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Anxiety & Panic Disorders Health Center

Is Shyness a Mental Disorder?

Most of the time, no. But when it becomes anxiety, watch out.
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Shrinking Violet or Social Phobic? continued...

Like any personality trait, shyness occurs across a spectrum -- from being uncomfortable at parties to being unable to leave the house for fear of being seen and judged by others.

Social anxiety becomes a problem when it seriously interferes with people's ability to live their lives, says Jonathon Davidson, MD, professor of psychiatry at Duke University Medical Center's Anxiety and Traumatic Stress Program. To diagnose the condition, Davidson has developed a widely used inventory of 17 questions. A mini-version of the test, he says, with only three questions, can correctly diagnose social phobia with 93% accuracy. The questions are:

  • Does fear of embarrassment cause you to avoid doing things or speaking to people?
  • Do you avoid activities in which you are the center of attention?
  • Are being embarrassed or looking stupid among your worst fears?

If people answer yes to at least two of these questions, says Davidson, they are probably phobic. If these fears cause you to hide at home or avoid contact with anyone but your closest friends, you may want to consider therapy.

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.

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