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Most people with social anxiety disorder or social phobia recognize they have excessive or unreasonable fear, yet often avoid those feared situations instead of seeking out help. In the U.S., up to 13% of the population will experience social anxiety during their lifetime. When finding themselves in a feared situation, those with social anxiety typically experience intense anxiety.

Social Anxiety Disorder

Experiencing social phobia or social anxiety is tied to the intense fear of being humiliated in social situations in front of other people. For those with social anxiety disorder they often feel that others will judge them as anxious, weak, stupid, inarticulate, that they may “mess up,” or that others may notice their trembling hands or voice. Anxiety can occur during simple social situations such as eating out where needing to speak publicly is not a requirement.

Symptoms of Social Anxiety Disorder

Some of the symptoms experienced include:

• Heart palpitations
• Dry mouth
• Tremors
• Sweating
• Gastrointestinal discomfort
• Diarrhea
• Muscle tension or trembling
• Shaky voice
• Blushing
• Confusion
• Panic attack in severe cases

Experiencing these symptoms often cause added concern and anxiety over the worry that they will bring unwanted and embarrassing attention.

Types of Social Anxiety Disorder

Social phobia or anxiety can be expressed in several different ways and may occur in a variety of situations; however, those with this disorder will either avoid social or performance situations or find themselves enduring them with intense anxiety or stress. Some of the types of social anxiety include:

• Anticipatory anxiety – fear and anxiety regarding an upcoming event or social situation which can become a vicious cycle leading to feelings of being embarrassed or giving a poor performance which affect future situations
• Generalized social phobia – fear and anxiety is experienced in almost any social interaction
• Non-generalized social anxiety – one or two situations bring anxiety and fear
• Social anxiety disorder – a significant and persistent fear of humiliation or embarrassment in social or performance situations; recognition of their excessive or unreasonable fears; avoidance of feared social and performance events or tolerating only with intense anxiety or distress; the fear, anxiety, and distress experienced interfere with one’s normal routine or relationships; the fear and anxiety reported are not due to medication, a medical condition, substance abuse, or another mental health disorder.

Treatment for Social Anxiety Disorder

Most people with a diagnosed social anxiety disorder need professional treatment to find relief. Treatment which may include Cognitive Behavioral Therapy, specific psychiatric medications, and use of other adjunct services are highly effective in the treatment of social phobia or anxiety.

Social Anxiety Disorder Psychiatrist

Stop the suffering, fear, and avoidance of social situations in your life. Treatment is very effective and successful and can stop your social anxiety from limiting your ability to function and enjoy daily living. Call Dr. Hege for a confidential appointment – take steps to get rid of the control anxiety has on your life.

There are many different mental health disorders and conditions that can be diagnosed and successfully treated by qualified mental health professionals. It may be found during a comprehensive evaluation that a person may have a primary disorder or illness with other psychiatric disorders present that require treatment as well.

Qualified Mental Health Evaluation Critical

Diagnosis of multiple mental illness in a person is not uncommon. In addition some mental illness disorders have components of others in them. Some examples: someone with PTSD who also presents with a depression component or a person who may be diagnosed with depression but who also has suicidal tendencies. Working with an experienced psychiatrist provides you with the skills needed to determine your individual issues and needs.

Common Mental Illness Diagnoses

The more common types of mental illness or mental disorders follow.

• Anxiety Disorders: An anxiety disorder is typically diagnosed when a person’s response is not appropriate to the event or situation — if a person cannot control the response, or if the anxiety is interfering with normal daily life. Anxiety disorders usually come with feelings of fear and dread, physical signs of panic such as sweating and rapid heartbeat. Anxiety disorders do include panic disorder, obsessive-compulsive disorder, social anxiety disorder, generalized anxiety disorder and other specific phobias.

• Mood Disorders: These disorders involve chronic long lasting feelings of sadness, periods of feeling overly happy, or feelings that fluctuate from extreme happiness to extreme sadness. This category includes the most common mood disorders of bipolar disorder, depression and cyclothymic disorder (low and high mood swings not as severe as those seen in bipolar disorder). 

