrounding social situations, figuring out why they are unhelpful, and replacing them with more helpful and healthy beliefs and thought patterns.

  • Exposure Therapy Exposure therapy is a type of CBT that is designed to teach your brain, and specifically your amygdala, different reactions to the stimuli it reacts to with anxiety. It does this by setting up multiple non-threatening encounters with the stimuli. The amygdala, a pair of almond-shaped neuron clusters near the base of the skull, cause anxiety by recalling the strength of emotional reactions to various stimuli and producing stress reactions to those stimuli based on the information it has stored. Retraining the amygdala by decreasing the severity of your reactions to a particular stimulus over time teaches it to produce less severe anxiety reactions, or in some cases, no anxiety reactions at all to a specific stimulus.

  • Exposure Therapy with Cognitive Restructuring Exposure therapy with cognitive restructuring operates on the same principle but also involves actively teaching the person by way of verbal communication rather than simply by providing them with experientially acquired knowledge.

  • Cognitive Restructuring Cognitive restructuring entails verbally discussing the client's behavior and the thoughts and beliefs behind it, and then teaching the client to overcome those thoughts and beliefs by suggesting and building up the strength of more useful ones.

  • Social Skills Training Social skills training is completed in a group workshop format. It allows the client to practice and improve their social skills within a controlled and safe environment so that they can learn to apply those skills on a regular basis outside of therapy.

Exposure therapy and social skills training should be undertaken in a relaxed and controlled environment to prevent increasing the severity of your disorder. Undertaking either without the guidance of a professional risks intensifying your negative associations with social settings and making it even more difficult for you to overcome them.

Prescription Medications

The most common prescription medications used to fight social anxiety disorder belong to a class of drugs called SSRIs, or selective serotonin reuptake inhibitors. These drugs are designed to increase levels of serotonin in the brain, promoting relaxation and positive thinking.

Originally designed to treat depression, SSRIs have been found to be similarly effective, if not more effective, for treating anxiety. Unlike antidepressants such as benzodiazepines, SSRIs have a much lower potential for causing addiction and severe fatigue. Even so, it is recommended that SSRIs be taken in liquid form, as liquid SSRIs make it possible to decrease dosage in smaller increments. This helps to prevent the risk of possible withdrawal symptoms that can mimic and even cause a resurgence of anxiety once treatment has ended.

Well-known and frequently prescribed SSRIs include Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), and Luvox (fluvoxamine).

It can take 6-8 weeks for SSRIs to reach full efficacy. During the 1-4 initial weeks of treatment, a variety of short-term symptoms can be expected as the body adjusts. These symptoms may include:

  • Nausea/Vomiting
  • Drowsiness
  • Headache
  • Vivid dreams
  • Diarrhea
  • Changes in body weight.
  • Dizziness
  • Tremors
  • Increased anxiety or depression
  • Suicidal thoughts

Possible long-term symptoms of SSRIs include:

  • Sexual dysfunction
  • Cardiovascular effects
  • Developmental problems in unborn fetuses

Also, SSRIs should not be taken in combination with any of the following anxiety treatments or recreational substances.

  • Beta blockers
  • Tricyclic antidepressants
  • Benzodiazepines
  • Lithium
  • MAOIs
  • Alcohol
  • St. John's Wort
  • Yohimbe

Taking the above substances in combination with SSRIs can produce an effect known as serotonin syndrome. Serotonin syndrome occurs when the body is flooded with more serotonin than it can handle at one time. In its mildest form serotonin syndrome simply looks like an anxiety attack, causing sweating, shaking, dilated pupils and an increase in heart rate. In its moderate form loud bowel sounds and temperatures of up to 104 degrees F are added to the mix, and in its most severe form, the rapidity of the heart rate and degree of the body temperature (up to 106 F) can result in shock and, in some cases, death.

Due to the risk of side effects that may be unmanageable for someone already suffering from anxiety, it may be advisable to look into gentler natural remedies with fewer reported side effects.

At Home Remedy For Anxiety?

There are plenty of effective and natural ways to reduce anxiety. If you're looking for one that's effective for you, make sure you take my free 7-minute anxiety test, now.

Non-Prescription Supplements

There are many herbal and vitamin-based supplements commonly thought to be effective treatments for social anxiety, though most of them have their potential drawbacks. The effects and possible disadvantages of 4 herbal supplement varieties are outlined below.

  • L-theanine L-theanine, a substance naturally found in green tea, can aid relaxation in social situations in a multitude of ways. It promotes relaxing alpha waves in the brain, raises dopamine levels, increases GABA (gamma-amino-butyric acid) production, may increase serotonin levels and in combination with caffeine (another substance naturally found in green tea) can improve memory and reaction time. It should be noted, however, that caffeine has the effect of increasing the heart rate, which may be unwanted stimulation for someone with anxiety. It is recommended for people with anxiety that L-theanine in the form of green tea be taken in its non-caffeinated variety to prevent unwanted side effects.

