Does Alcohol Help With Social Anxiety?

Does Alcohol Help With Social Anxiety
Sarah W. Book, M.D., and Carrie L. Randall, Ph.D. – Sarah W. Book, M.D., is an assistant professor and Carrie L. Randall, Ph.D., is a professor in the Department of Psychiatry at the Center for Drug and Alcohol Programs and Alcohol Research Center, Medical University of South Carolina, Charleston, South Carolina.

Social anxiety disorder—an excessive fear of social situations, such as eating or speaking in public—affects 2 to 13 percent of the U.S. population. About one–fifth of patients with social anxiety disorder also suffer from an alcohol use disorder (AUD) (i.e., alcohol abuse or dependence).

One theory to explain the comorbidity between social anxiety disorder and AUDs is the tension reduction theory, which posits that people with social anxiety use alcohol to alleviate their fears. This expectation that alcohol reduces anxiety may motivate alcohol consumption even if pharmacological studies do not support that assumption.

Social anxiety disorder is treatable with both pharmacotherapy and psychotherapy, and some of those treatments also would be expected to be effective for patients with comorbid AUDs. Evaluation of patients seeking alcoholism treatment for coexisting social anxiety disorder is important for improving treatment outcome.

Ey words: comorbidity; anxiety; social phobia; AODU (alcohol and other drug use); alcoholic beverage; tension reduction theory of AODU; diagnostic criteria; prevalence; positive AOD (alcohol and other drug) expectancies; drug therapy; psychotherapy; monoamine oxidase; benzodiazepines; serotonin uptake inhibitors; literature review Many people experience social anxiety—that is, they feel uncomfortable or even anxious in social situations, such as talking with strangers (or even friends) or speaking in front of a group of people.

In the general population, levels of social anxiety exist on a continuum from mild to severe. A clinical diagnosis of social anxiety disorder, also referred to as social phobia, 1 ( 1 These two terms tend to be used interchangeably in the literature.) is assigned only when the social anxiety results in significant fear when faced with the situation, impairment of performance, or avoidance of anxiety–provoking situations.

People with high levels of social anxiety typically report that alcohol helps them feel more comfortable in social situations. Thus, it is not surprising that individuals with clinically diagnosed social anxiety disorder have a higher incidence of alcohol–related problems than does the general population.

This article explores the diagnosis and prevalence of social anxiety disorder and reviews studies evaluating the relationship between alcohol consumption and social anxiety. In addition, the article summarizes treatment approaches for social anxiety disorder alone as well as in combination with alcohol–related problems.

SOCIAL ANXIETY DISORDER According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM–IV) (1994), social anxiety disorder is defined as excessive fear in social situations in which the person believes he or she will do something embarrassing or have anxiety symptoms (e.g., blushing or sweating) that will be humiliating.

The feared situations can vary from interpersonal social interactions in small groups to talking to strangers. Performance fears, such as speaking in public, also are common. People with social anxiety disorder either avoid feared situations or experience them with extreme anxiety.

  • Most individuals with the disorder have the more severe, “generalized” type, in which the person has other social fears in addition to the common fear of public speaking.
  • The complete criteria set for an official diagnosis of social anxiety disorder is detailed in the textbox.
  • DIAGNOSTIC CRITERIA FOR SOCIAL PHOBIA Social phobia* is diagnosed if the person meets all of the following criteria: A.

A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing.B.

  • Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed panic attack.C.
  • The person recognizes that the fear is excessive or unreasonable.D.
  • The feared social or performance situations are avoided or else are endured with intense anxiety or distress.E.

The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.F.

In individuals under the age of 18, the duration is at least 6 months.G. The fear or avoidance is not the result of the direct physiological effects of a substance or a general medical condition and is not better accounted for by another mental disorder.H. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it.

*Social phobia may be specific to one or a few social situations or generalized to most social situations. SOURCE: Adapted from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association 1994). Typically, social anxiety disorder begins in the teenage years and does not improve without treatment.

  • The mechanisms or causes underlying the disease are unknown but may involve multiple predisposing factors.
  • These potential factors include genetic background, traumatic early emotional learning experiences, observation and modeling of parental behaviors, and biological irregularities in brain chemical systems.

People with the disorder often report having been shy or behaviorally inhibited as small children and, in severe cases, a child with social anxiety may not want to go to school (Beidel 1998). As young adults, people with social anxiety disorder tend to make life choices based on their fears, such as avoiding classes requiring oral presentations or accepting jobs beneath their ability because they can work alone.

  • Because these life choices circumvent their underlying social fears, many people with social anxiety disorder may be able to function adequately for extended periods of time.
  • Once the contrived situation changes (e.g., when a promotion is offered), however, the social anxiety fears may resurface.
  • Many people with social anxiety disorder will turn down a promotion rather than encounter the social demands required for the new job.

Thus, for many of these people, life is orchestrated around social fears, even if this results in social isolation or less financial independence and academic achievement. The Prevalence of Social Anxiety Disorder Prevalence estimates of social anxiety disorder vary considerably, both for social anxiety alone and concurrently with alcohol use disorders (AUDs) 2 ( 2 Alcohol use disorders as defined in the DSM–IV include alcohol abuse and alcohol dependence.) (e.g., Kessler et al.1997; Schneier et al.1992; Van Ameringen et al.1991).

This variability results in large part from methodological differences among studies. For example, an analysis of data from the Epidemiologic Catchment Area study, a door–to–door survey conducted in four communities across the United States in the 1970s, found the prevalence of social anxiety disorder to be only 2 percent (Schneier et al.1992).

In this analysis, a diagnosis of social phobia was given to respondents who admitted to extreme anxiety while eating in front of others, speaking to a small group of people they knew, or speaking to a large group of strangers. In contrast, a later community study, the National Comorbidity Survey, found the prevalence of social anxiety disorder to be as high as 13 percent (Kessler et al.1998).

  1. In this study, respondents acknowledging anxiety in a wider range of social situations were considered to have social anxiety disorder.
  2. This higher prevalence rate of social anxiety disorder would make it the third most prevalent psychiatric disorder after alcohol dependence and depression.
  3. Conservative estimates of the prevalence of co–occurring, or comorbid, social anxiety disorder and AUDs found that approximately 20 percent of patients treated for social anxiety disorder and 15 percent of people receiving alcoholism treatment have both disorders (Randall et al.2001 a ).

Despite a paucity of controlled research in the area, many researchers have written about the high comorbidity between social anxiety disorder and alcohol use problems. One viable hypothesis to explain this high comorbidity is that people with social anxiety use alcohol as self–medication for social fears.

This tension reduction hypothesis is discussed next. THE TENSION REDUCTION HYPOTHESIS Clinical reports indicate that people use alcohol as a means of coping with social fears as well as with stress. One standard theory of why people drink—the tension reduction hypothesis—implies that alcohol acts as a negative reinforcer to reduce stress and anxiety.

A negative reinforcer is something that eliminates an unpleasant experience. In this case, anxiety or stress is the unpleasant experience and alcohol consumption, which reduces these feelings, would be considered the negative reinforcer. Once a person experiences stress relief after consuming alcohol, he or she is likely to continue to use alcohol for its stress–reducing properties.

Whether alcohol actually reduces stress is debatable (see Carrigan and Randall, in press). In fact, some researchers have argued that based on its pharmacological properties, alcohol actually should increase stress and that therefore negative reinforcement using alcohol would be ineffective (Spencer and Hutchison 1999).

Nevertheless, people with social anxiety disorder report that aside from totally avoiding anxiety–inducing situations, alcohol use is one of their primary means of coping. It is possible that positive expectancies—beliefs that alcohol will relieve social anxiety, whether supported in fact or not—play a role in the relationship between social anxiety and alcohol use.

For example, people with social anxiety may drink excessively because they strongly expect alcohol to reduce their anxious feelings in social situations. The role of alcohol expectancies and their relation to alcohol consumption and behavior has been studied extensively in young adults (e.g., Burke and Stephens 1999; Tran et al.1997).

These experiments demonstrated that both positive and negative expectations can be powerful behavioral moderators. Differences in expectancies might in fact explain why not all people with social anxiety drink alcohol to cope with their fears. People with negative expectancies about alcohol’s effects probably do not consume alcohol because it increases their fear of appearing even more foolish.

Positive expectancies that alcohol can relieve social fears may explain why some people experiment with alcohol as a coping strategy in the first place. If a person’s expectancy that alcohol reduces stress is left unchallenged (i.e., if the person is not shown by a clinician or researcher that alcohol consumption does not actually reduce stress either behaviorally or physiologically), it may be a powerful enough belief system to explain why a person continues to use alcohol to relieve stress.

Alternatively, one can argue that for a subgroup of socially anxious people alcohol may have a genuine pharmacological effect that results in decreased social anxiety. These individuals may have started drinking as a coping mechanism because of their positive expectancies, but they may continue to use alcohol because they associate alcohol consumption with symptom relief.

Unfortunately, few experimental studies have investigated expectancies about alcohol’s ability to reduce social fears, determined how expectancies translate into actual alcohol consumption, or demonstrated that alcohol reduces social fears in a laboratory setting (see Carrigan and Randall, in press).

Much of what is known about the association between social anxiety and alcohol consumption comes from research with college students who did not have clinical diagnoses of social anxiety disorder, rather than from research with patients diagnosed as having the disorder.

In one study examining the effects of alcohol expectancies on drinking, Tran and colleagues (1997) divided a sample of college students into two groups according to their anxiety level (i.e., high or low) and assessed their expectancies about alcohol’s ability to relieve social anxiety as well as their alcohol consumption.

