How to treat social phobia?

Social phobia is an anxiety disorder in which the person feels an irrational fear of interacting with others. The person fears being evaluated negatively by others, either because they examine, judge, reject or humiliate their behavior.

Social phobia, also known as social anxiety, It can occur in situations as common as a conversation, when asking something to a stranger, feeling observed while we eat or if we give a talk.

Symptoms and prevalence of social phobia

The main symptoms of social anxiety are the following:

  • Experience difficulty when speaking.
  • Feeling a lack of concentration in speech.
  • Excessive sweating
  • Tremors
  • Tachycardias
  • Dry mouth
  • To blush.

The estimated prevalence varies depending on the geographic area studied. We find population groups in which it is barely present, with 0.5%, and societies with a 7% presence, such as the United States. On average, it is estimated that between 2% and 5% of adults suffer from social phobia.

Read also: 8 tips to combat insecurity and improve your relationships

Treatment of social phobia

There are different ways to treat social anxiety. The most common are the drug approach, psychotherapy and a combination of both. Let's look at them in more detail.

The use of antidepressants and benzodiazepines constitutes the mainstay of the pharmacological approach. Adverse effects should always be evaluated.


Among the drugs, the most prescribed are the following:

  • Serotonin reuptake inhibitors (SSRIs): they are the treatment of choice for treating social phobia. Paroxetine is the one that has shown the greatest efficacy, especially in people who also have panic disorder, depression or obsessive compulsive disorder.
  • Benzodiazepines: some of them are alprazolam, clonazepam and bromazepam. Given their side effects, such as sedation, ataxia and cognitive disturbances, they are not of choice.
  • MAOI: Before the advent of SSRIs, phenelzine was the most prescribed treatment, with up to a 70% positive response. Due to its significant side effects it is not a current option.
  • Beta-adrenergic blockers: Propanolol and atenolol are prescribed to control vegetative symptoms, such as tremors, rapid heartbeat, or sweating. They are administered between 60 and 90 minutes prior to the anxiety situation.


Social phobia can be treated from different types of approaches. The most studied is the cognitive behavioral, with very good results both in the short, medium and long term.

This type of therapy helps people question their most skewed thoughts and to act in a more functional way when faced with a situation that produces fear, such as speaking with strangers or exposing oneself to uncomfortable situations.

The most commonly used cognitive behavioral techniques to treat social anxiety are the following:

Combined treatment for social phobia: psychotherapy and drugs

There is a certain superiority of combination therapy over monotherapy treatments in which only drugs or psychotherapy are prescribed. However, the limitations of the analyzed studies (D'Alessandro et al. 2013) do not allow us to extract conclusive results.

This is due to different factors:

  1. In various studies the drugs administered were not the treatment of choice for social phobia.
  2. Psychological therapies varied in the different studies examined.
  3. The samples of patients evaluated were very heterogeneous.

Therefore, it is recommended to abide by the precautionary principle before drawing conclusions and extrapolating the results to all possible combinations between psychotherapy and drugs.

Other psychotherapies

Although cognitive behavioral therapy is effective, not all people respond well to it. This is not a great impediment, since there are many therapies that can also be effective. Among them, the following stand out:

  • Psychoanalytic psychotherapy: focuses on working on the basic psychological needs of attachment and approval of the person suffering from social phobia.
  • Supportive therapy: Its objective is to promote safety in the patient, working on acceptance, consideration, affection and understanding.
  • Interpersonal therapy: focuses on improving the interpersonal life of the patient.

When choosing a type of psychotherapy it is important that we know the fundamental principles on which it is based. This will avoid frustrated expectations and opt for a method with which we feel comfortable at the outset.

Social phobia could be treated with a combination of drugs and psychological therapy, in order to improve the final results.

Discover: Psychoanalysis: what it is and how it works

Conclusions about social phobia

Social anxiety is a disorder that can be very limiting, since human beings interact with other people in many areas of life.

Nevertheless, people with it can benefit from current treatments available and significantly reduce your symptoms. Studies show how patients with high levels of social phobia decrease their discomfort.

If you manifest very pronounced discomfort in social interactions, feel free to seek help. A mental health specialist can contribute to lessen your symptoms more intense and to relate to others in a more appropriate way.