How To Overcome Social Anxiety In South Africa

How To Overcome Social Anxiety In South Africa

Social Phobia is defined as an intense fear of becoming humiliated in social situations – more specifically, of becoming embarrassed in front of other people. 

How To Overcome Social Anxiety In South Africa?

Fewer than 25% of social phobia sufferers receive treatment for their conditions, despite the fact that social phobia responds extremely well to treatment. Several factors confound the successful treatment of social phobia :

  • The perception of social phobia as an exaggerated form of shyness or social unease. As a result of this, many sufferers do not consider their condition to be a disorder for which consultation with a doctor is appropriate.
  • The nature of social phobia means that sufferers are often reluctant to seek treatment. This is due in part to a fear of public scrutiny and the belief that nothing can be done to help.
  • There is a low level of awareness among many doctors of the diagnosis and treatment of social phobia.

However, the sever impairment and the onset of comorbid conditions can be prevented or alleviated by the early administration of pharmacological and psychological therapies. Once social phobia is diagnosed, treatment must be introduced without delay. Extensive research has shown that in any anxiety disorder, a combination of drug and psychological therapy yields the best treatment results, and the most rapid recovery with the fewest relapses.

Medication

Social Phobia responds well to drug therapy, but it is important to realise that social phobia is a chronic condition that requires long-term management. Drug therapy should be maintained for a bare minimum of six months. Upon completion of the drug treatment program, medication should be withdrawn gradually, with periodic attempts to lower the dose.

Drugs found to be the most effective in treating Social Phobia are the Anti-depressants: Selective Serotonin Reuptake Inhibitors (SSRIs), Monoamine Oxidase Inhibitors (MAOIs), and Reversible Inhibitors of Monoamine Oxidase (RIMAs) being the most commonly used.

Different types of Antidepressants

Monoamine Oxidase Inhibitors (MAOIs)

These are antidepressants that work by activating an enzyme called Monoamine Oxidase. The only MAOI available in South Africa is Parnate (Tranylcypromine). The MAOIs have been in existence for about 30 years and are effective for the treatment of Depression and Social Phobia, especially in cases where serious sleep and eating disturbances are observed.

They are not widely used because they may have a dangerous reaction with certain foods, and tend to be reserved for patients who have not responded to other medications. If switching between an MAOI and another antidepressant, there will need to be an interval of between one and two weeks to effect wash-out.

Reversible Inhibitors of Monoamine Oxidase (RIMAs)

RIMAs are a new class of drug that are generally safer and better tolerated than MAOIs. The drug functions by selectively binding to a specific isoenzyme of Monoamine Oxidase. At present, Aurorix (Moclobemide) is the only drug to have undergone long-term trials in the treatment of Social Phobia.

Selective Serotonin Reuptake Inhibitors (SSRIs)

The SSRIs are among the newer antidepressants and have been available since 1988. SSRIs include Aropax (Paroxetine), Cipramil (Citalopram), Luvox (Fluvoxamine), Prozac / Lorien (Fluoxetine) and Zoloft (Sertraline). They are now the most widely used antidepressants because they tend to have fewer side effects than the older drugs. Although called anti-depressants, the SSRIs are also used to treat Social Phobia, Panic Disorder and Obsessive-Compulsive Disorder.

Are Antidepressants safe to take?

Antidepressants are safe to take in prescribed doses but are not suited to everyone. There are some conditions where extra care will need to be taken. If any of the following apply to you, you should discuss medication especially carefully with your doctor:

  • If you are taking other prescribed and over-the-counter medication, including antihistamines, stomach acid neutralisers, cough and cold treatments and the like.
  • If you have any pre-existing illnesses, including diabetes, epilepsy, heart problems, kidney or liver problems, hyperthyroidism etc.
  • If you are pregnant, breast feeding or hoping to fall pregnant.

Side effects of the antidepressants are likely to be experienced during the first few weeks of treatment, but usually disappear with time. It is important to overcome this period of having to endure side-effects in order to allow a full recovery to take place. The most common side-effects include nervousness, sleep problems and impaired sexual functioning.

Other typical side-effects of the SSRIs include:

  • Headaches
  • Nausea

Other typical side-effects of the MAOIs include:

  • Dizziness and agitation
  • The need for a special diet

Particular care must be taken when MAOIs are used as the drug interacts with several food types, including cheese and wine. These foods must be avoided during treatment with MAOIs.

Other Medications

Certain benzodiazepines are useful in the treatment of Social Phobia. In addition, Beta-blockers are useful in treating performance anxiety.

Continuation of treatment is important as there is a substantial rate of relapse once therapy has been prematurely withdrawn.

“I first noticed the treatment was working when I had to
cash a cheque at the bank. For the first time that I can
remember, my hand did not shake as I signed it”