There are three common types of social phobia experienced by patients.  These include generalized social phobia and specific social phobia.

Generalized social phobia is the most prevalent social phobia type.  If you are diagnosed with this type you will find that you fear becoming the focal point of other people’s attention, anywhere you have the need to interact with other people, especially those you don’t know.  This will be intensified by an unreasonable concern with if people are noticing you and if they are taking note of everything you may be doing. 

With generalized social phobics, what may seem like the easiest tasks for everyone else, like going shopping or eating out a restaurant, may be an extremely distressful and anxious experience.  When going to enjoy a swim at your local pool or beach, you may feel overly embarrassed about public dressing rooms and the act of removing some of your clothing in public.  In other situations, simple things like confronting your employer or approaching other important authorities may seem like a very fearful situation, one that you may even choose to ponder over for many hours, instead of just simply getting up and doing it.  Even the pleasure of parties seems like a doomed and possibly humiliating undertaking.

Specific social phobia is specifically related to entering into socialization situations.  This may include meeting people (new), eating in the presence of others, or simply using a public toilet.  In fact, the most common of all these are an unreasonable fear of speaking in public, which in itself relates to an anxiety about performance.  To most people this would simply be called stage fright, but for some the experience is much more intense and in some cases very traumatic.

A person with social phobic disorders may also do some or all of the following:

·         Over exaggerate any possible physical dangers, risks or difficulties that may occur in doing the most normal tasks.

·         Have only one or no close confidants or friends outside of their immediate relatives and they may well avoid all other social activities outside of these people.

·         Show an unwillingness to interact with new people unless they can assure themselves or be assured that they will not meet disapproval, be hurt or criticized, and/or be definitely liked.

·         Have an intense and unusual fear of being embarrassed in front of others to the point of noticeable anxiety, crying or blushing. 

·         Avoid public speaking for fear of speaking out of turn, or being seen to have said something foolish or possibly inappropriate.

·         Find that concentrating on individual tasks, hobbies or jobs are very difficult and may not achieve their potential in life.

There are two types of social phobia that define a patient’s affliction with this disorder.  Sadly, most people will fall into the category of the generalized social phobic.  However, there are those whose affliction is so severe that their ability to function in daily life is not just fractionally compromised, but detremented to the point that the person cannot go outside their home without specific assurances that they will not be hurt or otherwise embarrassed by social interactions, isolating themselves almost completely from other people or simply just sticking to their immediate family or the one person they trust above all else.  If you find that one of these types describes what you are experiencing then you need to speak to your family doctor, who can refer you to someone who can specifically help diagnose your condition, treat it and help you move forward into a happier, social phobia free existence. 

Social phobia does not have to be a lifelong affliction, but a treatable, even curable condition that can go away with time, treatments and understanding.  Never be ashamed to admit that you have social phobia as there are so many people that suffer it and never get treatment.  Those people do not have the opportunity that you do to fix the problem so that in the end you get what you deserve, enjoying a happy and distress free life just like everyone else.

There are times when treatments for social phobia, such as cognitive behavioral therapies and other psychological methods, do not work.  In this situation a patient’s doctor may recommend medication to help alleviate social phobia symptoms.

Most medications are given singularly whereby a patient uses one drug at a time until their symptoms are under control.  However, there are times when doctors may employ more than one medication to reduce severe symptoms and get a better control on the anxieties.

Social phobia medications are used based on the patient’s ability to tolerate them over a long period of time and their ability to treat the symptoms.  Antidepressant medications are prescribed for social phobia and can be used alone or in combination with other types of drugs to stop symptoms.  Some examples of these include:

·         Effexor – side effects include impotence, other sexual malfunctions, nausea, anorexia, dry mouth, vision problems, sweating and constipation; doses are recommended at 75 to 225mg twice a day with food; no known drug interactions have yet been found

·         Nardil – side effects include dizziness, constipation, drowsiness, headaches, constipation, low blood pressure when getting up, liver conditions, troubles sleeping, digestive problems, increased weight, water gain and sexual problems; doses are 15 to 90mg daily; some drugs and foods that should be avoided whilst taking Nardil and for 2 weeks after completing the treatment include excessive caffeine, beer, cheeses, chocolate, processed salamis/pepperonis/bologna, fava beans, liver, meat extracts, pickled/aged/smoked/fermented/poorly stored fish/dairy/meat products, wine, sauerkraut, yeast extracts, yogurt, appetite reducers, amphetamines, antidepressants (exact or related), inhalants (asthma), hay fever/sinus/cold medications, decongestants (any variety), products containing l-tryptophan, and stimulant medications (EpiPen, Ritalin, etc.)

