Check out new https://anpene.com/blog/social-anxiety-treatment-overview/
Social Anxiety Disorder Treatment Overview
If you’re here then you’re probably among the 13% of people who will experience social anxiety during their lifetime. And for 66% (two thirds!) of those people that means struggling with at least one other mental disorder.
Unfortunately for the majority it’s depression. Statistics show that people who struggle with SA are around 2.5 times more likely to suffer from depression than the general population.
Most of these people won’t ever seek treatment. 36% of them will wait 10 years or more to do that. But you have decided to act, and I want to say out right – I congratulate you for it!
Choosing a treatment or even learning about the possibilities can get pretty overwhelming. There are tens of options available, some more easily than others, and most of them have their advocates who will claim that their choice of treatment is absolutely the best.
But their case of SA isn’t your case of SA, it differs for all of us. You need something that will work for you, and to be honest it doesn’t matter whether it works for anybody else – as long as it works for you. This can get confusing.
And I know how it feels, I’ve struggled with SA for the majority of my life. As a matter of fact all of us here at anpene did at some point. But our history is not what you’re here for, we’ve established that already.
You’re here to learn about the treatments, their pros and cons, their side effects and success rates. You’re here for knowledge, and that’s what this article intends to give you.
I divided the treatments into four categories listed below, so that they’ll be easier for you to navigate than the >4,100 words of text. Let’s dig in!
Therapy
Medication
Natural Remedies
Self-help Solutions
Cognitive behavioral therapy
Cognitive behavioral therapy is the most common and most successful type of psychotherapy for social anxiety.
It usually teaches you cognitive restructuring, how to shift your attention whenever you need it, and also the social skills necessary to prevent relapsing into SA. CBT is usually time limited, and I’ve rarely seen it lasting more than 20 sessions, but it happens.
The reason for limiting the amount of sessions is simple – CBT is aiming to give you the tools to deal with your SA and prevent you from relapsing. The therapist is there to point you towards the right direction. Once that happens his or her role becomes more or less obsolete.
Exposure therapy for social anxiety can often be coupled with CBT and that’s when the therapist gives you tasks or “homework” to do on your own. It’s a gradual process and when you have somebody to talk to about it and guide you through it, it can be very effective.
But be aware, because it’s pretty easy to get it wrong when working at it all by yourself. Most of us are taught from an early age that forcing your exposure at any cost is the key and unfortunately that rarely works.
It’s main goal is to establish an emotional bond between the therapist and the patient, later reinforcing the patient’s positive beliefs and habits so that they will lead his or her later psychological development.
Supportive therapy for social anxiety is mostly used as an initial course of treatment. Studies have found that it’s much more beneficial for patients to engage in Cognitive-Behavioral Therapy instead of the traditional supportive approach.
It’s often based around CBT but conducted in a group setting where you can interact with other socially anxious people and even try controlled exposure to some of your anxiety’s triggers.
Group therapy is gaining more and more interest and the reasons for this include its high success rate but also the decreased cost of therapy resulting from the greater number of participants.
These are among the most commonly prescribed medications for social anxiety. Doctors generally don’t choose antidepressants as the first line of treatment but it’s not a rule everyone abides by.
There are many kinds of antidepressants prescribed for social phobia. Some of them work right away, some take weeks and some of them don’t work for some people at all.
They are known to cause patients to experience a whole spectrum of side effects, hence it is advised that they shouldn’t be used for longer periods of time, and the whole course of treatment must be closely monitored by a doctor.
Selective Serotonin Reuptake Inhibitors are antidepressants, but I felt they needed a separate category since prescribing them for social anxiety is becoming more and more popular.
They work by altering the chemical balance within your brain. The exact mechanism for how they work is not known, but they are believed to be increasing the extracellular level of serotonin by limiting its reabsorption into the presynaptic cell.
The SSRIs are considered to be safer primarily because you can’t overdose them which is a significant risk when taking other antidepressants.
They have been developed and are most widely used for cardiac arrhythmias, however prescribing them to treat anxiety disorders is not uncommon.
When it comes to social anxiety, beta blockers are most often suggested for patients who experience a lot of physical symptoms in certain social situations, such as excessive sweating, elevated heart rate or shaking associated with performance anxiety (or stage fright).
They don’t address the underlying causes of social anxiety, and they only work with the outside, physical symptoms.
They are considered minor tranquilizers, or sedatives and are prescribed to deal with anxiety disorders and also insomnia, muscle spasms, seizures and other problems which can be managed by slowing down the central nervous system.
Benzodiazepines are highly addictive, and they shouldn’t be used by people with prior substance abuse problems or as a long-term course of treatment for social anxiety.