The study found that among those respondents who believed that alcohol would definitely reduce social fears, the level of social anxiety did not affect the level of alcohol consumption. Thus, although the investigators had expected the high–anxiety group to consume more alcohol than the low–anxiety group when alcohol was being used to cope with social fears, no such difference existed, at least in these non–treatment–seeking college students.

  • This lack of a difference might, however, be, in part, the result of the social context of college student drinking.
  • That is, for both groups baseline drinking levels would be expected to be relatively high, to be defined by drinking binges, and to occur in the context of peer pressure and social situations.

Another way to examine the relationship between alcohol expectancies and alcohol consumption is to ask whether people with high expectations of reduced social anxiety actually experience less anxiety when they are drinking. In a sample of 72 female college–age social drinkers, women who expected positive results from alcohol did, in fact, report less anxiety after drinking alcohol than did women with negative or neutral beliefs (de Boer et al.1994).

One can assume that the greater reduction in anxiety after alcohol consumption would result in more drinking in the group with the positive alcohol expectancies. However, the study did not examine drinking behavior, nor did it compare results for women with high or low levels of social anxiety. Another study assessed drinking in a sample of male college students with high social anxiety and failed to find evidence of increased alcohol consumption compared with students with lower levels of anxiety (Holroyd 1978).

In fact, severity of social anxiety was a negative predictor of alcohol quantity consumed—that is, participants with higher levels of anxiety consumed less alcohol than did those with lower levels of anxiety. Unfortunately, however, this study did not examine alcohol expectancies and only sampled males.

Taken together, the results from these last two studies suggest that the interaction of gender and alcohol expectancies may be an important factor in determining who will report that alcohol benefits them and who might drink alcohol to cope with their anxiety. Whether alcohol reduces social anxiety in a controlled laboratory environment is still open to debate.

Several studies have addressed this issue in college students (see Carrigan and Randall, in press), and one study was conducted in a clinical sample of clients with a formal diagnosis of social anxiety disorder (Himle et al.1999). This latter study did not find that alcohol had any effect in reducing social fears.

  • The conclusions from this study are limited, however, because the investigators excluded patients with a diagnosis of alcohol abuse or dependence and did not evaluate alcohol expectancies.
  • Thus, researchers do not yet know whether alcohol reduces social anxiety in people who believe it is effective or in people who consume it to the point that they meet the criteria for an AUD.

The specific alcohol effects observed may also depend on how anxiety is measured (e.g., by behavioral or psychophysiological measures or by self–report). Regardless of whether researchers can demonstrate in the laboratory that alcohol reduces social fears, many people with social anxiety report that they expect alcohol to have that effect and that they use it to cope with their social anxiety.

Because of their alcohol consumption, some of these individuals will eventually develop alcohol use problems in addition to their preexisting social anxiety disorder. For other people, alcohol use as a coping mechanism could still lead to alcohol–related risks, such as automobile crashes, interpersonal conflicts, or medical risks, even if they do not meet the criteria for an AUD.

Treatment of social anxiety therefore is warranted to prevent the development of alcohol–related problems and AUDs. TREATMENT OF SOCIAL ANXIETY DISORDER As with most anxiety disorders, social anxiety disorder responds well to pharmacologic treatment and psychotherapy.

  • The aim of both types of interventions is to reduce social fears so that the feared situations are no longer avoided or that they are associated with minimal discomfort.
  • The following sections review various therapeutic interventions.
  • Pharmacotherapy Several different classes of medication have been shown to be effective in the treatment of social anxiety disorder.

The primary drug classes include the monoamine oxidase inhibitors (MAOIs), benzodiazepines, and more recently, selective serotonin reuptake inhibitors (SSRIs) (Blanco et al.2002). MAOIs. These medications block monoamine oxidase, an enzyme that breaks down monoamines.

  1. Monoamines are one of the major classes of signal–transmitting chemicals (i.e., neurotransmitters) in the brain and are thought to play a role in mood and anxiety disorders.
  2. MAOIs have been shown to be efficacious in the treatment of anxiety disorders in several well–designed studies (Blanco et al.2002).

However, these medications require a special diet that restricts the ingestion of the amino acid tyramine (which is contained in cheese, red wine, some imported beers, and yogurt) to avoid a potentially deadly episode of high blood pressure (i.e., a hypertensive crisis).

  • Because of this potentially serious side effect, most physicians no longer prescribe these medications.
  • Benzodiazepines.
  • These sedative medications are also effective in the treatment of social anxiety disorder.
  • For example, alprazolam and clonazepam are both well tolerated and have shown promise in the treatment of social anxiety (Blanco et al.2002).

However, as discussed more fully below, their use in patients with comorbid social anxiety and alcohol problems may not be advisable. SSRIs. These agents, which affect a brain signaling system using the brain chemical serotonin, are perhaps the best tolerated and most carefully studied pharmacologic treatment for social anxiety disorder.

Although several of these medications have shown some efficacy, paroxetine (Paxil ) is the only medication currently on the market that has been approved by the U.S. Food and Drug Administration for the treatment of social anxiety disorder. At least three clinical trials have shown this agent to be significantly more effective than an inactive substance (i.e., a placebo) in reducing social anxiety and alleviating the problems associated with social anxiety disorder (Baldwin 2000).

Based on these results, SSRIs have been proposed as the first line of treatment for social anxiety disorder (Blanco et al.2002). Psychotherapy Psychological treatment of people with social anxiety disorder has used various approaches that focus on role playing, coping skills training, exposure to feared situations, and changing the patients’ erroneous negative beliefs about how people perceive them (Heimberg 2002).

Because social anxiety disorder involves excessive fear of humiliation and criticism, cognitive behavioral therapies (CBT) have proved to be successful for this disorder and, like medications, to be more effective than control conditions (Heimberg et al.1998). CBT approaches are based on the assumption that human behavior is largely learned and that learning processes therefore can be used to change problem behaviors.

CBT is not one uniform type of therapy but can be classified into four different categories (Heimberg 2001):

Exposure therapy is a technique in which patients are given skills to alleviate anxiety and then are encouraged to expose themselves to an anxiety–provoking situation in an attempt to extinguish the anxiety. Exposure to anxiety–inducing situations is considered an essential component of therapy because many patients, if left on their own, would avoid such situations altogether, thereby restricting their lifestyle. Cognitive restructuring is a model in which clients are taught to identify thoughts that provoke anxiety and to think in a less biased, anxiety–provoking way. Challenging erroneous beliefs with video feedback or feedback from group members is an important component of cognitive therapy. Relaxation training is a method of decreasing anxiety by controlling the amount of physical tension experienced in a stressful situation. Relaxation training alone, however, is not usually as successful as cognitive restructuring or exposure therapy. Social skills training teaches patients how to improve their behavioral skills in social interactions. However, not all people with social anxiety disorder have deficits in social skills. Therefore, social skills training alone would not benefit all clients with the disorder.

Most CBT for social anxiety disorder involves a combination of these different approaches. Regardless of which specific CBT measures are evaluated, it is important to recognize that nonpharmacological treatments for social anxiety disorder are effective (Taylor 1996) and generally work as well as medication.

In addition, some findings indicate that despite a slower onset of improvement compared with pharmacotherapy, the beneficial effect of psychotherapy may be more enduring (Heimberg 2002). TREATMENT OF COMORBID SOCIAL ANXIETY DISORDER AND AUDS The previous discussion indicates that social anxiety disorder is treatable, at least in people without comorbid alcohol problems.

Unfortunately, all of the above–mentioned clinical trials evaluating social anxiety therapies have excluded participants who met the diagnostic criteria for an AUD. Consequently, it is unknown if similar approaches are efficacious in clients with comorbid AUDs and social anxiety disorder.

  • Pharmacotherapy Some treatments are contraindicated for people with AUDs for safety reasons.
  • For example, as mentioned previously, patients taking MAOIs must avoid foods containing the amino acid tyramine, which include certain alcoholic beverages.
  • Therefore, MAOIs could be particularly dangerous for patients with AUDs.

Benzodiazepines also should not be used in clients with AUDs for several reasons. First, benzodiazepines can cause behavioral disinhibition, which may make it more difficult for a person to limit their alcohol consumption to an intended amount. Second, benzodiazepines and alcohol affect some of the same brain areas, including a region responsible for maintaining breathing activity.

  1. Therefore, people who mix alcohol and benzodiazepines may inadvertently shut down that brain area, with potentially deadly consequences.
  2. Finally, people who abuse or are dependent on alcohol are also at risk for abusing or becoming dependent on benzodiazepines.
  3. Only a few studies have evaluated treatment of people with comorbid social anxiety disorder and AUDs, but based on research in individuals with social anxiety disorder alone, some treatments would be expected to be efficacious.

Of the pharmacological treatments, SSRIs may be most appropriate for clients with both types of disorders. These medications are safe, are not addictive, and do not interact with alcohol in the brain. In addition, accumulating evidence suggests that SSRIs also have some efficacy in improving outcome in treatment–seeking alcoholics with a late onset of alcoholism (i.e., after age 25) (Pettinati et al.2000), which includes most socially anxious alcoholics.

Randall and colleagues (2001 b ) recently completed the only study to date that examines the use of SSRIs by clients with comorbid social anxiety disorder and alcoholism. The study was an 8–week, placebo–controlled pilot clinical trial comparing the efficacy of paroxetine to placebo. Results indicated that paroxetine not only reduced social anxiety to a significant degree but also tended to decrease the frequency and severity of alcohol use.

