Some level of social anxiety is normal. But there’s a difference between wanting to be accepted and fearing rejection so much that you avoid any place you think you might be judged.
Social anxiety becomes a problem when it’s so intense that it prevents you from enjoying your social life1.
The best social anxiety treatment has an integrative approach that includes one essential factor: you.
Overcoming social anxiety on your own is a challenge, and many people are forced to because therapy costs add up quick. Luckily, this article shares resources and tools to help you overcome it successfully.
Psychological Social Anxiety Treatment
Through psychotherapy, psychologists can help you work through social anxiety challenges.
There are several approaches to psychotherapy, including cognitive-behavioral therapy, interpersonal therapy and other kinds of talk therapy2. Of all that exist, cognitive-behavioral therapy (CBT) is the most common for treating social anxiety3.
CBT is based on the belief that what you think affects how you feel and behave. Consequently, if you change the way you think about social situations that trigger anxiety, you’ll feel and perform better.
In exposure-based CBT, you progressively work up to facing the situations you fear most. This kind therapy can help you develop the confidence and self-control to deal with anxiety-inducing situations.
Your therapist may also encourage you to participate in skills training sessions to practice your social skills and feel more comfortable relating to others.
Group therapy for social anxiety4 uses role playing, recording video and then watching, doing mock interviews, and other activities to work on situations that make you anxious in the real life. As you practice and prepare for situations you’re afraid of, you will become more and more ease and confident in your social abilities, and your anxiety will lessen.
Other group cognitive-behavioral methods used as social anxiety treatment include role-playing and social skills training.
Supportive therapy and family therapy, which makes loved ones affected by your condition a part of the social anxiety treatment process, can also help.
It’s important to know that when you start psychotherapy, you may also feel more anxious. That’s normal, and it’s an important part of your development process.
Psychotherapy is a collaborative treatment based on the relationship between you and your psychologist.
The two of you will work together to identify and change the thought and behavior patterns that are keeping you from enjoying your social life.
Don’t give up if social anxiety treatment doesn’t work immediately. You will continue to make strides over several weeks or months.
Medical Social Anxiety Treatment
When you see a doctor, he will begin an evaluation by asking questions about your symptoms and medical history and performing a physical exam.
Although there are no lab tests to diagnose social anxiety, specifically, the doctor may use lab tests to make sure that a physical disease isn’t the root of the social anxiety symptoms.
Other conditions, such as depression, panic and substance abuse, may overlap with your social anxiety. For this reason, your doctor may ask you certain questions to evaluate that.
After a complete evaluation, your doctor may prescribe medication for social anxiety treatment.
Medicines for social anxiety
There are many types of medications used to treat social anxiety5. However, selective serotonin reuptake inhibitors (SSRIs), like paroxetine and fluoxetine, are often the first type of drugs used for social anxiety symptoms.
The medicines may cause side effects that may make your anxiety worse at first. These side effects may get better over time, but if they don’t, your doctor may just prescribe a different drug.
To diminish the risk of side effects, your doctor may start you on a low dose of medication and slowly increase to a full dose. It may take several weeks to several months of treatment for your symptoms to noticeably improve.
There is no such thing as the best medicine. The best social anxiety treatment approach varies from person to person.
Here is a list of the types of medications commonly used to treat social anxiety 6:
- Selective serotonin reuptake inhibitors (SSRI). These medications are used to treat depression and anxiety, but they are often the first type of medicine used to treat social anxiety. SSRIs include fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram, and escitalopram.
- Serotonin-norepinephrine reuptake inhibitors (SNRI). These medications are used to treat depression and anxiety, but they are used to treat social anxiety too. SNRIs include Venlafaxine and Duloxetine.
- Monoamine oxidase inhibitors (MAOI). These medications are used to treat depression, but they are particularly effective in treating social anxiety. However, they are rarely used as the first treatment because when you take MAOIs combined with certain foods or other medicines, dangerous side effects can occur. Among these drugs are Tranylcypromine and Phenelzine.
