What is the root cause of social anxiety?

Researchers don't know why social anxiety disorder occurs. They believe there are multiple interacting factors, which include: Genetic/hereditary factors: There is evidence of family history increasing the risk of SAD; people with biological relatives with anxiety disorders are more likely to have SAD.Personality Traits: Individuals who are born shy, inhibited, or with a tendency to be cautious or restrained in novel social situations may be at higher risk. Early childhood temperament (e.g., behavioral inhibition) matters. Brain structure: Overactivity of the amygdala (fear response center) and dysregulation of neurotransmitter systems can also help cause social anxiety disorder. Environmental / life experiences: Negative or humiliating social experiences (bullying, rejection, ridicule), overprotective or overcontrolling parenting, or stressful social or work demands, transitions (e.g., starting school, public speaking) can all trigger or worsen social anxiety symptoms.

Does Adderall help with social anxiety?

Short answer: Generally, no. In fact, it’s more likely to worsen social anxiety in many people. A big caveat is that if social anxiety is caused by ADHD, then, yes, Adderall can help with social anxiety disorder. However, “true” social anxiety disorder is not caused by another disorder, according to the DSM-5. Although many people with ADHD do experience social anxiety, it is usually as a symptom, not a comorbid disorder.

The Best Medication for Social Anxiety Disorder

Q: What is the best medication for social anxiety?

There is no one “best” medication that works for everyone. Instead, there will likely be a medication that is best for you. Your psychiatrist can help you find this. In general, clinical guidelines and meta-analyses point to several first-line and effective options. SSRIs (Selective Serotonin Reuptake Inhibitors) like paroxetine (Paxil) or sertraline (Zoloft) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) like venlafaxine XR. are most often prescribed first. Other medications that may be used include Benzodiazepines for more immediate relief of symptoms, though never for long-term or chronic use, and Beta-blockers.

Social anxiety disorder is the intense fear of rejection, humiliation, or embarrassment in front of peers. The discomfort social anxiety can cause is acute and very distressing. It mostly affects younger adults and adolescents, with women more likely to experience it than men.

The most common treatment for social anxiety is therapy. Many therapists like to use variations of Exposure Therapy and coping strategies to manage stress while helping the individual engage in social environments.

However, for more severe cases of social anxiety disorder, this might not work. For some, the anxiety surrounding social environments is so severe that it induces panic attacks, nausea, and other debilitating symptoms. These experiences can create a deeper association between social situations and danger in the individual's mind, and worsen social anxiety symptoms.

In these more severe cases, many therapists recommend medication for social anxiety disorder. Medication can help lower the intensity of symptoms and the fear surrounding social situations, so that individuals can fully engage in the people and experiences around them.

This article covers what social anxiety disorder is and how medication for social anxiety can be helpful, along with some of the best types of social anxiety disorder medications.

Signs You Might Have Social Anxiety Disorder

According to the DSM-5, the handbook for diagnosing and treating mental health disorders, symptoms of social anxiety disorder include:

Intense fear or anxiety about one or more social situations where the person is exposed to possible scrutiny by others (e.g., social interactions, being observed, performing in front of others).
Fear of embarrassment, humiliation, or rejection from peers.
Social situations are avoided or endured with intense fear or anxiety.
The fear is out of proportion to the actual threat posed by the social situation.
Fear, anxiety, or avoidance is persistent, typically lasting 6 months or more.

Symptoms must cause clinically significant distress or impairment and are not attributable to other mental health disorders, medical conditions, or drug use.