·         Moclobomide – has no side effects for more most people, but is only useful for very mild social phobia; doses are generally 10 to 150mg taken as directed by the prescribing doctor per day; there are currently no known drug interactions

·         Bupropion – side effects include dry mouth, agitation, insomnia, nausea, tremors, constipation and insomnia; doses generally start at 150mg, 3 times/day; there are not many drug interactions, but those to be avoided include prochlorperazine, chlorpromazine and other antipsychotic drugs (phenothiazine varieties)

·         Prozac – one of the most commonly used, especially for males because it has limited side effects like drowsiness; doses start at 20mg/day; drugs that should not be taken during the use of or for 3 weeks after finishing the treatment include MAO inhibiting medications,  lanoxin and coumadin

·         Sertraline – side effects include apathy, drowsiness and sexual problems;  doses are 25 to 200mg daily; drugs that should be avoided during and for at least 2 weeks after finishing treatment include SSRI’s, cimetidine, pimozide, warfarin and monoamine oxidase inhibitors or MAOI’s due to the risk of serious blood pressure problems, heart function problems and potential death

·         Paxil – side effects include yawning, sleeping problems, drowsiness, sedation, nausea, increased weight, vomiting, apathy, dry mouth and sexual problems; doses are generally at the discretion of the doctor and based on varied health and other factors; drug interactions that should be avoided include MAO inhibiting drugs, astemizole, thioridazine, sibutramine, terfenadine, phentermine, antiarrhythmics, cimetidine, digoxin, clozapine, natural/herbal remedies, lithium, procyclidine, nefazodone, thrombolytic medications (TPA’s, anticoagulants), antidepressants (SSRI), trazodone, theophylline, antidepressants (tricyclics), migraine medications, tryptophan, aspirin (low doses), venlafaxine, diazepam, antihistamines, anti-seizure medications, sleeping pills, muscular relaxants, pain medication (narcotic), psychiatric drugs, sedatives, paroxetine, tranquilizers, dofetilide, quinidine, procainamide, , procainamide, sotalol and sparfloxacin due to their potentially fatal effects

·         Citalopram – side effects include increased or decreased energy, sedation, apathy and sexual problems; doses are generally 20 to 40mg per dose as per instructions from the prescribing doctor; drugs to avoided during the use of and for 3 weeks after using citalopram include MAO antidepressants, selegiline, fenfluramine, dexfenfluramine and tryptophan which due to their dangerous effects and potentials when combined.

·         Escitalopram – side effects include increased or decreased energy, sedation, apathy and sexual problems; doses are 10 to 20mg daily; drugs to be avoided during use and for 3 weeks after include MAO antidepressants, selegiline, fenfluramine, dexfenfluramine, tryptophan, aspirin and anti-inflammatory/bleeding medications (anti-steroidal)

·         Duloxetine – side effects include nausea, constipation, dry mouth, appetite loss, fatigue, dizziness, drowsiness, blurry vision, increased sweating, itching and rashes; doses are prescribed at varied levels at the discretion of the prescribing doctor; drugs to be avoided during and for 3 weeks after using duloxetine, including MAO antidepressants, thioridazine, herbal remedies, ciprofloxacin, cimetidine, heart rhythm drugs, paroxetine, fluoxetine, fluvoxamine, fluoxetine, thrombolytic medications,  aspirin, antihistamines,  anti-anxiety medications,  anti-seizure medications, sleeping pills, muscular relaxants, pain medications (all types), psychiatric drugs, tranquilizers, cough/cold products and anti-fever drugs due to potentially dangerous results

Medications used for social phobia vary greatly in type, dosage, side effects and drug interaction.  However, it is important to never administer prescription drugs without the approval and guidance of a medical doctor, or to combine these with other drugs.