A larger trial to replicate and extend these findings is currently under way. Psychotherapy Whether CBT is beneficial in patients with comorbid social anxiety disorder and AUDs is not clear.3 ( 3 CBT also is frequently used in the treatment of AUDs, although the specific treatment approaches used and their target behaviors differ from those used for clients with social anxiety disorder.) A recent randomized, controlled clinical trial failed to demonstrate any benefit when the patients received simultaneous CBT for each condition (Randall et al.2001 a ).

In fact, treatment outcome was slightly better in the group that only received CBT for their alcohol problems than in the group that received CBT treatment for both conditions. These results highlight several important factors that must be addressed when treating individuals suffering from more than one psychiatric disorder.

For example, which condition should be treated first? Should the treatments be integrated or separated? Should different treatment approaches be used (e.g., pharmacotherapy for one disorder and psychotherapy for another)? It is likely that the answers to these questions depend at least in part on the problem for which a given patient seeks treatment.

For example, for teenagers and young adults, who generally use alcohol only as a coping strategy, treatment primarily of the social anxiety disorder is desirable to prevent the development of further AUDs. Once an AUD has developed, treatment of the social anxiety is likely to be more difficult because each disorder will have a life of its own.

Treatment–seeking alcoholics are rarely assessed for the presence of social anxiety. Alcoholics with comorbid social anxiety disorder, however, are unlikely to benefit as much from traditional alcoholism treatment if their anxiety disorder is not treated.

  1. For example, such clients will probably resist or avoid participation in group therapy or self–help meetings, such as Alcoholics Anonymous.
  2. This resistance may be especially common in women with social anxiety (Thevos et al.2000).
  3. Thus, in order to improve treatment outcomes it is important to determine whether comorbid social anxiety disorder is present among people seeking alcoholism treatment (Randall et al.2000).

It is equally important to inquire about alcohol consumption in people seeking treatment for social anxiety problems in order to improve the outcome of treatment for social anxiety as well as to prevent or identify alcohol–related problems. SUMMARY The discussion presented in this article clearly indicates that the data associating drinking with relief of social anxiety are complex and inconclusive.

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Studies in college students with a certain level of social anxiety did not support the assumption that drinking alcohol can indeed relieve social anxiety; however, these students did not have a formal diagnosis of social anxiety disorder. The only study involving individuals meeting the diagnostic criteria for social anxiety disorder excluded clients who met the criteria for an AUD—a group who possibly would be expected to experience relief of social anxiety symptoms after alcohol consumption.

Regardless of whether some people experience actual benefits from alcohol consumption, the belief that alcohol may reduce social anxiety motivates many socially anxious people to use alcohol as a primary coping strategy. This is especially true for individuals who are still engaging in social interactions and are not yet avoiding them completely.

As described above, social anxiety disorder is treatable. If it is left untreated, however, repeated use of alcohol to self–medicate may result in the development of a secondary AUD, so that the individual suffers from two comorbid disorders requiring treatment. The onset of social anxiety disorder nearly always precedes the onset of an AUD, often by more than 10 years (Randall et al.2001 a ).

Because of this delay, this particular comorbidity is a primary target for intervention in order to prevent the development of an AUD. ACKNOWLEDGMENTS The authors wish to thank the anonymous reviewers for their constructive comments on the article and Ms.

  • Nancy White for her technical and administrative assistance.
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Does alcohol make social anxiety worse?

Alcohol As A Coping Mechanism – Appropriately called “liquid courage,” alcohol reduces inhibition and is associated with increased confidence, prompting those with social anxiety disorder to often see alcohol as symptom relief in a bottle. Whether alcohol actually reduces social anxiety is still up for debate; however, positive expectations that alcohol can relieve social fears may explain why so many people turn to alcohol as a coping strategy in the first place.

Aside from completely avoiding anxiety-inducing social situations, people with social anxiety disorder report that alcohol use is one of their primary methods of coping. Many researchers attribute this to the Tension Reduction Theory, the belief that alcohol acts as a negative reinforcer to reduce stress and anxiety.

Once a person experiences stress relief after consuming alcohol, he or she is likely to continue to use alcohol before and/or during stressful situations. Some people with social anxiety then drink excessive amounts because they strongly associate alcohol with reduced feelings of anxiousness in social situations.

  1. This can then create an unhealthy cycle of substance abuse.
  2. From research within the community and clinical samples, we have learned that not only do individuals with social anxiety drink during social situations to feel more relaxed, they are also more likely to drink before engaging in a planned social activity that they believe will make them anxious.

They believe that they ‘need’ alcohol, in order to participate in social situations. Sarah Book Management of Patients with Alcohol and Co-Occurring Disorders: Problems and Solutions Alcohol is a depressant and therefore has a sedative effect, which is why many people often use the substance to “unwind” or relax.

Does alcohol help with social skills?

Alcohol’s Role as a Social Lubricant – Individuals often turn to alcohol before an evening out with friends. For many, it is perceived to be a social lubricant that improves mood, reduces self-consciousness and enhances social skills. A study published in Psychological Science supports this theory.

Researchers noted that alcohol increased social bonding among strangers randomly assigned to groups of three. The alcohol drinkers were more engaged than those drinking nonalcoholic beverages in discussions. The social drinkers were also more likely to involve everyone in these conversations. Alcohol helps create a comfortable environment for some partygoers.

Alcohol enhances dopamine levels, increasing drinkers’ generosity, empathy and friendliness.

Does alcohol help with shyness?

The Link Between Shyness and Drinking – There is a clear connection between shyness and drinking. Why? The lowered inhibitions that come with drinking can greatly reduce shyness and increase confidence. Of course, this isn’t a healthy solution to a timid personality.

Rather, drinking eventually leads to reckless or belligerent behavior and ultimately addiction. Many shy individuals discover that a couple of drinks greatly reduces the uncomfortableness of timidity. In fact, alcohol is so effective in “treating” shyness, that many become dependent on it from the first drink.

Unfortunately, alcohol is not a sustainable solution for an introverted personality. It only creates more problems. The only solution is overcoming this bashful characteristic to improve the ability to interact with people without alcohol.

Why does alcohol make you less shy?

– There’s some truth to the idea that alcohol can reduce stress. Alcohol is a sedative and a depressant that affects the central nervous system. At first, drinking can reduce fears and take your mind off of your troubles. It can help you feel less shy, give you a boost in mood, and make you feel generally relaxed.

  • In fact, alcohol’s effects can be similar to those of antianxiety medications.
  • Occasionally unwinding with alcohol isn’t necessarily dangerous if your doctor approves.
  • But once you start drinking, you can build a tolerance to the de-stressing effects of alcohol.
  • This can make anxiety and stress even more difficult to cope with.

Drinking excessive amounts of alcohol can also have noticeable physical and mental consequences. Over time, consuming too much alcohol can lead to blackouts, loss of memory, and even brain damage (especially if it causes other health problems, such as liver damage).

  • These issues can create more anxiety as you cope with their symptoms.
  • Learn more: Alcohol-related liver disease » The sense of relaxation you feel when you drink can often be attributed to your blood alcohol content (BAC).
  • A rise in BAC levels leads to temporary feelings of excitement, but feelings of depression occur as BAC levels fall.

As a result, it’s possible that having a few drinks that make your BAC rise and then fall back to normal again can make you more anxious than you were before.

Should I drink if I have social anxiety?

Sarah W. Book, M.D., and Carrie L. Randall, Ph.D. – Sarah W. Book, M.D., is an assistant professor and Carrie L. Randall, Ph.D., is a professor in the Department of Psychiatry at the Center for Drug and Alcohol Programs and Alcohol Research Center, Medical University of South Carolina, Charleston, South Carolina.

Social anxiety disorder—an excessive fear of social situations, such as eating or speaking in public—affects 2 to 13 percent of the U.S. population. About one–fifth of patients with social anxiety disorder also suffer from an alcohol use disorder (AUD) (i.e., alcohol abuse or dependence).

One theory to explain the comorbidity between social anxiety disorder and AUDs is the tension reduction theory, which posits that people with social anxiety use alcohol to alleviate their fears. This expectation that alcohol reduces anxiety may motivate alcohol consumption even if pharmacological studies do not support that assumption.

Social anxiety disorder is treatable with both pharmacotherapy and psychotherapy, and some of those treatments also would be expected to be effective for patients with comorbid AUDs. Evaluation of patients seeking alcoholism treatment for coexisting social anxiety disorder is important for improving treatment outcome.

Key words: comorbidity; anxiety; social phobia; AODU (alcohol and other drug use); alcoholic beverage; tension reduction theory of AODU; diagnostic criteria; prevalence; positive AOD (alcohol and other drug) expectancies; drug therapy; psychotherapy; monoamine oxidase; benzodiazepines; serotonin uptake inhibitors; literature review Many people experience social anxiety—that is, they feel uncomfortable or even anxious in social situations, such as talking with strangers (or even friends) or speaking in front of a group of people.

In the general population, levels of social anxiety exist on a continuum from mild to severe. A clinical diagnosis of social anxiety disorder, also referred to as social phobia, 1 ( 1 These two terms tend to be used interchangeably in the literature.) is assigned only when the social anxiety results in significant fear when faced with the situation, impairment of performance, or avoidance of anxiety–provoking situations.

People with high levels of social anxiety typically report that alcohol helps them feel more comfortable in social situations. Thus, it is not surprising that individuals with clinically diagnosed social anxiety disorder have a higher incidence of alcohol–related problems than does the general population.

