Recent clinical trials indicate that Cognitive Behavioral Therapy (CBT) might be more effective and longer lasting than antidepressants in the treatment of social anxiety disorder. Sometimes referred to as social phobia, social anxiety disorder is defined by Mayo Clinic doctors as, “a chronic mental health condition,” characterized by an irrational fear of normal social interactions. Most people get a little nervous in certain anxiety-producing situations, like giving presentations or going on a job interviews. In these same scenarios, people who suffer from social anxiety disorder become paralyzed with fear.
For those who suffer from this disorder, just the thought of public speaking or even joining in a conversation can cause extreme anxiety and sometimes physical distress. The person may become nauseated and have heart palpitations. They may also experience dizziness and have difficulty breathing. More than everyday shyness, the person feels inordinately self-conscious and firmly believes that ordinary social interactions will result in criticism, embarrassment and humiliation.
It is estimated that over 15 million Americans suffer from social anxiety disorder and lots of people live with the condition. For others, it can have a profoundly negative impact on quality of life, often causing isolation and loneliness as well as difficulties at work or school. In recent years, the most common treatment for social anxiety disorder has been antidepressants but a new study seems to indicate that treating this condition with CBT might work better than pharmaceutical interventions.
Dr. Evan Mayo-Wilson and his team of researchers at John Hopkins University recently offered findings, which seem to indicate that CBT might provide more effective and longer lasting relief for those who suffer from social anxiety disorder. The team looked at data from over 13,000 participants in more than 100 clinical trials and found that helping people deal with or change their thought patterns regarding anxiety-producing social situations could be a more valuable solution. The anxiety reducing effects of antidepressants or selective serotonin re-uptake inhibitors (SSRIs), like Prozac or Paxil, unfortunately wear off when the person stops taking the drug.
CBT can be defined as a form of therapy in which the patient is asked to consider the patterns between destructive thoughts and feelings and the potentially negative or limiting behaviors that result from these patterns. The goal of this type of talk therapy is to get the person to focus on altering the thoughts and feelings that prompt undesired behaviors. The person works closely with the therapist in a safe environment to face their fears and to test the erroneous beliefs associated with their perceptions. According to the National Alliance on Mental Illness (NAMI), CBT can be as useful as antidepressants in the treatment of social anxiety disorder, and “may be superior in preventing relapse of symptoms.”
Dr. Mayo-Wilson points out that teaching a person how to monitor and adjust their thought patterns offers a long-term solution that medications simply cannot. “Drugs, he says, often stop working. With [cognitive behavioral therapy], you’re teaching people skills that they take with them after the therapy ends.” He feels strongly that CBT should be the first line of defense in the treatment of social anxiety disorder.
Others like research psychiatrist Dr. Franklin Schneier from New York’s State Psychiatric Institute, do not necessarily disagree but feel that more research should be done. While other countries, like Great Britain, already advocate the use of CBT in the treatment of this type disorder, the practice is not as widespread in the U.S. People who seek this form of treatment might find it difficult to find a qualified therapist and insurance coverage might be an issue as well. For now, Dr. Mayo-Wilson is excited about the study’s results and believes that he and his team have provided evidence to support the use of CBT as a more effective and longer lasting treatment of social anxiety disorder.
By Constance Spruill