- Anxiety And Shaking
- Temporary and Problematic Shaking
- Why the Body Shakes During Anxiety
- When Your Shaking is a Problem
- Effects of Anxiety Disorders
- Other Factors That Affect Shaking
- How to Stop Shaking
- Strategies to Reduce Anxiety
- Anxiety shaking: Causes and management
- What is Social Anxiety Disorder? Symptoms, Treatment, Prevalence, Medications, Insight, Prognosis
- Triggering Symptoms
- University Health Service
- Symptoms of anxiety disorders:
- Types of Anxiety Disorders:
- What is a panic attack?
- Tips for helping someone with an anxiety disorder:
- When should I get help?
- For more information:
- A cure for social anxiety disorders
Anxiety And Shaking
Shaking is one of the most common symptoms of anxiety, and one of the clearest ways to tell that you're nervous. There are confident public speakers – men and women used to being in front of an audience – whose hands will shake violently during their presentations because it is a part of anxiety and nervousness that is very hard to control.
It is also a common issue in anxiety disorders. This article will explore the causes and solutions to anxious shaking.
Temporary and Problematic Shaking
Once in a while, you're going to find yourself nervous—you may be on a first date, you may have an important test, or you may be giving a speech or a presentation. It is only natural to feel nervous in these times, and unfortunately, there is little that you can do to control the shaking.
But there are many people that shake all the time, at random times of day, even when nothing is there to trigger it. There are people who shake at work, at home, and every time they have a panic attack. This may be a sign of an anxiety disorder.
Why the Body Shakes During Anxiety
Shaking is a result of an activated fight or flight system – an evolutionary tool that's meant to keep you safe in times of danger. During intense anxiety, your body is flooded with a hormone called epinephrine (adrenaline). That hormone activates your nerves and muscles, giving them the energy they need to fight, flee, or react.
When Your Shaking is a Problem
Without anxiety, you wouldn't have any idea what you should be afraid of, and if you were faced with danger you'd have a much harder time running away or protecting yourself.
That's why during regular events, taking the SATs, getting in a fight, or asking someone to marry you, you naturally get nervous. You're faced with a situation that is scary, exciting, or dangerous to you, and so it is natural to feel anxious. You need that to make good decisions and stay safe.
The problem is not the anxiety itself, and it's not the shaking. As much as it would be nice not to shake, it is a natural and healthy response. The problem is when you cannot control your anxiety even when you are not facing those kinds of situations. When that occurs, you may have an anxiety disorder.
Effects of Anxiety Disorders
An anxiety disorder occurs when you experience anxiety without any of these types of triggering situations. Those with an anxiety disorder might find themselves shaking without being confronted with a dangerous situation. For example:
- Generalized Anxiety Disorder Shaking may occur all the time or because of nervous thoughts.
- Panic Disorder Shaking may occur before, during, and after a panic attack.
- Post-Traumatic Stress Disorder Shaking may occur in response to hearing loud noises.
Other Factors That Affect Shaking
It's possible you're shaking for other reasons. Diabetes and Parkinson's disease are both linked to shaking and tremors. Dehydration and hypoglycemia are two very common causes of shaking.
How to Stop Shaking
You simply need to wait for it to pass and try to control your anxiety in the process. In the meantime, there are a few simple things you can try:
- Jogging or running Using your muscles by jogging or running may help releive some of your stress and pent-up energy.
- Deep Breaths Breathing slow can be helpful for shaking as well. Deep, full, slow breaths can be calming to anxiety and may reduce hyperventilation.
Some people have trained themselves to shake less. Drinking water and eating healthier may help too. Some people shake worse when their body needs more nutrients or hydration.
Strategies to Reduce Anxiety
If you find yourself shaking often, you need to get help. There are many avenues that you can choose to control your anxiety.
- Lifestyle modification Eating healthier, exercising, spending time with more positive people, and finding more time to yourself to relax is very important for controlling anxiety. Even if you decide to go with other treatments, a complete lifestyle change can make dealing with anxiety easier.