You might have social anxiety disorder if you relate to some of these experiences:

Not wanting to eat in public. You might go out of your way to eat in your car or a bathroom stall, for example.
Refusing to use public restrooms, to the point of pain, discomfort, or inconvenience.
Being unable to give a presentation or speak in front of a group. You might call us sick or take a failing grade to avoid this.
Avoiding answering or making phone calls. You might have a friend or family make phone calls for you or order at restaurants.
Refusing to meet new people or join social gatherings.
Avoiding raising a hand in class or speaking up in meetings, even if you know the answer or disagree with the direction a group project is going.
Avoiding meeting new people at all costs, often running away or making an escape from forced interactions whenever you can. When you do have to meet someone new, you might spend a lot of time thinking about how you will introduce yourself, where you will sit, or what you will say to new people.
Avoiding dating or one-on-one interactions with someone they’re interested in.
Feeling panicked when entering a room where others are already seated. You might get places very early to stake out the best spot where you will be the least noticed, and to avoid having everyone stare at you when you walk in.
Avoiding job interviews or professional networking. This might put a damper on your career and financial situation.
Choosing routes or times to avoid crowded places. You might refuse to use public transportation or go out of your way to only travel when it isn’t busy.

In these situations, you might experience a physical reaction, like your body is reacting to something it thinks is physically dangerous. This can look like:

Rapid heartbeat (palpitations)
Sweating
Trembling or shaking
Shortness of breath
Nausea or stomach upset
Muscle tension
Dizziness or lightheadedness
Dry mouth
Feeling faint or weak

Social anxiety disorder can be incredibly disruptive to normal life and our health and wellness. It is one of those disorders that can worsen over time if not treated, but sometimes treatment itself can make it worse, as you are being forced to confront some of your worst anxieties.

One way researchers have found around this issue is through medication. Social anxiety medication can help make social interactions more bearable and pleasant, which will help your brain and body learn the difference between real danger and an uncomfortable situation.

What Is the Best Medication for Social Anxiety?

The best way to get medication for social anxiety is to talk to a psychiatrist. A psychiatrist is a medical professional who has been trained in mental health issues and treatments. They can diagnose, prescribe, and manage medication.

Talk to your therapist about getting a referral to a psychiatrist.

A psychiatrist will take into consideration your history, symptoms, and any other medications you are taking. With all of this in mind, they may recommend some of the following best medications for social anxiety.

Best medication for social anxiety:

SSRIs: SSRIs are often the first choice for treatment of social anxiety disorder. They have been heavily researched and proven effective for social anxiety disorder. It might take a few weeks for you to feel the therapeutic effects of an SSRI, because the medication has to build in your body. Examples: paroxetine (Paxil) or sertraline (Zoloft).
SNRI: If an SSRI doesn’t work or isn’t a good fit for you, you might be prescribed an SNRI such as venlafaxine (Effexor XR). SSRIs and SNRIs work in similar ways, with SNRIs blocking both serotonin and norepinephrine, whereas SSRIs block just serotonin. This can lead to different symptoms. Both are effective treatments.
Benzodiazepines: Medications like Xanax work quickly to reduce anxiety, but can be sedating. Over time, people can begin to rely on them. Instead of solving the problem, this only serves to cover up the issue. Instead, Benzodiazepines are often prescribed for short-term work, like when you’re first starting therapy and need a little extra help to get through the day.
Beta blockers: Beta blockers are not recommended to be used long-term, because they block the effect of adrenaline, which is an important neurochemical. Instead, they can be prescribed and taken for short, specific situations. For example, some people take beta blockers before a presentation or before they fly.

Whatever your psychiatrist prescribes, it’s really important to stick with the treatment. With treatment, social anxiety can get worse before it gets better. This is because, possibly for the first time, you’re actively facing your fear and learning how to cope with it, instead of avoiding it. This might cause a spike in symptoms, but it does not mean you’re doing something wrong.

Communicate all changes in symptoms to your psychiatrist and therapist.

Other Treatment Options

For social anxiety, talk therapy has been proven to be the most effective. Medication can be an important step in the right direction and can help you navigate the worst of social anxiety’s debilitating symptoms. But it should be used as one of many tools in your toolbox.

Cognitive Behavioral Therapy, Exposure Therapy, and Mindfulness-Based Therapy are all effective treatments for social anxiety disorder.

Ready to start your treatment of social anxiety disorder? Contact Lifebulb to be scheduled with a social anxiety disorder therapist or to meet with a psychiatrist who can prescribe you social anxiety disorder medications.

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