Generalized anxiety disorder (GAD) and social anxiety disorder (SAD) share many similarities but differ in one important way: If you suffer with GAD, your worry tends to be broad and not limited to particular situations or circumstances. On the other hand, if you have SAD, the symptoms you feel are always related in some way to social or performance situations in which you expect scrutiny or evaluation by others.

If you have GAD, you will experience:an unhealthy tendency to worry about a variety of things (e.g., work, family, money, health)

a tendency to anticipate the worst and to worry over trivial matters

the inability to control your worry

physical symptoms, such as fatigue, headaches, restlessness, muscle tension and trouble sleeping

behavioral symptoms, such as irritability

When you suffer with SAD, you will share characteristics, such as a tendency to worry and anticipate the worst, an inability to control anxiety and trouble sleeping, with GAD. Your anxiety, however, is always triggered by social and performance situations. In addition, you know that your anxiety is irrational and out of proportion to the event that triggers it.

When you suffer with GAD, you may fear embarrassment in front of others, but it is not your main focus. As an example, consider a professional athlete with each of these disorders: The athlete with GAD may worry excessively about his ability to compete and provide for his family as well as his physical health — in this way, his anxiety is very broad in scope. On the other hand, the athlete with SAD will also worry excessively, but the worry will be focused on the anticipation of these competitions, where he will be evaluated.

If you believe that you may suffer with GAD or SAD, talk with your doctor about the symptoms that you are experiencing. Ideally, you should receive a referral to a mental health professional for diagnosis and treatment.

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If you are the parent of a teen with social anxiety disorder (SAD), it can be hard to know how best to help your teen cope. In addition to helping your child obtain a proper diagnosis and effective treatment, such as cognitive-behavioral therapy (CBT) and/or medication, there are a number of steps that you can take to help your teen on a daily basis.Exposure to Social Situations

Although it may be tempting to be overprotective or to shelter your adolescent, it is important to provide her with confidence-building experiences. Gradual exposure to new social experiences will help her build social skills and feel more confident about her abilities. This will inherently involve some pushing beyond her comfort zone, but that should of course be approached in a measured way. A therapist can guide this, and your involvement as a parent is key.

If you have a younger teenager, be sure to give her the opportunity to speak for herself in situations such as ordering in a restaurant or asking for movie tickets. Be sure to offer praise and rewards when your teen faces feared social situations. Listen and Offer Advice

If your teenager is comfortable talking to you about her feelings, listen carefully and offer advice. Let her know that feeling nervous sometimes is normal for all teenagers. Remind her of how she has coped well in the past with difficult situations, and let her know that you have confidence in her ability to cope.

If your teenager is suffering from extreme social anxiety that greatly impairs her daily functioning, has stopped her from attending school, or has posed a danger of self-harm or suicide, it is important to seek professional help immediately.

Sources:

Akron Children’s Hospital. Social phobia and excessive shyness in teens. Accessed Oct 27th, 2009.

Technorati Tags: anxiety, Disorder), Parenting, Social, Teens

Tips for Teaching Teenagers With Social Anxiety Disorder
Teaching a teenager with social anxiety disorder can be more difficult than working with students who do not suffer from social anxiety. Learn about how to help the student with SAD cope in the classroom.

Three Tricks for Starting a Conversation With a Stranger
Starting a conversation with a stranger can be difficult if you suffer with social anxiety disorder. Here are some tricks to get you help you become better at opening conversations with strangers.

How to Talk to People When You Have Social Anxiety Disorder
It can be hard to know how to talk to people if you have social anxiety disorder (SAD). Having a great conversation with someone can be as simple as doing something together to stimulate conversation.

Public Speaking Anxiety: Preparing to Give a Speech
Public speaking is a common fear among people with social anxiety disorder (SAD) as well as in the general population. One strategy for reducing speech anxiety is to prepare well before a speaking engagement. Here are some tips for making the most of your prep time.

