Social Anxiety Disorder (social Phobia)

Tests and diagnosis
When you decide to seek treatment for social anxiety disorder symptoms, you may have a physical exam and your doctor will ask a number of questions. The physical exam can determine if there may be any physical causes triggering your symptoms. Answering questions will help your doctor or mental health provider find out about your psychological state.

There's no laboratory test to diagnose social anxiety disorder, however. Your doctor or mental health provider will ask you to describe your signs and symptoms, how often they occur and in what situations. He or she may review a list of situations to see if they make you anxious or have you fill out psychological questionnaires to help pinpoint a diagnosis.

To be diagnosed with social anxiety disorder, a person must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Criteria for social anxiety disorder to be diagnosed include:

A persistent fear of social situations in which you believe you may be scrutinized or act in a way that's embarrassing or humiliating.
These social situations cause you a great deal of anxiety.
You recognize that your anxiety level is excessive or out of proportion for the situation.
You avoid anxiety-producing social situations.
Your anxiety or distress interferes with your daily living.


Social anxiety disorder shares symptoms with other psychological disorders, including other anxiety disorders. Your mental health provider will want to determine whether one of these other conditions may be causing your social anxiety, or if you have social anxiety disorder along with another mental health disorder. Often, social anxiety occurs along with other mental health conditions, such as substance abuse problems, depression and body dysmorphic disorder.


The two most common types of treatment for social anxiety disorder are medications and psychological counseling (psychotherapy). These two approaches may be used in combination.

Psychotherapy
Psychological counseling (psychotherapy) improves symptoms in most people with social anxiety disorder. In therapy, you learn how to recognize and change negative thoughts about yourself. Cognitive behavioral therapy is the most common type of counseling for anxiety. This type of therapy is based on the idea that your own thoughts — not other people or situations — determine how you behave or react. Even if an unwanted situation won't change, you can change the way you think and behave.

Cognitive behavioral therapy may also include exposure therapy. In this type of therapy, you gradually work up to facing the situations you fear most. This allows you to become better skilled at coping with these anxiety-inducing situations and to develop the confidence to face them. You may also participate in skills training or role-playing to practice your social skills and gain comfort and confidence relating to others.

Several types of medications are used to treat social anxiety disorder. However, selective serotonin reuptake inhibitors (SSRIs) are often the first type of medication tried for persistent symptoms of social anxiety. SSRIs your doctor may prescribe include:

Paroxetine (Paxil)
Sertraline (Zoloft)
Fluvoxamine (Luvox)
Fluoxetine (Prozac, Sarafem, others)
The serotonin and norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor) also may be an option for social anxiety disorder.

To reduce the risk of side effects, your doctor will start you at a low dose of medication and gradually increase your prescription to a full dose. It may take up to three months of treatment for your symptoms to noticeably improve.

Your doctor or mental health provider may also prescribe other medications for symptoms of social anxiety, including:

Other antidepressants. You may have to try several different antidepressants to find which one is the most effective and has the fewest unpleasant side effects.Anti-anxiety medications. A type of anti-anxiety medication called benzodiazepines (ben-zo-di-AZ-uh-peens) may reduce your level of anxiety. Although they often work quickly, they can be habit-forming. Because of that, they're often prescribed for only short-term use. They may also be sedating. If your doctor does prescribe anti-anxiety medications, make sure you try taking them before you're in a social situation so that you know how they will affect you.

Beta blockers. These medications work by blocking the stimulating effect of epinephrine (adrenaline). They may reduce heart rate, blood pressure, pounding of the heart, and shaking voice and limbs. Because of that, they may work best when used infrequently to control symptoms for a particular situation, such as giving a speech. They're not recommended for general treatment of social anxiety disorder. As with anti-anxiety medications, try taking them before you need them to see how they affect you.

Don't give up if treatment doesn't work quickly. You can continue to make strides in psychotherapy over several weeks or months. And finding the right medication for your situation can take some trial and error.

For some people, the symptoms of social anxiety disorder may fade over time, and medication can be discontinued. Others may need to take medication for years to prevent a relapse.

To make the most of treatment, keep your medical or therapy appointments, take medications as directed, and talk to your doctor about any changes in your condition.

Thanks to to the writers and researchers for this paper (Mayo Clinic)
redtailfree48 redtailfree48
46-50, M
2 Responses May 10, 2012

what's up!!!

happy to help