• Impulse Control and Addiction Disorders: With a diagnosis or diagnoses of this type of mental illness comes the inability to resist urges or impulses as well as performing acts that may to harmful to themselves or others. Some examples of impulse control and addiction disorders are compulsive gambling, alcohol and drug addiction, pyromania or kleptomania. It is not uncommon for the person to become so involved with their addiction that they start to ignore their work, home and social responsibilities and relationships.

• Personality Disorders: Those people with personality disorders generally have extreme and inflexible personality traits that cause distress and problems not only to the person with this mental health illness, but also cause disruption at work, school or in social relationships. With personality disorders the pattern of thinking and behavior are often so rigid that they interfere with normal daily living skills. Some examples of this disorder are antisocial personality disorder, obsessive compulsive disorder, and paranoid personality disorder.

• Post-Traumatic Stress Disorder (PTSD): This mental illness usually develops after a traumatic or terrifying event. People who are diagnosed with PTSD typically have lasting and frightening thoughts and memories of the event and often find themselves emotionally numb.

Expert Mental Illness Help Available

If you see yourself in one or more of the multiple descriptions above and are having difficulty with daily life functioning it may be time to take a proactive step; call for an appointment with a qualified mental health psychiatrist for evaluation.

To a certain degree, most people experience a mild bit of panic during every day life. For example, if you have to give a speech, you may be anxious about not embarrassing yourself or not forgetting the speech material. If you are starting a new job, you may be anxious about making a good impression and may worry about learning new procedures. If you are going out on a first date, you may worry about how you look or if you’ll like the person you are dating. But, many people routinely suffer from panic or anxiety that keeps them from living a “normal” life. If you are one of the more than 6 million Americans who frequently experience an overwhelming degree of anxiety, you may need help for your anxiety and panic attacks.

The first thing to do after experiencing a panic attack is to go through a medical evaluation so physical conditions can be ruled out as the cause of the panic attack. Thyroid disorders, anemia, pheochromocytoma, heart problems, fluctuating hormones caused by pregnancy or menopause, too much nicotine or caffeine, and certain medications can cause symptoms similar to panic attacks. The physical symptoms of a panic attack include a sense of impending doom combined with a pounding and rapid heart beat, sweating, shakiness or dizziness, a feeling of shortness of breath or hyperventilating, and sometimes either chills or flushing. The sense of panic during an attack is increased by the knowledge that these same symptoms can be signs of more serious conditions, such as a heart attack, which raises the person’s level of anxiety.Although scientists aren’t sure what causes true panic attacks, they suspect that they may be caused by chemical imbalances in the brain. Also panic attacks can be an inherited condition. Many times there is no physical reason for an attack, but it is best to get medical help to rule out physical causes first when taking steps to get help for anxiety and panic attacks.

If you routinely experience several of these symptoms, you may be living with an anxiety disorder:

• Do you feel like every day experiences make you anxious (driving, social interactions, etc)?
• Does your anxiety interfere with your work, school, or family responsibilities?
• Do you experience fears that you know are irrational, but can’t shake?
• Do you believe that something bad will happen if certain things aren’t done a certain way?
• Do you experience sudden, unexpected attacks of heart-pounding panic?
• Do you feel like danger and catastrophe are around every corner?

So, how can you get help for anxiety and panic attacks? Sometimes you can get relief through natural methods and sometimes you need to seek help through counseling and medication. If the natural route is what you would like to try first, you should think about learning and practicing tai chi, yoga, or meditation to help you relax and reduce stress. Healthy eating habits and an exercise program can also help to reduce the stress of the day. Deep breathing exercises practiced during stressful times of the day (the commute, after a talk with the boss, etc) can help calm and center your mind.