- Benzodiazepines. These medications may reduce your level of anxiety. Although they are fast-acting, they can be sedating and habit-forming, so they’re typically prescribed for short-term use only. Benzodiazepines are not recommended for long-term treatment of social anxiety. Examples of benzodiazepines include Clonazepam, Alprazolam, Diazepam, and Bromazepam.
- Beta-blockers. These medications work by blocking adrenaline’s stimulating effect. They may reduce heart rate, blood pressure, shaky voice, and tremors. Because of this, they may work best when occasionally used to control symptoms for specific situations, like giving a speech. Beta-blockers are not recommended for long-term treatment of social anxiety. Atenolol and Propranolol are examples of beta-blockers.
It’s important to know that although antidepressants (SSRIs, SNRIs, IMAOs and others classes) can be effective and safe for many people, they may be risky for some, especially children, teens, and young adults. A “black box” warning has been added to the labels of antidepressant medications to alert people that the drugs may cause some people to have suicidal thoughts or even attempt suicide.
That’s why is so important that you have regular checkups to monitor the medications and their potential side effects.
Don’t give up if medication doesn’t work quickly. It can take several weeks or months to notice the affects of your progression.
Social Anxiety Treatment Online
In social anxiety treatment, there is no silver bullet, so the best approach for varies from person to person.
You may discover that self-help approaches are enough to ease your social anxiety symptoms. Some people do better with psychotherapy, while others do better with medication. Then there are those that do best with a combination of approaches.
However, you need to understand your personal role in the process. Develop the knowledge, skills, and confidence to take on the role of overcoming social anxiety to make the most of the treatment.
More specifically, you need to be more active, and less passive in your role.
This is where digital therapeutics come in.
Digital therapeutics are health care interventions delivered either entirely or almost entirely through a smartphone, a computer or any technological device7.
Whether they are wholly automated or blend automation with human supervision, the therapy offered can be personalized to the needs of each user.
Many digital therapy platforms include a mix of features, such as a way for people to connect with peers and health professionals remotely; to access reliable information about their condition; or to use digital tools for dealing with that condition.
At a minimum, digital therapeutics need to blend science-based interventions into an engaging experience for empowering you to overcome social anxiety.
You can use digital therapeutics both by itself or combined with mental health professionals. They’re an effective8 and personal tool to empower you before, during and after consulting a therapist.
Have you tried something I didn’t include here? Share your story in the comments and help others find better solutions. Click here to start Youper’s free Essential Trail.
- Social anxiety disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org (accessed June 02, 2016).
- Understanding psychotherapy and how it works. American Psychology Association. https://www.apa.org/helpcenter/understanding-psychotherapy.aspx (accessed June 02, 2016).
- Psychological and pharmacological interventions for social anxiety disorder in adults: A systematic review and network meta-analysis. Mayo-Wilson E., et al. The Lancet Psychiatry. 2014.
- Efficacy of group psychotherapy for social anxiety disorder: A meta-analysis of randomized-controlled trials. Barkowski S1, et al. J Anxiety Disord. 2016
- Psychological and pharmacological interventions for social anxiety disorder in adults: A systematic review and network meta-analysis Mayo-Wilson E., et al. The Lancet Psychiatry. 2014.
- Social anxiety disorder: the NICE guideline on the recognition, assessment, and treatment of social anxiety disorder. Clark DM, et al. London: Royal College of Psychiatrists. 2013.
- The digital revolution: eight technologies that will change health and care. Cosima G., et al. http://www.kingsfund.org.uk/publications/articles/eight-technologies-will-change-health-and-care (accessed June 02, 2016)
- Self-help cognitive–behavioral therapy with minimal therapist contact for social phobia: a controlled trial. Abramowitz, J.S. et al. J. Behav. Ther. Exp. Psychiatry. 2009.
I’ve been trying self-help books to overcome social anxiety and I’m not feeling better, so I think it’s not working.
You’re an extremely practical web site; couldn’t make it