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 Overcoming Social Anxiety Disorder: Help for Social Phobia

  Social Anxiety Disorder Treatment and Management Approaches 

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tiny ref flower  Social Anxiety Disorder Article - all rights reserved Ernest J. Bordini, Ph.D.Treatment, stress management, and education can often help overcome much of the impact of Social Anxiety Disorder (social phobia).  In the accompanying article, "Social Anxiety Disorder Definition and Manifestations”, characteristics and course of the disorder was discussed.  This article will provide some basic concepts involving management and treatment strategies for Social Anxiety Disorder or Social Phobia. 


Treatment approaches include education, psychotherapy, and/or medication. Not everyone will require medication. Many of the approaches also apply to phobias, panic disorder, or other anxiety disorders.


The basics seem to be common sense but involve reducing habits which may increase physiological anxiety.  This involves reducing or eliminating coffee or caffeinated beverages, nicotine, alcohol (which initially is relaxing but later creates increased physiological anxiety), improving sleep habits, using exercise, and promoting healthy eating habits.


There are a variety of pharmacotherapy approaches to treating social phobia.  Medication is best combined with psychological treatment approaches.  Individuals using medication alone are likely to experience relapse of social anxiety disorder when medication is discontinued.  Psychologists strive to establish routines and skills which bring the anxiety under the control of the individual.


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 Medication Approaches                                                                                 Helpful Self-Management Strategies


Antidepressant Medication:

A variety of antidepressants have been found to be helpful for some individuals with social anxiety disorder.  MAO – inhibitors require dietary restrictions and had been the main antidepressant used for Social Anxiety Disorder until antidepressants with far fewer side effects came to be prominently favored.  Selective-Serotonin Reuptake Inhibitor antidepressant medications (SSRI’s) have been used with some success in treating social anxiety disorder and have the advantage of not being addictive.  



Beta-blockers can help reduce some of the outward physiological manifestations associated with anxiety such as racing heart, sweating or tremulousness, but may not offer as much relief of the individual’s experience of being anxious. 


Anti-Seizure Medications:


Gabapentin, an anti-epileptic drug has also been studied for use with Social Anxiety Disorder, though, as with the benzodiazepines, there are some concerns about neuropsychological or cognitive interference. 

 Anxiolytic Medication:

Anti-anxiety medication such as benzodiazepine medications and Buspar (the latter is non-addictive) can often be used in limited quantities when the nature of the phobia or situation is rather limited in time or circumstance, or when other approaches have not failed.  However, the benzodiazepines tend to have cognitive side effects and have abuse and addiction potential. 


Children or adolescents and anyone who may be predisposed to bipolar disorder should be followed closely when placed on antidepressant medication.  FDA recommendations suggest this should be at least weekly for the first months.  Often children and adolescents will respond best to psychotherapy provided by a child psychotherapist or a therapist who has experience working with adolescents.  Some antidepressants can cause weight gain, which can be an issue for people who are anxious or concerned about their health and appearance.

As noted above, anxiolytic medication does have abuse and addiction potential.  Anxiolytic and anti-seizure medication can interfere with attention, memory or other cognitive skills.


Get Enough Sleep - Sleep deprivation tends to increase physiological anxiety.                                            

Avoid caffeine and cigarettes.  Stimulants such as caffeine, nicotine, stimulant medication and some diet pills can increase anxiety.

Exercise.  Exercising helps reduce physiological anxiety by producing muscle fatigue and releasing endorphins.  Exercise is often helpful in managing anxiety and depression.

Eat Right - Good nutrition is part of a healthy lifestyle and stress management.

Avoid alcohol.  Alcohol may produce initial relaxation, but for every effect there is an opposite effect.  Alcohol can produce subsequent physiological anxiety symptoms.

Learn relaxation techniques.  Try yoga, meditation, or learn breathing and muscle relaxation techniques.

Seek out a support group for individuals with excessive shyness or social anxiety disorder.


Many individuals can be treated by psychologists without medication and many individuals on medication can reduce or stop medication use with cognitive-behavioral psychotherapy techniques.  The general principal is that one cannot be anxious and relaxed at the same time because the parasympathetic (which is involved in relaxing and eating) and sympathetic nervous system (involved in fight or flight) tend to work in opposition. 

Psychologists use stress management and formal relaxation techniques such as diaphragmatic breathing and muscle relaxation to help treat social phobia as well as more severe anxiety disorders such as panic disorder.  Reducing the anxiety response can be learned by such techniques and applied to situations which would provoke the anxiety.  Often, this is practiced with the psychologist in session through imagining the anxiety-provoking thoughts or circumstances and applying the relaxation technique until exposure or recall can occur without anxiety.

A psychological behavioral approach called systematic desensitization involves successive exposure and mastery. As success is achieved the range of situations is expanded and it is applied to situations or thoughts associated with more severe anxiety.

In therapy, psychologists also address irrational thoughts about being watched, negative self-statements, or negative expectations associated with social anxiety disorder. Such approaches have also been proven to be quite effective in panic disorder.


Additional approaches or components of treatment may involve group therapy, individual role-playing and teaching and practicing social skills.


It is reassuring to know that through work with a psychologist and using some of these approaches, the majority of individuals with social phobia or social anxiety disorder can be treated successfully and achieve better success in personal and professional relationships.

Clinical Psychology Associates of North Central Florida has offices in Gainesville and Ocala.  We offer comprehensive psychological and neuropsychological assessment services and offer psychotherapy for Social Anxiety Disoreder,  other anxiety disorders , mood disorders and other psychological conditions.   

Update 11/24/14: Colleen Cummings, Ph.D. now practices as a licensed psychologist in Rockville, Maryland. Her practice website link is:

See books below for more information.  Clinical Psychology Associates of North Central Florida does not make any representations, warranties or endorsement of any books below or any links from or to this site.  All decisions about your healthcare should be made in consultation with a licensed provider.


Please call (352) 336-2888 for information about this or any of our programs.



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