Social anxiety disorder is a persistent fear of being judged or embarrassed in social situations, leading to avoidance that limits work, school and relationships. It is treated with SSRIs or venlafaxine, cognitive behavioral therapy with graded exposure, or both, and beta blockers such as propranolol for specific performance situations. Most people improve substantially within 12 to 16 weeks. Stedfast Psychiatry treats social anxiety disorder at 11641 Kew Gardens Ave in Palm Beach Gardens and by video across Florida; new patients call (561) 437-2199.
Social Anxiety Disorder at our Palm Beach Gardens office
Patients come to the Palm Beach Gardens office for social anxiety disorder treatment from PGA National, BallenIsles, Mirasol, Frenchman's Creek and Frenchman's Reserve, and from nearby North Palm Beach, Juno Beach, Jupiter and Lake Park. The office is at 11641 Kew Gardens Ave, Suite 209, close to The Gardens Mall.
New-patient scheduling for Palm Beach Gardens runs through (561) 437-2199. Existing patients reach the office directly at (561) 402-3971. Free surface parking is available at the building, including accessible spaces near the main entrance. If a same-week in-person slot is not open, a video visit with the same provider usually is.
Both Deep TMS and Spravato are delivered on site at this office, so a patient who does not respond to medication can move to an interventional option without changing clinics.
Who you will see in Palm Beach Gardens
The Palm Beach Gardens team includes psychiatrists Dr. Louis Velazquez and Dr. Tanya Peguero Estevez, psychiatric nurse practitioner Sophia Schulman and physician assistant Ellington Curtis. Visits in Spanish are available with Tanya Peguero Estevez. Children and teens are seen by Louis Velazquez, Sophia Schulman, Ellington Curtis and Stephanie Mills.
Dr. Louis Velazquez, MD
Psychiatrist · Ages 4 to 80
Sophia Schulman, PMHNP-BC
Psychiatric Nurse Practitioner · Children 7+, adolescents and adults
Ellington Curtis, PA-C
Physician Assistant · Adults and teens 14+
Dr. Tanya Peguero Estevez, MD
Psychiatrist · Adults 18+ · English, Spanish
Stephanie Mills
Clinician · Adults and teens 13+
Signs of social anxiety disorder
- Intense fear of being judged, embarrassed or humiliated
- Avoiding or enduring with dread situations like meetings, parties, dating or presentations
- Fear of showing anxiety symptoms such as blushing, sweating or a shaky voice
- Blushing, sweating, trembling, rapid heartbeat or nausea in social situations
- Mind going blank or difficulty speaking when attention is on you
- Avoiding eye contact, phone calls or speaking to strangers
- Rehearsing conversations in advance and replaying them afterward
- Low self-esteem and harsh self-criticism after social events
How we diagnose it
We diagnose social anxiety disorder through a clinical interview that identifies the feared situations, the specific fears behind them (looking stupid, being seen to blush, being rejected), how long the fear has lasted, and how much you avoid. We use the Liebowitz Social Anxiety Scale or the Social Phobia Inventory to measure severity and track progress, along with the GAD-7 and PHQ-9. We distinguish social anxiety from panic disorder, agoraphobia, generalized anxiety, autism spectrum disorder, body dysmorphic disorder and avoidant personality disorder, and we screen for depression and alcohol use, which frequently accompany it. We also note whether the fear is generalized across most situations or limited to performance, since that changes treatment.
About 7.1 percent of US adults had social anxiety disorder in the past year, and 12.1 percent will have it at some point in their lives.
Source: NIMH, National Comorbidity Survey Replication
About 9.1 percent of adolescents aged 13 to 18 have social anxiety disorder.
Source: NIMH
The median age of onset for social anxiety disorder is 13, and most people wait more than a decade before seeking treatment.
Source: American Psychiatric Association, DSM-5-TR
Cognitive behavioral therapy produces lasting improvement in social anxiety and in head-to-head trials has outcomes at least equal to medication with lower relapse after treatment ends.
