Is Social Anxiety a Risk Factor for Drugs Use?

No, Not Just Shyness

Going on a date or giving a presentation may cause that feeling of butterflies in your stomach. This is normal. But in Social Anxiety Disorder (formerly called social phobia), fear and anxiety lead to avoidance that can disrupt your life.

• Everyday interactions cause significant anxiety, self-consciousness and embarrassment because you fear being scrutinized or judged negatively by others.
• Severe stress can affect your relationships, daily routines, work, school, or other activities.
• People with SAD sometimes experience intense worry, fear, or dread about a social situation days or weeks in advance.
• Social anxiety disorder usually starts when a person is young, often emerging in adolescence or early adulthood.
• Contributing risk factors include genetics, brain chemistry, or trauma.
• Some healthcare professions also attribute the development of SAD to parenting styles, stating that overprotective parenting styles may keep children from learning necessary social skills.

Emotional and behavioral symptoms include:

• Fear of situations in which you may be judged negatively
• Worry about embarrassing or humiliating yourself
• Fear that others will notice that you look anxious
• Avoidance of doing things or speaking to people out of fear of embarrassment
• Avoidance of situations where you might be the center of attention
• Intense fear or anxiety during social situations
• Analysis of your performance and identification of flaws in your interactions after a social situation

Physical signs and symptoms may include:

Blushing, tachycardia, trembling, sweating, upset stomach or nausea, trouble catching your breath, dizziness or lightheadedness, feeling that your mind has gone blank, and muscle tension.

The Root of Addiction

According to the  Anxiety and Depression Association of America (ADAA), approximately 15 million American adults suffer from Social Anxiety Disorder (SAD).

The diagnosis is usually based on:

• Physical exam (a medical condition or medication may trigger symptoms of anxiety)
• Discussion of the symptoms, their frequencies, and moments of exacerbation
• Self-report questionnaires about symptoms
• DSM-5 criteria

Treatment depends on the severity of social anxiety disorder and its effect in daily life. The most common treatment for social anxiety disorder includes:

• Psychotherapy (Cognitive Behavioral Therapy and Support Groups): learning how to recognize and change negative thoughts about yourself, and develop skills to help you gain confidence in social situations.
• Medications: usually, you start with a low dose of medication and gradually increase your prescription to a full dose.
  • Selective serotonin reuptake inhibitors: Paroxetine, Sertraline§  Serotonin and norepinephrine reuptake inhibitor: Venlafaxin
  • Benzodiazepines can be addictive and sedating, usually prescribed for only short-term use.

For people suffering from SAD, drinking alcohol and taking drugs can rapidly become a necessity to get through social situations.

In some cases, addiction can develop first and eventually lead to anxiety. Anxiety is a side effect of many controlled substances, including cocaine, marijuana, methamphetamine, and fentanyl. All these drugs have a high potential for abuse and may result in severe physical or psychological dependence.

Around 20 % of sufferers of SAD also suffer from either alcohol dependence or abuse, according to the ADAA.

If you have a dual diagnosis of coexisting SAD and substance-use, it’s imperative to seek professional assistance to:

• Detox from alcohol or drugs
• Treat your SAD and substance addiction