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    Suggest treatment for social phobia

Posted on Thu, 2 Jun 2016 in Mental Health
Question: hello sir am 27 years old male. I have a fear of speaking or can say fear of blocking while speaking (stammering).
I know the whole story behind this fear. Till the age of 09 yrs i was a fluent speaker. I remembered i used to give
speeches in front of whole class till age of 09 years and very good speaker. One day when i was in 4th class our
NEW school teacher was beating the students very hard or brutely or cruely with a stick for not completing the home work.
I was also in the row at second last position ready to beaten up.Teacher was beating us one by one so hard that all
students were crying badly in the extreme pain. To saw them beating badly i was under extreme emotional fear. That cruel
beating filled my mind with so much fear that i was trembling, shaking , my face become red , my jaw and tongue got locked.
And finally my turn came and starightaway teacher asked my name and i was BloCKED TOTALLY WITHOUT A WORD OUT FROM MY MOUTH.
Again he asked wats your father's name and again i was just trembling and mouth locked without a word out. That incident
changed my life completely. I was locked in that speaking pattern.After that incident i was there in continious anxiety
always thinking about that; i have a speech problem , i will again block in front of anyone while talking , people will
laugh at me and all this negative chit chat made me a real stutterer. after this whenever i spoke a voice(thought) in my head
always follows me, Dont Blocked, Dont Stutter, and i always stutter. My parents saw this difficulty with me and they took
me to ENT Specialist but nothing wrong found in tounge and throat. It continioud till age of 13 yrs and finally i found
a trick to say AA before any feared blocked word i was able to say that word after. Slowly Slowly this trick worked for me
and i was out this problem PHYSICALLY BUT NOT MENTALLY. In the back of the mind the voice was always there that am a
stutterer but its volume was very low.I had got my job at the age of 19 years after clearing INTERVIEW. So 13 yrs to 22 yrs
I faced some problems like SELF INTRODUCTION PHOBIA in class or when there was a quick demand to speak in front of class
or group otherwise in day to day life conversations i was a complete fluent speaker . After getting my job at 19 yrs i
started to use alcohal or drinks and from occasional drinker to i started to took heavy drinks. At my job i blocked on
phone and after that i started to afraid from phone AND THE VOICE IN MY HEAD TOLD THAT DONT USE PHONE U WILL GET BLOCKED.
After drinks i was comletely fluent EVEN ON PHONE without any fear this led me to more frequently drinking. But till age
of 25 yrs i became very much alcoholic that i have to cut the limit and with my enough will power am again a occassional
drinker. But from the age of 24 yrs the DEVIL of my speech came back very badly and VERY HIGH VOLUME OF THE VOICE IN MY
HEAD that you will Block and as always am following this and Blocking.
At last i want i want to say that please dont advice me to seek Speech Pathologist etc because I KNOW HOW TO SPEAK BUT
THE VOICE IN MY HEAD DONT LET ME SPEAK. I can say all those words while alone on which i feared or blocked in front of
The only problem is the voice in my head and only problem is in my head only. In my childhood my fear got me blocked not
my speech. And as a kid i had mistaken that i had speech problem but the stuttering was only side effect of that voice
not the main cause. I also observed that while doing anything a sudden voice came in my mind that you cant and i freeze
not one time but everytime whenever i repeat this thing in future. Like roll call in class, talking on phone and many
others are there.Now i am having tremors also while speaking.
Sorry for so long story , Finally all problems are due to beleiving on these voices or thouthts
i want the solution of these nagative voices or thoughts in my mind. My inner feared child is still here at the age of 27 yrs.

Answered by Dr. Ashok Kumar 45 minutes later
Brief Answer:
There are multiple treatment options

Detailed Answer:
Thanks for using Healthcare magic.

I read your query with keen interest and understand your concerns.

First of all I like to tell you that you do not have any articulation problem and it is simple social phobia which is a psychiatric disorder under phobic disorder category. You are right in pointing out that negative voice is the only reason which blocks you while communicating with others or in group.

Having said this I am glad to inform you that social phobia can be treated with both medications as well as behavior therapy. In regard to medicines almost 30 drugs are vailable which can be used for treatment of social phobia. Similarly in regard to therapy both CBT as well as BT can be used in your case.

You do not need to visit a speech therapist as he has nothing to do in your case. You just need to visit a psychiatrist in your city to get your self treated and can choose any of the treatment options available for social phobia.

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ashok Kumar 28 minutes later
thanks for your quick reply sir. can you suggest me any mediciens which having minimum or no side effect if use for short period like 02-03 weeks of uses regarding the same social phobia. As am doing meditation and some other stuff like inner child healing/Re parenting inner child which i got on youtube. And am enjoying by feeling relaxed now in normal coversations. But on speak on demand am getting blank. So i need some help from medications also which drugs and in how much quantity . i have heared about zoloft or any if u can suggest me will be appreciated.
Answered by Dr. Ashok Kumar 19 minutes later
Brief Answer:
Medication will need prescription from local doctor

Detailed Answer:
Thanks for reverting back to me.

I am glad to know that you are making conscious effort but it will be appropriate to visit a psychiatrist in your city.

As I said in last reply there are more than 30 drug options available and not every option is suitable for everybody.

In clinical practice I use following options depending on the patient profile after due physical examination
Tab, Sertraline 25-200 mg per day
Tab Fluoxetine 20-40 mg per day
Tab Escitalopram 5-20 mg er day
Tab Paroxetine 12.5 to 50 mg per day
Tab Venlafaxine 75-225 mg per day
And many others.

Since all these medicine have side effects they should be used only after after prescription.

You can take this list to your local doctor and he will examine you phisically and will prescribe right medicine suitable for you.

You need to understand that these medicine take some time to show improvement (generally 2-3 weeks ).

I hope this helps you.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ashok Kumar 29 minutes later
thanks Dr. XXXXXXX sir for so quick replys..you are right to visit a psychiatrist but am living in a small town so it is very hard to search a psychiatrist nearby thats why am taking online help but i will try..i have attached my latest annual medical reports which have done in this week only..in reports sugar value is fasting value not random..age 27 yrs,height 171 cm, weight 63 kg, not allergic to any mediciane, bp is 135/85, heart beat between 72-84, also done ecg which is also normal, thanks for bearing me so long dr..suggest me any mediciance if u can after watching these reports
Answered by Dr. Ashok Kumar 7 minutes later
Brief Answer:
These medicine can be prescribed by any MBBS doctor

Detailed Answer:
Dear Annop,
Thanks for follow up.

All the medicines I mentioned earlier can be used in your case. In case you have been my patient I will prefer 10 mg of escitalopram per day to be taken at night time.

At the same time these all medicine can be prescribed any medical graduate. Your diagnosis is almost clear and after due physical examination he can prescribe any of these medications including Esitalopram.

I hope this helps you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Ashok Kumar


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