Public Speaking Anxiety: Giving a Speech
Giving a speech can be a nerve-wracking experience if you have social anxiety disorder (SAD). Read more to learn about coping strategies that you use to help manage anxiety and put your best foot forward on the day of a big speech or presentation.

How to Ask Someone on a Date
It can be difficult to know how to ask for a date when you suffer from social anxiety. Here is a relatively painless way to give it a try.

Developing Good Eye Contact
Eye contact is often described as anxiety-provoking by people with social anxiety disorder (SAD). Still, good eye contact is one of the keys to successful social interaction. Use this quick tip to make sure that you are taking advantage of this useful social skill.

How to be Assertive
Assertiveness is an effective means of communication and a skill that you can learn.

How to Make Requests
Making requests of others requires the use of assertive communication.

How to Refuse Requests
Refusing requests of others requires the use of assertive communication.

Social Anxiety and Weddings
Choosing a wedding party can be a little more difficult when you suffer with social anxiety disorder. There are no hard and fast rules about how to choose your attendants and allowing yourself some flexibility can help with this wedding task.

Social Anxiety and Weddings
Giving a wedding speech can be challenging if you suffer with social anxiety. Here are some tips for managing anxiety about delivering a speech at your wedding.

Social Anxiety and Weddings
The first dance at your wedding can be nerve-wracking, particularly for brides or grooms suffering with social anxiety. Here are five tips to ease your nerves before you step out on the dance floor.

Social Anxiety and Weddings
Managing out-of-town guests during your wedding can be challenging when you suffer with social anxiety disorder. Here are some tips to make sure that you don’t become a tour guide instead of a bride or groom.

Social Anxiety and Weddings
Planning a wedding when you suffer from social anxiety disorder can be a challenge. Here are some tips to make the process a little easier.

Social Anxiety and Weddings
There are many reasons to have a receiving line at your wedding if you suffer with social anxiety. Here are five reasons why you may want to consider having a receiving line if you get married.

Social Anxiety and Weddings
Saying wedding vows can be more difficult if you suffer with social anxiety. Here are some tips to help overcome anxiety about saying your wedding vows.

Social Anxiety and Weddings
As a bride with SAD, you may worry about social anxiety while walking down the aisle. Here are some tips to keep anxiety at bay during this special time.

Social Anxiety and Weddings
Bridal shower anxiety can be a problem for shy brides, but for those with social anxiety disorder, nerves can become overwhelming. Here are some tips for managing worry and anxiety when you have to be the center of attention at a bridal shower.

Social Anxiety and Weddings
Wedding photos may be difficult if you suffer with social anxiety. Here are some tips to help relax prior to your photo shoot.

Social Anxiety and Weddings
Social anxiety during your wedding reception can make the process of meeting and greeting guests difficult. Use these tips to help manage anxiety and make mingling during the reception a little easier.

How to Practice Autogenic Training
Autogenic training is a form of relaxation training similar to meditation that induces relaxation by influencing the autonomic nervous system. The technique involves a set of self-statements about the body and is used for reducing anxiety and improving other conditions.

How to Practice Guided Imagery
Guided imagery is a relaxation technique that focuses on visualization. By visualizing images of a serene and relaxing environment, the body, in turn, enters a relaxed state. Guided imagery is often used in combination with other relaxation techniques as part of treatment for anxiety disorders.

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The first choice of medication for treating social anxiety disorder (SAD) is usually a class of medications called selective serotonin reuptake inhibitors (). are also used to treat other disorders such as depression. affect your brain chemistry by slowing reabsorption of the neurotransmitter serotonin, a chemical believed to regulate mood and anxiety.Types of

Six are recommended in treating SAD. Your doctor may prescribe any one of the following. Each medication is listed by the brand name followed by the generic name in parentheses: Celexa (Citalopram)Paxil (Paroxetine)Prozac (Fluoxetine)Lexapro (Escitalopram)Luvox (Fluvoxamine)Zoloft (Sertraline)

Three , paxil, zoloft, and luvox have been approved by the FDA for treating SAD. However, all have been shown in clinical studies to offer improvement of symptoms. Paxil was the first SSRI to receive FDA approval and is often the first choice for treating SAD. However, the medication that works for one person doesn’t always work for another. So, your doctor will work with you to find the right prescription for you. How Do I Take an SSRI?