Source: Mayo-Wilson et al., The Lancet Psychiatry, 2014 network meta-analysis
Treatment for social anxiety disorder in Palm Beach Gardens
Medication management
SSRIs and SNRIs are first-line for generalized social anxiety disorder. Sertraline, paroxetine, fluvoxamine CR and venlafaxine XR are FDA-approved for it, and escitalopram is widely used. We start low, increase over four weeks, and expect early benefit at four to six weeks with full response by 12 weeks. For performance-only anxiety (presentations, auditions, interviews), propranolol 10 to 40 mg taken an hour beforehand blocks the physical symptoms of trembling, racing heart and shaky voice without sedation. Benzodiazepines are used sparingly because of dependence and because they blunt the learning that exposure depends on. For patients who do not respond to SSRIs, the MAOI phenelzine has strong evidence but requires dietary restrictions, and gabapentin or pregabalin are alternatives. Medication is continued for at least 12 months after improvement.
Psychotherapy
Cognitive behavioral therapy for social anxiety is the most effective psychological treatment and, for many people, the most durable treatment of any kind. Over 12 to 16 sessions you learn to identify the predictions driving the fear, shift attention outward during conversations, drop safety behaviors (avoiding eye contact, rehearsing, holding a drink), and carry out graded exposures to feared situations, often with video feedback that shows the gap between how anxious you feel and how you look. Group CBT works well because the group itself is the exposure. Our therapists coordinate with the prescriber when medication is also used.
What to expect
The first visit is a 45 to 60 minute evaluation, available by video for patients who find an office visit daunting. We go at your pace and focus on the situations that matter most to you. You leave with a plan that may include medication, CBT or both. Follow-ups are every three to four weeks during medication titration, then every two to three months. Therapy sessions are weekly. Telehealth is available throughout Florida and South Carolina and is a good fit for social anxiety, with exposures planned for the real situations in your life.
The complete guide, including causes, subtypes and research, is on our Social Anxiety Disorder page.
Emergency and crisis resources near Palm Beach Gardens
In an emergency, call 911 or go to Palm Beach Gardens Medical Center Emergency Room (3360 Burns Rd, Palm Beach Gardens). The 988 Suicide and Crisis Lifeline is available by call or text 24 hours a day. Jupiter Medical Center Emergency Department and 988 Suicide and Crisis Lifeline are also listed on the Palm Beach Gardens office page.
Frequently asked questions
Who provides social anxiety disorder treatment at the Palm Beach Gardens office?
The Palm Beach Gardens team includes psychiatrists Dr. Louis Velazquez and Dr. Tanya Peguero Estevez, psychiatric nurse practitioner Sophia Schulman and physician assistant Ellington Curtis. Visits in Spanish are available with Tanya Peguero Estevez. Every provider works under psychiatrist oversight and the same evaluation standard: about an hour for a first visit, validated screening scales, and a written plan.
Can I be seen by video instead of coming to Palm Beach Gardens?
Yes. Stedfast Psychiatry providers are licensed in Florida and offer video visits for evaluations and follow-ups. Some situations, including certain controlled-substance prescriptions and first visits for young children, require an in-person appointment at 11641 Kew Gardens Ave.
Does the Palm Beach Gardens office take my insurance?
We accept most major commercial plans and Medicare. Call (561) 437-2199 with your member ID and we will verify benefits before the visit. Self-pay new-patient evaluations are $185.
How soon can a new patient be seen in Palm Beach Gardens?
Most new patients are scheduled within one to two weeks. If you need to be seen sooner, ask about a video visit; those often open up within days. If you are in crisis, call or text 988 or go to the nearest emergency room rather than waiting.
Can I get Deep TMS or Spravato as a Palm Beach Gardens patient?
Yes. Deep TMS is delivered on site in Palm Beach Gardens. Spravato is available at Palm Beach Gardens, Palm Beach Gardens and Royal Palm Beach.
What is the difference between shyness and social anxiety disorder?
Shyness is a temperament: discomfort that fades as you warm up, and it does not stop you from living your life. Social anxiety disorder is a persistent fear of judgment that lasts six months or more, causes intense distress or physical symptoms, and leads you to avoid or endure situations at real cost to work, school or relationships. If you are declining promotions, skipping classes or avoiding dating because of the fear, it is more than shyness.
What is the best medication for social anxiety?
Sertraline, paroxetine, escitalopram and venlafaxine XR are first-line and reduce anxiety across all social situations over 8 to 12 weeks. For performance-only anxiety, propranolol taken before the event controls the physical symptoms without affecting your thinking. Benzodiazepines work quickly but are not a good long-term plan. For people who do not respond to SSRIs, other options exist and we will walk through them.
Nearby Stedfast offices
If you are in crisis, call or text 988 or go to the nearest emergency room. Educational content; individual results vary. Reviewed by Dr. David Husted, board-certified psychiatrist.