Social anxiety disorder

Social anxiety disorder (SAD), also known as social phobia, is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable distress and impairing ability to function in at least some aspects of daily life.^[5][6][7] These fears can be triggered by perceived or actual scrutiny from others. Individuals with social anxiety disorder fear negative evaluations from other people.

Physical symptoms often include excessive blushing, excessive sweating, trembling, palpitations, rapid heartbeat, muscle tension, shortness of breath, and nausea.^[8] Panic attacks can also occur under intense fear and discomfort. Some affected individuals may use alcohol or other drugs to reduce fears and inhibitions at social events. It is common for those with social phobia to self-medicate in this fashion, especially if they are undiagnosed, untreated, or both; this can lead to alcohol use disorder, eating disorders or other kinds of substance use disorders. According to ICD-10 guidelines, the main diagnostic criteria of social phobia are fear of being the focus of attention, or fear of behaving in a way that will be embarrassing or humiliating, avoidance and anxiety symptoms.^[9] Standardized rating scales can be used to screen for social anxiety disorder and measure the severity of anxiety.

The first line of treatment for social anxiety disorder is cognitive behavioral therapy (CBT).^[5][6][10] CBT is effective in treating this disorder, whether delivered individually or in a group setting.^[11] The cognitive and behavioral components seek to change thought patterns and physical reactions to anxiety-inducing situations.

The attention given to social anxiety disorder has significantly increased since 1999 with the approval and marketing of drugs for its treatment. Prescribed medications include several classes of antidepressants: selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs).^[12] Other commonly used medications include beta blockers and benzodiazepines. Medications such as SSRIs are effective for social phobia, such as paroxetine.^[6][13][14]