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Social anxiety disorder (SAD, SAnD) (DSM-IV 300.23), also called social phobia (SP), is an anxiety disorder characterized by intense fear in social situations causing considerable distress and impaired ability to function in at least some parts of daily life. The diagnosis can be of a specific disorder (when only some particular situations are feared) or a generalized disorder. Generalized social anxiety disorder typically involves a persistent, intense, chronic fear of being judged by others and of being embarrassed or humiliated by one’s own actions. These fears can be triggered by perceived or actual scrutiny from others. While the fear of social interaction may be recognized by the person as excessive or unreasonable, overcoming it can be quite difficult. Physical symptoms often accompanying social anxiety disorder include excessive blushing, sweating (hyperhidrosis), trembling, palpitations, nausea, and stammering often accompanied with rapid speech. Panic attacks may also occur under intense fear and discomfort. An early diagnosis may help minimize the symptoms and the development of additional problems, such as depression. Some sufferers may use alcohol or other drugs to reduce fears and inhibitions at social events. It is common for sufferers of social phobia to self-medicate in this fashion, especially if they are undiagnosed, untreated, or both; this can lead to alcoholism, eating disorders or other kinds of substance abuse.
A person with the disorder may be treated with psychotherapy, medication, or both. Research has shown cognitive behavior therapy, whether individually or in a group, to be effective in treating social phobia. The cognitive and behavioral components seek to change thought patterns and physical reactions to anxiety-inducing situations. Attention given to social anxiety disorder has significantly increased in the United States since 1999 with the approval and marketing of drugs for its treatment. Prescribed medications include several classes of antidepressants: selective serotonin reuptake inhibitors (SSRIs) such as Zoloft, Prozac, and Paxil; serotonin-norepinephrine reuptake inhibitors (SNRIs); and monoamine oxidase inhibitors (MAOIs). Other commonly used medications include beta-blockers and benzodiazepines (which are more and more being restricted to short-term use due to side effects), as well as newer antidepressants, such as mirtazapine. An herb called kava has also attracted attention as a possible treatment, although safety concerns exist, especially given the unregulated nature of herbs in the United States.
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