- Cognitive Behavioral Therapy (CBT) CBT is the most effective therapy currently available for controlling anxiety disorders. It deals specifically with how to recover from some of the faulty thought processes that lead to anxiety and is a great tool for controlling daily.
- Medications Ideally you should avoid medications since they don't treat anxiety directly. But they are useful for short term control if therapy and lifestyle changes aren't enough. There are also natural medicines kava that may be beneficial.
The best way to find an effective treatment, however, is to base it off of your anxiety symptoms. Your symptoms are what define your anxiety, and ultimately give you the tools you need to stop it.
Anxiety shaking: Causes and management
Anxiety is a general feeling of worry, fear, or nervousness. Certain situations can cause anxiety, such as financial worries, the illness or death of a loved one, or work-related stress.
For some people, anxiety can become overwhelming and affect normal daily activities. When this occurs, a person may have an anxiety disorder. Anxiety is a common occurrence, with about 40 million adults in the United States experiencing some form of anxiety disorder.
Anxiety disorders can cause a variety of symptoms, including sweating, a racing pulse, and rapid breathing. In some cases, a person may find themselves shaking due to their anxiety. This shaking is the body’s response to a perceived threat.
Keep reading to find out more information about anxiety-related shaking, including the possible causes and how to manage them.
Share on PinterestReceiving treatment for the underlying anxiety will help a person manage anxiety shaking.
Anxiety disorders occur when the body’s fight-or-flight response becomes triggered too easily. The fight-or-flight response is a biological reaction to real or perceived danger. The response helps prepare the body either to fight the threat or to run from it.
When it occurs, a person can experience:
- an increased heart rate
- rapid breathing
- muscle shaking
The trigger for such physical reactions in the body tends to vary among individuals.
According to the National Institute of Neurological Disorders and Stroke, a person’s anxiety can also trigger other existing conditions, potentially leading to further anxiety. In other words, if a person has an underlying condition, such as essential tremor, anxiety may cause the symptoms to worsen.
Managing anxiety-related tremors and shaking involves treating the underlying anxiety. Once a person can control their anxiety, they should see a reduction or elimination of the shaking.
A person with anxiety may find it helpful to know what triggers cause their symptoms to worsen. If a person can understand their triggers, they may be able to avoid them or, at least, understand how to manage the resulting symptoms more effectively.
According to the National Alliance on Mental Illness, some general tips for managing anxiety and promoting wellness include:
- getting adequate sleep
- eating a healthful diet
- reducing stress
Yoga, meditation, and breathing techniques can all help a person reduce stress.
Read more about 10 possible remedies for stress and anxiety here.
If home remedies are not enough, a person may wish to seek professional help. Often, professional anxiety treatment will consist of psychotherapy and medication.
Some possible therapies for anxiety include cognitive behavioral therapy (CBT), which can help the person focus on their responses to events, and exposure response prevention, which helps people with specific anxiety disorders develop a constructive response to fear.
In some cases, a doctor may prescribe medications for anxiety. These may include anti-anxiety medications, such as benzodiazepines and buspirone (Buspar), and antidepressants, including selective serotonin reuptake inhibitors such as sertraline (Zoloft).
These medications are available through prescriptions. A person should talk to their doctor about what the safest option is for them to take. Often, a doctor will recommend a combination of medication, therapy, and lifestyle changes to treat the anxiety.
Anxiety may create a range of emotional and physical responses. The symptoms that a person experiences may vary. Some common symptoms include:
- feeling tense
- racing or pounding heart
- upset stomach
- feeling of dread or apprehension
- feeling jumpy
- restlessness or irritability
- frequent urination
- anticipating the worst
- watching for signs of danger
In some cases, a person may be experiencing anxiety as a side effect of a medication. In these situations, a doctor will ly discuss switching to an alternative medication.
