Social Anxiety Treatment: Social Phobia Treatment That Works
Social anxiety treatment and treatment for social phobia can be very effective. Some social anxiety is normal for certain people in public situations, but social phobia, or social anxiety disorder, takes this anxiety to a new level. In social phobia, anxiety interferes with everyday life and can even lead to agoraphobia. Social anxiety disorder treatment can stop this debilitating anxiety. (If you're wondering if you have SAD, take our social anxiety disorder test)
While minor cases of social anxiety tend to go away on their own, treatment is generally needed for social anxiety disorder. No cure for social anxiety disorder is known, but treatment works for many people. Treatment for social phobia involves medication, therapy or both. A combination of social anxiety disorder treatment approaches is often most successful, particularly in those with the most severe cases.
Over 10 million adults suffer from social anxiety disorder and most can be helped with appropriate social anxiety treatment.
Social Anxiety Treatment
Social anxiety is the kind of anxiety that many people feel when being in a crowd, when meeting people for the first time or when performing for people. Social anxiety can include blushing, a shaky voice, difficulty speaking, clammy hands and other common symptoms. Social anxiety is seen in children and adults.
A person may be able to overcome social anxiety (not social phobia) on their own with self-help methods or social anxiety therapy may be helpful. The Anxiety Disorder Association of American recommends the self-help book: Triumph Over Shyness: Conquering Social Anxiety Disorder, Second Edition by Murray Stein, MD, MPH, and John Walker, PhD.1
Medication Treatment for Social Phobia
Medication treatment for social phobia includes several types of medication. This type of treatment for social anxiety disorder may be long- or short-term depending on the medication, but most medications require long-term use to be effective in treating social anxiety disorder. Few medications are Food and Drug Administration (FDA)-approved in the treatment of social phobia but many medications are prescribed off-label.
Medication treatments for social phobia include:2
- Antidepressants – several types of antidepressants are prescribed for social anxiety disorder. Selective serotonin reuptake inhibitors (SSRIs) are the most common medication treatment for social phobia. Sertraline (Zoloft) and paroxetine (Paxil) are both FDA-approved to treat social phobia.
- Benzodiazepines – tranquilizers are generally used for short-term management of acute anxiety or panic. Most benzodiazepines are FDA-approved for treatment of anxiety disorders in general. This type of medication carries the concerns of tolerance, dependence and withdrawal in long-term use. Examples are:
- Clonazepam (Klonopin)
- Alprazolam (Xanax)
- Lorazepam (Ativan)
- Diazepam (Valium)
- Antianxiety – Buspirone (BuSpar) is used in the long-term treatment of anxiety disorders.
- Anticonvulsants - Gabapentin (Neurontin), an anti-seizure medication, may have antianxiety effects.
D-cycloserine (Seromycin), a novel medication, may also be useful as a social anxiety disorder treatment.
Social Phobia Therapy
Cognitive behavioral therapy (CBT) may be useful for both adults and children with social phobia. A variety of cognitive approaches may be used in social phobia therapy including:3
- Prompted behavior learning – the desired behavior (like speaking) is learned to be done in response to a prompt. This prompt is then gradually removed until the individual can act on their own.
- Positive reinforcement of desired behavior (negative behavior is ignored)
- Desensitization – the feared situation is encountered in a safe setting so the person can learn to face it without reactions of anxiety; this can also be done mentally with imaginings
- Learning to act by watching others, such as a therapist or parent
- Teaching social-skills and social problem solving
CBT computer programs for treating social anxiety disorder are available for both children and adults. While CBT has been shown more effective than interpersonal therapy, both social phobia therapy types produce improvement in social anxiety disorder symptoms.
Last Updated: 30 June 2016
Reviewed by Harry Croft, MD