Your doctor will give you specific instructions on how to take your medication. It is important that you follow these directions. Generally, you will take an SSRI once a day, usually in the morning. Your doctor will usually prescribe a low dose initially, which will be increased gradually. The dose that you require does not necessarily relate to the severity of your symptoms. Sometimes it is simply a reflection of your unique metabolism. It may take several weeks for you to notice improvement of your symptoms. What are the Side Effects?

are generally the preferred medication for SAD because the side effects tend to be well-tolerated. Nevertheless, as with all medications, several possible side effects include:Sleep problems: drowsiness, fatigue or insomniaSexual dysfunction: decreased sex drive, delayed or absent orgasm, erectile dysfunctionPhysical ailments: skin rashes, dry mouth, headaches, nausea, dizzinessAnxiety-like symptoms: irritability, nervousness, shaky hands, sweatingEating problems: weight gain or loss, loss of appetite

If you have great difficulty with side effects, your doctor may decide to prescribe a different SSRI. In general, lower initial doses that are gradually increased reduce the likelihood that you will experience problematic side effects.Advisories/Warnings

should never be taken at the same time as monoamine oxidase inhibitors (MAOIs). The results of such a combination can be fatal. In addition, never start taking one of these medications within weeks of stopping the other.

In 2004, the FDA released an advisory concerning and risk of suicidal thoughts and behaviors. Although rare, it is possible during the initial phase of treatment for symptoms to worsen rather than improve. It is important to monitor symptoms during this time and report any negative changes to your doctor.

In addition to the FDA advisory on suicidal thoughts, there has also been an advisory released regarding the use of triptans for migraine headaches in combination with . In combination, there is a risk of serotonin syndrome, a potentially life-threatening condition. In general, it is important to inform your doctor of all medications, both prescription and nonprescription, that you are already taking.Discontinuing Treatment

should always be discontinued under the supervision of a medical professional. Abruptly stopping these medications can result in a relapse of anxiety symptoms and serotonin withdrawal symptoms including trouble with coordination, tingly sensations, vivid dreams, flu-like symptoms, anxiety, and depressed mood. To avoid these serotonin withdrawal symptoms and the possibility of relapse, should always be gradually tapered off.

Sources:

Bezchlibnyk-Butler KZ, Jeffries, JJ, eds. Clinical Handbook of Psychotropic Drugs. Toronto, Canada: Hogrefe & Huber; 2003.

Technorati Tags: anxiety, Disorder), Share, Social, Symptoms

See More About: social anxiety disorder help-seeking workplace social anxiety social anxiety disorder self-help

Living with social anxiety disorder (SAD) can take a toll on your personal and professional life. Usually people go many years before being diagnosed and have developed maladaptive coping mechanisms. During and after treatment, it is important to acknowledge the disorder and to use strategies to minimize the negative impact on your life. First Steps: Getting Help

Without proper treatment, SAD can be chronic and severely impair your quality of life. Unfortunately, the nature of the disorder means that you are a person who is afraid to ask for help. If even approaching a friend, family member or your doctor seems too overwhelming, look to see if there is a university in your area that offers confidential counseling. You may even be able to contact them for the first time via email. No matter what course of action you take, it is important to take the first step.How to get help for SAD How to find an anxiety therapistSAD and Your Career

A strong relationship has been found between SAD and lower educational attainment, reduced employment opportunities, lower income, and dependence on social assistance. If you are currently employed, it is important to be aware of the best ways of managing a mental health disorder in the workplace. Below are some tips for coping with SAD in the workplace.SAD and your workTelling your employer you have SADCoping with job interview anxietyCoping with work meetingsDealing with business lunchesHandling business conferencesSelf-Help

