Treating social anxiety disorder (SAD) is crucial for reducing how significantly this condition affects your daily life. Individuals living with this anxiety disorder feel overwhelming distress in social settings. They harbor deep fears of being judged, rejected, or embarrassed by those around them.

These fears can trigger avoidance behaviors that interfere with professional responsibilities, academic performance, and routine daily tasks. Healthcare professionals recommend prescription medications, psychotherapy, or a combination of both for managing SAD. Additionally, adjusting certain lifestyle habits may support overall symptom management.

Prescription Medications

Mental health specialists frequently suggest that individuals with SAD begin medication treatment while also engaging in various forms of psychotherapy. Research demonstrates that combining these two treatment methods can enhance long-term results for people managing SAD.

Medication Safety

Store medication securely in a location accessible only to you. Make certain that other household members, including children and pets, cannot reach the medication. Anyone who consumes the medication—whether prescribed to them or not—risks experiencing adverse effects. Should side effects become severe, immediately call 911 and proceed to the closest emergency room.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Serotonin serves as a crucial chemical messenger, or neurotransmitter, controlling various bodily functions like sleep patterns, emotional state, and hunger. When serotonin drops to insufficient levels, individuals may develop anxiety and depression symptoms.

Healthcare providers consider SSRIs a primary treatment option for SAD due to their effectiveness and relatively gentle side effect profile, as demonstrated through clinical research. These medications function by preventing serotonin reuptake (reabsorption) in the brain, allowing more serotonin to remain available for alleviating anxiety and mood-related symptoms.

SSRIs prescribed for social anxiety include:

• Paxil (paroxetine)
• Luvox (fluvoxamine)
• Zoloft (sertraline)
• Lexapro (escitalopram)
• Celexa (citalopram)
• Prozac (fluoxetine)

Over 20 placebo-controlled studies have confirmed SSRIs’ strong effectiveness in managing SAD. That said, they may produce side effects like headaches, digestive problems, sleep difficulties, tiredness, sexual dysfunction, and initial anxiety increases.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs represent another medication category that addresses both serotonin and the neurotransmitter norepinephrine. Norepinephrine plays vital roles in focus and other mental processes, energy levels, and emotional regulation.

These medications demonstrate comparable safety and effectiveness to SSRIs, earning them first-line treatment status for social anxiety as well. A comprehensive review highlighted five substantial placebo-controlled studies confirming venlafaxine’s (an SNRI) effectiveness for SAD.

SNRIs prescribed for SAD include:

• Effexor XR (venlafaxine extended-release)
• Cymbalta (duloxetine)
• Pristiq (desvenlafaxine)

Potential side effects include initial anxiety elevation, sleep disturbances, restlessness, possible sexual problems, and headaches.

The Food and Drug Administration (FDA) has approved these SSRIs and SNRIs specifically for SAD treatment: paroxetine, sertraline, fluvoxamine controlled-release, and venlafaxine extended-release.

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs constitute an earlier generation of antidepressants that also influence brain neurotransmitters. They operate by inhibiting the monoamine enzyme responsible for breaking down various neurotransmitters, including norepinephrine, dopamine, and serotonin.

By preventing neurotransmitter breakdown, MAOIs elevate their availability. Studies indicate individuals with social anxiety respond favorably to these medications, with MAOIs capable of diminishing SAD symptom severity.

MAOIs prescribed for SAD include:

• Nardil (phenelzine)
• Parnate (tranylcypromine)
• Marplan (isocarboxazid)

These medications see limited use, however, because they carry risks of serious adverse effects and dangerous interactions with other medications and specific foods. Doctors typically prescribe them when alternative treatments prove unsuccessful. Taking MAOIs also necessitates adhering to strict dietary restrictions.

MAOIs block tyramine breakdown, and consuming certain foods and beverages like aged cheese and draft beer can be problematic. When people on MAOIs consume tyramine-rich items, elevated tyramine levels can trigger dangerous blood pressure spikes.

Antianxiety and antidepressant medications carry the FDA’s most serious warning (boxed warning) regarding elevated risks of suicidal thinking and behaviors in children, adolescents, and young adults.

Should you or someone close to you experience self-harm thoughts after starting prescribed medication, contact your healthcare provider immediately or visit the nearest emergency room. Your mental health specialist will reassess your anxiety treatment approach.

Benzodiazepines

Benzodiazepines work by targeting the neurotransmitter GABA to amplify its brain activity. GABA performs an inhibitory role, suppressing signals traveling along neural pathways.

Benzodiazepines consequently promote calmness throughout body and mind, addressing anxiety symptoms linked to SAD.

Individuals with social anxiety can use these medications as needed. They’re typically taken at least thirty minutes before facing anxiety-triggering situations. They also serve people who cannot tolerate or haven’t responded to SSRIs or SNRIs.

