Early detection of Social Anxiety Disorder can prevent long-term dysfunction

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Early detection of Social Anxiety Disorder can prevent long-term dysfunction

According to a US survey Social Anxiety Disorder or social phobia is the third largest mental health care problem in the world today. Although it is treatable, failure to identify it at an earlier stage makes the problem persist and lead to long-term dysfunction and complications (such as alcohol abuse, depression).

What is Social Anxiety Disorder?

It is a fear of performing in social situations. The person has a persistent fear of being judged negatively by other people leading to feelings of embarrassment and humiliation. This causes the person to avoid social gatherings altogether or he may have extreme anxiety while enduring such situations. 

It is important to understand that some degree of social anxiety may be seen in every person but when this anxiety becomes so severe that it interferes with the social or work life of a person it becomes a matter of concern. 

What are the symptoms?

Social anxiety disorder usually begins in mid-teens and is more common in men as compared to women. 

A person suffering from generalized social anxiety disorder may experience emotional distress while addressing a group of people, on being the center of attention, on being introduced to others, being criticized or being watched, while doing some task and this is not the end. The person is anxious, nervous and fearful in almost all social situations. 

In addition to the emotional symptoms the person may also experience physical symptoms before or during social interaction. The symptoms include palpitations, excessive sweating, trembling, flushes etc.

Hence, social anxiety disorder may affect the performance at school/workplace, interactions with peers/co-workers, success in making friends, difficulty in participating in social and public activities etc.

What can be done?

Social anxiety disorder is usually detected at a later stage as the feelings of shame and embarrassment related to this disorder inhibit the patients from seeking medical help. Hence, it is essential that the doctor encourages the patient to discuss the symptoms by including a brief query into social anxiety or avoidance.

As for the treatment, behavior therapy and medication therapy have proven to be successful in treating social anxiety disorder.

Behavior therapy helps the patient to quell the feeling of anxiety or fear that arises in social situations and prepare them to face the situations rather than avoid them. Basically, patients are made to face the situations, which they commonly fear. This is called ‘exposure‘. The therapists help the patients to identify the fears and avoidance, develop productive coping thoughts and confront situations using these new coping techniques. Studies have shown clinical improvement occurring with behavior therapy over 12-16 weekly sessions and it usually has long-lasting results. Behavior therapy is safe and free of side-effects but it requires a lot of patience and efforts on the part of therapist as well as the patient.

Medication therapy helps to decrease the frequency and intensity of anxiety and also decreases anticipatory anxiety and avoidance behavior. Studies have shown that around 70% of patients have achieved worthwhile gain from medications. Selective serotonin reuptake inhibitors are the drugs of choice for social anxiety disorder, with controlled trials showing efficacy for paroxetine, sertraline, and fluvoxamine. Medication therapy is continued for 6-12 months after response; some patients may require longer treatment to continue experiencing the positive effects. Alternative drugs include the monoamine oxidase inhibitor (MAO inhibitor), which has been shown to be effective in several controlled trials but is usually reserved for those patients who do not respond to other treatment. 

Hence, early detection and treatment of social anxiety disorder holds promise for prevention of long-term dysfunction and complications

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