If these techniques are not enough to provide  help for your panic attacks and anxiety, counseling and medication are an important next step. Find a therapist who has experience in dealing withpanic attacks and can provide help for your anxiety. Treatment such as cognitive behavior therapy can alleviate or eliminate panic attacks for many people. Cognitive behavioral therapy helps you change the way you “see” things and helps you alter behaviors that contribute to panic attacks or keeps them going. It helps you see your fears more realistically. Exposure therapy can also help you with panic attacks and anxiety. This type of therapy mimics the sensations you feel when you have a panic attack. For example, you might hold your breath or be asked to hyperventilate with a counselor present and while in a safe environment. In this way, you can learn how to cope with the feelings you experience so that you have more control over the sensations and your reaction to them.

Anti-anxiety medications can also help for anxiety and panic attacks. Dr. Darvin Hege provides help for panic attacks in the Atlanta area. Dr. Hege most commonly prescribes Xanax XR, Klonopin, Zoloft, Prozac, Celexa, Lexapro, Paxil, Effexor, or Cymbalta. For more information from Dr. Hege about panic attacks and the most effective medications for anxiety and panic attacks, go to the Panic Attacks Information page on his website.

Dr. Hege has 25 years of experience dealing with patients who need help for anxiety and panic attacks. Call him today at 770-458-0007 for an evaluation for relief of your panic, and for help deciding the most effective and safest treatment for your anxiety attacks.

Panic attacks and pregnancy simultaneously create risks for the fetus. Stress and anxiety in the mother increase adrenaline and cortisol that can reduce oxygen to the fetus and contribute to risks during labor and delivery. The peak age of onset is in the 20s and more women than men get panic attacks. Therefore, the incidence of panic attacks and pregnancy together is elevated. The prevalence of panic attacks and pregnancy is about 1 to 2%.

In a retrospective study of first onset of panic attacks in childbearing age women, 10 times as many women reported their first panic attack occurred in the first trimester of a pregnancy. Other retrospective studies suggested that breast-feeding reduced the risk of panic disorder during the postnatal period and weaning increased the risk. If a woman has had panic attacks before pregnancy, studies have suggested that they may have worsening of the panic attacks during pregnancy and/or the postnatal period if the panic disorder was severe.

Medical causes of panic attacks need to be ruled out. These include thyroid disorders, anemia, preeclampsia, and pheochromocytoma. Comorbid psychiatric conditions frequently underlie panic disorder. These include mild bipolar disorder, depression, ADHD, other anxiety disorders such as PTSD, generalized anxiety disorder, or alcohol or drug abuse or withdrawal.

Panic attacks and pregnancy present challenges for treatment. Self-care strategies include elimination of caffeine, reduction of sleep deprivation, and relaxation techniques. Non-medication therapy with cognitive behavioral therapy with a professional therapist may be effective.

Medication treatment for panic attacks and pregnancy are often very helpful, but risk and benefit analysis include the following: as mentioned in the beginning there are medical, physical development, labor and delivery, postpartum, and later physical and mental developmental risks for the baby when the mother is having uncontrolled panic attacks during pregnancy, postpartum, and early childhood stages.
Now I will address some of the concerns of taking medication during panic attacks and pregnancy. Medications that help panic attacks the quickest are benzodiazepines. Benzodiazepines include Xanax, Klonopin, Ativan, Valium, Librium, Tranxene, and Serax. There was at least one study suggesting an increased risk of cleft palate if Valium is used during pregnancy. That suggestion was about a 1% risk. SSRIs retrospective studies have not suggested any congenital malformations except possibly in Paxil. Hence, the other SSRIs are first choice. These include Prozac, Zoloft, Celexa, and Lexapro. The drawback of the SSRIs are that they require one to two weeks of administration before getting any benefit and one to two months before getting full benefit against panic attacks. Withdrawal or discontinuation symptoms of any of these medicines in the baby after delivery are additional concerns.

Dr. Hege has 25 years of experience dealing with patients who have panic attacks and pregnancy simultaneously. Call today at 770 458-0007 for an evaluation for relief of your panic during the planning or managing of a pregnancy or postpartum, and for help deciding the most effective and safest treatment.