People who struggle with social phobia sometimes resort to substance use in an attempt to cope with their symptoms. Fortunately, treatment for social anxiety is available.
Social anxiety disorder (SAD) is challenging to manage, particularly when it is severe. Often, people who struggle with this condition become isolated as a result of their difficulties. Also known as social phobia, SAD can impact a person’s ability to work, attend school or go into public places, such as the grocery store. SAD goes beyond the fleeting fears of disapproval or nervousness that most people experience. Rather, it can get in the way of living a satisfying life and even cause someone to use drugs or alcohol in an attempt to self-medicate.
An estimated 15 million people in the U.S. struggle with social anxiety disorder. In a study of 43,000 individuals, 17.7% of those with a substance use disorder also met the criteria for an anxiety disorder. Among people who had an existing anxiety disorder, 15% also had a co-occurring substance use issue.
Because social phobia and substance use disorders often overlap and exacerbate one another, it is important to explore ways to treat both conditions simultaneously.
The Connection Between SAD and Drug Addiction
SAD can stem from genetic influences and may also be caused by underdeveloped social skills or excessive stressors in a person’s environment. People with social anxiety often have thoughts that others may be judging them or staring at them, and these thoughts can create feelings of anxiety and increase social avoidance. In an effort to reduce uncomfortable anxiety symptoms and tend to necessary tasks, people with social phobia sometimes resort to substance use.
Using drugs or alcohol as a coping strategy for SAD often results in worsened SAD symptoms. As dependence on drugs and alcohol increases, anxiety levels increase as well, resulting in a cycle that continuously reinforces itself. Withdrawal symptoms can mimic anxiety symptoms, which can also worsen substance use.
Treatment of Co-Occurring SAD and Substance Use
When someone struggles with social anxiety and addiction, both of their conditions should be treated simultaneously. If only one of the disorders is treated, it can worsen the other and make recovery more challenging.
Effective treatment options for co-occurring conditions are offered in professional rehab facilities like The Recovery Village Cherry Hill at Cooper in New Jersey. If you’re looking elsewhere, consider programs that offer comprehensive services that include psychotherapy, pharmacotherapy, family work and group therapy.
There are many effective therapeutic approaches for social anxiety disorder, including cognitive-behavioral therapy (CBT). CBT is an evidence-based treatment that includes several subcategories, such as:
Acceptance and commitment therapy
All of these CBT treatment options help people identify triggers, address underlying thoughts and feelings and find ways to challenge unhelpful beliefs that may be exacerbating their condition. Behavioral changes help reinforce cognitive and emotional work while helping people practice how to live in a different way and experience success. CBT methods are effective for social anxiety and substance use disorders, particularly when treated together as co-occurring conditions.
Co-occurring treatment that includes medication management offers an additional layer of protection for people in recovery. Medications can treat the physical aspects of substance dependence and social anxiety so people in treatment can focus on recovery. In addition to managing medications, medical experts at comprehensive treatment facilities also monitor and treat symptoms that may arise.
People with social anxiety and substance use disorders may also benefit from additional types of treatment, including family or group therapy. As part of the assessment and planning process, each client can work with their team and determine a treatment approach that best addresses their needs.
What Is Social Anxiety Disorder (Social Phobia)?
Social anxiety disorder is a condition in which a person has difficulty being around others or in social settings. When people with social phobia are faced with these situations, they may have an extreme anxiety response that includes emotional and physical reactions.
Social anxiety disorder can be generalized or non-generalized. Some people struggle only in certain settings, such as public places with a lot of people or while interacting with strangers. Others may have difficulty interacting one-on-one with people, even family members or friends. Social phobia is believed to be caused by genetic factors as well as environmental and personal experiences.
People with social anxiety experience intense emotional distress when confronted with the task of interacting with others. The stress of interacting with others can cause panic symptoms, feelings of dread and avoidance behaviors.
Social anxiety is often easy to detect, as it causes intense symptoms when a person needs to interact with others or go into certain social situations. Social phobia differs from other types of anxiety since it is specifically related to interactions with others or being in public places.
While there is no exact known cause for social anxiety disorder, it is likely caused by genetic factors, life experiences or elements of one’s environment. Often, people who have first-degree relatives with anxiety disorders are more prone to having anxiety.
Yes, social anxiety can be treated effectively with therapy and medication management.
There are many medications used to help people who struggle with social anxiety. It is important to consult a medical professional to determine the best course of action and discuss whether medication would be helpful in your situation.
Some anxiety treatment medications are addictive or habit-forming, so it is helpful to explore non-addictive options with your medication manager.
Social Anxiety Symptoms
The symptoms of social anxiety can vary from person to person, but they are often overwhelming. Common symptoms include:
- Racing heartbeat
- Feeling nauseous
- Feeling self-conscious
- Thoughts that others are judging or staring at you
- Shortness of breath
- Fear of or avoiding social interactions
- Experiencing the loss of thoughts or feeling “blank”
When these symptoms arise, it can feel difficult to communicate with others and express one’s thoughts and feelings. The urge to escape can be overwhelming for people with SAD, especially when symptoms are activated.
Effects of Substance Use on Social Anxiety Symptoms
Certain substances can worsen symptoms of social phobia. In some rare cases, substances can even cause social anxiety to emerge. Consider:
- Alcohol use can increase anxiety and symptoms like irritability and depression. These symptoms can emerge within a few hours or begin the next day in some cases.
- Marijuana can exacerbate anxiety symptoms, particularly when used excessively. High doses of marijuana can bring on anxiety reactions, even in long-term users.
- Stimulant misuse depletes dopamine stores in the brain, which can lead to increased social phobia symptoms or cause them to develop.
- Inhalant abuse is commonly associated with anxiety disorders and can increase or cause symptoms.
Helping Someone With SAD and Drug Addiction
Social anxiety disorder and substance use disorder are common co-occurring conditions. When both conditions are present, it is often the result of self-medicating for anxiety and becoming addicted.
If you or someone you love is struggling with social anxiety disorder and co-occurring addiction, help is available at The Recovery Village Cherry Hill at Cooper. Our accredited rehab facility offers comprehensive dual diagnosis treatment in a supportive, enriching environment that helps you take the critical first steps of recovery. Contact us today to learn more about treatment programs that can work well for your needs.
Mental Health America. “Social Anxiety Disorder.” Accessed November 18, 2021.
Brady, Kathleen T.; et al. “Substance Use Disorders and Anxiety: A T[…]e for Social Workers.” Social Work in Public Health, 2013. Accessed November 18, 2021.
National Institute of Mental Health. “Social Anxiety Disorder: More Than Just Shyness.” Accessed November 18, 2021.
Perelmen School of Medicine. “Social Anxiety Disorder.” Accessed November 19, 2021.
Buckner, Julia D.; Schmidt, Norman B.. “Social anxiety disorder and marijuana us[…] effect expectancies.” Depression and Anxiety, 2009. Accessed November 19, 2021.
Anxiety and Depression Association of America. “Social Anxiety Disorder and Alcohol Abuse.” Accessed November 19, 2021.
Wu, Li-Tzy; Howard, Matthew Owen . “Psychiatric disorders in inhalant users:[…]d Related Conditions.” Drug and Alcohol Dependence, 2007. Accessed November 19, 2021.
Williams, K., et al. “Amphetamine Misuse and Social Phobia.” American Journal of Psychiatry, 2000. Accessed November 19, 2021.
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.