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In situations where social anxiety disorder is minor, or where people are able to overcome their fears so they do not limit their interactions, treatment may not be necessary. However, social anxiety disorder typically does not resolve on its own and more severe cases may require treatment. Psychotherapy, use of medications or a combination of both approaches may be used to treat social anxiety disorder.

Psychotherapy is likely to focus on reducing anxieties and fears and managing reactions to fear-inducing stimuli. Treatment sessions may be in individual or group settings. Group therapy is known to be particularly effective for those with social anxiety disorder.

Cognitive behavior therapy is used to treat social anxiety disorder. It involves learning new skills that enable the person to react differently to situations that typically trigger anxiety. Patients also learn more about negative thought patterns that increase anxiety and ways to redirect such thinking. In addition, patients may be gradually exposed to situations that are frightening and in which they can test new coping skills with the help of a professional. This is known as exposure therapy.

Medications may also be prescribed to help reduce the anxiety that patients feel. Some antidepressants are effective in treating anxiety disorders, even in patients who are not depressed. These drugs usually take several weeks to work, so patients should not become discouraged if they do not notice immediate improvement. The U.S. Food and Drug Administration (FDA) recently noted that antidepressants may increase the risk of suicidal thinking and behavior in children and adolescents, and that people being treated with these drugs should be closely monitored for unusual changes in behavior. However, the benefits of these medications may outweigh the potential risks.

Anti-anxiety medications may also be prescribed. Many anti-anxiety medications, such as benzodiazepines, should be used only for short periods of time because of their addictive potential. Patients should not stop using anti-anxiety medications unless under the close supervision of a physician because they may experience withdrawal symptoms. Mild to moderate withdrawal symptoms may include anxiety, restlessness, insomnia or nightmares. More serious symptoms can include seizures, high fever, psychosis and even death.

Beta-blocker medications, which are typically used to treat heart conditions, are also sometimes effective in treating social anxiety disorder. These medications work by blocking the stimulating effect of the hormone adrenaline. Patients who know in advance that they soon will be in an anxiety-provoking situation – such as giving a speech in public – may use beta-blockers to reduce symptoms, such as a pounding heart or trembling hands.