A Cure For Social Anxiety Disorders
- Date:
- The Norwegian University of Science and Technology
- Summary:
- Social phobia is the most common anxiety disorder of our time. But the current treatment regimen for patients with this diagnosis has not proven very effective. Now a team of researchers believes they have found a cure for social anxiety disorders.
Social phobia is the most common anxiety disorder of our time. But the current treatment regimen for patients with this diagnosis has not proven very effective. Now a team of Norwegian and British researchers believe they have found a cure for social anxiety disorders.
“We’ve set a new world record in effectively treating social anxiety disorders,” says Hans M. Nordahl, a professor of behavioural medicine at the Norwegian University of Science and Technology . He has led a project with a team of doctors and psychologists from NTNU and the University of Manchester in England to examine the effects of structured talk therapy and medication on patients with social anxiety disorders.
Until now, a combination of cognitive therapy and medication was thought to be the most effective treatment for these patients. The researchers’ results, which have just been published in the journal Psychotherapy and Psychosomatics, show that cognitive therapy on its own has a much better effect in the long term than just drugs or a combination of the two.
Nearly 85 per cent of the study participants significantly improved or became completely healthy using only cognitive therapy.
Can You Use Other Medications To Treat Symptoms Associated With Social Anxiety Disorder
Other medications may be used off-label to treat social anxiety disorder. According to the Anxiety and Depression Association of America , other SSRIs such as , , and may also be effective in treating social anxiety disorder. These might be prescribed if youve tried sertraline, paroxetine, or extended-release venlafaxine, and they havent seemed to help enough.
Benzodiazepines, including clonazepam and alprazolam , may sometimes be second-choice treatments for people with social anxiety disorder. Because many of these medications help calm anxiety symptoms within a few hours of a dose, they can be helpful when first starting SSRIs or venlafaxine until they kick in.
However, people taking benzodiazepines long-term may develop dependence on the medication and experience withdrawal symptoms when attempting to stop them. Its best to discuss the safest way to take benzodiazepines with your healthcare provider if they prescribe them for you.
Medications used to treat seizures or nerve pain, such as gabapentin and pregabalin , are also sometimes used off-label to treat social anxiety disorder. However, research suggests that these medications are less effective in relieving symptoms than SSRIs or venlafaxine.
Some medications may be particularly effective in treating specific symptoms of social anxiety disorder, such as performance anxiety. People with performance anxiety may have an intense fear or worry while speaking or performing in public.
Risks Of Anxiety Disorder Medications
Like any medication, those designated for anxiety disorders can carry some risks. There are a range of side effects, which, depending on the medication, can include dry mouth, diarrhea/constipation, lower appetite, sleep issues, nausea and heartburn. Some medications can also spark feelings of nervousness, irritability or, in severe cases, suicidal thoughts. Because these side effects can pose significant health problems, a doctor should be consulted if any of them appear.
Patients should also make sure their physicians know about anything they may be taking that could interfere with anxiety disorder medications. That includes over-the-counter drugs, herbal or vitamin supplements, other medications or even regular consumption of caffeine or alcohol.
Finally, anxiety disorder medications such as benzodiazepines carry the risk of abuse and addiction. Some medications can have a powerful effect on the brain and if they are taken frequently, a tolerance can develop. That means more of the medication needs to be taken to obtain the desired effect, and continued, accelerated use can lead to dependency. If the medication dependency interferes with a persons daily life and take the drug becomes the sole focus, it can indicate a possible addiction. People who abuse antidepressants and benzodiazepines over a long period of time may also suffer withdrawal symptoms when they attempt to stop using the medication.
Nothing changes if nothing changes.
Nothing changes if nothing changes.
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What Medications Are Used To Treat Anxiety Disorders
When treating anxiety disorders, antidepressants, particularly the SSRIs and some SNRIs ,Ã Ã have been shown to be effective.
Other anti-anxiety drugs include the benzodiazepines, such as as alprazolam , diazepamà , buspirone ,à and lorazepam . These drugs do carry a risk of addiction or tolerance , so they are not as desirable for long-term use. Other possible side effects include drowsiness, poor concentration, and irritability. Some anticonvulsant drugs , some blood pressure medications , and some atypical antipsychotics are also occasionally used “off label” to treat anxiety symptoms or disorders.
Social Phobia Can Extend Beyond The Social Event
A person with social phobia can feel anxious while simply anticipating an upcoming social event. After the event, the person may replay the conversations they had and rate their performance. Brooding on these feelings of social failure can make the person feel even worse, and reinforce the desire to avoid social situations in the future.
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How Do You Treat Social Anxiety
There are a variety of ways to treat social anxiety disorder. A common treatment approach includes a combination of ongoing psychological counseling and medication. According to a review originally published in Cognitive Therapy and Research, Cognitive Behavioral Therapy is an especially reliable treatment modality for the immediate and most pressing symptoms of various anxiety disorders. CBT is a type of psychotherapy based on the idea that internal thoughts, not external stimuli, are ultimately responsible for feelings and behaviors.
Although CBT is typically administered on a timeline that has an established end date from the start, ongoing psychological counseling can also help individuals cope with the symptoms of social anxiety. During therapy, clients learn how to recognize the thought patterns that might lead to panic attacks, and they will practice breathing exercises and other coping mechanisms that aim to diminish fear and anxiety in particularly stressful situations.
For people who suffer from severe symptoms, medication may also help to manage social anxiety. According to the National Institute of Mental Health, there are three kinds of medications that doctors might prescribe to treat social anxiety: antidepressants, beta blockers, and anti-anxiety medications.
They work by slowing functions in the central nervous system, but they may cause unwanted side effects like drowsiness, confusion, slurred speech, and poor coordination.