5-Hydroxytryptophan is a naturally occurring amino acid which serves as the metabolic intermediate in the biosynthesis of serotonin and melatonin.
It’s also often used for social anxiety, but its effects vary from person to person. When trying out 5-HTP make sure to follow the instructions provided by its manufacturer and consult it with your doctor if possible.
People who have used 5-HTP for dealing with social anxiety reported feeling better when waking up, experiencing more ease when making conversation and feeling a bit less anxious in general.
However, using this supplement coupled with other medicine or even dietary habits has not been clinically studied. It’s known to cause nausea, heartburn, stomach pain among other complications and you have to be aware of how your body reacts to 5-HTP especially in the first weeks of taking it.
Kava kava is by many considered helpful when it comes to regaining control over your feelings of anxiety, however it also has the potential to damage your liver and shouldn’t be used by anybody with a history of liver problems.
Due to this fact many countries have issued warnings about the use of this supplement. When considering kava kava for coping with your social anxiety, be sure to consult your doctor first.
Passion Flower (or passiflora)
A herbal supplement made from passion flower’s stems, leaves and flowers is often used for dealing with problems such as insomnia, nervousness and anxiety.
Some people report that it’s been helpful in their struggle with social anxiety, lifting their social inhibitions and allowing them to feel comfortable in situations they couldn’t bear before.
There are no significant risks associated with using passion flower as a supplement, therefore you might try it whenever you wish.
It grows in the cold, on high altitudes and is often also called arctic root, golden root, rose root, Aaron’s rod, or king’s crown.
Rhodiola Rosea was primarily used as an anti-depressant supplement, however it’s known to be useful when struggling with anxiety – it can calm your nervous system, help you feel more relaxed and allow you to take another perspective on things.
But be aware, some sellers of Rhodiola Rosea have tried to associate it with all sorts of miraculous effects like treating the flu, migraines, infections and even cancer. This has led the FDA to remove some of Rhodiola Rosea-based products from the market.
In some cases when people took too much of the supplement, they experienced an increase in the levels of Beta waves associated with anxiety in their brains, meaning that when taken without consideration Rhodiola Rosea can actually increase your anxiety.
It also has the potential to stimulate your metabolism and elevate your energy levels as a result – this can lead to increased anxiety levels for some.
For some St. John’s Wort has been helpful when dealing with social anxiety and for others it made no difference. It’s quite popular among people interested in natural remedies for social anxiety, however when a study was done to see its effects compared to a placebo, no meaningful difference has been found between the two.
It’s generally agreed upon that when starting supplementation with St. John’s Wort you should wait around 4 weeks to judge its results. Most people react well to taking this herbal remedy but it can cause nausea, stomach pains or headaches in some cases.
In alternative medicine this herb has been used for quite long time as a sedative but also for headaches and digestive problems. Many people report feeling better and being more confident about their social skills after taking valerian root for social anxiety.
It hasn’t been clinically studied for its effects on SA, therefore there are no scientific proofs to how well can it work for unbiased patients.
It’s advised not to take Valerian Root when pregnant, suffering from a liver disease or taking MAOIs (Monoamine Oxidase Inhibitors). It has the potential to interact with other medications too, therefore you should consult your doctor before taking it on a regular basis.
Also known as Ashwagandha or Indian Ginseng, Winter Cherry has been used to deal with physical and emotional stress.
People who took Winter Cherry for social anxiety reported feeling better and less stressed overall, also more at ease when making conversation and interacting with strangers.
It’s side effects are rare and just like Valerian Root it shouldn’t be used by pregnant women, people struggling with a liver disease or taking MAOIs. It can also interfere with other medications so it would be wise to consult your doctor before introducing Ashwagandha into your daily reality.
Most people recognize Chamomile in the form of tea, hence this is the most popular way of taking it as a supplement.
It’s known to have a calming effect on people, lowering their anxiety levels for a few hours after ingestion and has been used to deal with social anxiety. For example before going to a party or a networking event where you know you might be exposed to a lot of triggers.
Chamomile can cause an allergic reaction in some people, it shouldn’t be used by pregnant women and when struggling with a bleeding disorder or when taking medications that might increase the risk of bleeding – be sure to consult your doctor before introducing Chamomile into your diet.
The deficiency in Zinc and vitamin B6 associated with a condition called pyroluria has been associated with increased levels of social anxiety. Here’s a questionnaire which will help you determine whether that may be an issue for you.
Drink lots of water. It isn’t a micronutrient, but I felt this is the best place to mention it. Most people walk the Earth with various levels of dehydration. It’s advised to drink at least 2 litres (or half a gallon) of water a day, but most of us are barely reaching half of that amount. The benefits of being properly hydrated are endless and they include the improvement of your wellbeing.