This article explores the diagnosis and prevalence of social anxiety disorder and reviews studies evaluating the relationship between alcohol consumption and social anxiety. In addition, the article summarizes treatment approaches for social anxiety disorder alone as well as in combination with alcohol–related problems.

SOCIAL ANXIETY DISORDER According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM–IV) (1994), social anxiety disorder is defined as excessive fear in social situations in which the person believes he or she will do something embarrassing or have anxiety symptoms (e.g., blushing or sweating) that will be humiliating.

The feared situations can vary from interpersonal social interactions in small groups to talking to strangers. Performance fears, such as speaking in public, also are common. People with social anxiety disorder either avoid feared situations or experience them with extreme anxiety.

Most individuals with the disorder have the more severe, “generalized” type, in which the person has other social fears in addition to the common fear of public speaking. The complete criteria set for an official diagnosis of social anxiety disorder is detailed in the textbox. DIAGNOSTIC CRITERIA FOR SOCIAL PHOBIA Social phobia* is diagnosed if the person meets all of the following criteria: A.

A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing.B.

  1. Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed panic attack.C.
  2. The person recognizes that the fear is excessive or unreasonable.D.
  3. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.E.

The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.F.

In individuals under the age of 18, the duration is at least 6 months.G. The fear or avoidance is not the result of the direct physiological effects of a substance or a general medical condition and is not better accounted for by another mental disorder.H. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it.

*Social phobia may be specific to one or a few social situations or generalized to most social situations. SOURCE: Adapted from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association 1994). Typically, social anxiety disorder begins in the teenage years and does not improve without treatment.

The mechanisms or causes underlying the disease are unknown but may involve multiple predisposing factors. These potential factors include genetic background, traumatic early emotional learning experiences, observation and modeling of parental behaviors, and biological irregularities in brain chemical systems.

People with the disorder often report having been shy or behaviorally inhibited as small children and, in severe cases, a child with social anxiety may not want to go to school (Beidel 1998). As young adults, people with social anxiety disorder tend to make life choices based on their fears, such as avoiding classes requiring oral presentations or accepting jobs beneath their ability because they can work alone.

Because these life choices circumvent their underlying social fears, many people with social anxiety disorder may be able to function adequately for extended periods of time. Once the contrived situation changes (e.g., when a promotion is offered), however, the social anxiety fears may resurface. Many people with social anxiety disorder will turn down a promotion rather than encounter the social demands required for the new job.

Thus, for many of these people, life is orchestrated around social fears, even if this results in social isolation or less financial independence and academic achievement. The Prevalence of Social Anxiety Disorder Prevalence estimates of social anxiety disorder vary considerably, both for social anxiety alone and concurrently with alcohol use disorders (AUDs) 2 ( 2 Alcohol use disorders as defined in the DSM–IV include alcohol abuse and alcohol dependence.) (e.g., Kessler et al.1997; Schneier et al.1992; Van Ameringen et al.1991).

This variability results in large part from methodological differences among studies. For example, an analysis of data from the Epidemiologic Catchment Area study, a door–to–door survey conducted in four communities across the United States in the 1970s, found the prevalence of social anxiety disorder to be only 2 percent (Schneier et al.1992).

In this analysis, a diagnosis of social phobia was given to respondents who admitted to extreme anxiety while eating in front of others, speaking to a small group of people they knew, or speaking to a large group of strangers. In contrast, a later community study, the National Comorbidity Survey, found the prevalence of social anxiety disorder to be as high as 13 percent (Kessler et al.1998).

In this study, respondents acknowledging anxiety in a wider range of social situations were considered to have social anxiety disorder. This higher prevalence rate of social anxiety disorder would make it the third most prevalent psychiatric disorder after alcohol dependence and depression. Conservative estimates of the prevalence of co–occurring, or comorbid, social anxiety disorder and AUDs found that approximately 20 percent of patients treated for social anxiety disorder and 15 percent of people receiving alcoholism treatment have both disorders (Randall et al.2001 a ).

Despite a paucity of controlled research in the area, many researchers have written about the high comorbidity between social anxiety disorder and alcohol use problems. One viable hypothesis to explain this high comorbidity is that people with social anxiety use alcohol as self–medication for social fears.

This tension reduction hypothesis is discussed next. THE TENSION REDUCTION HYPOTHESIS Clinical reports indicate that people use alcohol as a means of coping with social fears as well as with stress. One standard theory of why people drink—the tension reduction hypothesis—implies that alcohol acts as a negative reinforcer to reduce stress and anxiety.

A negative reinforcer is something that eliminates an unpleasant experience. In this case, anxiety or stress is the unpleasant experience and alcohol consumption, which reduces these feelings, would be considered the negative reinforcer. Once a person experiences stress relief after consuming alcohol, he or she is likely to continue to use alcohol for its stress–reducing properties.

Whether alcohol actually reduces stress is debatable (see Carrigan and Randall, in press). In fact, some researchers have argued that based on its pharmacological properties, alcohol actually should increase stress and that therefore negative reinforcement using alcohol would be ineffective (Spencer and Hutchison 1999).

Nevertheless, people with social anxiety disorder report that aside from totally avoiding anxiety–inducing situations, alcohol use is one of their primary means of coping. It is possible that positive expectancies—beliefs that alcohol will relieve social anxiety, whether supported in fact or not—play a role in the relationship between social anxiety and alcohol use.

For example, people with social anxiety may drink excessively because they strongly expect alcohol to reduce their anxious feelings in social situations. The role of alcohol expectancies and their relation to alcohol consumption and behavior has been studied extensively in young adults (e.g., Burke and Stephens 1999; Tran et al.1997).

These experiments demonstrated that both positive and negative expectations can be powerful behavioral moderators. Differences in expectancies might in fact explain why not all people with social anxiety drink alcohol to cope with their fears. People with negative expectancies about alcohol’s effects probably do not consume alcohol because it increases their fear of appearing even more foolish.

Positive expectancies that alcohol can relieve social fears may explain why some people experiment with alcohol as a coping strategy in the first place. If a person’s expectancy that alcohol reduces stress is left unchallenged (i.e., if the person is not shown by a clinician or researcher that alcohol consumption does not actually reduce stress either behaviorally or physiologically), it may be a powerful enough belief system to explain why a person continues to use alcohol to relieve stress.

Alternatively, one can argue that for a subgroup of socially anxious people alcohol may have a genuine pharmacological effect that results in decreased social anxiety. These individuals may have started drinking as a coping mechanism because of their positive expectancies, but they may continue to use alcohol because they associate alcohol consumption with symptom relief.

Unfortunately, few experimental studies have investigated expectancies about alcohol’s ability to reduce social fears, determined how expectancies translate into actual alcohol consumption, or demonstrated that alcohol reduces social fears in a laboratory setting (see Carrigan and Randall, in press).

Much of what is known about the association between social anxiety and alcohol consumption comes from research with college students who did not have clinical diagnoses of social anxiety disorder, rather than from research with patients diagnosed as having the disorder.

In one study examining the effects of alcohol expectancies on drinking, Tran and colleagues (1997) divided a sample of college students into two groups according to their anxiety level (i.e., high or low) and assessed their expectancies about alcohol’s ability to relieve social anxiety as well as their alcohol consumption.

The study found that among those respondents who believed that alcohol would definitely reduce social fears, the level of social anxiety did not affect the level of alcohol consumption. Thus, although the investigators had expected the high–anxiety group to consume more alcohol than the low–anxiety group when alcohol was being used to cope with social fears, no such difference existed, at least in these non–treatment–seeking college students.

  1. This lack of a difference might, however, be, in part, the result of the social context of college student drinking.
  2. That is, for both groups baseline drinking levels would be expected to be relatively high, to be defined by drinking binges, and to occur in the context of peer pressure and social situations.

Another way to examine the relationship between alcohol expectancies and alcohol consumption is to ask whether people with high expectations of reduced social anxiety actually experience less anxiety when they are drinking. In a sample of 72 female college–age social drinkers, women who expected positive results from alcohol did, in fact, report less anxiety after drinking alcohol than did women with negative or neutral beliefs (de Boer et al.1994).

One can assume that the greater reduction in anxiety after alcohol consumption would result in more drinking in the group with the positive alcohol expectancies. However, the study did not examine drinking behavior, nor did it compare results for women with high or low levels of social anxiety. Another study assessed drinking in a sample of male college students with high social anxiety and failed to find evidence of increased alcohol consumption compared with students with lower levels of anxiety (Holroyd 1978).

In fact, severity of social anxiety was a negative predictor of alcohol quantity consumed—that is, participants with higher levels of anxiety consumed less alcohol than did those with lower levels of anxiety. Unfortunately, however, this study did not examine alcohol expectancies and only sampled males.

  1. Taken together, the results from these last two studies suggest that the interaction of gender and alcohol expectancies may be an important factor in determining who will report that alcohol benefits them and who might drink alcohol to cope with their anxiety.
  2. Whether alcohol reduces social anxiety in a controlled laboratory environment is still open to debate.

Several studies have addressed this issue in college students (see Carrigan and Randall, in press), and one study was conducted in a clinical sample of clients with a formal diagnosis of social anxiety disorder (Himle et al.1999). This latter study did not find that alcohol had any effect in reducing social fears.

  1. The conclusions from this study are limited, however, because the investigators excluded patients with a diagnosis of alcohol abuse or dependence and did not evaluate alcohol expectancies.
  2. Thus, researchers do not yet know whether alcohol reduces social anxiety in people who believe it is effective or in people who consume it to the point that they meet the criteria for an AUD.