Although no substitute for proper diagnosis and treatment, the use of self-help strategies may offer some control over your symptoms and allow you to be an active participant in the recovery process. Below are some self-help strategies that may help to reduce your anxiety.Deep breathingGuided imageryAutogenic trainingProgressive muscle relaxationThe Stories of Others

Reading stories about other people that are living with SAD will help to make you feel less isolated. Below are some personal stories about social anxiety, including those of well-known celebrities.Celebrities with SADInterview with a social phobicBlogs about SADMovie characters with social anxietyRelationships

SAD can take a toll on your relationships with others. It can affect your ability to make friends and to find a romantic partner. It can even negatively affect those that are closest to you, as they try to help you deal with your anxiety symptoms. Below are some articles to help you cope with the impact of SAD on your relationships.How to help someone with SADCoping for friends and family membersFinding loveGetting married with SADHow to ask someone on a dateHow to help your teenager copeSocial SkillsSome people who have SAD also suffer from a deficit in social skills. Fortunately, social skills can be learned as part of a social skills training program sometimes incorporated with treatment. There are also many strategies that you can use on your own to improve your social skills. Below are some tips to get you started.Making eye contactConversation tipsManaging party anxietyMaking telephone callsAccepting complimentsHow to say “no”How to be more assertiveHandling Performance AnxietyPerformances can take many forms: public speaking, athletic competitions, and even musical events. If you suffer from SAD and are involved in some sort of performing, chances are that you have battled nerves on stage or during a competition. Below are some tips to help you cope.Managing athletic competitionsDealing with public speaking anxietyDealing with musical performance anxiety

In the end, only you can decide how best to live with SAD. If you have been in treatment, you may simply need to be vigilant about using coping strategies to avoid a relapse of symptoms. Most people will never live completely without social anxiety, but rather achieve a balance in which your anxiety does not negatively affect your daily functioning or place limits on what you can achieve.

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Social anxiety disorder (SAD) is commonly treated with (CBT), a form of therapy that first became popular in the 1980s and 1990s for treating anxiety disorders. Research has shown that CBT is one of the few forms of therapy that reliably helps in overcoming clinical anxiety disorders.

CBT is not one set method but rather a combination of various techniques that depend on the disorder being treated. For example, CBT for treating depression will be different from CBT for treating SAD or other anxiety disorders. Because there are so many different techniques, it is important that your therapist is experienced in using CBT for treating SAD, and knows which particular techniques are most effective for this disorder. Goals of CBT for Social Anxiety Disorder

One of the central goals of CBT is to identify irrational beliefs and thought patterns and replace them with more realistic views. As part of the therapy process, you will work on a number of problem areas including:misperceptions you may have about your abilities and self-worthguilt, embarrassment, or anger over past situationshow to be more assertivetackling perfectionism and being more realisticdealing with procrastination related to social anxiety

Your CBT therapy sessions may feel somewhat like a student-teacher relationship. The therapist will take the role of a teacher, outlining concepts and helping you on a path of self-discovery and change. You will also be assigned homework assignments that are key to making progress. Cognitive Methods

CBT consists of a number of techniques, many of which focus on problematic thinking. Cognitive methods help lessen anxiety in interpersonal relationships and groups, and give the person with SAD a feeling of control over their anxiety in social situations. The ultimate goal of cognitive therapy is to change your underlying core beliefs (also known as your “schemas”) which influence how you interpret your environment. A change in your core beliefs will lead to long-lasting improvement of your anxiety symptoms.

One of the central problems targeted by CBT are automatic negative thoughts, also known as cognitive distortions. People with SAD have developed automatic negative ways of thinking that are misaligned with reality, increase anxiety, and lessen your ability to cope. These thoughts occur instantly when you think about an anxiety-provoking situation. For example, if you have a fear of public speaking, just thinking about the situation will elicit thoughts of embarrassment and fear of failure. The goal of CBT is to replace these cognitive distortions with more realistic views.

