What tools are available to manage social anxiety disorder when triggered by rejection?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 17, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

When feeling triggered by rejection, the most effective tool to manage social anxiety is cognitive behavioral therapy (CBT), specifically the Clark and Wells model or the Heimberg model, administered through individual sessions by a skilled therapist, as suggested by the Japanese Society of Anxiety and Related Disorders/Japanese Society of Neuropsychopharmacology: Clinical Practice Guideline for Social Anxiety Disorder (2021) 1. This approach is prioritized due to its superiority in terms of clinical and health-related economic effectiveness. Some key techniques to manage social anxiety include:

  • Deep breathing exercises to activate the parasympathetic nervous system and reduce physical anxiety symptoms
  • Challenging negative thoughts by asking for evidence supporting fears and considering alternative interpretations
  • Grounding techniques like the 5-4-3-2-1 method to bring focus back to the present moment
  • Progressive muscle relaxation to release physical tension For medication options, Selective Serotonin Reuptake Inhibitors (SSRIs) are suggested as a first-line treatment for ongoing anxiety, with a weak recommendation and low certainty of evidence, as stated in the Japanese Society of Anxiety and Related Disorders/Japanese Society of Neuropsychopharmacology: Clinical Practice Guideline for Social Anxiety Disorder (2021) 1. It's essential to note that while these tools can be effective, individual results may vary, and what works best may depend on the specific circumstances and the individual's preferences and needs, as highlighted by the guideline's weak recommendation and low certainty of evidence 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Social Anxiety Tools

When feeling triggered by rejection, individuals with social anxiety disorder (SAD) can benefit from various therapeutic strategies. Some of these tools include:

  • Cognitive Behavioral Therapy (CBT): CBT is a consistently effective treatment for SAD, and can be used in combination with pharmacotherapy 2, 3.
  • Acceptance and Commitment Therapy (ACT): ACT is a form of CBT that has been found to be effective in treating SAD, and can help individuals improve their attentional bias, awareness, emotion regulation, and safety/avoidance behaviors 4.
  • Pharmacotherapy: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors have been extensively studied and shown to be effective in treating SAD 3, 5.

Rejection and Social Anxiety

Research has shown that individuals with low degrees of social anxiety tend to respond to rejection in a compensatory pro-social manner, while those with high degrees of social anxiety fail to do so 6. Additionally, early life adversity can moderate symptom change following SSRIs and CBT, with individuals with a positive history of early life adversity having a greater reduction in depression symptoms following SSRIs compared to CBT 5.

Treatment Options

Treatment options for SAD include:

  • CBT: Can be used to help individuals manage their social anxiety symptoms and improve their quality of life 2, 3.
  • ACT: Can be used to help individuals improve their psychological flexibility and reduce their social anxiety symptoms 4.
  • Pharmacotherapy: Can be used to help individuals manage their social anxiety symptoms, particularly those with severe symptoms or those who have not responded to other treatments 3, 5.
  • Online psychotherapy and virtual reality exposure: Can be useful alternatives to traditional CBT and pharmacotherapy 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.