The specific alcohol effects observed may also depend on how anxiety is measured (e.g., by behavioral or psychophysiological measures or by self–report). Regardless of whether researchers can demonstrate in the laboratory that alcohol reduces social fears, many people with social anxiety report that they expect alcohol to have that effect and that they use it to cope with their social anxiety.

  • Because of their alcohol consumption, some of these individuals will eventually develop alcohol use problems in addition to their preexisting social anxiety disorder.
  • For other people, alcohol use as a coping mechanism could still lead to alcohol–related risks, such as automobile crashes, interpersonal conflicts, or medical risks, even if they do not meet the criteria for an AUD.
See also:  Does Alcohol Give You Energy?

Treatment of social anxiety therefore is warranted to prevent the development of alcohol–related problems and AUDs. TREATMENT OF SOCIAL ANXIETY DISORDER As with most anxiety disorders, social anxiety disorder responds well to pharmacologic treatment and psychotherapy.

The aim of both types of interventions is to reduce social fears so that the feared situations are no longer avoided or that they are associated with minimal discomfort. The following sections review various therapeutic interventions. Pharmacotherapy Several different classes of medication have been shown to be effective in the treatment of social anxiety disorder.

The primary drug classes include the monoamine oxidase inhibitors (MAOIs), benzodiazepines, and more recently, selective serotonin reuptake inhibitors (SSRIs) (Blanco et al.2002). MAOIs. These medications block monoamine oxidase, an enzyme that breaks down monoamines.

Monoamines are one of the major classes of signal–transmitting chemicals (i.e., neurotransmitters) in the brain and are thought to play a role in mood and anxiety disorders. MAOIs have been shown to be efficacious in the treatment of anxiety disorders in several well–designed studies (Blanco et al.2002).

However, these medications require a special diet that restricts the ingestion of the amino acid tyramine (which is contained in cheese, red wine, some imported beers, and yogurt) to avoid a potentially deadly episode of high blood pressure (i.e., a hypertensive crisis).

  • Because of this potentially serious side effect, most physicians no longer prescribe these medications.
  • Benzodiazepines.
  • These sedative medications are also effective in the treatment of social anxiety disorder.
  • For example, alprazolam and clonazepam are both well tolerated and have shown promise in the treatment of social anxiety (Blanco et al.2002).

However, as discussed more fully below, their use in patients with comorbid social anxiety and alcohol problems may not be advisable. SSRIs. These agents, which affect a brain signaling system using the brain chemical serotonin, are perhaps the best tolerated and most carefully studied pharmacologic treatment for social anxiety disorder.

  • Although several of these medications have shown some efficacy, paroxetine (Paxil ) is the only medication currently on the market that has been approved by the U.S.
  • Food and Drug Administration for the treatment of social anxiety disorder.
  • At least three clinical trials have shown this agent to be significantly more effective than an inactive substance (i.e., a placebo) in reducing social anxiety and alleviating the problems associated with social anxiety disorder (Baldwin 2000).

Based on these results, SSRIs have been proposed as the first line of treatment for social anxiety disorder (Blanco et al.2002). Psychotherapy Psychological treatment of people with social anxiety disorder has used various approaches that focus on role playing, coping skills training, exposure to feared situations, and changing the patients’ erroneous negative beliefs about how people perceive them (Heimberg 2002).

  1. Because social anxiety disorder involves excessive fear of humiliation and criticism, cognitive behavioral therapies (CBT) have proved to be successful for this disorder and, like medications, to be more effective than control conditions (Heimberg et al.1998).
  2. CBT approaches are based on the assumption that human behavior is largely learned and that learning processes therefore can be used to change problem behaviors.

CBT is not one uniform type of therapy but can be classified into four different categories (Heimberg 2001):

Exposure therapy is a technique in which patients are given skills to alleviate anxiety and then are encouraged to expose themselves to an anxiety–provoking situation in an attempt to extinguish the anxiety. Exposure to anxiety–inducing situations is considered an essential component of therapy because many patients, if left on their own, would avoid such situations altogether, thereby restricting their lifestyle. Cognitive restructuring is a model in which clients are taught to identify thoughts that provoke anxiety and to think in a less biased, anxiety–provoking way. Challenging erroneous beliefs with video feedback or feedback from group members is an important component of cognitive therapy. Relaxation training is a method of decreasing anxiety by controlling the amount of physical tension experienced in a stressful situation. Relaxation training alone, however, is not usually as successful as cognitive restructuring or exposure therapy. Social skills training teaches patients how to improve their behavioral skills in social interactions. However, not all people with social anxiety disorder have deficits in social skills. Therefore, social skills training alone would not benefit all clients with the disorder.

Most CBT for social anxiety disorder involves a combination of these different approaches. Regardless of which specific CBT measures are evaluated, it is important to recognize that nonpharmacological treatments for social anxiety disorder are effective (Taylor 1996) and generally work as well as medication.

  • In addition, some findings indicate that despite a slower onset of improvement compared with pharmacotherapy, the beneficial effect of psychotherapy may be more enduring (Heimberg 2002).
  • TREATMENT OF COMORBID SOCIAL ANXIETY DISORDER AND AUDS The previous discussion indicates that social anxiety disorder is treatable, at least in people without comorbid alcohol problems.

Unfortunately, all of the above–mentioned clinical trials evaluating social anxiety therapies have excluded participants who met the diagnostic criteria for an AUD. Consequently, it is unknown if similar approaches are efficacious in clients with comorbid AUDs and social anxiety disorder.

Pharmacotherapy Some treatments are contraindicated for people with AUDs for safety reasons. For example, as mentioned previously, patients taking MAOIs must avoid foods containing the amino acid tyramine, which include certain alcoholic beverages. Therefore, MAOIs could be particularly dangerous for patients with AUDs.

Benzodiazepines also should not be used in clients with AUDs for several reasons. First, benzodiazepines can cause behavioral disinhibition, which may make it more difficult for a person to limit their alcohol consumption to an intended amount. Second, benzodiazepines and alcohol affect some of the same brain areas, including a region responsible for maintaining breathing activity.

Therefore, people who mix alcohol and benzodiazepines may inadvertently shut down that brain area, with potentially deadly consequences. Finally, people who abuse or are dependent on alcohol are also at risk for abusing or becoming dependent on benzodiazepines. Only a few studies have evaluated treatment of people with comorbid social anxiety disorder and AUDs, but based on research in individuals with social anxiety disorder alone, some treatments would be expected to be efficacious.

Of the pharmacological treatments, SSRIs may be most appropriate for clients with both types of disorders. These medications are safe, are not addictive, and do not interact with alcohol in the brain. In addition, accumulating evidence suggests that SSRIs also have some efficacy in improving outcome in treatment–seeking alcoholics with a late onset of alcoholism (i.e., after age 25) (Pettinati et al.2000), which includes most socially anxious alcoholics.

  1. Randall and colleagues (2001 b ) recently completed the only study to date that examines the use of SSRIs by clients with comorbid social anxiety disorder and alcoholism.
  2. The study was an 8–week, placebo–controlled pilot clinical trial comparing the efficacy of paroxetine to placebo.
  3. Results indicated that paroxetine not only reduced social anxiety to a significant degree but also tended to decrease the frequency and severity of alcohol use.

A larger trial to replicate and extend these findings is currently under way. Psychotherapy Whether CBT is beneficial in patients with comorbid social anxiety disorder and AUDs is not clear.3 ( 3 CBT also is frequently used in the treatment of AUDs, although the specific treatment approaches used and their target behaviors differ from those used for clients with social anxiety disorder.) A recent randomized, controlled clinical trial failed to demonstrate any benefit when the patients received simultaneous CBT for each condition (Randall et al.2001 a ).

  • In fact, treatment outcome was slightly better in the group that only received CBT for their alcohol problems than in the group that received CBT treatment for both conditions.
  • These results highlight several important factors that must be addressed when treating individuals suffering from more than one psychiatric disorder.

For example, which condition should be treated first? Should the treatments be integrated or separated? Should different treatment approaches be used (e.g., pharmacotherapy for one disorder and psychotherapy for another)? It is likely that the answers to these questions depend at least in part on the problem for which a given patient seeks treatment.

For example, for teenagers and young adults, who generally use alcohol only as a coping strategy, treatment primarily of the social anxiety disorder is desirable to prevent the development of further AUDs. Once an AUD has developed, treatment of the social anxiety is likely to be more difficult because each disorder will have a life of its own.

Treatment–seeking alcoholics are rarely assessed for the presence of social anxiety. Alcoholics with comorbid social anxiety disorder, however, are unlikely to benefit as much from traditional alcoholism treatment if their anxiety disorder is not treated.

  1. For example, such clients will probably resist or avoid participation in group therapy or self–help meetings, such as Alcoholics Anonymous.
  2. This resistance may be especially common in women with social anxiety (Thevos et al.2000).
  3. Thus, in order to improve treatment outcomes it is important to determine whether comorbid social anxiety disorder is present among people seeking alcoholism treatment (Randall et al.2000).

It is equally important to inquire about alcohol consumption in people seeking treatment for social anxiety problems in order to improve the outcome of treatment for social anxiety as well as to prevent or identify alcohol–related problems. SUMMARY The discussion presented in this article clearly indicates that the data associating drinking with relief of social anxiety are complex and inconclusive.

Studies in college students with a certain level of social anxiety did not support the assumption that drinking alcohol can indeed relieve social anxiety; however, these students did not have a formal diagnosis of social anxiety disorder. The only study involving individuals meeting the diagnostic criteria for social anxiety disorder excluded clients who met the criteria for an AUD—a group who possibly would be expected to experience relief of social anxiety symptoms after alcohol consumption.