As a person suffering from SAD, at some point in your life someone has probably told you to just “think positive”. Unfortunately, the problem is not that simple to solve –- if it were, you likely would have overcome your anxiety long ago. Because your brain has become hardwired over time to think negatively and have anxious thoughts, it needs to be gradually trained to think in a new way. Just telling yourself “I will be less anxious next time” doesn’t work because this is an irrational statement, given your current way of thinking.

Changing negative automatic thinking in the long term requires practice and repetition, every day for several months. At first you might be asked simply to catch negative automatic thoughts and make them rationally neutral. As this becomes easier, you would work your way up to thoughts that are more realistic. Only then does it become automatic and habitual.

Over time, your memory processes will be affected and the neural pathways in your brain will be altered. You will begin to think, act and feel differently, but it will take persistence, practice, and patience for progress to be made. At first, this is a conscious process but as it is practiced and repeated it becomes automatic. Behavioral Methods

One of the most commonly used behavioral techniques to treat SAD is exposure training, also known as systematic desensitization. Exposure training involves gradually exposing yourself to anxiety-provoking situations so that over time they elicit less fear.

Exposure training for SAD has to be a very gradual process. People may have told you to “toughen up and face your fears;” unfortunately this is extremely bad advice. People with social anxiety are already forced to face what they fear on a daily basis. Exposure that is not structured in a gradual step-by-step process does more damage than good. It will make your anxiety worse, keep you locked in a vicious cycle, and eventually lead to doubt and depression.

With your therapist, you will gradually expose yourself to feared situations so that over time they no longer elicit fear. At first, you may practice “in vivo” exposure, such as imagining giving a speech or practicing a job interview through role playing. Once the practiced or imagined situation becomes easier, you would move to the situation in the real world. If exposure training moves too fast or the situations are too demanding too soon, it will backfire. Keys for Success

Research has shown that there are several keys for success when it comes to CBT and SAD. The likelihood that CBT will help you depends largely on your expectations about success, your willingness to complete homework assignments, and your ability to confront uncomfortable thoughts. People who are willing to work hard and believe that CBT will help them are more likely to improve. Although this form of therapy is intensive and requires active participation by the person with SAD, the improvement shown tends to be long-lasting and well worth the effort invested.

Sources:

Anxiety Treatment and Resource Centre, Hamilton, Ontario, Canada. Social Anxiety Disorder. 5 September 2007.

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Chamomile is a dietary supplement popular for a variety of uses including sleep problems, anxiety, digestive upset, skin infections, wound healing, colic and diaper rash. German (matricaria recutita) is the focus of most scientific research and is available almost everywhere except for England where Roman (chamaemelum nobile) is popular. In North America is most often found prepared as an herbal tea to aid in sleep. In general, not enough reliable scientific research has been conducted to support any of the many common uses of . How to Take :

is available as capsules, liquid extracts, tinctures, teas, and topical creams, among other preparations.Dosage Guidelines for :

You should always read the product label for dosing instructions and consult a healthcare provider if necessary.

For adults, the recommended doses are:Capsules: 400 to 1600 mg in divided doses dailyLiquid extract: 1 to 4 ml three times dailyTincture: 15 ml three to four times dailyTea: 1 to 4 cups of tea per day

There is not enough scientific evidence to recommend use of in children.Who Shouldn’t Take :

The following groups of people should avoid the use of :those with allergies to plants in the daisy family such as aster, chrysanthemum, ragweed, marigold and daisy

those with bleeding disorders and those taking drugs that may increase the risk of bleeding

pregnant and nursing women ( may act as a uterine stimulant or lead to abortion)Medication Interactions With :

In general, more research is needed to fully evaluate medication interactions for . There are a number of potential interactions with medications and other dietary supplements. Before using you should consult with a medical professional about potential interactions with other products you are using.

