The doctor will assess the patient's conditions and recommend medications or psychotherapy, or both.
1. Medications
To cure social phobia, the most frequently used medication is selective serotonin reuptake inhibitors (SSRI), and serotonin and norepinephrine reuptake inhibitors (SNRI). Both can help serotonin and norepinephrine to resume balance, thus improving the symptoms and curing social phobia with less side effects.
i) Selective serotonin reuptake inhibitors (SSRI)
The commonly used SSRI are Paroxetine, Sertraline, Fluvoxamine, etc. These may cause short-term nausea, insomnia, fatigue, etc. but when the medical effects begin, the side effects will gradually lessen or disappear.
ii) Serotonin and norepinephrine reuptake inhibitors (SNRI)
One example is Venlafaxine. Its effects are quicker than those of SSRI. At the early use of medications, side effects such as dizziness, headache, nausea, insomnia, etc. may occur, but they will lessen or disappear after the patient has adapted to it.
iii) Benzodiazepine
This type of anti-anxiety medication may reduce the patient’s level of anxiety in a short time, but it is habit-forming with significant long-term side effects. It is, therefore, prescribed only for short-term use.
iv) Beta blockers
These medications help the patients in a particular situation such as giving a speech through reducing heart pounding, blood pressure, shaky voice and trembling limbs. These medications, however, would not help treat social phobia.
2. Psychotherapy
Cognitive behavioural therapy is the commonly employed method of psychotherapy so far. The clinical psychologist will first develop a mutual trust with the patient. Through interview, analysis and various skills deployed, the clinical psychologist helps the patient correct certain mistakes in thinking, thus enabling one to change his/her escaping behaviour and to reduce his/her level of anxiety. During the therapy, the patient follows the schedule agreed upon between him/her and the clinical psychologist. The patient is taught to practice how to gradually face the situations he/she is afraid of and to improve his/her managing skills, thus enabling him/her to recover the confidence in dealing with these situations.
The clinical psychologist will also advise the patient on some social interaction skills and relaxation management, in the hope of improving his/her performance in social situations, thereby strengthening his/her confidence.