Archive for August, 2008
It's sort of a self diagnoses. I've been asking around for years and doing research off and on and I came across the symptoms for Social Anxiety Disorder. I seem to have about 90% of the symptoms in such a severe way that it effects my daily life dramatically. I'm unable to see psychologists or doctors due to the cost, and I don't have any support from family. I've been reading about Cognitive Behavioral Therapy, but how do I know that's right for me? As long as I know a certain treatment will work for me, I would be willing to do everything in my power to try and get it. I'm afraid if I wait too long, my depression as a result from my social anxiety will get even worse and impair any chances I have of recovering. Thanks everyone!
I also have social anxiety and I feel for you….I tried everything because I'm not much of a medicine person and I thought I could handle it myself but I couldnt I'm on Lexapro right now and I'm doing so much better you wouldnt even think I had social anxiety. If you don't have the money I would say get a good book about the subject…goodluck
whats the best treatment for social anxiety disorder?
Posted by: | CommentsI was just diagnosed with social anxiety disorder whats the best treament.
I suffered for years, but it improved when I started Paxtil / Aropax (Antidepressant). It's not to be taken lightly, and get good medical advice first, but it solved my problem after years of intense unwelcome anxiety.
What is the up- to- date treatment of social anxiety disorder?
Posted by: | CommentsI am a 64-year-old man ,is there any appropriate
therapy available that could improve my long standing anxiousness?
Social anxiety is an experience of fear, apprehension or worry regarding social situations and being evaluated by others. People vary in how often they experience anxiety in this way or in which kinds of situations. Anxiety about public speaking, performance, or interviews is common.
Social anxiety disorder (SAD), also referred to clinically as social phobia, is a psychiatric anxiety disorder involving overwhelming anxiety and excessive self-consciousness in everyday social situations. People experiencing social anxiety often have a persistent, intense, and chronic fear of being watched and judged by others and being embarrassed or humiliated by their own actions. Often the triggering social stimulus is a perceived or actual scrutiny by others. Their fear may be so severe that it significantly impairs their work, school, social life, and other activities. While many people experiencing social anxiety recognize that their fear of being around people may be excessive or unreasonable, they encounter considerable difficulty overcoming it. This differs from shyness, in that the person is functionally debilitated and avoids such anxiety provoking situations by all means. At the same time, a person with social anxiety may only feel the fear of the disorder during certain situations. For example, an actor or singer may feel fine on stage, but afraid of social situations in everyday life.
Social anxiety is often part of only a certain situation—such as a fear of speaking in formal or informal situations, or eating, or writing in front of others—or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people. Many people have the specific fear of public speaking, called glossophobia. In this case, the fear is not actually of public speaking, but a fear of doing or saying something which may cause embarrassment. Approximately 13.3% of the general population will experience social phobia at some point in their lifetime; with the male to female ratio being 1.4:1.0, respectively. Physical symptoms often accompany social anxiety, and include blushing, profuse sweating, trembling, nausea, and stammering. Panic attacks may also occur under intense fear and discomfort. An early diagnosis helps in minimizing the symptoms and having other mental illnesses such as depression. Some sufferers also use alcohol or drugs to reduce fears and inhibitions at social events.
A person with the disorder may be treated with therapy, medication, or both. Research has shown cognitive behavior therapy, whether individually or in a group, to be effective in treating social phobics. The cognitive and behavioral components seek to change thinking patterns and physical reactions to anxious situations. This may be done through a technique called role playing. Prescribed medication consists of a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Such treatment has a high response rate and low risk of dependency but has been criticized for its adverse side-effects and possible increase in suicide risk.
Attention given to social anxiety disorder has significantly increased since 1999 with the approval of drugs for its treatment. Marketing campaigns by pharmaceutical companies may be largely responsible for driving this.
Treatment
Arguably the most important clinical point to emerge from studies of comorbid social anxiety disorder is the necessity for early diagnosis and treatment. Social anxiety disorder remains underrecognized in primary care practice, with patients presenting for treatment only after the onset of complications such as major depression or substance use disorders. Up to 80% of those treated for social phobia claim to have their anxiety under control, according to the Anxiety Disorders Association of America. Improvement is lower for those with more severe social phobia and with comorbid disorders, such as avoidant personality disorder and depression. The patients who achieve full resolution are usually far fewer; there are still many who, after receiving treatment, are unable to function in the long-term without anxiety symptoms.
Research supported by the NIMH has shown that there are two effective forms of treatment available for social phobia (and anxiety disorders): certain medications and a specific form of short-term psychotherapy called cognitive-behavioral therapy (CBT), the central component being gradual exposure therapy. Medications include antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs), as well as a benzodiazepene.
Pharmacological treatments
SSRIs
Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants, are considered the first choice by doctors in defusing fears associated with social phobia and related anxiety disorders. These drugs are designed to elevate the level of the neurotransmitter serotonin. The first drug formally approved by the Food and Drug Administration was paroxetine, sold as Paxil. Compared to older forms of medication, there is little risk of tolerability and drug dependency. However, their efficacy and increased suicide risk has been subject to controversy.
In a 1995 double-blind, placebo-controlled trial, the SSRI paroxetine was shown to result in clinically meaningful improvement in 55% of patients with generalized social anxiety disorder, compared with 23.9% of those taking placebo. An October 2004 study yielded similar results. Patients were treated with either fluoxetine, psychotherapy, fluoxetine and psychotherapy, placebo and psychotherapy, and a placebo. The first four sets saw improvement in 50.8 to 54.2% of the patients. Of those assigned to receive only a placebo, 31.7 percent achieved a rating of 1 or 2 on the Clinical Global Impression-Improvement scale. Those who sought both therapy and medication did not see a boost in improvement.