Some common interactive effects include:drowsiness when combined with benzodiazepines, barbituates, narcotics, some antidepressants, and alcohol

increased risk of bleeding if combined with blood thinners, ibuprofen, and naproxen

risk if combined with medications that affect blood sugar or blood pressure

Given the potential for drowsiness, it is not recommended to drive or operate heavy machinery until you know how affects you.Side Effects of :

Reported side effects of using include:serious allergic reactions including anaphylaxis, throat swelling, and shortness of breath

skin allergic reactions such as eczema

vomiting when taken in large doses Risks Associated with :

The U.S. Food and Drug Administration does not regulate the production of herbs and supplements. Most herbs and supplements are not thoroughly tested, and there is no guarantee regarding the ingredients or safety of the products.

Although a number of potential side effects and interactions are presented here, the risks associated with have not been adequately studied.

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Social Anxiety Disorder (SOD) is associated with an increased risk of problems with alcohol, impairments in social and occupational functioning, poorer response to treatment, and risk of suicide. In addition, if you have been diagnosed with SAD and also suffer with a depressive disorder, you are more likely to have more severe and chronic depressive symptoms. What Comes First — Anxiety or Depression?

Although developing SAD at an early age is known to predispose you to later depression, not everyone who has SAD becomes depressed. We do know, however, that when SAD appears at a young age, appropriate treatment may reduce the risk of developing depression at a later age. Social Withdrawal Differs Between

Imagine a young college student who wants to make friends and go to parties but fears that she will embarrass herself in front of others. As a result, she stays in her dorm room night after night, wishing she could be a part of the group. Contrast this with the student who avoids social contact because it’s just not any fun to her — the thought of going to parties or getting together with a friend holds no promise of enjoyment.

Although both may involve social withdrawal, the cause of the withdrawal is different. People with SAD withdraw out of fear of negative evaluation by others, while people with depression withdraw due to a lack of enjoyment. People with SAD expect that they could enjoy themselves if they could somehow interact appropriately with others, whereas those with depression don’t ever expect to enjoy themselves. Treatment of

Depression is often what leads people to seek help, even though SAD may be the underlying problem. Usually people who have SAD will not speak to anyone about the problems that they face and often do not realize that they have a diagnosable illness. As a result, most people with SAD do not usually receive treatment unless the disorder occurs alongside another condition. Unless a medical professional is trained to look for secondary disorders, SAD may continue to go undiagnosed. Unfortunately, treating depression without addressing underlying SAD can be ineffective. Although many of the treatments recommended for depression are also effective in treating SAD, such as selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT), treatment must still be tailored to the specific disorder. If you suffer with both , your doctor or mental health professional will devise a treatment plan designed to address symptoms of both disorders.

Sources:

Douglas S. Comorbid major depression and social phobia. Primary Care Companion Journal of Clinical Psychiatry: Psychotherapy Casebook. 2001; 3(4): 179-180.

Hales RE, Yudofsky SC. (Eds.). (2003). The American psychiatry publishing textbook of clinical psychiatry. Washington, DC: American Psychiatric.

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Zoloft is the brand name of the generic medication sertraline hydrochloride. is a prescription medication used to treat depression, anxiety disorders, and other serious mental health problems. Manufactured by Pfizer, has been approved by the Food and Drug Administration (FDA) for the treatment of social anxiety disorder (SAD) since 2003, and is the only medication approved for long-term treatment. A selective serotonin reuptake inhibitor (SSRI), slows reabsorption of the chemical serotonin in the brain. Serotonin is believed to play a role in the regulation of mood and anxiety.How to Take :

comes in tablet or liquid form. Tablets must be swallowed whole — not chewed or crushed.

The liquid form of must be combined with one of the following fluids before use — water, ginger ale, lemon-lime soda, lemonade or orange juice. The prescribed amount of medication should be combined with one half cup of the chosen liquid, and each dose should be prepared immediately prior to use, not in advance.

is generally taken once daily, with or without food. If you forget to take a daily dose, take it when you remember. However if it is close to the time of your next dose, it is better to skip the missed dose altogether.