Regardless of whether some people experience actual benefits from alcohol consumption, the belief that alcohol may reduce social anxiety motivates many socially anxious people to use alcohol as a primary coping strategy. This is especially true for individuals who are still engaging in social interactions and are not yet avoiding them completely.

  1. As described above, social anxiety disorder is treatable.
  2. If it is left untreated, however, repeated use of alcohol to self–medicate may result in the development of a secondary AUD, so that the individual suffers from two comorbid disorders requiring treatment.
  3. The onset of social anxiety disorder nearly always precedes the onset of an AUD, often by more than 10 years (Randall et al.2001 a ).

Because of this delay, this particular comorbidity is a primary target for intervention in order to prevent the development of an AUD. ACKNOWLEDGMENTS The authors wish to thank the anonymous reviewers for their constructive comments on the article and Ms.

  • Nancy White for her technical and administrative assistance.
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Why does alcohol calm my anxiety?

Hangxiety Explained – Hangxiety has become a buzzword that describes the uneasy feeling that often accompanies heavy alcohol use, but what does it really mean? We asked Dr. Bulat to explain what hangxiety is and how to manage it best. Q: What is hangxiety? A: Drinking alcohol dumps a flood of dopamine into the pleasure center of the brain.

The feel-good chemical swirls through your head, but the rush only lasts for a short while. When dopamine levels dip back down, feelings of anxiety rebound. Researchers think that may be one reason why people who experience hangxiety, especially those who are extremely shy, may have a higher risk of developing alcohol use disorder (AUD).

Q: How does alcohol boost anxiety levels? A: Heavy drinking produces physiological changes in the brain. When you’re drinking, there’s an influx of the GABA (gamma aminobutyric acid), which causes you to feel relaxed and calm. When you stop drinking, you have withdrawal symptoms.

Your body gets used to that crutch to feel calm. Take it away and anxiety often follows. Add interrupted sleep to the mix, which often happens when people drink to excess, and feelings of depression and anxiety can get even worse. Q: Who is most likely to develop hangxiety? A: People who suffer from depression and anxiety are more likely to experience anxious feelings after drinking.

Though alcohol can suppress anxious feelings while a person is imbibing, the rebound effect can be far worse than their baseline level of anxiety. Unfortunately, those uncomfortable emotions can drive people straight back to the culprit: alcohol. Q: How does alcohol compare to medications used to treat anxiety? A: Like alcohol, medications such as benzodiazepines that are used to treat anxiety target GABA in the brain.

  • In fact, some people with depression and anxiety turn to alcohol to self-medicate.
  • Unfortunately, self-medicating with alcohol or other substances increases the risk of developing substance abuse disorders, which can lead to negative effects on your heart, liver and other vital organs.
  • Q: How do you know if your hangxiety indicates an alcohol use disorder, or AUD? A: If you’re using alcohol to soothe anxiety, that’s a red flag.

It becomes a vicious cycle: You drink, you get anxious, then you drink more to relieve that anxiety. That’s how the trouble starts — and continues. Over time, you become dependent on the alcohol to function in your daily life. If alcohol becomes a coping mechanism, or you realize your body is getting used to the effects — not just anxiety, but also shakes, sweats and interrupted sleep — the risk of negative consequences skyrockets.

  1. Q: How do doctors treat hangxiety? A: If you’re drinking to manage feelings of anxiety — or if you regularly experience hangxiety after a night of drinking — talk to your primary care provider.
  2. There are a number of effective treatments available, not just for depression and anxiety, but also for AUD.

Your doctor may suggest a variety of therapies ranging from cognitive behavioral therapy and psychotherapy to prescription medication for AUD or anxiety.

Can social anxiety be cured?

Stick with it – Don’t give up if treatment doesn’t work quickly. You can continue to make strides in psychotherapy over several weeks or months. Learning new skills to help manage your anxiety takes time. And finding the right medication for your situation can take some trial and error.

Why am I more social when drunk?

Drinking alcohol is associated with aggressive behaviour, accidents and ill health. Yet many of us choose to drink socially. This may reflect alcohol’s actions on specific brain circuits which make us feel euphoric and less anxious. Alcohol may also make us more empathic and cause us to see other people as more attractive,

  • But why do these reactions occur and are the positive effects of alcohol expressed towards everybody we interact with? Alcohol is a drug, one of the three most commonly used in the world, along with nicotine and caffeine.
  • When we drink, the alcohol binds to a specific type of receptor in the brain and boosts the activity of a natural brain chemical called GABA.

The effect the alcohol has on us depends in large part on the dose, and the location of these GABA receptors within the brain. Early on in a drinking session, the alcohol acts on GABA systems to boost the levels of dopamine, the brain’s reward chemical.

This gives a sense of well-being and a sense of mild euphoria. Alcohol also acts on GABA receptors to impair the activity of the brain circuits that make us feel anxious and, at higher doses, alcohol inactivates a second set of brain circuits that control fear. So threatening stimuli no longer seem quite so scary.

Alcohol also compromises our ability to compute risk so that situations we would normally shy away from may now seem quite inviting. Does Alcohol Help With Social Anxiety Are you drunk? Gift by Shutterstock All of this points to alcohol as a facilitator of social interactions. As well as making us more empathic, laboratory studies have also shown that drinking alcohol can make us trust others more and make us temporarily more generous.

  1. On the other hand, heavy drinking is associated with violent behaviour.
  2. This situation, however, is complex.
  3. Laboratory studies have shown that alcohol increases aggression.
  4. For example, it increases the willingness with which individuals will administer electric shocks to others,
  5. However, this effect seems to be largely restricted to those who are intrinsically aggressive in the first instance.

Don’t try this at home. Equally, alcohol can corrupt our ability to understand the intentions of others. The brain contains specific circuits, which connect parts of the prefrontal cortex, amygdala and temporal parietal junction, that handle our social cognitive abilities.

  1. So our ability to understand somebody else’s mental perspective and their motivations for acting in a certain way become unreliable.
  2. Very big doses of alcohol can leave the functioning of these circuits so compromised that individuals can appear to be as impaired as patients with some forms of dementia,

This is quite a disturbing thought given the number of people who end up in this state in city centres at the end of a good night out. Does Alcohol Help With Social Anxiety She’s definitely pleased to see me.J.K. Califf, CC BY-SA Alcohol also impedes our ability to accurately interpret emotional expressions in faces. As we drink, we have a tendency to erroneously assume that some facial expressions of negative emotions are happy, and we find it particularly difficult to identify sad and angry faces.

This leaves us prone to making embarrassing social errors. One important, but often overlooked, aspect of alcohol’s effect on social functioning relates to how we perceive members of our in and out-groups. Alcohol appears to encourage us to bond to members of our in-groups, However, this may come at the cost of the way we treat people outside of these groups.

Similarly, alcohol makes members of our ethnic in-group appear more attractive but this effect does not extend to members of other ethnic groups. It must be emphasised that the effects described so far are potentially reversible once the drinker has sobered up.

However, chronic heavy drinking can lead to brain damage and irreversible cognitive impairments, especially poor memory function, and psychiatric problems including depression, psychoses, anxiety and suicide. So overall, alcohol may be a friend, and indeed make us friendlier, but only to a select group of people – and they may not always reciprocate.

Alcohol Friend or Foe? is part of the Pint of Science festival where academic experts talk about the latest in scientific research – at the pub.

Why does alcohol help introverts?

That’s not to say that introverts don’t become lonely sometimes, and desire interaction. During such times, alcohol offers effects such as the lowering of social inhibitions, and numbing of harsh outside stimuli. All of this can make it more enticing, as a way to make reaching out to others easier.

Do introverts drink more alcohol?

Personality Types and Addiction: Who is at Greater Risk? – Ultimately, while evidence suggests that introverts and extroverts have different drinking patterns, it’s hard to say if one group actually drinks more than the other. And, particularly when it comes to addiction, there really isn’t enough evidence to suggest one personality type has a higher likelihood of alcoholism.

Not only do both introverts and extroverts have their own unique risks, many people fall on a spectrum between the two extremes. In fact, experts warn against placing too much stock in the idea of an “addictive personality” in general.5 Traits like introversion and extroversion likely represent only a small fraction of the risk for developing an addiction.

And, in general, personality traits are hard to separate from other influencing factors. Still, it’s worthwhile to know how your personality might influence your drinking behavior. If you’re extroverted, be aware of how much you drink socially, and try to avoid binging.

And if you’re introverted, be conscious of why you are drinking. Look for other healthy coping mechanisms if it seems to be a risk. In conclusion, anyone can develop an addiction to alcohol. Our personalities may influence why. But no matter who you are, it’s important to stay aware of how much you drink.

If you’re concerned you’re drinking too much, consider taking our alcohol assessment to find out where you stand. Have questions about online alcohol treatment?

What happens when shy people drink?

Drinking alcohol puts shy people at risk of suffering ‘hangxiety’ the next day. People who dread social situations often drink alcohol to ease their anxiety, but they may ultimately feel worse, study finds.

Are introverts more sensitive to alcohol?

If you consider yourself an introvert (same!), you know that our needs differ from our extroverted counterparts, For instance, we need lots of alone time to recharge our batteries, especially after socializing. And some introverts may opt for a quiet, cozy night at home over going out any day of the week.

  • It turns out that it’s entirely possible introverts are more sensitive to stimulants like caffeine, music, and alcohol.
  • Here’s one explanation for this: In general, “introverts tend to be intuitive, and deeply aware of their own thoughts, as well as sensitive to their external environment,” says Gregory Scott Brown, MD, a board-certified psychiatrist, mental health writer, and author of The Self-Healing Mind, adding that this is especially true when introverts are surrounded by people.
See also:  Does Soy Sauce Have Alcohol?

