Social anxiety disorder – a psychiatric condition characterized by severe fear of social situations such that the person affected by it, lives in constant fear of meeting people and avoids social situations altogether. This disorder affects 13% of Americans and Europeans. Most people pass it as shyness and never receive treatment for it and those who do get medications because that is the most accessible treatment. There is a shortage of trained psychotherapists who could help people suffering from social anxiety disorder.
Antidepressants is the most commonly treatment prescribed for social anxiety disorder, however a new study reveal that cognitive behavioral therapy (CBT) is more effective in the long run. Unlike medication whose effects wanes once one stops taking them, CBT can have long lasting effects even after the treatment has been stopped.
The study took into account and analysed data from 101 clinical trials and compared multiple types of medication and talk therapies. The results of the same are published online in The Lancet Psychiatry dated September 26th.
Evan Mayo-Wilson, DPhil, a research scientist in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health and the study leader remarked that social anxiety disorder is more than just shyness. People suffering from this disorder experiences severe impairment – like they shun friendships, turn down promotions at work which requires increased social interaction, etc. The good news however is that social anxiety is treatable. It is now known what works best for this condition; therefore the need of the hour is to improve access to psychotherapy for those who are suffering.
The research was conducted in collaboration between the Johns Hopkins Bloomberg School of Public Health, Oxford University and University College in London.
For the research, Mayo-Wilson and his colleagues accumulated data from 13,164 participants in 101 clinical trials and analysed them. All the participants had severe and longstanding social anxiety. About 9,000 had received medication or a placebo pill, and more than 4,000 were prescribed psychological intervention. For few of the trials, medication was combined with talk therapy. But, there was no substantial evidence that combined therapy worked better than talk therapy alone. For this study several different types of talk therapy were compared and it was found that individual CBT was the most effective. Mayo-Wilson explains that CBT is a form of treatment that focuses on the relationships between thoughts, feelings and behaviors. It is aimed to help people challenge irrational fears and overcome their avoidance of social situations.
People who do not have access to CBT or those who do not want to avail of it are commonly prescribed antidepressants. Researchers say that selective serotonin reuptake inhibitors (SSRIs) are effective but they can also have serious adverse events. For some that it doesn’t work at all while among others the improvement symptoms do not last long. The researchers are of the opinion that medication is important; however it should be used as a second-line therapy for people who do not respond to or do not want psychological therapy. Mayo-Wilson also remarked that more investment in psychological therapies would improve quality of life, increase workplace productivity, and will reduce healthcare costs.
Typically, social anxiety disorder begins in adolescence or early adulthood, which is a critical phase in a person’s life. It can adversely impair a person’s daily functioning by hindering the formation of relationships, by negatively affecting performance at work or school, etc. In a nutshell, it reduces the overall quality of life. If not treated in due time, it can have long lasting adverse consequences.
The group’s research and study has already led to new treatment guidelines guidance in the U.K. Mayo-Wilson is of the opinion that it could have a significant impact on policymaking and the organization of care in the U.S as well.