Anxiety

Brain Facts

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Social anxiety Medication

Social anxiety medication is useful for many, but not all, people with social anxiety disorder. For social anxiety, research indicates use of the anti-anxiety agents, and (perhaps) certain antidepressants in conjunction with CBT have proven most beneficial. Medication without the use of active, structured cognitive-behavioral therapy has no long-term benefits. Only CBT can change the neural pathway associations in the brain permanently. The therapy used must "fit" the way the human brain is structured.

Current research indicates many antidepressant medications for social anxiety disorder to be useless, even in the short-term. About 15% of our in-person socially-anxious people are helped by antidepressants. Some of the large-scale medication studies for social anxiety have been questioned and found to be skewed in favor of the drugs marketed by the same pharmaceutical companies who paid for these studies to be done in the first place. These kind of studies are conflicts-of-interest, and their conclusions should be thoroughly questioned.

In addition, each person is different, and there is no general rule that works concerning social anxiety and medications. For a typical person with social anxiety, who has an "average" amount of anxiety, along the quantifiable continuum, we have found an anti-anxiety agent to be most effective, if the person has no history of substance abuse. Antidepressants do not work anywhere near as well, in general. A typical superstititon, promoted by the drug companies, is that antidepressants have anti-anxiety properties. This is not true. If anything, many of the antidepressants make a person MORE anxious. However, not all people want or need medication. One of the big changes in the last decade is the gradual non-use of medications by people coming into active therapy for social anxiety. The majority of people in our groups now choose not to use medications and to concentrate solely on CBT.

Nevertheless, it is the combination of cognitive and behavioral therapy that changes the brain and allows you to overcome social anxiety. Medications can only temporarily change brain chemistry and can be useful in some cases. This is very general advice, and you must consult with your psychiatrist when it comes to medications. Try to find someone who understands that anti-anxiety agents are not addictive to people with diagnosable anxiety disorders. In twenty years, we have never had even one patient who has moved up their dosage of an anti-anxiety agent once an adequate baseline is established as being effective. Social anxiety people can be helped by a low dose of an anti-anxiety agents (there is a reason why we prefer a low dose of either lorazepam or clonazepam for this purpose).

THIS ADVICE (above) only applies to people who have a diagnosable (DSM-5: 300.23) case of social anxiety disorder. You cannot generalize this out to other mental health care conditions.

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