What Are the Treatments for Social Anxiety Disorder?

Overview of the Treatments for Social Anxiety Disorder

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Treatments for social anxiety disorder (SAD) depend on the severity of your emotional and physical symptoms and how well you function daily.

The length of treatment also varies. Some people may respond well to initial treatment and not require anything further, while others may require some form of support throughout their lives.

Both medication and therapy have been shown effective in treating SAD.

Generalized social anxiety disorder responds best to a combination of medication and therapy, while therapy alone is often sufficient for specific SAD. Below is a description of the main treatments for SAD.

Medications for Social Anxiety Disorder

Several different types of medication are prescribed to treat SAD. Each has its advantages and disadvantages depending on your particular situation.

  • Benzodiazepines

    Benzodiazepines are mild tranquilizers that prevent or reduce symptoms of anxiety. They have several effects on the brain that are generally sedative. Some examples of brand name benzodiazepines are the following:

    Although fast-acting and well-tolerated, benzodiazepines have the potential to be habit-forming and should not be prescribed for someone with a substance abuse disorder. This class of medications is not considered the first-line of treatment for social anxiety disorder.

  • Beta Blockers

    Beta blockers are a form of medication that can be taken orally a few hours before a performance to reduce symptoms of anxiety such as a rapid heart rate, hand tremors and the “butterflies in the stomach” feeling. Beta blockers are considered a better alternative than benzodiazepines for performance situations because they do not have adverse effects on mental sharpness. Some brand name beta blockers include the following:

    • Inderal
    • Tenormin
  • Other Medications for SAD

    There are several other medications used off-label for social anxiety disorder that do not fall into the above classes. Some examples include:

Cognitive-Behavioral Therapy (CBT)

CBT is a form of psychotherapy designed to modify your thoughts and behaviors in order to positively influence your emotions. Three major cognitive-behavioral techniques have been shown to help treat SAD—exposure, cognitive restructuring and social skills training.

  • Exposure

    Exposure can take place either through imagining the specific performance or social situation, or in-vivo. If you have extremely severe social anxiety disorder, your therapist may begin with imagined exposure and eventually progress to in-vivo. The underlying principle of exposure therapy is that through practice and experience, you will become more comfortable in situations that you would otherwise avoid.

    Below are some exposure exercises that you can practice on your own:

  • Cognitive Restructuring

    Cognitive restructuring focuses on the cognitive symptoms of SAD: poor self-concept, fear of negative evaluation by others and negative attribution bias (attributing positive outcomes to chance and negative outcomes to your own shortcomings).

    Cognitive restructuring involves a series of exercises designed to identify negative thoughts, evaluate how true they are, and construct alternative thoughts to challenge original thoughts. Cognitive restructuring is thought to be important for the treatment of social anxiety disorder because of the strong cognitive aspect of the disorder and the typical chronic lifetime course.

  • Social Skills Training

    Social skills training involves various exercises such as modeling, rehearsal and role-playing designed to help people learn appropriate behaviors and decrease anxiety in social situations. Not everyone will require social skills training as part of their treatment. These exercises are designed specifically for people who have actual deficits in social interaction above and beyond social anxiety. Below are some areas that might be targeted for social skills training:

Other Psychotherapies

Psychodynamic therapy, in which a therapist works to elicit a person’s underlying emotions so that he can work through them, is helpful for some people with SAD. It is most useful for people who have a deeper unresolved reason for their anxiety.

Psychodynamic therapy may help address the potential influences of the patient's early life experiences, and also may be useful in some instances to explore potential resistance to change.

Alternative Treatments

Alternative treatments for social anxiety disorder include such things as dietary supplements, aromatherapy and hypnotherapy. Most alternative treatments have not been scientifically proven to work in the treatment of SAD. In addition, alternative treatments may not be regulated as strictly as standard forms of treatment. Below are some alternative treatments for social anxiety disorder:


Hales, R.E., & Yudofsky, S.C. (Eds.). (2003). The American psychiatry publishing textbook of clinical psychiatry. Washington, DC: American Psychiatric.

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