Try drinking at least 2 litres of water per day for a week and you’ll experience them all for yourself.
Foods with a low Glycemic Index are the ones that provide your body with a steady dose of energy stretched over a period of time instead of quick, almost unexpected energy spikes and long-lasting feelings of fatigue provided by high-GI foods. The resource linked above will provide you with examples and rational reasons for introducing the former into your diet.
Omega-3 Fatty Acids are a good thing to include in your diet, because being depleted of them can lead to increased feelings of anxiety, stress and depression.
Training your social skills will make you more confident when faced with an awkward social situation.
Think of it this way: lifting weights regularly, 3 times a week for an hour, for 3 months makes you more comfortable and more confident moving furniture, lifting heavy things off the ground, some people even say they feel safer walking down the street!
And it’s the same with every skill and its training. So, what are social skills then? It’s knowing about body language and what do certain gestures mean to the majority of people, it’s learning small talk (how to start, maintain and exit the conversation gracefully), it’s basically knowing what to do to make most strangers like you.
Bear in mind that there will always be exceptions to the rule. You can’t expect everybody to like you, because lots of people approach others with their mind already set on whether they like them or not based on what they associate with a certain characteristic of the other person.
This has to do with their past experiences and not the other person. And it’s pretty hard to change someone’s mind once it’s set.
Symptom management skills
You know best what the symptoms of your social anxiety are, but to make it a bit easier we’ll divide them into two categories: physical and psychological.
You physical symptoms might include blushing, sweating, elevated heart rate, etc. They’re mainly present when you’re experiencing an anxiety attack, or are exposed to either a high amount of your SA’s triggers or a very strong trigger.
All of these are rather natural reactions, resulting from your body sensing possible danger and releasing corresponding chemical substances into your blood.
These mechanisms were developed through thousands of years of evolution and even though they might not be very helpful for you when experiencing anxiety, they were helpful to your ancestors one way or another.
Your psychological symptoms are the thoughts, feelings and behaviours resulting from your exposure to the anxiety trigger. For example, let’s say that you’re afraid of being criticized and uncomfortable around people with authority.
Suddenly, you see your boss dashing out of his office and walking towards you with a furious expression on his face. You might think: “I must have done something wrong. Oh my God, of course I have! He’s coming to get me! I’m gonna get fired!”
All of a sudden you’re feeling afraid and in danger. You’re thinking about the loss of your job. The image of your landlord throwing you out of the apartment pops up in your head. The future is doomed! You start shaking, looking at the things on your desk trying to assess which are your personal belongings and what you’re going to have to let go when leaving the building with a half-filled cardboard box in your arms.
And then the boss walks past you and out of the building.
Your interpretation of the situation didn’t match what was really going on – your brain wanted to make sense out of what was going on and it associated the image of an angry boss storming through the hall with someone getting fired. Your anxiety and the direction he was heading in made that someone to be you.
Now, how could you prevent this from happening?
To calm your body and get into a more peaceful place you could try breathing exercises. Just take a look at the 5-Breath Anxiety Tamer. It will help you relax and doesn’t require anything other than a few moments of your time to work.
There’s not much more than that for you to do to immediately reduce your physical symptoms, because as I said earlier – they’re natural to your body, it does what it feels is necessary in the given situation (or more accurately, in your interpretation of the situation).
But it does what it FEELS is necessary, and here’s where the fun begins. How to start feeling more comfortable when facing an anxiety trigger?
Do a reality check. Instead of telling yourself “I must have done something wrong” ask yourself: “What could he be angry about? Could a manager of a company have more to worry about than the details of what his employees are up to? What could I have done wrong anyways?”
Then think about the past. Has this happened before? Have you seen your boss angrily walking out of his office? What were the consequences of that? If you’ve seen him doing that, was it always because someone was going to get fired?
Consider your assumptions about the future. If it’s highly unlikely you’re going to lose your job, it’s possible you won’t be thrown out of your apartment. If your boss gets angry a lot and it frightens you, maybe the workplace he manages isn’t the best environment for you. Would it be a good idea to start looking for other opportunities?
You can go even farther with this, ground yourself in reality as well as you can. This will give you a more rational, less anxious perspective on how to go about your triggers.
Education about the disorder
You know as much as there is to know when looking at your particular social anxiety from the first person perspective. But SA, given that it’s recognized by the whole world can describe a number of symptoms, and there’s a lot of different approaches you can take when trying to overcome it.
There are also different perspectives. You know how you feel but given that it’s all connected for you – the mind (thoughts feelings, interpretations), the body (physical reactions resulting from the thoughts) and the environment as you perceive it – there might be quite a lot you can miss. Literally, you can’t physically see everything there is!
