A Cure For Shyness?
Many of us experience a pounding heartbeat or shaking when faced with a public situation, especially if we think we are going to be judged by others. When does this cross the line between normal and a mores serious disorder? Social anxiety disorder, a relatively newly recognized disorder by the psychiatric profession, involves many of the same symptoms as shyness. What makes the difference between a case of the jitters and a real disorder?
Social Anxiety Disorder was first recognized by the American Psychiatric Association as a disorder in 1980 (1). It is characterized by such physical symptoms as increased heartbeat, blushing, dry mouth, trembling and shaking, difficulty swallowing, and twitching in the muscles (2). Many people with social anxiety disorder also have depression. A study in France found that 70 percent of patients who developed social anxiety disorder before the age of 15 also suffered from major depression (3). Diagnostic criteria, according to the current definition of social anxiety disorder given by the Diagnostic and Statistical Manual of the American Psychiatric Association, 4th ed. (DSM-IV), requires a persistent fear of at least one social situation which involves exposure to unfamiliar people or scrutiny by others. The patient must fear that he or she will act in this situation in a way that will cause embarrassment, and avoid the situation or experience extreme anxiety or a panic attack if faced with the situation. The patient must also realize that the fear is unreasonable. The avoidance or anxiety must interfere to a large extent with the normal routine, functioning, social activities, or relationships with the person (1).
This last criterion, a significant interference in the person's everyday life, is possibly the most important one in distinguishing social anxiety disorder form shyness that is a normal facet of personality. What constitutes such a significant interference in one's normal routine, however, is not necessarily easily determined; there is no specific point at which the line is drawn between shyness and social anxiety disorder. Many of the symptoms can be experienced in bouts of shyness that many people undergo from time to time. Perhaps because it is so hard to diagnose and the criteria are not absolute, estimates about how widespread social anxiety disorder is vary. The Anxiety Disorders Association of America says 10 million Americans suffer from the disorder (4), and the Social Anxiety institute says it affects 15 million Americans in a year (1). Regardless, studies show that it is the third most common mental disorder (the first two are substance abuse and depression) (3).
Social anxiety disorder is also often misdiagnosed or fails to be diagnosed at all. The Social Anxiety Institute suggests that almost 90% of people who suffer from social anxiety are misdiagnosed, often told they have schizophrenia, depression, panic disorders, or personality disorders (1). The...