Social phobia, also called social anxiety disorder, is the third most common mental health disorder after depression and substance abuse. Persons with this disorder fear being humiliated or embarrassed in social and/or performance situations by their actions and may become intensely anxious, with an increased heart rate, diaphoresis, and other signs of autonomic arousal. These physical symptoms may cause additional anxiety, often leading to a conditioned fear response that reinforces their anxiety in public situations.
Signs and symptoms
- Fear of situations in which you may be judged
- Worrying about embarrassing or humiliating yourself
- Intense fear of interacting or talking with strangers
- Fear that others will notice that you look anxious
- Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling or having a shaky voice
- Avoiding doing things or speaking to people out of fear of embarrassment
- Avoiding situations where you might be the centre of attention
- Having anxiety in anticipation of a feared activity or event
- Enduring a social situation with intense fear or anxiety
- Spending time after a social situation analysing your performance and identifying flaws in your interactions
- Expecting the worst possible consequences from a negative experience during a social situation
Causes
Exact cause is not known in many cases. But the following factors are considered to play a role:
Inherited traits
Mental or physical trauma
Brain structure – an overreactive amygdala
Environment
Pathophysiology
The pathophysiology of social phobia is evolving as a result of research into brain connectivity and function and recent hypotheses regarding cognition.
Diagnosis
Clinical examination
Criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association
Treatments
Psychotherapy
Medications – selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitor (SNRI), anti-depressants, anti-anxiety medications, Beta-blockers.
Prognosis
Mild social phobia has a good prognosis and mostly a benign course. Severe avoidance behaviour and substance abuse are often associated with a guarded prognosis.
Complications
Low self-esteem
Trouble being assertive
Negative self-talk
Hypersensitivity to criticism
Poor social skills
Isolation and difficult social relationships
Low academic and employment achievement
Substance abuse, such as drinking too much alcohol
Suicide or suicide attempts
Disease & Ayurveda
Unmada (Kaphaja)
Nidana
Intake of viruddha (contradictory to each other), dushta (rotten or toxic), and ashuchi (unhygienic) foods and drinks
Insulting the gods, teachers and high-profile people in the society
Fear
Grief
Sudden happiness
Unwholesome diet and activities
Excess sleep
Purvaaroopa
Not mentioned
Samprapti
The causative factors vitiate the doshas and affect the hrudaya(heart) which is the seat of intellect & feelings. In a person with abnormal emotional quotient and less tolerance level (heena satwa) when the doshas reach the channels of emotional impulses (manovahasrotas) they afflict the mind and generate the signs and symptoms of unmada.
Lakshana
Sluggish or slow movements, speech and actions
Anorexia or aversion to food
Liking for women or lonely places (hating crowd, meeting people etc.)
Excess sleep
Vomiting and excessive salivation
Paleness or whitish discolouration of nails, face etc.
Divisions
Not mentioned
Prognosis
Yaapya
Chikithsa
Ayurvedic treatment for unmada primarily focuses on cleansing the body which is the seat of mind. It is done by doing sodhana therapies(panchakarma) in strong patients with snehana & swedana as preparatory procedures and samsarjana krama (stepwise improving Agni with light to heavy diet plans)
Samana
Aamapachanam
Agnideepanam
Rasayanam
Sodhana
Snehana-abhyanga, siropichu, sirovasti
Swedana
Vamanam
Virechanam
Nasyam
Dhoomapanam
Asthapanavasti
Snehavasti
Commonly used medicines
Varanadi kashayam
Mahapaisachika ghrutam
Manasamitravatakam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
No home remedies are proven scientifically to cure social phobia. But relaxation techniques, meditation, yoga and pranayama can help the person to Improve the quality of life.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products causing indigestion, obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, honey, fresh fruits and vegetables
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extreme hot & cold climates.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule. Avoid keeping awake late night.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active.
Yoga
Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Yoga for social anxiety
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://pubmed.ncbi.nlm.nih.gov/16639184/
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.

Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
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