Social Anxiety Disorder

Q I get so nervous before job interviews or presentations that I ruin them every time. Can treatment improve situations like this?

A. Through treatment, the level of anxiety in interview and presentation situations can be lowered enough. Rather than complete absence of anxiety, the realistic goal is to bring it down to a manageable level, and that alone can make a big difference in your performance.

Q When I go to crowded places I suddenly feel short of breath and want to run away. Is this social phobia or panic disorder?

A. It could be either, or both. The core of social phobia is fear of others' judgment, while the core of panic disorder is fear of the attack itself. A professional differential diagnosis is needed.

Q How is social phobia different from avoidant personality disorder? I'm curious which one I have.

A. The two have very similar symptoms, but avoidant personality disorder affects the whole sense of self more broadly and deeply. Both are treatable, and an accurate distinction is made through professional evaluation.

Q Meeting people terrifies me and I find myself staying home more and more. How can I start tackling this on my own?

A. The most effective way to reduce avoidance is gradual, step-by-step exposure to feared situations, starting with the smallest ones. If it is difficult to do alone, systematic exposure training with a therapist is recommended.

Q Every night before a presentation I cannot sleep, and on the day my hands and feet tremble. Is there any way to reduce anxiety in that moment?

A. Diaphragmatic breathing and grounding techniques help stabilize the autonomic nervous system immediately. Regular aerobic exercise is also the most powerful self-management tool for reducing overall anxiety levels over the long term.

Q Are there any side effects, such as drowsiness or feeling spaced out, when taking herbal medicine? I am worried because I have to work or study during the day.

A. Herbal medicine used for social phobia does not produce a strong sedative effect like sleeping pills. However, since there may be slight drowsiness when first taking it, adjusting the timing of administration to before bedtime can ensure that it does not interfere with daytime activities.

Q I have heard that taking psychiatric medication for a long time causes dependence or harms the brain. Is that true?

A. SSRIs are not medications that cause tolerance or dependence. However, stopping them abruptly on one's own can produce discontinuation symptoms, so dosage reduction must always be done slowly and in consultation with a specialist.

Q I am currently taking SSRIs prescribed by a psychiatrist. Is it okay to take herbal medicine at the same time?

A. In most cases, it is possible to take SSRIs and herbal medicines together. However, since certain ingredients, such as St. John's wort, interact with SSRIs, you must inform the Korean medicine doctor of all medications you are currently taking.

Q How long does it take to get better with treatment for social phobia? I don't have to live like this forever, do I?

A. Many people experience meaningful improvement within a few months of consistent treatment. Full recovery of social functioning is possible, and the earlier treatment begins, the better the prognosis.

Q Can social phobia lead to depression? I think I might have both and I am worried.

A. Social phobia and depression very frequently occur together. When both are present, an integrated approach addressing both simultaneously leads to faster recovery than treating each separately.

Q My heart feels like it will burst and I cannot find my words when standing in front of people. Is this just a shy personality, or is it a disorder?

A. Social phobia (social anxiety disorder) is not a personality trait but a medical condition in which the brain's fear response circuit becomes overactivated. It is difficult to overcome by willpower alone and requires proper treatment.

Q What happens in the brain with social phobia? Why does it feel so out of control?

A. The amygdala (the brain's fear-processing center) overreacts to social stimuli, while the prefrontal cortex fails to suppress it, resulting in a loss of control. Because this is a brain-circuit issue, willpower alone cannot regulate it.

Q Coffee seems to worsen my anxiety, and I need alcohol to be around people. Is this related to social phobia?

A. Caffeine directly worsens anxiety responses, and the habit of using alcohol to cope with anxiety is very dangerous as it can develop into alcohol dependence. Both are among the first factors to address in managing social phobia.

Q After looking at social media I feel more inferior among people and my anxiety grows. Does social media worsen social phobia?

A. Excessive social media use repeatedly triggers comparison with others, reinforcing the core fear of social phobia — the dread of negative evaluation. Reducing daily usage time and taking digital detox periods can be helpful.

Q How often and for how long do I need to visit the clinic for social phobia treatment?

A. The basic rhythm for the first two months is a visit every two weeks with consistent daily herbal medicine. This gradually reduces to once a month as improvement is confirmed. For those near Dong-gu or Dong-Incheon in Incheon, visit schedules can be arranged flexibly.

Q In what order does the Korean medicine treatment for social phobia proceed? What happens when you first visit?

A. During the initial consultation, we identify symptoms, lifestyle, and medications being taken. We then analyze constitutional patterns, such as Liver Qi Stagnation or Heart and Gallbladder Deficiency, to establish a treatment plan for herbal medicine and acupuncture. After two weeks, we monitor progress and adjust the prescription accordingly.

Q I want to combine Korean medicine treatment with psychotherapy. How should I coordinate the two?

A. Cognitive behavioral therapy and Korean medicine treatment serve different roles and do not conflict. When Korean medicine treatment lowers the body's anxiety responses, the exposure exercises of CBT work better. Just let us know both schedules and we will coordinate them.

Q Does Korean medicine treatment actually help with social phobia? Shouldn't psychological counseling or medication come first?

A. For moderate-to-severe social phobia, SSRIs and cognitive behavioral therapy are the first-line choices, while Korean medicine is used as a complement alongside medication and counseling, or as a supportive measure for mild symptoms. Korean medicine can make a meaningful contribution to reducing the body's anxiety response.