“That means any external stimulus, whether it’s a comment, look, action by someone else, or gesture is something the introvert is likely to notice.” Although introverts are commonly perceived as shy or anti-social, Dr. Brown says that isn’t always the case.

From a scientific perspective, the difference between extroverts and introverts is arousal, also called cortical activation levels. Extroverts have low arousal levels, so to reach optimal arousal, they require more stimulation, hence why they become naturally energized by social interactions. On the other hand, introverts have a high cortical activation level, so they tend to avoid stimulation.

With that in mind, below, Dr. Brown and Carla Marie Manly, PhD, a clinical psychologist, and author of Joy from Fear and Date Smart, explain why it’s possible introverts are more sensitive to stimulants, in particular, caffeine, music, and alcohol. Related Stories

Why am I confident when drunk?

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One reason many people drink is to boost their confidence. Alcohol is often used to remove inhibitions and make you feel more self-assured, brave and confident in yourself. You may drink at parties to feel more relaxed or down a beer before talking to someone you’re attracted to.

  • Yet does alcohol truly increase your confidence? The simple answer is no.
  • It’s true that alcohol directly affects the brain, but not in positive ways.
  • While drinking may make you feel a little more confident, it’s just a mask that you can hide behind.
  • Self-acceptance without alcohol is the real way to find the strength to be yourself.

Alcohol courage, or liquid courage, is a term that originated in the 17th century. Soldiers heading to the front lines to face cannons and gunfire were given a good dose of gin, which was thought to boost their confidence. Today, people use alcohol courage for other purposes.

Drinking gives them the confidence to do things they are otherwise too scared to do — flirting, fighting, singing karaoke at a bar. Alcohol causes our brain to release a flood of dopamine. This chemical is associated with pleasure and can make you feel confident and powerful. Alcohol also directly impacts the part of the brain associated with good judgment.

This reduces your inhibitions and fears, making you more likely to make an impulsive decision without thinking things through.

Does alcohol make socializing easier?

Myth 2: Alcohol makes it easier for people to socialise. Truth: Alcohol in small quantities can make people feel more relaxed and sociable. However, alcohol is a ‘downer’. Drinking too much alcohol can make people want to withdraw from others.

What can worsen social anxiety?

Prevention – There’s no way to predict what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you’re anxious:

Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait. Keep a journal. Keeping track of your personal life can help you and your mental health professional identify what’s causing you stress and what seems to help you feel better. Set priorities in your life. You can reduce anxiety by carefully managing your time and energy. Make sure that you spend time doing things you enjoy. Avoid unhealthy substance use. Alcohol and drug use and even caffeine or nicotine use can cause or worsen anxiety. If you’re addicted to any of these substances, quitting can make you anxious. If you can’t quit on your own, see your health care provider or find a treatment program or support group to help you.

What should I avoid if I have social anxiety?

– Another go-to for people who experience social anxiety is to avoid engaging in social situations by checking social media or doing other activities on their smartphones. Share on Pinterest Hiding behind your smartphone to avoid social interaction could do more harm than good.

I used to wallow in and just sort of stand there and pretend to play on my phone,” someone else told us. A study from 2016 looked at data on 367 young adult participants who were smartphone users. It found “significant positive correlations” between excessive smartphone use and the presence of social anxiety.

A 2017 study found that of 182 young adult smartphone users, those who admitted to being addicted to technology also displayed potential markers of social anxiety, including isolation and low self-esteem. “Our smartphones have turned into a tool that provides short, quick, immediate satisfaction, which is very triggering,” warns one of the study authors, Isaac Vaghefi, who is an assistant professor of management information systems at Binghamton University-State University of New York.

Moreover, hiding behind a smartphone will only avoid addressing the problem of social anxiety. Although it may seem counterintuitive and even scary at first, it is far better to face social anxiety face-on, through gradual exposure to increasingly complex social situations. One key therapeutic approach in the treatment of social anxiety calls for intentional exposure to social mishaps,

According to researchers, “the goal of the social mishap exposures is to purposely violate the perceived social norms and standards to break the self-reinforcing cycle of fearful anticipation and subsequent use of avoidance strategies.” “As a result, are forced to reevaluate the perceived threat of a social situation after experiencing that social mishaps do not lead to the feared long lasting, irreversible, and negative consequences.” Put simply, purposely and repeatedly being awkward in social situations to learn that even a few social slips will not lead to rejection or exclusions from social groups.

After all, everybody is awkward and makes blunders on occasion. Someone described her experience of social mishap therapy for social anxiety in this way to MNT : “or a while, when I was doing therapy, my therapist at the time suggested I just ‘experiment’ with social failure and awkwardness. This made me place myself in uncomfortable situations in which, if something I said or did came out wrong, I would only ‘win’ at the end of the day because I’d just carried out an experiment that nobody else knew about.

That gave me back some control over situations that I felt were out of my control.” “But overall, what helped the most was the acknowledgment of the fact that most people go through, and we’re all in the same boat,” she added.

Can I be happy with social anxiety?

Abstract – Quality contact with other people serves as a reliable mood enhancement strategy. We wondered if the emotional benefits of socializing are present even for those with a psychological disorder defined by social distress and avoidance: social anxiety disorder (SAD).

We conducted two ecological momentary assessment (EMA) studies and analyzed 7243 total surveys. In both studies, community adults diagnosed with SAD and healthy controls received five surveys each day for 2 weeks. Consistent with research on positivity deficits in SAD, between-person analyses in both studies suggest that, on average, participants with SAD reported lower positive and higher negative affect in social and non-social situations than healthy controls.

Within-person analyses, however, revealed that in both studies participants with SAD and healthy controls reported higher positive affect when with others than when alone; no differences were found for negative affect for those with SAD. The difference in positive affect between social and nonsocial situations was smaller for participants with SAD in Study 1, suggesting that people with SAD may experience diminished reward responding when socializing.

Is drinking a coping mechanism for anxiety?

Handling Stress – Alcohol is an Unhealthy Coping Mechanism The COVID19 pandemic can take an emotional toll on us as well as a physical toll. Stress, anxiety, frustration, and even fear are normal feelings to be experiencing during this uncertain time. Ways to handle stress

Take a break from the news and social media. Get outside! Just a few minutes of fresh air a day can make a difference! Do things you enjoy like reading, playing games, or watching funny movies and shows. Care for your body. Exercise, meditate, stretch, take deep breaths. Stick to your sleep schedule and try to eat healthy.

Reach out to others. Talk to friends and families about your concerns, and be there for others when they need someone to talk to also.

Alcohol is an Unhealthy Coping Mechanism While there is nothing wrong with an adult enjoying an occasional glass of wine or mixed drink at home (as long as you are cleared to do so by a doctor), drinking too much can cause significant health problems including a weakened immune system. You might think that alcohol helps you cope with stress, but it is not a good coping mechanism, as it is known to increase the symptoms of panic and anxiety disorders, depression and other mental disorders, and the risk of family and domestic violence. Moderate drinking = 1 drink per day for adult women, 2 drinks per day for adult men Binge = consuming within about 2 hours: 4 or more for women, 5 or more for men Heavy alcohol use = 3 or more drinks any day for women, 4 or more drinks per day for men Even with moderate drinking, one should take caution that alcohol is not being used to cope with stress, anxiety, or boredom.

Binge drinking and heavy alcohol use are problematic. If you find yourself or a loved one drinking this much, seek help. If you or a friend is struggling and need additional support and resources, call our local addiction helpline at 330-678-3006 crisis helpline at 330-678-HELP Source: World Health Organization & Prevention Action Alliance : Handling Stress – Alcohol is an Unhealthy Coping Mechanism

What can worsen social anxiety?

Prevention – There’s no way to predict what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you’re anxious:

Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait. Keep a journal. Keeping track of your personal life can help you and your mental health professional identify what’s causing you stress and what seems to help you feel better. Set priorities in your life. You can reduce anxiety by carefully managing your time and energy. Make sure that you spend time doing things you enjoy. Avoid unhealthy substance use. Alcohol and drug use and even caffeine or nicotine use can cause or worsen anxiety. If you’re addicted to any of these substances, quitting can make you anxious. If you can’t quit on your own, see your health care provider or find a treatment program or support group to help you.

Why am I more social when drunk?

Drinking alcohol is associated with aggressive behaviour, accidents and ill health. Yet many of us choose to drink socially. This may reflect alcohol’s actions on specific brain circuits which make us feel euphoric and less anxious. Alcohol may also make us more empathic and cause us to see other people as more attractive,

But why do these reactions occur and are the positive effects of alcohol expressed towards everybody we interact with? Alcohol is a drug, one of the three most commonly used in the world, along with nicotine and caffeine. When we drink, the alcohol binds to a specific type of receptor in the brain and boosts the activity of a natural brain chemical called GABA.

The effect the alcohol has on us depends in large part on the dose, and the location of these GABA receptors within the brain. Early on in a drinking session, the alcohol acts on GABA systems to boost the levels of dopamine, the brain’s reward chemical.

This gives a sense of well-being and a sense of mild euphoria. Alcohol also acts on GABA receptors to impair the activity of the brain circuits that make us feel anxious and, at higher doses, alcohol inactivates a second set of brain circuits that control fear. So threatening stimuli no longer seem quite so scary.

