What happens when the mere thought of talking to a stranger is terrifying?
EVERYONE FEELS SELF-CONSCIOUS occasionally. Many folks would rather die than give a speech or introduce themselves to a stranger. But a number of Americans harbor an irrational fear that their social performance is being carefully monitored and criticized by others all the time. As a result, these shy-meisters will go to great lengths to avoid eating, drinking, speaking, or even writing in public.
The condition, social phobia, affects about 2% of the population and is "one of the worst neglected disorders of our time," insists psychologist Barry Wolfe, Ph.D., of the National Institute of Mental Health. He is one of a pack of researchers and clinicians across the country paying heightened attention to the disorder, encouraged by the results of new behavioral and drug therapies.
The condition has been ignored in the past primarily because extreme social phobics rarely seek help, so embarrassed are they by behavior that society deems "trivial" or "outgrowable." Typically, concerned parents notice that their abnormally anxious teenagers or twenty-something stay-at-homes are avoiding classes or job responsibilities and drag them off to therapy. Accurate diagnosis and treatment are difficult because the disorder manifests itself in many ways. Some fear simply using a public toilet, while others believe any interaction with strangers will lead to public ridicule. In addition, many suffer more from secondary symptoms such as depression, suicidal ideation, and agoraphobia, complicating diagnosis.
No one knows for sure what sets off social phobia, but it may result from a combination of biological vulnerability-an inborn predisposition to shyness- and some embarrassing event during childhood or adolescence. And though social phobia appears to be passed down from generation to generation, it's not child-raising skills that are at fault.
For those brave enough to come forward, treatment does exist. In behavioral therapy, participants identify self-destructive thinking patterns, compare notes with fellow sufferers, and role-play uncomfortable situations, such as cocktail parties, that force them to face - and ultimately master-the initial stages of anxiety they feel in real life.
Medications such as the betablocker propranolol, phenelzine, and the antidepressant Prozac also alleviate symptoms, says NIMH's Wolfe, who predicts that a combination of drug and cognitive therapy may ultimately prove most effective.
* If you or someone you know is struggling with Social Phobia or Social Anxiety, click on our Schedule/Fees Tab at the top of the page to schedule an initial assessment.