“This Beer Should Do the Trick!”: Heading to College with Social Anxiety Disorder

Abstract

Social Anxiety Disorder may adversely impact transition to college. Alcohol and cannabis can be misused or abused in an attempt to self-medicate symptoms. Academic underachievement is common due to lack of self-advocacy, fear of public speaking, and avoidance of classes. This chapter describes the case of a young woman diagnosed with Social Anxiety Disorder and Major Depression Disorder prior to college matriculation. While her symptoms were relatively stable prior to starting college, she experiences a relapse of both anxiety and depressive symptoms in the context of disrupted treatment. This contributes to misuse of alcohol as well as declining academic achievement. Discussion focuses on the need to adequately prepare the patient and family for the transition to college through psychoeducation, establishing a treatment team on or near campus, anticipating potential difficulties with academics and social relationships, and developing a plan for accessing campus resources and supports. Other topics discussed include introversion, social maturity, and developmental readiness for college.