Mental Health Anxiety

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Second most commonly diagnosed anxiety disorder Improve your daily life and routine Physical and behavioral symptoms may occur

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*Prescriptions are provided at the doctor's discretion. Learn more about our controlled substances policy and how to save up to 80% with our prescription discount card. PlushCare doctors cannot treat all cases of social anxiety disorder. Our primary care physicians can conduct an initial evaluation of your symptoms, but may need to refer you to a specialist or for in-person treatment. If you are experiencing life-threatening symptoms, seek emergency medical attention immediately.

Learn about social anxiety

Social anxiety disorder or social phobia, is a common type of anxiety disorder. According to the Anxiety and Depression Association of America, social anxiety disorder is the second most commonly diagnosed anxiety disorder.

People with social anxiety disorder feel intense anxiety or fear in a social setting. These intense feelings can manifest as strong physical symptoms, such as a rapid heart rate, sweating, even panic attacks. Social anxiety disorder is a chronic mental health condition that can negatively impact daily life, work, school, and relationships. Some example social situations are meeting new people, being asked to answer in classes, attending a job interview, and even everyday things such as eating and drinking in a public setting.

Social anxiety causes

The exact causes of social anxiety disorder remain an area of active research. Some studies suggest that the disorder can be a result of complex interaction between biological and environmental factors.

Several biological related factors have been observed to play a role, including:

Age: The average age of onset for social anxiety disorder is during the teenage years.
Family genetics: It tends to run in families, but not all family members will get it.
Brain structure: People who possess an overactive amygdala tend to experience increased anxiety during stressful social situations. The amygdala is a part of the brain that plays a role in fear response control.
Temperament: People who are shy and withdrawn during social interactions tend to have a higher chance of developing social anxiety disorder.

Below are some environmental factors:

High stress situations: These situations, such as public speaking for the first time, can trigger anxiety attack symptoms for the first time.
Negative experiences: These are is tied to high stress situations. The human mind and body are constantly learning. If intense negative experiences such rejection or humiliation are the results of high stress social situations such as public speaking or meeting new people, the mind will learn to associate both together. As a result, when similar social situations arise in the future, the mind and body will view these as a trigger.

Some common triggers are:

Public speaking
Using public restrooms
Meeting new people
Speaking up in a meeting
Eating or drinking in public

Social anxiety and COVID-19

According to the Anxiety and Depression Association of America, social anxiety disorder affects approximately 15 million American adults. This number may increase as the United States steps into the post-COVID era. As the COVID-19 restrictions are lifted and Americans try to resume normal work and social life after years in quarantine, many may begin to experience anxiety when exposed to social settings once again.

The COVID restrictions and social distancing have changed the social interaction norms. As a result, many people will become uncertain of their actions as they navigate group social settings again. Worry or fear of being judged or criticized by other people if one does or does not wear a mask or if one accidentally coughs or sneezes in public can become triggers for people to develop social anxiety.

COVID's impact can be especially hard on children. Many children have been in both virtual and in-person environments. During quarantine periods, isolation could cause anxious and depressive symptoms in kids and teens. Younger kids who were used to social distancing during COVID may now feel anxious as they have to go into classrooms and interact with teachers and other children.

Social anxiety symptoms

Note that social anxiety disorder is not simply shyness or everyday nervousness in certain social settings. For people with social anxiety disorder, the intense anxiety or fear can manifest as physical and behavioral symptoms that can negatively impact daily life and routine.

Physical social anxiety disorder symptoms

Some physical symptoms of social anxiety disorder may include:

Rapid heartbeat
Sweating
Shivering
Feeling of chest tightness
Breathlessness
Dizziness

Emotional and behavioral social anxiety disorder symptoms

Some emotional symptoms of social anxiety disorder may include:

Intense anxiety in anticipation of a feared activity or event, often days, weeks or months before the event
Intense fear of self humiliation
Extreme self consciousness and self judgement even in normal social situations
Always anticipating worst case scenarios
Withdrawal or avoidance of normal social situations

How to treat social anxiety disorder

First, your doctor may conduct a physical exam to ensure that your current symptoms of social anxiety disorder are not due to an unrelated physical problem.

The main social anxiety disorder treatment options are:

Psychotherapy, including cognitive behavioral therapy, is the main treatment for Social anxiety
Medications, including anti-anxiety and antidepressant medications, are used as adjuncts in treatment with psychotherapy.

Psychotherapy (cognitive behavioral therapy)

Psychotherapy, also known as talk therapy, is a common non-medicinal method. Psychotherapy can help you gain a better understanding of negative thoughts that creep up during social situations. Your therapist will then work with you to develop ways to change these negative thoughts and improve your confidence.

Cognitive behavioral therapy, a type of psychotherapy, is effective in treating social anxiety disorder. A therapist, working with a patient, recreates the stress inducing social situations in a safe, repetitive manner. The repetitive experiences allow the patient to learn and practice social skills, slowly gaining comfort and confidence in these social situations. As the patients slowly overcome the unreasonable fear, the frequency and intensity of the anxiety begin to decrease.

