Social phobia: more than just shyness
Shyness is a common, often quite attractive, characteristic, especially in children. With the passage of time, and increasing self-confidence, most of us grow out of it.
But sometimes what might appear to be an extreme form of shyness is a far more serious problem, the mental illness known as social phobia.
Phobias are irrational fears. Social phobia is often characterised by:
- fear of scrutiny by other people in social (usually small group) situations;
- fear of humiliation or embarrassment when having to ‘perform’ in front of others; and
- the avoidance of situations where these fears might arise.
Some of the situations likely to cause problems for affected people include:
- being introduced to strangers;
- making telephone calls;
- eating in restaurants;
- public speaking; and
- almost any situation where other people are watching them do something.
Social phobia is thought to affect at least one in 10 people at some time in their lives. It usually starts at a young age and is most common in adolescents. Nearly half of those affected have the problem before they reach 10 years of age. It is not common for the condition to begin after age 20.
Having social phobia can have a serious effect on people's lives. School performance is usually affected, and children with the problem may achieve poorer results than their schoolmates. Many will persistently refuse to go to school. In later life, employment opportunities are reduced, as is the likelihood of marriage.
Dealing with social phobia
Some people with social phobia are so badly affected that they withdraw from social life almost completely, leading very isolated and unhappy lives. Others will attempt to lead more normal lives. They often suffer a great deal of anxiety when they have to appear in public. This anxiety may show up as one of a variety of physical symptoms which include palpitations, difficulty in breathing or swallowing, trembling and excessive sweating.
Social phobia can be successfully treated, particularly if it is recognised early. Treatment usually needs to be carried on for quite a long time, and may be either psychological or pharmacological (drug) treatment. Sometimes a combination of the 2 is helpful.
Psychological treatment may take the form of cognitive therapy, which attempts to change the way people think (as opposed to behavioural therapy, which attempts to change the way people behave).
If you know a young person whose shyness is interfering excessively with their leading a normal life, discuss social phobia with your doctor.
Last Reviewed: 31 May 2001