  • Kava-Kava Kava-kava, or simply kava, as it is sometimes known, is a plant whose roots are consumed in Pacific Ocean cultures of Polynesia as a sedative that works without disrupting mental clarity. The kavalactones within kava-kava are psychoactive substances that promote muscle and mental relaxation primarily by stimulating GABA activity in the brain. GABA or gamma-amino-butyric acid is a substance that regulates the speed and activity of the nervous system. Some concerns have been raised about a potential for liver damage related to kava-kava use, and it is recommended that alcohol consumption is avoided while kava-kava is in the system. A Cochrane Collaboration review concluded that kava-kava was likely to be more effective than placebo in treating at least short-term social anxiety.

  • Rhodiola Rosea Rhodiola Rosea decreases sympathetic nervous system activity (the system responsible for fight-or-flight impulses triggered by anxiety attacks), increases serotonin production, and has been shown in studies to potentially improve memory and focus. It should, however, be noted that on some people rhodiola rosea has been shown to stimulate beta waves in the brain, which are the opposite of the calming alpha waves the brain produces when a person is in a state of waking relaxation. Other than that, no harmful side effects have been cited. Even so, no more than the recommended dosage amount should be taken at a time.

  • Passion Flower Passionflower is a flowering vine whose leaves, stems and fruit were traditionally used by cultures in the Western hemisphere to treat a variety of conditions. It contains the flavonoids chrysin and benzoflavone, which are believed to increase the amount of GABA in the brain, much in the same way that benzodiazepines do. GABA limits the excitability or reactivity of the brain's neurons, resulting in the calming effect that gives passion flower its reputation as a mild sedative but means that it can disrupt mental and motor functions in high quantities.

Anti-anxiety supplements, like prescription medications, sometimes but do not always have the long-term effects that most people are looking for. The reliable and risk-free treatment options in the next section involve making positive lifestyle changes that decrease your overall levels of anxiety and increase your confidence for the long term, both within social situations and beyond.

Pill-Free Activities

If you would rather stay pill-free altogether in treating your social anxiety, the following tips should help you learn to control your anxiety in a healthy and long-lasting way.

  • Exercise Regularly Doing exercise on a regular basis, whether it's walking, running, biking, hiking or swimming, keeps your body healthy and both feeling and looking good. Not only can this give you a boost of self-confidence in social situations, but it can also limit the severity of physical anxiety symptoms by strengthening your heart, muscles, and lungs. Also, doing the hard work of exercise causes your brain to naturally increase levels of serotonin in your body to compensate, which will help you to feel more relaxed and happy on a regular basis.

  • Join a Sports Team or Exercise Group Joining a team allows you to interact with others in a social setting where the rules are well-defined, and everyone has the same goal in mind, making regular social rules secondary and not particularly important. This will help you learn to relax around others and cultivate a sense of belonging rather than isolation and frustration.

  • Eat Healthy Foods Eating right, like exercising regularly, will keep your body strong and give you the self-confidence that comes from feeling and looking healthy. Avoiding foods high in caffeine and sugar, in particular, will help to reduce the stress on your body caused by the energy jolts and addictive properties of sugar and caffeine.

  • Keep a Journal Keeping a journal can help you reduce anxiety much in the same way that cognitive behavioral therapy can it allows you to look into your own mind, at your own thoughts, and examine them. What beliefs of yours seem to be holding you back? After examining your writing for negative beliefs and thoughts about yourself and others, consciously replace those with positive beliefs and thoughts and concentrate on them instead the next time you are in a social situation.

  • Overcome the Fears Social anxiety often has specific fears associated with it, such as a fear of embarrassing yourself. Challenge each of these fears one at a time. For example, stand in a public place and hand out candy to strangers, or wear a clown suit and sit on a park bench with a friend to help you feel better. This will help you get used to the emotions you're afraid of and make it easier to relax when faced with these fears in the future.

  • Read Self-Help Books Self-help books can be found for free at your local library and offer a variety of tactics for relieving social anxiety, from positive mantras to relaxing visualization routines to self-hypnosis. If you spend enough time looking you are sure to find something that speaks to you and reflects your individual experience.

While there are many routes you can take in treating your anxiety, it is always a good idea to talk to someone such as a doctor, counselor, or therapist who can help you to determine the severity of and reasons behind your condition. These individuals can also advise you on the safety of different medications and activities for your health and lifestyle. From there, you can design the most effective treatment plan to suit your personal needs.

One of the most effective treatments can be found by taking my free 7-minute anxiety test. This test looks at your information to find the best treatment and then recommends an at-home remedy that is certain to meet your needs.

Take the test here.

Author: Micah Abraham, BSc Psychology, last updated Nov 27, 2017.

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