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Social anxiety disorder

Phobia socialis · Sociální úzkostná porucha (sociální fobie)

What it is

An intense fear of being judged in social situations that leads to avoidance — far more than shyness.

Symptoms & signs

  • Fear of speaking, eating or performing in front of others
  • blushing, sweating, trembling
  • avoiding social situations
  • dread for days beforehand
  • low mood

🚩 Get help if…

  • call 112 / 911 now Thoughts of ending your life
  • see a doctor soon Avoiding school, work or leaving home
  • see a doctor soon Using alcohol or drugs to face people
  • see a doctor soon Panic attacks or low mood most days

Where it strikes

Medical treatment

  • Cognitive behavioural therapy (the most effective)
  • SSRIs or venlafaxine
  • beta blockers for performance only
  • group therapy

Natural & lifestyle

  • Gradual exposure
  • breathing and relaxation
  • no alcohol as a crutch

Emerging & experimental

  • MDMA- and psilocybin-assisted therapy trials
  • virtual-reality exposure

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Mindfulness — trials reduce symptoms early / small studies
  • Kava — trials help anxiety; liver risk early / small studies
  • CBD oil — a small trial before public speaking helped early / small studies

ICD codes