While highly effective, these medications carry significant addiction potential, with many users developing dependence—particularly those taking them continuously over extended periods. Individuals with substance abuse histories should generally avoid these medications.

Benzodiazepines prescribed for social anxiety include:

• Ativan (lorazepam)
• Valium (diazepam)
• Xanax (alprazolam)
• Klonopin (clonazepam)

Discontinuing benzodiazepines can prove extremely challenging. Discuss the safest discontinuation approach with your healthcare provider so they can gradually reduce your dosage over time. Never stop taking antianxiety medication without medical guidance.

Beta-Blockers

SAD, along with other anxiety types, produces both emotional and physical symptoms. When your body perceives a threatening situation, it activates fight-or-flight mode. This mobilizes all bodily resources for either fleeing or fighting for survival.

Consequently, heart rate and breathing accelerate. Beta-blockers are frequently prescribed for cardiac conditions, functioning by reducing heart rate and diminishing your body’s response to fight-or-flight hormones.

Beta-blockers used for SAD management include:

• Inderal (propranolol)
• Tenormin (atenolol)

Like benzodiazepines, these medications are frequently taken before anticipated stressful situations to prevent uncomfortable physical reactions, such as during public speaking.

Most SSRIs, SNRIs, and MAOIs require oral administration once or twice daily. However, benzodiazepines and beta-blockers may be prescribed for as-needed use. Confirm with your healthcare provider exactly how many pills to take daily and when. Medications work most effectively when taken precisely as directed.

Psychotherapy

Non-medication approaches to SAD are equally essential for helping individuals better control their symptoms. Cognitive-behavioral therapy (CBT) is the psychotherapy type commonly employed for this anxiety disorder. It aims to deepen your understanding of how you think. Various CBT forms can address SAD.

Exposure Therapy

During exposure therapy for social anxiety, you’re progressively introduced to anxiety-producing situations, with gradual escalation to more challenging scenarios. Your therapist helps you develop strategies for managing your fear. Exposure can occur virtually or face-to-face.

Cognitive Restructuring

Cognitive restructuring involves collaborating with a mental health professional to identify the origins of negative thinking patterns. You then explore methods for redirecting thoughts toward alternative pathways. This approach may decrease both the impact and occurrence of negative thoughts.

Social Skills Training

Social skills training focuses on addressing specific behaviors that challenge you in stress-inducing social situations. This training may enhance your social performance, such as maintaining conversation in a crowded restaurant setting.

Interpersonal Therapy

Interpersonal therapy represents a psychodynamic approach originally developed for depression that’s being modified for SAD patients. It employs role-playing and additional techniques to strengthen your interaction and socialization abilities with others.

SAD Treatment Goals

• Transforming negative self-perceptions
• Developing confidence in social situations generally, especially those you find most challenging
• Strengthening your coping mechanisms
  

Complementary and Alternative Medicine

Plant-based remedies, including herbal teas, have historically been promoted as natural calming agents. Despite widespread use, only select plant medicines have undergone rigorous clinical evaluation for SAD management:

Passionflower, kava, and valerian have been assessed in clinical research and found to produce mild-to-moderate anxiety symptom relief.

Recently, cannabidiol (CBD) from hemp has gained popularity for anxiety relief. Some studies suggest potential effectiveness for social anxiety, though comprehensive research remains limited.

Numerous options exist at health food retailers and online, but over-the-counter products lack regulation—not all are safe or contain advertised ingredients.

Inform your healthcare provider before beginning alternative treatments or supplements. Even seemingly harmless items like tea can potentially interact with prescription medications and cause serious complications.

Lifestyle Changes

Successfully managing SAD demands treatment commitment. Maintaining a healthy lifestyle is equally important. Certain lifestyle decisions can trigger or intensify anxiety symptoms.

SAD impacts both body and brain, making it essential to optimize both aspects of health.

Consider incorporating these habit changes:

• Increasing outdoor time
• Consuming more fruits, vegetables, and protein-rich foods
• Connecting with loved ones (in low-stress circumstances)
• Maintaining consistent sleep patterns
• Increasing water intake

Consult your healthcare provider about establishing sustainable healthy habits that complement your treatment plan.

Beginning new social anxiety disorder treatment can feel incredibly daunting. Don’t hesitate to discuss any questions with your healthcare provider. Given the numerous medication types and therapy approaches available, it’s perfectly acceptable if your initial attempt doesn’t succeed. Your provider will continuously refine your symptom management plan to identify the optimal treatment for you.

Keep in mind that medications and therapy require several weeks before showing improvement, making patience essential. However, contact your healthcare provider immediately if symptoms intensify or you experience side effects.