In some situations, a person experiencing shaking or other symptoms of anxiety may not need to see a doctor. When an acute, short-term situation causes stress, a person will often display these symptoms. However, as the situation resolves, a person’s symptoms should start to clear.
In other cases, anxiety may be long-term or interfere with daily life. A person should see their doctor if this happens. In addition, a person should talk to their doctor if they:
Anxiety shaking is one of several potential symptoms that a person may experience when they have anxiety.
To treat shaking due to anxiety, it is usually necessary to treat the underlying cause of the anxiety.
Treatment for anxiety typically consists of therapy, medication, and lifestyle changes.
What is Social Anxiety Disorder? Symptoms, Treatment, Prevalence, Medications, Insight, Prognosis
by Thomas A. Richards, Ph.D.
Psychologist/Director, The Social Anxiety Institute
Social Anxiety Disorder (social phobia) is the third largest mental health care problem in the world today.
The latest government epidemiological data show social anxiety affects about 7% of the population at any given time. The lifetime prevalence rate (i.e., the chances of developing social anxiety disorder at any time during the lifespan) stands slightly above 13%. (See journal citation on the Social Anxiety Association home page.)
Social anxiety is the fear of social situations that involve interaction with other people. You could say social anxiety is the fear and anxiety of being negatively judged and evaluated by other people.
It is a pervasive disorder and causes anxiety and fear in most all areas of a person's life. It is chronic because it does not go away on its own.
Only direct cognitive-behavioral therapy can change the brain, and help people overcome social anxiety.
People with social anxiety are many times seen by others as being shy, quiet, backward, withdrawn, inhibited, unfriendly, nervous, aloof, and disinterested.
Paradoxically, people with social anxiety want to make friends, be included in groups, and be involved and engaged in social interactions. But having social anxiety prevents people from being able to do the things they want to do. Although people with social anxiety want to be friendly, open, and sociable, it is fear (anxiety) that holds them back.
People with social anxiety usually experience significant distress in the following situations:
- Being introduced to other people
- Being teased or criticized
- Being the center of attention
- Being watched or observed while doing something
- Having to say something in a formal, public situation
- Meeting people in authority (“important people/authority figures”)
- Feeling insecure and place in social situations (“I don’t know what to say.”)
- Embarrassing easily (e.g., blushing, shaking)
- Meeting other peoples’ eyes
- Swallowing, writing, talking, making phone calls if in public
This list is not a complete list of symptoms — other symptoms may be associated with social anxiety as well.
The feelings that accompany social anxiety include anxiety, high levels of fear, nervousness, automatic negative emotional cycles, racing heart, blushing, excessive sweating, dry throat and mouth, trembling, and muscle twitches. In severe situations, people can develop a dysmorphia concerning part of their body (usually the face) in which they perceive themselves irrationally and negatively.
Constant, intense anxiety (fear) is the most common symptom.
People with social anxiety typically know that their anxiety is irrational, is not fact, and does not make rational sense. Nevertheless, thoughts and feelings of anxiety persist and are chronic (i.e., show no signs of going away).
Appropriate active, structured, cognitive-behavioral therapy is the only solution to this problem. Decades of research have concluded that this type of therapy is the only way to change the neural pathways in the brain permanently.
This means that a permanent change is possible for everyone.
Social anxiety, as well as the other anxiety disorders, can be successfully treated today. In seeking help for this problem, we recommend searching for a specialist — someone who understands this problem well and knows how to treat it.
Social anxiety treatment must include an active behavioral therapy group, where members can work on their “anxiety” hierarchies in the group, and later, in real-life situations with other group members.
Cognitive-behavioral therapy for social anxiety has been markedly successful. Thousands of research studies now indicate that, after the completion of social anxiety-specific CBT, people with social anxiety disorder are changed.
They now live a life that is no longer controlled by fear and anxiety. Appropriate therapy is markedly successful in changing people's thoughts, beliefs, feelings, and behavior.