Alcohol also compromises our ability to compute risk so that situations we would normally shy away from may now seem quite inviting. Does Alcohol Help With Social Anxiety Are you drunk? Gift by Shutterstock All of this points to alcohol as a facilitator of social interactions. As well as making us more empathic, laboratory studies have also shown that drinking alcohol can make us trust others more and make us temporarily more generous.

  • On the other hand, heavy drinking is associated with violent behaviour.
  • This situation, however, is complex.
  • Laboratory studies have shown that alcohol increases aggression.
  • For example, it increases the willingness with which individuals will administer electric shocks to others,
  • However, this effect seems to be largely restricted to those who are intrinsically aggressive in the first instance.

Don’t try this at home. Equally, alcohol can corrupt our ability to understand the intentions of others. The brain contains specific circuits, which connect parts of the prefrontal cortex, amygdala and temporal parietal junction, that handle our social cognitive abilities.

  • So our ability to understand somebody else’s mental perspective and their motivations for acting in a certain way become unreliable.
  • Very big doses of alcohol can leave the functioning of these circuits so compromised that individuals can appear to be as impaired as patients with some forms of dementia,

This is quite a disturbing thought given the number of people who end up in this state in city centres at the end of a good night out. Does Alcohol Help With Social Anxiety She’s definitely pleased to see me.J.K. Califf, CC BY-SA Alcohol also impedes our ability to accurately interpret emotional expressions in faces. As we drink, we have a tendency to erroneously assume that some facial expressions of negative emotions are happy, and we find it particularly difficult to identify sad and angry faces.

This leaves us prone to making embarrassing social errors. One important, but often overlooked, aspect of alcohol’s effect on social functioning relates to how we perceive members of our in and out-groups. Alcohol appears to encourage us to bond to members of our in-groups, However, this may come at the cost of the way we treat people outside of these groups.

Similarly, alcohol makes members of our ethnic in-group appear more attractive but this effect does not extend to members of other ethnic groups. It must be emphasised that the effects described so far are potentially reversible once the drinker has sobered up.

However, chronic heavy drinking can lead to brain damage and irreversible cognitive impairments, especially poor memory function, and psychiatric problems including depression, psychoses, anxiety and suicide. So overall, alcohol may be a friend, and indeed make us friendlier, but only to a select group of people – and they may not always reciprocate.

Alcohol Friend or Foe? is part of the Pint of Science festival where academic experts talk about the latest in scientific research – at the pub.

How can social anxiety get worse?

We all know the feeling of being nervous or uncomfortable in a social situation. Maybe you’ve clammed up when meeting someone new or gotten sweaty palms before making a big presentation. Public speaking or walking into a roomful of strangers isn’t exactly thrilling for everybody, but most people can get through it.

If you have social anxiety disorder, which is also known as social phobia, the stress of these situations is too much to handle. You might, for example, avoid all social contact because things that other people consider “normal” – like making small talk and eye contact – make you so uncomfortable. All aspects of your life, not just the social, could start to fall apart.

Social anxiety disorder affects about 5.3 million people in the United States. The average age it begins is between age 11 and 19 – the teenage years. It’s one of the most common mental disorders, so if you have it, there’s hope. The tough part is being able to ask for help.

Here’s how to know if your social silence has gone beyond shyness to a point where you need to see a doctor. In some people with social anxiety disorder, the fear is limited to one or two particular situations, like speaking in public or initiating a conversation. Others are very anxious and afraid of any social situation.

Anyone with social anxiety disorder can experience it in different ways. But here are some common situations that people tend to have trouble with:

Talking to strangersSpeaking in public Dating Making eye contactEntering roomsUsing public restroomsGoing to partiesEating in front of other peopleGoing to school or workStarting conversations

Some of these situations might not cause a problem for you. For example, giving a speech may be easy, but going to a party might be a nightmare. Or you could be great at one-on-one conversations but not at stepping into a crowded classroom. All socially anxious people have different reasons for dreading certain situations. But in general, it’s an overwhelming fear of:

Being judged or watched by others in social situationsBeing embarrassed or humiliated – and showing it by blushing, sweating, or shakingAccidentally offending someoneBeing the center of attention

Again, the experience may be different for everyone, but if you have social anxiety and you’re in a stressful situation, you may feel:

Very self-conscious in social situationsA persistent, intense, and chronic fear of being judged by othersShy and uncomfortable when being watched (giving a presentation, talking in a group)Hesitant to talk to othersThe need to avoid eye contact

You also might have physical symptoms such as:

Rapid heartbeatMuscle tension Dizziness and lightheadedness BlushingCryingSweatingStomach trouble and diarrhea Inability to catch breathAn “out-of-body” sensation

You may start having symptoms and getting anxious immediately before an event, or you might spend weeks worrying about it. Afterward, you could spend a lot of time and mental energy worrying about how you acted. There’s no one thing that causes social anxiety disorder.

Genetics likely has something to do with it: If you have a family member with social phobia, you’re more at risk of having it, too. It could also be linked to having an overactive amygdala – the part of the brain that controls your fear response. Social anxiety disorder usually comes on around 13 years of age.

It can be linked to a history of abuse, bullying, or teasing. Shy kids are also more likely to become socially anxious adults, as are children with overbearing or controlling parents. If you develop a health condition that draws attention to your appearance or voice, that could trigger social anxiety, too.

Low self-esteemNegative thoughts Depression Sensitivity to criticismPoor social skills that don’t improve

If your social anxiety keeps you from doing things you want or need to do, or from making or keeping friends, you may need treatment. Talk about your fears and worries with a doctor or therapist who has experience treating social anxiety disorder. They will be able to tell if you have normal social anxiety or if you need treatment.

Prescription medication and behavioral therapy are the two effective treatments for social anxiety disorder. You may receive both at the same time. Here are some details on each: Medications : For some, taking a prescription medication can be an easy and effective treatment for social anxiety disorder.

The drugs work by reducing the uncomfortable and often embarrassing symptoms. Sometimes medication can dramatically reduce your symptoms or even eliminate them. Some people may not react to a particular medication, and some aren’t helped at all. There is no way to predict whether a medication will help you or not.

Sometimes, you must try several before finding one that works. The Food and Drug Administration (FDA) has approved four medicines for social anxiety disorder: Paxil, Zoloft, Luvox, and Effexor, Although these are the only medications approved specifically for the condition, other medications may be used successfully, too.

The advantage of medications is that they can be very effective, and are taken just once a day. But there are some downsides. First, medication only treats symptoms. If you stop taking it, your symptoms can return. Second, some people have side effects from anxiety medications,

  • They may include headache, stomachache, nausea, and sleep difficulties.
  • Also, the FDA-approved medicines for social anxiety disorder, like all medicines that are also used to treat depression, carry a warning from the FDA.
  • The FDA says the medications may cause or worsen suicidal thoughts or behaviors in young people under age 24.

Therefore, teens who take these medicines should be monitored closely for changes in thoughts about suicide, For many people, the advantages of medications outweigh the disadvantages. You and your doctor must weigh the choice. If you take medication for social anxiety disorder, call your doctor immediately if you develop any side effects, including feeling down and depressed.

And never stop taking any anxiety medication without talking to your doctor first. Suddenly stopping an anxiety medication may cause serious side effects. Behavioral therapy: Behavioral therapy with a trained therapist can help you identify and change the thinking that makes you anxious in social situations.

A type of behavioral therapy called exposure therapy is frequently used for social anxiety disorder. Exposure therapy works by gradually exposing you to social situations that are uncomfortable and waiting until you feel comfortable. During this process, your brain is learning that a social situation you were afraid of is actually not so bad.

  1. Most therapists who practice exposure therapy begin with small exposures to uncomfortable situations, then move on to more difficult exposures once you feel comfortable.
  2. The advantage of this therapy is that you are treating the underlying problem, not just the symptoms of social anxiety disorder.
  3. So if you stop behavioral therapy, the chance of your symptoms returning is less likely.

Other therapies Other therapies have also been tried for treating social anxiety disorder. They include: Relaxation therapy: With this therapeutic approach, you learn techniques for relaxing like breathing exercises and meditation. Although relaxation therapy may help with some specific social phobias, it is not considered effective treatment for general anxiety disorder.

  1. Beta-blockers: These medications were originally used to treat high blood pressure or other heart problems.
  2. Yet beta-blockers are also effective for treating some people with a specific type of social phobia called “performance social anxiety.” This is when you are afraid of performing, like giving a public speech.

Beta-blockers are not effective for treating general social anxiety disorder. But they may help if fear of a specific circumstance, occurring at a specific, predictable time – like giving a speech to a class – is your problem. First, it’s important to know that you are not abnormal if you have social anxiety.

How does alcohol affect you socially?

Social consequences – What people think about us affects how we feel about ourselves. A humiliating drinking incident such as vomiting or passing out can result in ridicule, social ostracism and other forms of bullying. Hangovers can lead to time off work, poor work performance and workplace accidents, all of which could put your job at risk.

  1. Drinking too much can also affect personal relationships.
  2. Usually the people close to someone who regularly drinks too much are adversely affected.
  3. Teenagers of parents with alcohol problems tend to drink more frequently, more heavily, and more often alone than other teenagers.
  4. These teenagers tend to drink to cope or to forget their problems, in addition to the usual social motives for drinking, which are shared by most adolescent drinkers.

Other social consequences of drinking too much can include:

financial problems due to excessive spending on alcohol limited career opportunities due to a conviction for an alcohol-related offence impacts on work performance losing friends because of the way you act when you’re drunk a limited group of friends, due to constantly socialising with other people who drink to excess reduced sexual performance.

: Health, safety, legal and social consequences of drinking too much

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