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Clinical Social Anxiety


Social Anxiety Disorder, also known as Social Phobia, is an anxiety disorder characterized by “clinically significant anxiety provoked by exposure to certain types of social or performance situations, often leading to avoidance behavior” (DSM-IV).  People with SAD typically fear embarrassment or even humiliation in public situations, to the point where they may suffer panic attacks anticipating worst case scenarios.  Such fears must be constant and considered irrational for the person to be diagnosed with Social Anxiety Disorder.

Social Phobia can have a detrimental impact on the sufferer’s social, romantic, and professional life, leading to isolation, esteem issues, panic attacks, and depression.  The anticipatory anxiety caused by meeting and attempting to connect with people can make doing so an insurmountable task, isolating the individual and denying him-or-her the support system necessary to navigate through the stream of daily life.  Fear of intimacy can nullify the possibility of dating and romantic relationships.  The anxiety a person with SAD experiences speaking one-on-one with a potential employer can render full-time employment impossible as well.

The best and most effective treatment for Social Anxiety Disorder is Exposure and Response Prevention therapy (ERP), a subset of Cognitive Behavioral Therapy.  ERP involves placing people with social phobias in situations that trigger anxiety, allowing them to build up their tolerances, and gradually increase their comfort levels while engaged in those social settings.  For example, a person who fears confrontational situations may be asked to order a meal at a restaurant and ask the waiter to take it back after being served.  Or, a person who has an intense fear of rejection might be asked to go to a night club and ask 25 women for their phone numbers.  The more someone with a fear of rejection experiences what he or she fears, the less crushing the experience becomes.

Medications, including antidepressants, benzodiazepines, beta-blockers, and Buspar, can also be used to treat Social Phobia.  Among the most popular are Zoloft, Paxil, Prozac, and Lexapro.  While medications can ease symptoms related to Social Anxiety, people using them must be aware of the potential side effects.  According to the NIMH website, side effects from using antidepressants to treat SAD include headaches, nausea, drowsiness, insomnia, dry mouth, agitation, sexual dysfunction, constipation, and blurred vision.  Common side effects from benzodiazepines include upset stomach, blurred vision, headaches, confusion, grogginess, and nightmares.  Beta-blockers leave users susceptible to fatigue, dizziness, cold hands, and weakness.  Side effects from using Buspar include dizziness, headaches, nausea, nervousness, lightheadedness, excitement, and insomnia.

Celebrities known to suffer from social phobia include Kim Bassinger, Ricky Williams, Zack Greinke, Donny Osmond, Susie O’Neill, Jonathan Knight, Woody Allen, and Dontrelle Willis.  Various movies have featured characters suffering from SAD, including Eternal Sunshine of the Spotless MindNapoleon DynamitePunch Drunk LoveAmelie, and Clockwatchers.  The A&E show Breakout Kingsfeatures a character, Julianne Simms (portrayed by Brooke Nevin), with SAD.  On the popular CBS sitcom The Big Bang Theory, the social phobia of the character Raj is a running gag.

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Filed under: Conditions and Disorders, Treatment · Tags: anxiety, Anxiety disorder, anxiety treatment, Social Anxiety Disorder, Social Phobia