Both medication therapy and behavior therapy have proven successful in treating social anxiety disorder.
Medication treatment includes several classes of medications that have shown to have markedly beneficial effects for many patients.
Behavior therapy also provides a successful method for decreasing anxiety and avoidance in the social situations they fear most.
Many find that a combination of medication and behavioral therapy is most effective. Your clinician can help you choose the most appropriate course of action.
Medication treatment can decrease the frequency and intensity of anxiety and avoidance behavior for individuals with social anxiety disorder.
Advantages of medication treatment include minimal effort — you just have to remember to take the medicine — and that it may relieve symptoms more quickly than behavior therapy.
Medication may, however, cause side effects, and gains from medication may fade when medication is stopped.
What medications are used to treat social anxiety disorder?
Medications help reduce the frequency and intensity of anxiety in social situations, and also help decrease anticipatory anxiety and avoidance behaviors.
Research results indicate that about 70% of social anxiety disorder patients achieve worthwhile gains from medication therapy. Less than 30% of social anxiety disorder patients receiving a placebo (sugar pill) improve.
The amount of improvement with medication varies, but those who improve often find their gains so great that they want to continue the medication.
Some actually become symptom-free.
Obviously, some patients treated with medication do not benefit, and it is currently impossible to predict who will improve on a particular medication unless they have previously benefited from that medication.
There are five major categories of medications used to treat generalized social anxiety disorder and one additional category, beta-blockers, used to treat non-generalized social anxiety disorder (performance anxiety).
All of these have been studied systematically and found helpful in controlled research trials.
The following medications are currently approved by the U.S. Food and Drug Administration (FDA) for the treatment of social anxiety disorder: fluvoxamine CR (Luvox CR), paroxetine (Paxil), paroxetine CR (Paxil CR), and sertraline (Zoloft) (all of which are selective serotonin reuptake inhibitors [SSRIs]), and venlafaxine XR (Effexor XR), which is a serotonin norepinephrine reuptake inhibitor (SNRI).
FDA approval was based on positive results in well-designed, double-blind, multicenter research studies.
While not as extensively studied, other SSRIs and SNRIs are also likely to be beneficial alternatives.
With the exception of fluvoxamine, all SSRIs and SNRIs are also FDA-approved for use in major depressive disorder.
Which medication to use first is a matter of patient and physician preference.
Fluvoxamine (Luvox CR), paroxetine (Paxil), paroxetine CR (Paxil CR), sertraline (Zoloft) and venlafaxine XR (Effexor XR) are the medications that the FDA has approved for treatment of generalized social anxiety disorder and are generally considered medications of first choice.
These medications have side effect profiles that make them quite tolerable for most patients.
Each class of medication has advantages and disadvantages that can be explained by your doctor to help you make an informed choice.
Lifestyle and home remedies
Although social anxiety disorder generally requires help from a medical expert or qualified psychotherapist, you can try some self-help techniques to handle situations likely to trigger social anxiety disorder symptoms.
First, assess your fears to identify what situations cause the most anxiety.
Apply these techniques to those situations.
Practicing these techniques regularly can help you manage or reduce your anxiety.
You may need to begin with small steps in situations that aren’t overwhelming.
These techniques include:
* Eating with a close relative, friend or acquaintance in a public setting.
* Making eye contact and returning greetings from others, or being the first to say hello.
* Preparing for conversation. For instance, read the newspaper to identify an interesting story you can talk about.
* Giving someone a compliment.
* Focusing on personal qualities you like about yourself.
* Showing an interest in others. Ask about their homes, children, grandchildren, hobbies or travels, for instance.
* Asking a retail clerk to help you find an item.
* Getting directions from a stranger.
In addition, be sure to keep your medical or therapy appointments, take medications as directed, and talk to your doctor about any changes in your condition.