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Anxiety & Panic Disorders Health Center

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Is Shyness a Mental Disorder?

Most of the time, no. But when it becomes anxiety, watch out.

Drugs, Counseling, or Both

Untreated, social phobia can lead to serious problems, so it's important to identify and treat this condition. Psychiatrist Murray Stein and his colleagues at the University of California at Los Angeles have found that almost six in ten social phobics are clinically depressed, and one in four have recently been treated for substance abuse, according to a review article published in the December 1999 Journal of Clinical Psychiatry. The researchers speculate that the isolation brought on by social phobia contributes to the other disorders.

Luckily, a variety of treatments can help. In a study published in the August 26, 1998 Journal of the American Medical Association, 55% of patients taking Paxil reported that their symptoms improved after 11 weeks, compared to only 23.9% of those taking a placebo. Scores on a widely used test that measures social phobia, called the Liebowitz Social Anxiety Scale, fell by 39.1% in the Paxil group compared with only 17.4% in patients given the placebo.

In clinical practice, psychiatrists are discovering that other drugs similar to Paxil, including Serzone, Effexor, and Zoloft, can also effectively treat social phobia, says Lydiard.

Are such drugs likely to be overused? Probably not. They seem to work only in people with serious social anxiety, according to Davidson. Paxil won't turn a normally shy person into a social butterfly, in other words. And most people are willing to take a prescription drug -- which usually costs them money and can have side effects -- only if they perceive that they have a real problem.

Medication is only one approach. Psychotherapy can also help. At the University of California at Los Angeles' Social Phobia Clinic, patients meet once a week for 14 weeks of group sessions designed to help them replace negative thoughts ("She won't like me," or "I look stupid") with more positive thinking. In behavioral therapy sessions, patients are put in anxiety-producing situations in order to defuse their fears.

So it turns out that chatting about this problem does help, as more and more social phobia sufferers are discovering by going online to share their feelings with others. Several social phobia experts believe chat groups are useful to patients with the disorder. It's good to know that there's at least one place on the Internet -- so often blamed for isolating us -- where people can go to escape feelings of isolation.

Peter Jaret is a contributing editor at Health and National Wildlife magazines. His work has appeared in Newsweek, National Geographic, Hippocrates, Men's Journal, Vogue, Glamour, and many other magazines. He lives in Petaluma, Calif.

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