The person with social anxiety disorder must be compliant and do what is necessary to overcome this disorder.
National Institutes of Mental Health-funded studies report a very high success rate using cognitive therapy with a behavioral therapy group. Both are essential to alleviating anxiety symptoms associated with social anxiety disorder.
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.
Cognitive-behavioral (rational) therapy is not difficult to do, and has not been seen this way by participants.
The first factor in not complying with the therapy is that “I can't remember to do it every day” and “I have a hard time committing to something in which I don't see immediate results”.
The psychologist or group leader should have time-tested solutions to these irrational arguments.
Prognosis is markedly good. People completing CBT training report a high success rate, compared to control groups. In the National Institute of Mental Health longitudinal studies, people continued to report progress after CBT behavioral group therapy was over. Studies repeatedly indicate that treatment compatibility (i.e.
, did the person carry out the prescribed therapy?) is the key element in success. Using different terminology, the social anxiety people who understand and follow the directions to be repetitive with the therapy report the most positive changes in lessening anxious feelings and thoughts.
Repetition and reinforcement of rational concepts, strategies, and methods (and their implementation) is the key to alleviating social anxiety disorder on a long-term basis.
People can and do overcome social anxiety if they stick with the cognitive strategies and pratically apply them to their lives.
Social anxiety disorder is one of the five major anxiety disorders as listed in the DSM-5.
Social anxiety is many times confused with panic disorder. People with social anxiety do not experience panic attacks (they may experience “anxiety attacks”), in which the principal fear is of having a medical problem (e.g., heart attack). People with social anxiety realize that it is anxiety and fear that they are experiencing. They may say things “It was awful and I panicked!”, but, when questioned, they are talking about feeling highly anxious. They are not talking about the fear of having a medical problem. People with social anxiety do not go to hospital emergency rooms after an anxiety situation. People with panic disorder many times go to hospital emergency rooms, or doctor's offices, at first because they feel there is something physically wrong with them.
High rates of alcoholism and other substance abuse, family difficulties and problems, lack of personal relationships, and difficulty in obtaining and continuing with employment are among the everyday problems experienced by many people with social anxiety disorder.
Lack of professional and knowledgeable therapists is the biggest and most relevant problem to overcoming social anxiety. While it can be done, and a vast amount of clinical and research evidence supports this, overcoming social anxiety is difficult because of the scarcity of treatment facilities for people with this persistent anxiety disorder.
Often, we are led to the conclusion that effective therapy — whether from a psychologist or from a non-licensed person — comes only from people who have experienced this disorder themselves. Twenty years of experience points to the fact that people who have lived with this disorder and overcome it, make the best group leaders.
University Health Service
We have all felt anxiety—the nervousness before a date, test, competition, presentation—but what exactly is it? Anxiety is our body's way of preparing to face a challenge. Our heart pumps more blood and oxygen so we are ready for action. We are alert and perform physical and emotional tasks more efficiently. (See also Test Anxiety for tips on dealing with tests.)
It is normal to feel anxious when our safety, health, or happiness is threatened; however, sometimes anxiety can become overwhelming and disruptive and may even occur for no identifiable reason. Excessive, lasting bouts of worry may reflect an anxiety disorder.
Symptoms of anxiety disorders:
Anyone may experience these symptoms during stressful times. However, individuals with anxiety disorders may experience them in absence of stress, with more severe symptoms and/or with several symptoms appearing together.
- Inability to relax
- Unrealistic or excessive worry
- Difficulty falling asleep
- Rapid pulse or pounding, skipping, racing heart
- Nausea, chest pain or pressure
- Feeling a “lump in the throat”
- Dry mouth
- Irregular breathing
- Feelings of dread, apprehension or losing control
- Trembling or shaking, sweating or chills
- Fainting or dizziness, feelings of detachment
- Thoughts of death
Types of Anxiety Disorders:
Generalized Anxiety Disorder (GAD) is characterized by chronic and exaggerated worry and tension, much more than the typical anxiety that most people experience in their daily lives. People may have trembling, twitching, muscle tension, nausea, irritability, poor concentration, depression, fatigue, headaches, light-headedness, breathlessness or hot flashes.
