CASE STUDY

SOCIAL ANXIETY DISORDER

 CASE 1 – MALE
BASIC DETAILS:

Name Mr. R (name has changed )

Age 20 years old
Marital status Single
Father Public sector employee
Mother House wife
Sibling 1 ( elder sister)
Delivery Normal

The Motor skills milestones were achieved on time, no major illness and no major operation, failed in 5 th
standard, no friend circle, no outdoor games instead spend, no social accounts, always playing video games
and joined school hostel were the subject to alcohol
 DAILIY ROUTINE
Now the subject is staying with his parents in his home Where he woke up and go for gym then he have
breakfast, then his father leave him in the college campus, after college he used to go the basketball ground and
play there for sometimes. After that his father again pick him up from the college and then after reaching home
he spend time in mobile and games and then have dinner with family then sleep this the daily usual routine of
the subject.

SYMPTOMS AND DIAGNOSIS

 Does not wish to participate in any of the family function, being adamant to parents if they compel or ask him
to anywhere out.

 Parents, relatives and friends used to tag him as shy type person and introvert.

 School or any sports activity the subject used to have nausea, fear of eye contact, intense anxiety, not able to
process information, difficulty in breathing and used to take leave on that particular social event days.
 Subject put into hostel during his 11th grade, after joining hostel daily he used to cry inside the washroom, he
became psychologically weak, stressed and depressed.

 Then it has been noted by the teachers and parents about the alcohol addiction

 Even though they took him back to home it was found that he lost the ability to control his gratification and
cravings towards alcohol.

 So they took them to psychiatrist and joined him in rehabilitation centre where they undergone different
diagnostic methods

 Triage Assessment for Addictive Disorder (TAAD), Thematic appreciation test and the stories spoken by the
subject was somewhat match to the events of subject’s life where a boy sitting alone, crying such that.

 And Draw a person test was also administered in the diagnosis process.

 Followed by physical tests has also undertaken by the doctors. Also through subject past history it has been
confirmed that the patient diagnosed with social anxiety disorder with comorbid substance use.
 TREATMENT
 The subject entered in rehabilitation in 2017 for 7 months, later relapse in a month being discharged then
again admitted in Rehabilitation in 2018 for 10 months.

 Cognitive therapy has used in combination with appropriate behavioural interventions as a first line therapy.

 This cognitive approach used to help break the vicious cognitive circle which lead the subject to feel better.
Some of the cognitive exercise are such as drawing, writing story as per the subject’s interest and in order to
treat subject’s social anxiety group activities has also conducted.

 Diversions and other affirmation has also performed by the subject in order to reinforce his belief and to
gain motivation.

 When patient relapsed and admitted in rehab centre the same CBT has followed but with extended in time.
After that group therapy has also given to the subject in order to treat the social anxiety disorder.
Medications were also used by the subject. Self-meditation has also followed by the subject.
Family and social support - At first the family could not accept, after a period of time they started to
blame on themselves, they know the importance of supporting their child mentally and being there for him,
But socially there were so much of discrimination, judging the subject and his family which affect the family
member mentally. It has been found that none of the relatives supported them.

Challenges - Considering something was wrong with him. Peer influence leads to become a substance user.
Academic drop out which made the future more complicated. Society pressure on the subject and their family.

Current state - Currently the subject pursuing diploma course from a private institution, whole family
shifted their home and work to a different place, undergoing counselling under the same hospital branch, does
not have any nausea, blank mind status or fear of eye contact and no substance use also, focused on career.
And also sometimes the subject feel bad for the past behaviour. Now a days whenever he visit for counselling
session mostly discuss about the feel of guilt where getting therapy based on that.
 CASE 2 – FEMALE
BASIC DETAILS
Name Ms. M (name has changed )
Age 26 years old
Marital status Single
Qualification B. Tech
Father Business man
Mother Teacher (retired)
Sibling Single child.
Delivery Normal

Motor skills milestones were achieved on time, Subject mentioned normal upbringing no major illness and

no major operation, school life was normal with some traumatic events, does not have a friend circle also

mentioned that had an issue with maintaining , does not wish or maintained any sort of friendship and
 Daily routine

Staying away from the home for the job purpose who is staying in a home, household chores has to be done
by M and simultaneously she has to balance work life also so the subject woke up around 6.30 in the
morning, medication for half an hour to one hour, then followed by cooking, reaching office, working, then
returning to home, after that spending time with friends for some time. After that she cook her dinner for
herself.

Symptoms and diagnosis

 The childhood days the subject used to be reserved , bullying by her classmates , 10 th grade because of
higher anxiety she started to cry , subject’s father used to be reserved during family function, community
gathering , social anxiety runs in family, during college days stammered because of fear and anxiety,
 Self-realise that something is wrong, meeting or presentation in office - extreme fear and anxiety which lead
her no appetite, she experience excess of sweating, sleeplessness and because of acute fear and anxiety she
faced lot of psychosomatic issues such as fever, intense headache

 Sometimes whenever she talk or put into the situation in front a group of people the subject experience fast
heartbeat, intense fear, stammering, thinking about being judged negatively, also experienced feeling of
mind has gone blank, upset stomach and trouble catching breath and nausea.

 These are the symptoms which triggered greatly and disturbed her both physiologically and psychologically
once the subject start working then she became aware about the condition

 One of her friend suggest about anxiety disorder and then consulted a psychiatrist

 Diagnosed as Social anxiety disorder followed by certain psychological evaluation such as physical exam,
also explained all these symptoms and also examined about any other medication that has currently taken by
the subject.
 Treatment and Therapy

 The subject has undergone different therapy session totally 24 sessions which has scheduled according to her work schedule

from December 2018 till May 2019

 face to face counselling sessions , cognitive behavioural therapy (CBT) in which the psychiatrist help the subject to learn to

manage anxiety and other mentioned symptoms.

 acceptance and commitment therapy has given to the subject for one hour in which they provide counselling which helps to

work mindfulness, being focused on present moment and feelings without judgment and negative thoughts

 group therapy where the participants increased session by session – faced lot of difficulties

 after four continuous group therapy session she became comparatively comfortable

 After that for whole month both CBT and group therapy has undergone on scheduled basis.

 medications for the subject but tablets for anxiety disorder during severe headache has taken
Family and social support - subject’s family provided support , help from office balanced work,

friends helped a lot through taking to therapy sessions, motivating and make the subject to participate in
social activities.

Challenges faced - The subject faced bullying which is also the cause for her condition that results in
social anxiety disorder. Also during covid the subject was slightly into the phase of relapsed where her friend
stayed with her for all the time. And gradually had a counselling sessions with psychiatrist. And other
symptoms of social anxiety disorder.

Current state : excel in work, staying with group of friends, better interpersonal relationship, optimistic
thoughts, increased self-confidence, subject does not have or experience any symptoms such as intense
anxiety, fear, fear of being negatively judged, stammering and other symptoms which she undergone because
of the social anxiety disorder.
 CONCLUSION
Social anxiety disorder is known to appear at an early age in most cases. Fifty percent of those who
develop this disorder have developed it by the age of 11, and 80% have developed it by age 20.

This early age of onset may lead to people with social anxiety disorder being particularly
vulnerable to depressive illnesses, substance use, and other psychological conflicts. Social anxiety
disorder occurs more often in females than males.

The prevalence of social phobia appears to be increasing among teenage, married, and well-
educated individuals.
THANK YOU