Social Anxiety Disorder: Diagnosis and Management

J.T.’s mental disorder can be diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM). From his thoughts, beliefs, and actions, J.T.’s primary diagnosis is social phobia, while the differential diagnosis could be a generalized anxiety disorder. The biopsychosocial model of care is applicable in the management of mental health disorders. J.T., who has a social anxiety disorder, can benefit from the biopsychosocial model of care that addresses the biological, psychological, and social causes of disorders.

J.T.’s primary diagnosis is a social anxiety disorder, which is also known as social phobia. He meets many of the diagnostic criteria for this disorder. Firstly, he experiences noticeable fear or anxiety about social situations, including approaching his professors and meeting new people. Secondly, he is afraid that he will act in ways that will lead to negative evaluation (American Psychiatric Association, 2013). For instance, J.T. fears that new people will view him as “dumb,” “boring,” or a “loser.” Thirdly, J.T. experiences fear or anxiety in social situations. His fear and anxiety manifest in the form of stuttering, sweating, and feeling uneasy. Fourthly, J.T. tends to avoid social situations, isolate himself, and skip class because he is afraid of how others will perceive him. Fifthly, he has had these feelings of discomfort around social situations for more than six months (American Psychiatric Association [APA], 2013). He probably developed social anxiety before joining the elementary school. Finally, his symptoms cannot be explained by drug use or any other medical condition. From these symptoms, J.T. is likely to have a social anxiety disorder.

The client’s differential disorder could be generalized anxiety disorder (GAD). A distinguishing feature is that people with GAD experience anxiety over ongoing relationships, while individuals with social phobia fear negative social evaluation (APA, 2013). In addition to their social performance, GAD features anxiety related to nonsocial performance even in the absence of others, while social phobia does not. J.T. experiences anxiety pertaining to social situations, which makes social anxiety disorder his primary diagnosis rather than GAD.

The biopsychosocial can be useful in helping J.T. manage his symptoms. The model suggests that diseases and disorders are caused by the interaction of biological, psychological, and social factors (Gask, 2018). Biologically, J.T could be genetically predisposed to social anxiety disorder. Psychologically, social phobia can be attributed to a person’s thoughts and beliefs (Gask, 2018). For instance, J.T. may perceive himself as socially awkward and inept. Socially, factors such as his relationship with others and trauma could contribute to the disorder.

J.T. could take selective serotonin reuptake inhibitors (SSRIs) to help regulate his brain chemistry. Examples of SSRIs used to manage social anxiety include sertraline (Zoloft) and Paxil. This would help with the biological component of the social anxiety disorder. Psychosocially, the symptoms of social anxiety disorder can be alleviated by administering cognitive-behavioral therapy (CBT). CBT is a psychosocial intervention that involves challenging thoughts and beliefs that lead to unwanted behaviors. This intervention suggests that people can develop healthier coping methods by changing their cognition (Van Dis et al., 2020). For instance, CBT could be used to help J.T. realize that people do not perceive him as “dumb,” “boring,” or a “loser.” Consequently, he would learn to stop being afraid of social interactions, which would nudge him to make new friends, hang out with his old friends, and participate in class. It is essential to note that the biopsychosocial model is multidimensional but holistic (Gask, 2018). Therefore, J.T.’s biopsychological model of care entails administering both SSRIs and CBT.

In diagnosing mental disorders, DSM-5 makes a distinction between fear, worry, anxiety, and panic. According to the manual, fear is caused by a real or apparent threat, while anxiety is an emotional response to a future threat (APA, 2013). Worry is defined as “apprehensive expectation,” which means a person expects something bad to happen in the future (APA, 2013, p. 222). Lastly, panic refers to an abrupt intensification of fear or discomfort that typically lasts for a few minutes.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.

Gask, L. (2018). In defence of the biopsychosocial model. The Lancet Psychiatry, 5(7), 548-549.

Van Dis, E. A., Van Veen, S. C., Hagenaars, M. A., Batelaan, N. M., Bockting, C. L., Van Den Heuvel, R. M., Cuijpers, P., & Engelhard, I. M. (2020). Long-term outcomes of cognitive behavioral therapy for anxiety-related disorders: A systematic review and meta-analysis. JAMA Psychiatry, 77(3), 265-273.

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