Your eyes have blind spots, where they can’t register anything and yet what you see seems like a whole, as if it’s all there is. Not true, your brain fills the blind spots with an assumption of what might be in the spot derived from what it noticed previously.
This is just an example meaning to show you that it’s great to reach out for help, educate yourself, broaden your knowledge and even if from the 10,000 words you read or hear 10 will form into a sentence allowing you to decrease the anxiety – it’s worth it!
And if you’re struggling with social anxiety and don’t know how to go about fixing it you can always contact us through the contact form or our facebook page. We’ve been there and who knows, we could come up with something together!
Joining a support group, especially one focused on fighting your anxiety can do wonders for your progress. You’ll meet lots of like-minded people and learn from their experience as well as share your own with them. Here are just a couple of supportive groups or communities for people with social anxiety:
Social Anxiety Resource Center
Social anxiety
Overcoming Social Anxiety
r/socialanxiety
This has actually played a big part in my own journey towards becoming SA-free. I wanted to do it all at once and when it turned out social anxiety doesn’t want to comply, I was at the brink of giving up. If it wasn’t for the groups and for the friends I’ve made through them, I probably would have quit.
Through countless conversations with those friends I’ve realized that dealing with SA is a step-by-step process. It can’t be done in one night and it requires effort, real effort. Whether you’re going through therapy, or even taking medications or supplements – the crucial part of it all is your own effort.
Exercise and diet have been found to be useful in so many areas. You might even be tired of hearing about them everywhere and every time (though you probably would have been less tired if you exercised more and ate healthier – oh, just kidding!) but social anxiety is yet another area where your lifestyle choice might make a difference.
Take a look at this study, linking more exercise and eating fermented foods to experiencing less social anxiety.
I know it sounds weird, and especially the fermented foods part but that’s just a funny way to name them – these foods include: dark chocolate, yogurt, kimchi, sauerkraut, soy milk, etc. Consider adding a few of them to your diet every other day and see what happens.
Eating healthy in general is another matter. There are books, courses, university degrees built around our dietary habits and guidelines and here I’ll include just a few examples of the essentials.
When it comes to carbohydrates choose the more natural and less processed options if you can: fruits and vegetables, legumes, anything with fiber – you can find all the sweetness you need in fruits, and when it really is time for a trait, how about dark chocolate with strawberries? You’ll have your fermented food coupled with a fruit and it’ll taste delicious.
It would be best to eat fats coming from vegetables and if you’re about to include butter, the one coming from grass-fed cows is a much better choice. Also aim for nuts and seeds as a healthy snack. If you enjoy drinking milk, full fat is the healthier option even though it has more calories – if that’s an issue, you could just drink a bit less.
Protein we’ll make even simpler – just make sure you’re eating enough and there are tools for it all over the web, e.g. myfitnesspal.com. This site will show you how many calories to eat based on your daily activity and goals, there’s an enormous database of products and using it daily takes less than 5 minutes, more like 2.
Now, I’m aware that a healthy diet is more costly than the alternative and that’s a choice you’ll have to make for yourself. I can assure you that turning towards a healthier diet will make your life more enjoyable but it comes at a cost.
About exercise, just do what you enjoy doing the most whether that’s running, lifting weights, swimming or riding a bike. Taking a walk each day will also be fine. Make sure to do it around 3 times a week for an hour, or 6 times a week for half an hour, or even 4 times a week for 45 minutes – it’s your choice.
The total amount of 3 hours a week isn’t accidental, that’s around the amount recommended by a Mayo Clinic expert.
I can’t stress this enough. Whichever path you choose for dealing with your social anxiety – stick with it. Do it for 3 weeks – aren’t sure yet? Do it for 3 months. All of these require little of your time and energy, it’s the thinking and overanalyzing which take the most out of you.
There are support groups for SA, and I’m sure most people will admire you for setting out to make a difference for yourself and will be as helpful as they can.
Did you choose to start exercising? Great! There are plenty of support groups for people starting to exercise too. If you won’t feel like exposing yourself too much at first, join a group and just read. Then engage in the group’s activities gradually.
Hopefully this article has helped you get closer to choosing your own way of overcoming social anxiety. I’d love to hear your thoughts on all this, and if you have any suggestions as to how the article could be improved, don’t hesitate to let me know! Leave a comment down below or message me any way you wish.
If you’re now set towards getting rid of your SA, then you should join our group of like-minded people called: Overcoming Social Anxiety, and remember to like the anpene facebook page for the newest tips, techniques and knowledge for dealing with social anxiety.
var addthis_config = url: "", title: ""