Causes & Risk Factors
There are no clear-cut answers as to why some people develop social anxiety disorder, although research suggests that various factors may be involved. Like most mental health problems, social anxiety disorder appears to be caused by a combination of biological and psychological factors and challenging life experiences. These include:
- stressful or traumatic life events
- a family history of anxiety disorders
- other mental health or substance use problems.
Symptoms of social anxiety disorder usually begin prior to age 18, and symptoms tend to appear more in women than in men. Approximately seven per cent of people experience social anxiety disorder.
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What Are The Possible Side Effects Of Anti
Like other medications, anti-anxiety medications may cause side effects. Some of these side effects and risks are serious. The most common side effects for benzodiazepines are drowsiness and dizziness. Other possible side effects include:
- Nausea
- Excitement
- Trouble sleeping
Anti-anxiety medications may cause other side effects that are not included in the lists above. To report any serious adverse effects associated with the use of these medicines, please contact the FDA MedWatch program using the contact information at the bottom of this page. For more information about the risks and side effects for each medication, please see
Psychotherapy For Social Anxiety Disorder
One of the best treatments for social anxiety disorder is cognitive behavioral therapy . CBT helps you learn new ways to manage scary thoughts and feelings about social interactions. Your therapist may also recommend exposure therapy, which is a type of CBT.
During exposure therapy, you start to face your social fears one at a time. Each exposure will get a little harder as you practice new skills to cope with your anxiety. Over time, youll learn you can handle social situations, even when you feel anxious.
Some other types of therapy may be used to treat social anxiety disorder. These can include:
Depending on your symptoms, your provider might recommend other options. This could include:
-
Other antidepressants
-
Anti-anxiety medication
-
Beta blockers
It may take a few weeks to notice a difference when you first start taking medication. For many people, a combination of medication and therapy will be most helpful for social anxiety disorder. You and your provider will work together to create a treatment plan.
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Unresponsiveness To Standard Treatments
Before considering a patient to be treatment unresponsive, it should be ascertained that the diagnosis was correct, adherence to the treatment plan was sufficient, the dose prescribed had covered the full range, and there had been a trial period of adequate duration. When patients report previous treatment failures, it often turns out that a drug was only prescribed in the lowest dose or was stopped within the first 2 weeks due to side effects that occurred in the initial phase before the patient could experience improvement.
Elderly patients may take longer to show a response. Table III contains options in case of drug inefficacy or intolerance. In patients who are unresponsive to psychotropic drugs, the addition of CBT is generally recommended.
A combination of antidepressants and benzodiazepines is sometimes used in treatment-refractory cases.
When all standard treatments have failed, the off-label use of drugs may be considered, for example, drugs licensed for another anxiety disorder or that are not licensed but have shown efficacy in clinical studies. Such drugs include quetiapine and agomelatine.
The Role Of Medication For Treating Anxiety Disorders
If a doctor considers medication necessary, there are different types to choose from. Again, they can be combined with psychotherapy, which typically takes the form of cognitive-behavioral therapy, or used on their own. A doctor should continually monitor the treatment plan and make adjustments when necessary to achieve the best results.
Anxiety medications are given by prescription only, and different medications are used for different types of anxiety disorders. It is important to note that medication is generally used to treat and relieve symptoms of anxiety disorders and should not be considered a cure-all. The major types of anxiety medications include:
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Treatment Of Gad In Older Patients
With the exception of GAD, anxiety disorders are less common in patients over 65 years of age. Therefore, only a few studies for the treatment of GAD have been performed with older patients. Controlled studies have shown the efficacy of duloxetine, venlafaxine, pregabalin, and quetiapine in patients over 65 years old. In the elderly, an increased sensitivity to drug side effects and interactions must be considered, including anticholinergic effects, risk of orthostatic hypotension and cardiovascular events, risk of falling, and paradoxical reactions to benzodiazepines.
In the elderly, effect sizes for CBT tend to be somewhat smaller than those found in mixed-age populations. A meta-analysis of studies with older adults with GAD showed superiority of CBT to waitlist or treatment-as-usual conditions but not to active controls .
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When Its Time To Take Medication
All that being said, there are people who do benefit from taking anti-anxiety medication in addition to the above treatments. While there is no definitive time or sign to start medication, the general consensus among experts is this: When anxiety starts to significantly affect your ability to function in your everyday life, it might be time to try it.
In other words, if you feel overwhelmed or paralyzed by anxiety, if you have trouble focusing at work, if your relationships are suffering or if your health is deteriorating, reach out to a doctor. And remember, theres no shame in doing so. Mental health medication can be just as essential as heart medication or anything else. And for those of us who have a genetic predisposition, anxiety can be especially responsive to a prescription, Hudson said.
Today, the most common medications prescribed for anxiety are actually antidepressants, known as SSRIs . Examples include Zoloft, Lexapro and Prozac. Theyre intended to help patients manage anxiety in the long run, according to Dr. Michael Genovese, a clinical psychiatrist and chief medical officer of Acadia Healthcare in Nashville, Tennessee.
Benzodiazepines, which include Xanax, Ativan and Klonopin, are also used to treat anxiety but in the short term. They are meant to be used for intense anxiety and for brief periods of time, due to dangerous side effectssuch as dependency and withdrawal.
What Causes Social Anxiety Disorder
Social anxiety disorder sometimes runs in families, but no one knows for sure why some family members have it while others dont. Researchers have found that several parts of the brain are involved in fear and anxiety. Some researchers think that misreading of others behavior may play a role in causing or worsening social anxiety. For example, you may think that people are staring or frowning at you when they truly are not. Underdeveloped social skills are another possible contributor to social anxiety. For example, if you have underdeveloped social skills, you may feel discouraged after talking with people and may worry about doing it in the future. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.
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