Social anxiety disorder (SAD or SAnD) (DSM-IV 300.23), also known as social phobia, 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 of social anxiety disorder 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. SAD is sometimes referred to as an 'illness of lost opportunities'
Standardized rating scales such as Social Phobia Inventory can be used for screening social anxiety disorder and measuring severity of social phobia. 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 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, as well as newer antidepressants, such as mirtazapine. Kava-kava has also attracted attention as a possible treatment, although safety concerns exist.
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