It is important to continue taking as long as your doctor instructs, even if you begin to feel better. If you abruptly stop taking , you may experience withdrawal symptoms such as nausea, tremors, lightheadedness, muscle pains, weakness, insomnia, and anxiety. To avoid these symptoms, your doctor will slowly taper your dosage when you stop taking . Dosage Guidelines for :

For people with SAD, typical dosage of starts at 25 mg, with an increase to 50 mg after one week. Weekly increases up to a maximum dose of 200 mg are permitted for patients who do not respond to lower doses. Who Shouldn’t Take :

should be used with caution if you:have impaired liver or kidney function, heart disease, diabetes, or a history of seizureshave bipolar disorder or a family history of bipolar disorderare pregnant or planning to become pregnantare breastfeedingare receiving electroconvulsive therapyare allergic to sertralineare being treated with medication for alcohol abuse

has not been approved for the treatment of SAD in people under 18 years of age. There is some evidence to suggest an increased risk of suicidal thoughts and behaviors in children taking .Medication Interactions With :

should not be taken in combination with, or within weeks of taking Monoamine Oxidase Inhibitors (MAOIs), sibutramine, or pimozide. The result of such combinations can be fatal.

Caution should be used when taking a number of other medications in combination with . Consumption of alcohol is also not advised while taking . In general, you should inform your doctor of any prescription or over-the-counter medications, or any other substances that you are taking or plan to take. Side Effects of :

Side effects of may include nausea, drowsiness, sweating, dizziness, dry mouth, diarrhea, decreased appetite, sexual dysfunction and insomnia.

When first starting or when changing dosage, watch for more serious side effects such as agitation, nervousness, suicidal thoughts and behaviors, tremors, seizures, persistent vomiting or nausea, severe abdominal pain, changes in urine or stools (dark or increased urine, black stools), or yellowing of the eyes or skin. If you experience any of these symptoms, it is important to report these to your doctor immediately.

It is important to contact your doctor immediately if you experience symptoms of a serious allergic reaction such as trouble breathing, severe dizziness, swelling, itching, or a skin rash.

may cause you to feel drowsy and reduce alertness. It is important not to drive, operate dangerous machinery, or participate in hazardous activities unless you are sure that is not affecting you in this way. Risks Associated with :

The risk of a fatal overdose of is low. Symptoms of an overdose include dizziness, drowsiness, nausea, vomiting, increased or slow heart rate, and coma.

When combined with some medications, there is risk of Serotonin Syndrome, a potentially fatal condition. Symptoms of Serotonin Syndrome include agitation, confusion, sweating, hallucinations, abnormal reflexes, muscle spasms and rapid heartbeat. Jeffries, JJ, eds. Clinical Handbook of Psychotropic Drugs. Toronto, Canada: Hogrefe & Huber; 2003.

Technorati Tags: anxiety, Disorder), medication, Social, treatment, Zoloft

conversation skills communication skills

is an important aspect of social interaction, and it is something that many shy and socially anxious people have difficulty with. Often people with social anxiety describe looking someone in the eyes as anxiety-provoking and uncomfortable. This is likely due, in part, to genetic wiring — studies have shown that people diagnosed with social anxiety disorder (SAD) have a stronger fear response than others. If you have SAD, the part of your brain that warns you of danger can be set off by something as simple as the gaze of a stranger.

Fortunately, with proper treatment including cognitive-behavioral therapy and/or medication, most people with SAD can learn to overcome this fear response and maintain better — a key aspect of effective communication with others.

Communications expert Robert Graham offers training in delivering presentations, and one of his tips for good can be translated into conversational settings when speaking to more than one person:

When speaking to a group of people, instead of thinking of the group as a whole, imagine that you are having individual conversations with one person in the group at a time.

As you speak, choose one person in the group and pretend that you are talking just with that person. Look at him as you finish your thought or sentence. As you begin a new sentence or idea, choose another person in the group and look her in the eye as you finish your thought. Make sure that you eventually include everyone in the group.

What if looking someone in the eye is still too difficult? Choose a spot directly between or slightly above the listener’s eyes. If this doesn’t feel comfortable, try letting your eyes go slightly out of focus. This has the added benefit of softening and relaxing your gaze. Staring too intensely will turn people off and make them uncomfortable.

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