Social anxiety Disorder (SAD)

Social anxiety disorder is a persistent fear of one or more situations in which others expose the person to possible scrutiny and fears that he or she may do something or act in a way that will be humiliating or embarrassing. It exceeds normal “shyness” as it leads to excessive social avoidance and substantial social or occupational impairment.

Feared activities may include almost any type of social interaction, especially small groups, dating, parties, talking to strangers, restaurants, interviews, etc.

Those who suffer from social anxiety disorder fear being judged by others in society. In particular, individuals with social anxiety are nervous in the presence of people with authority and feel uncomfortable during physical examinations. People who suffer from this disorder may behave a certain way or say something and then feel embarrassed or humiliated after.

Let us look out what’s wrong in the brain SAD

• Sociability is closely tied, to dopamineneurotransmission.
• Direct relation of social status and binding affinity of dopamine D2/3 receptors in the striatum was found.
• Studies have shown high prevalence of social anxiety in Parkinson’s disease and schizophrenia. In a recent study, social phobia was diagnosed in 50% of Parkinson’s disease.
• Some evidence points to the possibility that social anxiety disorder involves reduced serotonin receptor binding.
• The amygdala is part of the limbic system which is related to fear cognition and emotional learning. Individuals with social anxiety disorder have been found to have a hypersensitive amygdala; for example in relation to social threat cues (e.g. perceived negative evaluation by another person), angry or hostile faces, and while waiting to give a speech.
• Recent research has also indicated that another area of the brain, the anterior cingulate cortex, which was already known to be involved in the experience of physical pain, also appears to be involved in the experience of ‘social pain’, for example perceiving group exclusion.

Who to deal and treat Social anxiety disorders?

There are many management plans to deal and treat SAD.

That includes conventional treatment of cognitive behavior therapy, SSRi medication, Benzodiazepines etc.

• All have been used in SAD since more than 25 years, still there is emerging need to manage SAD more effectively.
• I don’t deny importance of CBT and SSRI role in treating SAD; in fact they still are the leaders in the treatment.

Here, I want to seek your attention for new advancement in treatment of Social anxiety disorder.

Vagus nerve is one of 12 cranial nerves, and is biggest cranial nerve and descent till inguinal area and intervenes with almost every organ, especially gastric system, and maintains balance of all major organs and their functioning

Vagus nerve stimulates GABA and non-epinephrine levels in neo cortex and then regulates amygdala response in deductive and effective way.

Vagus nerve stimulation devices are available in USA and getting promising results.