What Causes Social Phobia? Understanding and Addressing the Source of Your Fear

Like many mental health issues, the exact causes of social phobia are not clearly defined. Everything from inherited genetics and overactivity in the amygdala (the brain structure that regulates fear) to learned behaviors have been hypothesized to contribute to social phobia in some way. Although social phobia shares many similarities to social anxiety disorder, including the physical symptoms that mirror those experienced during panic attacks (dizziness, sweating, blushing, et cetera.), it is distinct in that it primarily stems from the fears and insecurities that arise during a public performance. This can be anything from signing your name at the grocery store to using public restrooms.

The two challenges aren’t mutually exclusive, either. In fact, they overlap in many ways, and it’s possible to suffer from both social phobia and social anxiety disorder. Regardless, the most important similarity between the two lies in the way that both can successfully be treated—within a residential treatment setting that provides a calm, accepting environment to create new thought processes and behaviors. These ultimately pave the way for a new path where fear does not dictate the course of your life.

Comprehensive psychological testing is the first thing you will experience in a treatment center, and it sets the stage for the rest of your recovery. It will help your team create a personalized recovery plan that adapts and grows as you do, but first and foremost it will help medical professionals determine if medication is necessary and, if so, which are most suitable for you.

Common medications for social phobia include:

• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Beta-blockers
• Benzodiazepines

SSRIs are commonly used for their effectiveness in reducing stress, although some people respond just as well to supplements of 5-HTP—serotonin’s precursor. Then you have the beta-blockers, which block adrenaline and can stop the terrifying physical symptoms of social phobia that stem from heightened arousal, and benzodiazepines that act by completely eliminating both physical and mental symptoms at the expensive of a heightened risk of dependence and subsequent withdrawal symptoms.

Which is the right one? There is no medication that falls into such a category, and the variation in their effectiveness depends on your unique requirements. All of the medications above can be extremely helpful for some, while for others they may be ineffective or even detrimental to the healing process, depending on the situation. This is why a complete psychological evaluation and accurate diagnosis, along with a medical team and program that can adapt and evolve with your needs as they change over time, is crucial for your recovery.

The emotional and behavior patterns that make it feel impossible to simply try new things or change the way you look at yourself are best changed through therapy. Medication is still a great way to augment these therapies, but learning and growing through treatment modalities like Cognitive Behavioral Therapy (CBT) is believed to be more effective than medications and create lasting effects. It’s these kinds of learning experiences that are necessary to break free from the patterns of thought and behavior your phobia drives and create new ones.

Other forms of therapy that are effective include:

• Psychodynamic therapy, which shines a light on the effects of your interpersonal relationships, life experiences, and the way that your mind processes them. The end goal is harnessing these connections to influence your emotional and behavioral patterns for the better.
• Group therapies help you break down your barriers and connect with other people that have the same fears and struggles as you do. Through this bonding, you can reduce the sense of isolation that so often drives social phobia. Within these therapeutic social circles, you can benefit from an environment defined by acceptance, growth, and positivity.
• Somatic experiencing therapy focuses on restoring balance to your autonomic nervous system, which is responsible for bodily functions that aren’t consciously directed (also driving forces for physical symptoms of social anxiety and phobia) including sweating, increased heart rate, and dizziness. Medications like beta-blockers can curb these symptoms and provide a stepping stone into somatic therapy, where you learn to promote emotional, physical, and behavioral self-regulation and, potentially, eliminate the need for medications altogether.