Medication for social anxiety disorder

Medications can help reduce symptoms associated with social anxiety disorder. The following types of panic attack and anxiety disorder medications can be prescribed:

Selective serotonin reuptake inhibitors (SSRIs)

Commonly prescribed to treat social anxiety, these medications are generally considered safe with low side effects. Examples:

Prozac (fluoxetine) Zoloft (sertraline) Paxil

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

These anti anxiety medications can also be prescribed to treat social anxiety disorder.

Beta-blockers

Though not common, beta blockers can be prescribed to help control some of the physical symptoms of social anxiety disorder

Note that for all medications, remember to talk to your doctor about potential side effects.

How to prevent social anxiety

In addition to the strategies recommended by the therapists, some lifestyle changes can also help prevent social anxiety disorders, including:

Maintaining a healthy diet
Regular exercise
Reducing caffeine intake
Avoiding alcohol and smoking
Getting sufficient sleep
Learning stress management techniques (e.g. take yoga or meditation classes)
Joining support groups

According to Anxiety and Depression Association of America, for kids suffering from withdrawal (or avoidance of normal social situations), progressively increasing social interactions can boost mood and reduce severity of social anxiety symptoms. Parents can help kids and teens to increase social interactions with friends and family members by going to outdoor places such the park or mall and participating in family gatherings.

When to see a clinician for social anxiety disorder

See your clinician or a mental health professional if you feel intense fear and anxiety in normal social situations. In an effort to avoid these feelings of embarrassment or panic, you may find yourself consciously avoiding normal social situations.

The doctor can help you establish an official panic disorder diagnosis. This ensures that the symptoms you are experiencing are not due to other health issues. A professional diagnosis is the first step to effective treatment.

Social anxiety medication and treatment FAQs

What is the most effective treatment for social anxiety?

Psychotherapy, also known as talk therapy, is a common non-medicinal method. Psychotherapy can help you gain a better understanding of the negative thoughts that creep up during social situations. A mental health professional will then work with you to develop ways to change these negative thoughts and improve your confidence. Note that it may take several weeks to see positive effects of the treatment.

How is social anxiety disorder treated?

The main social anxiety disorder treatment options are:

Psychotherapy: Psychotherapy is often a first line treatment for social anxiety disorder. Working with a mental health professional, psychotherapy can help you gain a better understanding of the negative thoughts that creep up during social situations and develop effective management plans.
Anti-anxiety and antidepressant medications: Selective serotonin reuptake inhibitors (SSRIs), such as Prozac (fluoxetine), Zoloft (sertraline HCl), and Paroxetine (Paxil), can be prescribed to help. Serotonin and norepinephrine reuptake inhibitors (SNRIs) may also be prescribed to treat social anxiety disorder. Both SSRIs and SNRIs may take a few weeks to start working and have side effects so be sure to have a conversation with your doctor before taking these medications.

What causes social anxiety disorder?

The exact causes of social anxiety disorder remain an area of active research. Some peer reviewed studies suggest that the disorder can be a result of complex interaction between biological and environmental factors. Some biological related factors include age, family genetics, brain structure and temperament. Some environmental factors include high stress situations and negative experiences in social situations.

What is social anxiety disorder?

Social anxiety disorder or social phobia, is a common type of anxiety disorder. People with social anxiety disorder feel intense anxiety or fear of being judged or criticized by other people in a social setting. These intense feelings can manifest as strong physical symptoms, such as a rapid heart rate, sweating, and even panic attacks.

Can social anxiety be totally cured?

Social anxiety is treatable. The first step towards getting better is seeing a doctor to get an official diagnosis. Common treatment options such as psychotherapy and medications to reduce anxiety and fear during social situations. The fear and anxiety can be overcome as you gain confidence in specific social skills. One example is public speaking.

Even after you have gotten better, know that you are never alone. If the symptoms do come back, you may find it helpful to join support groups to continue to get help.

How do you cure social anxiety?

First, if you think you are developing anxiety symptoms (both physical and emotional) during social settings, see a doctor to get a diagnosis. Your doctor can refer you to a mental health specialist that can help you with psychotherapy and consider medications in treatment. With cognitive behavioral therapy (CBT), you can reduce anxiety and develop confidence in social events with time.

Step 1

Book a social anxiety treatment appointment.

Book a same day appointment from anywhere.

Step 2

Talk to your medical provider regarding your social anxiety symptoms.

Visit with a doctor on your smartphone or computer.

Step 3

Pick up a prescription for social anxiety treatment.

We can send prescriptions to any local pharmacy.

Related conditions to social anxiety disorder

According to research studies, some other health conditions are related to social anxiety disorder and can show up before, during, or after the patient is suffering from social anxiety disorder.

Obsessive-compulsive disorder

When a person suffers from obsessive-compulsive disorder, he or she displays compulsive behaviors due to unreasonable thoughts and fears.

Post traumatic stress disorder

PSTD is a mental health condition brought about by experiences with traumatic events such as a serious accident, war, or natural disaster. Symptoms can include persistent nightmares, anxiety, and depression.

Depression

The anxiety and depression association has been observed and researched. With anxiety disorders, the patient suffers persistent anxiety and fear. On the other hand, with depression, the patient can have symptoms such as feeling down, sad, irritable or fatigued. While anxiety disorder and depression have distinctive symptoms, they commonly occur together.

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