Social Phobia Tretament: Using Medications

I'm in the position where I believe social phobia should not be considered a “disorder”. The fact that you call it that way gives me the idea of illness. I would say it should be viewed as a condition, where the person needs to develop social skills through an integral treatment: healthy lifestyle, therapy (CBT), medicines, some type of spiritual discipline.

The idea with this post is to express my own experience with social anxiety treatment and medication, it is not intended to supplement, not substitute for, the expertise and judgment of your physician, neither to diagnose a health condition, but it can be used as a source to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed. A consultation with a medical professional, such as a psychiatrist who specializes in anxiety, is an important and necessary step when medication is being considered for social anxiety.

In the first place, not everyone with social phobia needs to be on medication. There are many factors that need to be taken in account, such as severity of the condition, conferring with your anxiety specialist, your psychiatrist, other medications you take and your general medical condition, etc. and the way you know your body responds to medication in general.

Please keep in mind that while medication can be very helpful in some cases, it is NOT a cure. It will not get you to where you want to be, it will not be the "solution".

I see medication as a "tool" or as an "encouragement" while undergoing a therapy process (e.g. cognitive-behavioral therapy). But it is the therapeutical process that helps you change your brain pathways (neural pathways) permanently, NOT the medication. Medication generally works faster (if it works), but permanent results (physiological changes) can only occur by learning to think and beginning to feel differently.

If you are looking for a band-aid, get the medication and ignore the therapeutical process.

If you are looking for a permanent solution (a change in your brain's chemistry and neural pathways), start a therapeutical process (CBT is mentioned as one of the most effective therapies) , along with a gradual change in your lifestyle and the practice of some type of spiritual discipline (religion, meditation, etc). The idea with CBT is to practice changes on the way you think and adapt, to improve your behavior on social situations, until it becomes an automatic habit. Medication changes brain chemistry temporarily; a therapy process can help you develop social skills to improve your quality life.

I’m on CBT (Cognitive Behavioral Therapy) process, started a couple months ago, I have taken medication before (Paxil), right now I’m not, but I will if it’s recommended by a psychiatrist with knowledge and expertise in social anxiety management and treatment.

I have found a general information guide about social anxiety medicines at: phobia-fear-release.com. It does not appear to me a based scientifically researched guide (they don’t show any reference to studies to support these findings); however I thought you could use it as an information resource to get a general overview of the classification and different medicines used to treat anxiety so you can have a reference to consult your physician when considering the use of medicines to treat social anxiety:

1- SSRIs - Social Anxiety Medication
Prozac, Zoloft, Paxil
Some research shows a 15-45% success rate in temporarily reducing social anxiety symptoms. Research also shows over 60% of people who have been prescribed an SSRI have had fairly negative responses.

2 - Anti anxiety agents - Social Anxiety Medication
Ativan and Klonopin
These are the agents of choice for starting anxiety management. The most positive research is available on these two anti-anxiety agents.”

These medications can be very helpful for people with social anxiety. These social anxiety medications are tolerated well and almost always help.

Sides effects are: tiredness at first. There seems to be more research support for the use of Ativan (lorazepam) and Klonopin (clonazepam) in the treatment of social anxiety than the other anti-anxiety medications.

When stopping anti-anxiety use, it is necessary to taper off the medication slowly, by reducing the dose gradually over a period of 3 to 4 weeks.

3 - MAOIs - Social Anxiety Medication
Parnate, Nardil
These medications, in general, have been shown to work effectively approximately 60-85% of the time for people with clinical social anxiety. Many people with social anxiety do not need this medication, however. If a medication is needed in addition to the anti-anxiety agents, these medications have been shown to work best for social anxiety disorder.

Research does show, Parnate as opposed to Nardil, is more effective with (generalized) social anxiety disorder, provided there are no other anxiety or mental health care complications. (Nardil has been shown by research to be effective, also. These medications require slight food restrictions.

4 - RIMAs - Social Anxiety Medication
RIMAs or the reversible MAOIs are available almost everywhere else in the world except the United States. It is possible to have your psychiatrist write a prescription for a RIMA and have it filled at a pharmacy in Australia, New Zealand, or in Europe. It will then be mailed to you. In general, moclobemide appears to be much less effective for social anxiety than Parnat or Nardil.

5- Tri-cyclic antidepressants (TCAs) - Social Anxiety Medication
BuspironeGenerally are TCAsnot much help for social anxiety. Buspirone may provide limited help, however empirical research is lacking. Research shows very little success from this medication when it is prescribed for social anxiety.

Other resources to Social Anxiety Treatment:
General Guide on Social Anxiety - Wikipedia
Social Anxiety Treatment - Yahoo Health
Social Phobia Medicines - About.com

Note: This information is intended as a general guide only. It is essential you consult with your psychiatrist about any medication, due to individual and/or interaction effects, and additional medical complications. It is also essential that you work with a psychiatrist that FULLY understands social anxiety and has kept up with the latest research on medical treatment for social anxiety.

Social Anxiety is a Survival response, not a pathology: Professor John Breeding, PH.D Psychologist

Have you noticed how I don't called Social Anxiety a "disorder", the word itself just gives me the sense of illness.



I found a great resource (video) from a well known Psychologist, Dr John Breeding, I was so glad to find it, in this 20 minute video he tells us his own perception of Social Anxiety and mentions that “Social Anxiety is a survival response, not a pathology). That confirms my theory. This is not a disorder.

He shows a very interesting approach to the subject, mentioning that the results of this type of diagnosis gives pharmaceutical companies a justification to sell medicines to “cure” you, when is not more but marketing, To the respect he mentions a document named: “Selling Sickeness” that approaches the marketing of mental illnesses in order to sell pharmaceutical products, we should check the document. Probably would be a reason for another post.

Professor Breeding also gives a couple tips when dealing with anxiety, he talks about three basic principles to follow:
- Better lifestyle: exercising, eating properly, meditation, breathing.
- Allow feelings during the crisis; permit yourself to feel what you are experiencing.
- Get off the attention of what is bothering you.

Finally he gives a couple resources to check that may help us in the process of a better quality life:
- Resources and Information on Drug Abuse
- How to get off Psychiatric Drugs Safely
- Dr. John Breeding Website

Writing to Heal Social Anxiety

Do you have any techniques that you have found work for you when your are anxious? What do you do in this cases?

I write as a way of helping myself to overcome social anxiety, is a way for me to flush my mind, to be able to let my thoughts come out. Most of the time the things that come out are very painfull, but I know that if I just let them out instead of blocking them, I'm going be able to give a different order to my mind and thoughts, I compare this to draining the toilet.

In a way is letting out all kind of "dirty things" out of my mind, I call them "the garbage or cockroaches" in my mind. That is a way I have found to deal with social anxiety, when I am anxious, I write about it, I write about what I feel, what I think.