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What is Social Anxiety or Social Phobia?

Social Anxiety (Social Phobia) is an excessive and unreasonable fear of social situations where interactions with other people are required. A person with social phobia fears they will embarrass themselves or make mistakes in front of other people, becoming overly self-conscious and apprehensive. A person with Social Anxiety will avoid situations where they may be forced to interface with people they don’t know. When placed in this type of social situation, they become anxious or may have a panic attack. As the condition progresses, persons with Social Anxiety may develop distorted thinking and they will often avoid contact with other people altogether. This makes work, school and personal relationships problematic.

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What causes Social Anxiety?

Social Anxiety, like other anxiety problems is usually related to a previous history of psychological trauma. Social Anxiety may also have a genetic basis, as the disorder runs in families. Brain chemistry, perhaps related to serotonin levels, may play an important role in social anxiety disorder. In persons with anxiety disorders, the amygdala, a part of the brain involved in processing emotional responses, may be overactive. Anxious behaviors may also be transmitted from parents to their children through direct exposure and observation. Persons with an anxious temperament, a history of psychological trauma, stress overload, poor self-esteem or personality issues may be predisposed to the development of anxiety problems in childhood and adulthood. Chronic insomnia, overworking, exposure to high levels of stress, substance abuse, medical problems, and difficulties with family or other interpersonal relationships can contribute to the onset of Social Anxiety.

Social Anxiety is diagnosed from symptoms of fear or anxiousness surrounding social interactions. A person with social anxiety may lack social skills or be quiet or shy. Accordingly, while they are immersed in a social interaction, they may endure extreme distress. This social anxiety may manifest as anticipatory anxiety or once in the situation, a panic attack. Ultimately, thought processes become distorted until the person with social anxiety starts to avoid interacting with other people, eliminating social engagements altogether. They fear becoming the center of attention, and may become afraid to eat, speak or work in front of other people. Persons with Social Anxiety may present with panic disorder, Obsessive Compulsive Disorder, or depression.

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What is the Prognosis for Social Anxiety?

Social Anxiety Disorder, when properly diagnosed, responds well to treatment. Psychotherapy, sleep and stress management, psycho-education and, when necessary, medication are the cornerstones of treatment. Unfortunately, many persons suffering from social anxiety self-medicate to alleviate their symptoms. Some find that ingesting alcohol prior to a social interaction helps lower their fear and worrying. Similarly, benzodiazepine (valium, klonopin, ambien) use is also prevalent. This self-medication is counterproductive and complicates both the diagnosis and treatment of Social Anxiety. Persons with Social Anxiety may also manifest panic disorder, depression, or Obsessive-Compulsive Disorder. It is important for the clinician to identify these issues and diagnose the underlying social phobia so that it can be properly treated.

A person suffering from social anxiety disorder may limit any social interactions to family members and loved ones. When their behavior becomes isolating, it is important for family members to help them reach a mental health provider or treatment center. Social Anxiety may go undetected for years. When a person with Social Anxiety develops avoidant behaviors that are negatively impacting their daily school or work life and personal and family relationships, an intensive treatment program should be considered.

The PCH Treatment Center approach to Social Anxiety

When a person with Social Anxiety enters PCH Treatment Center, they first undergo a thorough psychological assessment. At this time an accurate diagnosis is obtained, often necessitating that we discard improper diagnoses or stigmatizing labels. Each Client is assigned a case manager (Program Director) who is a doctoral or masters level clinician that helps design and coordinate the treatment plan. A doctoral level individual psychotherapist is also assigned upon admission. Each Client is also presented in our weekly case conferences where an experienced clinical team reviews their progress. Individual psychotherapy is the keystone at PCH Treatment Center, and it is complemented by Somatic Experiencing or sensorimotor therapy, Dialectical Behavioral Therapy (DBT), anger management, sleep management, psycho-education, and neurofeedback. Each Client is also evaluated upon admission by one of our staff psychiatrists. Our goal at PCH Treatment Center is to develop a healthy medication regimen, avoiding addictive substances and minimizing overall medication usage. We steadfastly avoid the use of benzodiazepines for anxiety, which are addictive, result in tolerance and severe withdrawal symptoms. We also incorporate holistic healing including yoga, mindfulness meditation and art therapies. Each client and their family (when appropriate) participate in a family weekend program, and optional family therapy sessions are also available. These valuable groups incorporate family members or loved ones into the Client’s treatment environment.

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