General side-effects are common during the first weeks while the body adjusts to the drug. Symptoms may include headaches, nausea, insomnia and changes in sexual behavior. Treatment safety during pregnancy has not been established. In late 2004 much media attention was given to a proposed link between SSRI use and juvenile suicide. For this reason, the use of SSRIs in pediatric cases of depression is now recognized by the Food and Drug Administration as warranting a cautionary statement to the parents of children who may be prescribed SSRIs by a family doctor. Recent studies have shown no increase in rates of suicide. These tests, however, represent those diagnosed with depression, not necessarily with social anxiety disorder. However, it should be noted that due to the nature of the conditions, those taking SSRIs for social phobias are far less likely to have suicidal ideation than those with depression.
Other drugs
Although SSRIs are often the first choice for treatment, other prescription drugs are also commonly issued.
Benzodiazepines are a more potent alternative to SSRIs. The drug is often used for short-term relief of severe, disabling anxiety. Although benzodiazepines are prescribed for long-term use, there is much concern over the development of drug tolerance, dependency and recreational abuse. Benzodiazepines, such as Xanax augment the action of GABA, the major inhibitory neurotransmitter in the brain; effects usually begin to appear within minutes or hours.
In 1985, before the introduction of SSRIs, anti-depressants such as monoamine oxidase inhibitors (MAOIs) were frequently used in the treatment of social anxiety by researchers such as Donald Klein and Michael Liebowitz. Irreversible MAOIs, most notably phenelzine, has been more efficacious than benzodiazepines in the short-term (8-12 weeks). Relapse is common, which may result in long-term usage. Because of the dietary restrictions required, high toxicity in overdose, and incompatibilities with other drugs, its usefulness as a treatment for social phobics is limited. Reversible inhibitors of monoamine oxidase subtype A (RIMAs) also inhibit monoamine oxidase. In contrast with MAOIs, reversibility means that they can inhibit the enzyme only temporarily. Because their action is short-lived and selective, they have a better safety profile than the older MAOI drugs. A special diet does not need to be strictly adhered to.
Some people with a form of social phobia called performance phobia have been helped by beta-blockers, which are more commonly used to control high blood pressure. Taken in low doses, they control the physical shaking of anxiety and can be taken before a public performance.
Psychotherapy
Research has shown that a form of psychotherapy that is effective for several anxiety disorders, particularly panic disorder and social phobia, is cognitive-behavioral therapy (CBT) (Burns, 1999). It has two components. The cognitive component helps people change thinking patterns that keep them from overcoming their fears. A person with social phobia might be helped to overcome the belief that others are continually watching and harshly judging him or her. The behavioral component of CBT seeks to change people's reactions to anxiety-provoking situations. A key element of this component is gradual exposure, in which people confront the things they fear in a structured, sensitive manner. This is done with support and guidance when the therapist feels the patient is ready and only with the permission of the patient and at the pace the patient wishes. Cognitive-behavior therapy for social phobia also includes anxiety management training, such as teaching people techniques such as deep breathing to control their levels of anxiety.
Cognitive behavioral group therapy (CBGT), founded upon research done by Richard Heimberg, is a similar psychotherapeutic approach. It is generally held for 12 weekly sessions which run for two or three hours. A range of 4-10 patients and two therapists are involved in sharing individual experiences, participating in simulated exposures, and completing homework assignments in the goal of replacing irrational and automatic negative thoughts in social situations. A sample homework assignment might include reading a book or initiating a conversation with an acquaintance. Even in CBGT, sufferers are treated individually. Each person is exposed to different levels of anxious situations, depending on the severity of their illness.
These two types of cognitive behavior therapy have proven effective in reducing anxiety among social phobics. A 1998 study by Heimberg and Michael Liebowitz and a 2004 experiment showed the efficacy of CBGT.
How do I get treatment for a anxiety disorder?
Posted by: | CommentsDo I go to a regular doctor of a psychiatrist?
A Psychiatrist. Meaning a Medical doctor, who specialized in the field of mental afflictions. They are the only doctors that can truly get as close as they can to knowing what's wrong with your brain. I know a lot about this illness, as I have it severely, along with Panic disorder. A Psychiatrist will most likely start you out with SSRI-antidepressant treament therapy for anxiety. If it doesn't work (which it doesn't, for ever single person I know with anxiety disorder. And I don't know why they teach that in the damn medical school. Benzodiazepines are THE most effective med for anxiety, and if only lower than 2mgs a day equivalent of Klonopin or Xanax, then the addiction potential is very low. But you will still have to do the whole long trial and error SSRI treatment, and eventually he'll give you the real deal. Just don't abuse them when you finally get them, because daily abuse can cause serious, and even fatal withdrawal.
I can tell you right now though, those things suck to run out of if your own a dose that causes dependency. It sucks BAD. Another reason to stray from taking even an extra every once in a while if on such a dose.
What is the treatment for social anxiety disorder? Has it helped you?
Posted by: | CommentsI never had any problems with being social in my life, but for the past year or so whenever I even think about going out on a Saturday night, I get horrible anxiety, stomach aches, nausea, and diarhea. I am terrified that if I go out I will get sick and/or make a fool out of myself. I am not sure if social anxiety disorder can come out of the blue like this. I was just wondering if anyone else has had experience with this. I am curious to know if I can ever get better.
I have had the same problems and it did come out of the blue for me too. My doctor perscribed Zoloft for the social anxiety and xanax for the anxiety attacks. Not on any medications now and I do fine in social settings with no anxiety at all.