Panic Disorder: People with panic disorder have panic attacks with feelings of terror that strike suddenly and repeatedly with no warning.
During the attacks, individuals may feel they can't breathe, have lost control, are having a heart attack or even that they are dying. Physical symptoms may include chest pain, dizziness, nausea, sweating, tingling or numbness, and a racing heartbeat.
Some people will have one isolated attack, while others will develop a long term panic disorder; either way, there is often high anxiety between attacks because there is no way of knowing when the next one will occur. Panic disorders often begin early in adulthood.
Many people with panic disorder also suffer from agoraphobia (abnormal fear of open or public places.). See more on Panic Attacks.
Phobias are irrational fears. Individuals with phobias realize their fears are irrational, but thinking about or facing the feared object or situation can bring on a panic attck or severe anxiety.
Phobias are often fears of a particular object or situation. Commonly feared objects and situations in specific phobias include animals, tunnels, water and heights. The most common specific phobia is fear of public speaking.
Social Phobia, or Social Anxiety Disorder, is characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social phobia have a fear of being judged by others, being embarrassed or being humiliated. This fear may interfere with work or school and other ordinary activities.
Obsessive-Compulsive Disorder (OCD) is characterized by uncontrollable anxious thoughts or behaviors. Individuals with OCD are plagued by persistent, unwelcome thoughts and images or by the urgent need to engage in certain rituals. Some OCD sufferers may only have obsessive thoughts without the related rituals. The disturbing thoughts or images (e.g.
, fear of germs) are called obsessions, and the rituals performed to try to get rid of them (e.g., hand washing) are called compulsions. For example, people who are obsessed with germs may wash their hands excessively. The individual is not happy to be performing the ritual behaviors but finds this to be the only way to get temporary relief from the obsessive thought.
Post-Traumatic Stress Disorder affects people after terrifying events such as physical or sexual abuse, car accidents, war or natural disasters.
Individuals with PTSD may experience depression, flashbacks, nightmares, sleep difficulties, irritability, aggression, violence, and a feeling of detachment or numbness.
Symptoms can be triggered by anything that reminds the individual of their trauma.
What is a panic attack?
Panic attacks can be caused by heredity, chemical imbalances, stress and the use of stimulants (such as caffeine or drugs).
Some people have only one or two attacks and are never bothered again. Panic attacks can occur with other psychiatric disorders.
In panic disorders, however, the panic attacks return repeatedly and the person develops an intense fear of having another attack.
Without help, this “fear of fear” can make people avoid certain situations and can interfere with their lives even when they are not having a panic attack. Therefore, it is very important to recognize the problem and get help.
Tips for dealing with a panic attack
(Adapted from “Understanding Panic Disorders,” National Institute of Health)
- Realize that although your symptoms are frightening, they are an exaggeration of normal stress reactions and aren't dangerous or harmful.
- Face the feelings rather than fighting them, and they will become less intense.
- Don't add to the panic by asking “What if?” Tell yourself “So what!”
- Stay in the present. Notice what is actually happening rather than what you think might happen.
- Rate your fear level on a scale of 1 to 10 and watch it change. Notice that it doesn't stay at a high level for more than a few seconds.
- Distract yourself with a simple task counting backwards or lightly snapping a rubber band around your wrist.
- When the fear comes, expect it and accept it. Wait and give it time to pass without running away.
Tips for helping someone with an anxiety disorder:
- Make no assumptions—ask the person what they need.
- Be predictable—don't surprise the person.
- Let the person with the disorder set the pace for recovery.
- Find something positive in every small step towards recovery.
- Don't help the person avoid their fears.
- Maintain your own life so you don't resent the person with the disorder.
