Social Anxiety Disorder (SAD, Social Phobia)

Last updated 20.09.12

 

Features

-  Anxiety disorder characterised by fear & avoidance of scrutiny or being the focus of social situations to avoid embarrassment or humiliation

-  Typically present w

-  Problems at work or interpersonal relationships

-  Anxiety about meeting new people, attending parties, work meetings, talking in front of colleagues

-  Depression

-  EtOH abuse

 

Associated S/S

-  Embarrasment or fear manifest by shaking, blushing, stuttering or a panic attack

-  Long Hx in childhood or teens

-  Social isolation, lack of friends, employment difficulties

 

DDx

-  Performance Anxiety (stage fright)

-  Public speaking, oral exams, not SAD unless ass w marked impairment or distress

-  Avoidant Personality Disorder

-  Lifelong social inhibition, feeling of inadequacy, hypersensitivity to criticism, shy, fearful of rejection

 

Mx

-  If caused by panic disorder treat as

-  CBT

-  Control hyperventilation

-  Assertiveness & social skill training

-  ID, challeng & change irrational thoughts

-  Graded exposure to avoid avoidance

-  Antidepressants

-  For Co-morbid depression, if severly disabled or other methods fail

-  SSRIs 1st line

-  MAOIs

-  Beta blockers for symptom control

 

 

 

References