- Don't panic when the person with the disorder panics, but realize it's natural to be concerned with them.
- Be patient and accepting, but don't settle for the affected person being permanently disabled.
- Say encouraging words such as: “You can do it no matter how you feel. I am proud of you. Tell me what you need now. Breathe slow and low. Stay in the present. It's not the place that's bothering you, it's the thought. I know that what you are feeling is painful, but it's not dangerous. You are courageous.”
- Avoid saying things : “Don't be anxious. Let's see if you can do this. You can fight this. What should we do next? Don't be ridculous. You have to stay. Don't be a coward.” These phrases tend to blame the individual for the anxiety.
When should I get help?
Some people believe that anxiety disorders can be overcome with willpower, but this is not ly. Untreated anxiety disorders can lead to depression, substance abuse and a range of other problems. If your normal routine is interrupted by excessive worry, you should seek help from a professional.
If you, or someone you know, has symptoms of anxiety disorder, visit a clinician, who can help determine whether the symptoms are due to an anxiety disorder, medical condition or both. Frequently, the next step in getting treatment for an anxiety disorder is referral to a mental health professional such as a psychiatrist, psychologist, social worker or counselor.
In general, two types of treatment are available, medication and psychotherapy (sometimes called “talk therapy”). Both can be effective for most disorders. The choice of one or the other, or both, depends on the patient's and the clinician's preference, and also on the particular anxiety disorder.
For more information:
See Stress and Mental Health Resources
UHS Care Managers can provide additional recommendations and referrals
A cure for social anxiety disorders
Social phobia is the most common anxiety disorder of our time. But the current treatment regimen for patients with this diagnosis has not proven very effective. Now a team of Norwegian and British researchers believe they have found a cure for social anxiety disorders.
“We've set a new world record in effectively treating social anxiety disorders,” says Hans M. Nordahl, a professor of behavioural medicine at the Norwegian University of Science and Technology (NTNU).
He has led a project with a team of doctors and psychologists from NTNU and the University of Manchester in England to examine the effects of structured talk therapy and medication on patients with social anxiety disorders.
Until now, a combination of cognitive therapy and medication was thought to be the most effective treatment for these patients. The researchers' results, which have just been published in the journal Psychotherapy and Psychosomatics, show that cognitive therapy on its own has a much better effect in the long term than just drugs or a combination of the two.
Nearly 85 per cent of the study participants significantly improved or became completely healthy using only cognitive therapy.
“This is one of the best studies on social anxiety disorders ever,” says Nordahl. “It's taken ten years to carry out and has been challenging both academically and in terms of logistics, but the result is really encouraging,” he says.
Mistreatment with “happy pills”
To clear up some terms: social anxiety is not a diagnosis, but a symptom that a lot of people struggle with.
For example, talking or being funny on command in front of a large audience can trigger this symptom.
On the other hand, social anxiety disorder — or social phobia — is a diagnosis for individuals who find it hard to function socially, and anyone with this diagnosis has high social anxiety.
Medications, talk therapy or a combination of these are the most common ways to treat patients with this diagnosis. NTNU researchers set out to examine which of these approaches is most effective.
“A lot of doctors and hospitals combine medications — the famous “happy pill” — with talk therapy when they treat this patient group. It works well in patients with depressive disorders, but it actually has the opposite effect in individuals with social anxiety disorders. Not many health care professionals are aware of this,” says Nordahl.
Drugs camouflage the problem
“Happy pills,” selective serotonin re-uptake inhibitors (SSRIs), may have strong physical side effects. When patients have been on medications for some time and want to reduce them, the bodily feelings associated with social phobia, shivering, flushing and dizziness in social situations tend to return. Patients often end up in a state of acute social anxiety again.
“Patients often rely more on the medication and don't place as much importance on therapy.
They think it's the drugs that will make them healthier, and they become dependent on something external rather than learning to regulate themselves.
So the medication camouflages a very important patient discovery: that by learning effective techniques, they have the ability to handle their anxiety themselves,” says Nordahl.
Social anxiety — a public health issue
The most common anxiety disorder experienced today is social anxiety disorder. It is a public health problem with major negative consequences for the individual and for society. Nearly twelve per cent of the population will be impacted during their lifetime.
Most affected individuals report that anxiety has significantly hampered their functioning at school and in their work life. These are issues that negatively affect their choice of career, entry into the labour market and how they adjust to their work environment. They are also a major cause of absenteeism.
People with social anxiety disorder dread situations where they risk being exposed to the critical gaze of others. They are afraid that others will look at them, judge them and form a negative opinion of them. They especially fear the embarrassment of being deemed nervous, weak or stupid.
Speaking in front of large groups, participating in parent meetings at school, and eating or writing with others watching can be problematic for people with the disorder. Some people are particularly afraid that others will see their hands or voice shake, or that they are blushing and sweating. They will do their best to avoid these types of situations.
They may also resort to various coping strategies to hide their anxiety, which unfortunately only reinforce the problem.
Cognitive therapy is a treatment where the therapist works to get patients to accept their fear, to go into challenging situations and to shift their attention to what they want to say and do in those situations. In other words: Accept inwardly and focus outwardly.
World record in treating social phobia
NTNU researchers set up the project to compare the most recognized methods for treating social anxiety disorders. Well over 100 patients participated in the study and were divided into four groups.
The first group received only medication, the second group received only therapy, the third group received a combination of the two, and the fourth received a placebo pill. The four groups were compared along the way, and researchers conducted a follow-up assessment with them a year after treatment ended.
During treatment and right afterwards, the patients in groups two and three were managing equally well. But after a year, it was clear that the group two participants — those who had only received cognitive therapy — fared the best.
Only with the help of cognitive therapy have researchers managed to increase the recovery rate in patients with social anxiety disorders by 20 to 25 per cent, as compared with the norm for this group.
“This is the most effective treatment ever for this patient group. Treatment of mental illness often isn't as effective as treating a bone fracture, but here we've shown that treatment of psychiatric disorders can be equally effective,” says Nordahl.
Many patients don't get adequate treatment
Torkil Berge is a psychologist at Diakonhjemmet Hospital in Oslo and head of the Norwegian Association for Cognitive Therapy. He says social anxiety disorder is a public health problem with major negative consequences for the individual and for society. Nearly twelve per cent of the population will be affected by this illness during their lifetime.
“This is a hidden disorder, and many patients find it difficult to communicate their struggle to their healthcare providers. Thousands upon thousands of individuals end up not receiving adequate treatment. Of those who do get treatment, most are probably offered drug therapy,” Berge says.
“I can well imagine that the combination of drug therapy and cognitive therapy isn't the best approach, as NTNU researchers have determined in this study,” he said.
Using metacognitive therapy
Nordahl and the rest of the research team have also worked to improve standard cognitive therapy. They have added new processing elements, which have shown greater effectiveness.
“We're using what's called metacognitive therapy, meaning that we work with patients' thoughts and their reactions and beliefs about those thoughts.
We address their rumination and worry about how they function in social situations.
Learning to regulate their attention processes and training with mental tasks are new therapeutic elements with enormous potential for this group of patients,” says Nordahl.
The researchers now hope to develop standardized cognitive therapy further for patients who suffer from social anxiety disorders.
Materials provided by The Norwegian University of Science and Technology (NTNU). Note: Content may be edited for style and length.
- Hans M. Nordahl, Patrick A. Vogel, Gunnar Morken, Tore C. Stiles, Pål Sandvik, Adrian Wells. Paroxetine, Cognitive Therapy or Their Combination in the Treatment of Social Anxiety Disorder with and without Avoidant Personality Disorder: A Randomized Clinical Trial. Psychotherapy and Psychosomatics, 2016; 85 (6): 346 DOI: 10.1159/000447013