Shyness and Social Phobia
Shyness & Social Phobia – What is it?
According to the Royal College of Psychiatrists’ booklet*, if you have shyness or a social phobia when you are with other people, usually because you worry that:
- they may be critical of you;
- you may do something embarrassing.
There are two main sorts of social phobia.
General Social Phobia
You:
- worry that other people are looking at you and noticing what you are doing
- dislike being introduced to other people
- find it hard to go into shops or restaurants
- worry about eating or drinking in public
- feel embarrassed about undressing in public, so you can’t face going to the beach
- can’t be assertive with other people, even when you know you need to.
Parties can be particularly difficult. Many of us hesitate slightly before going into a room full of people, even if we have been looking forward to it. If you have a social phobia, you may tend to hover around the entrance or outer rooms – because you feel unable to ‘go in’. This leads some people to believe that they are claustrophobic. If you do finally get into the room with other people, you feel as though everybody is looking at you. You may have to have a drink before you go to a pub or party, so that you can relax enough to enjoy it.
Specific Social Phobia:
This affects people who have to be the centre of attention as part of their way of life such as salesmen, actors, musicians, teachers, or union representatives may all feel like this. If you have a specific shyness and social phobia, you may find that you can mix and socialise with other people without any problems. However, when you have to get up and talk or perform in front of others, you become very anxious, stammer or ‘dry up’ completely. It can affect even people who are experienced at speaking in public and do it regularly. At its worst, it can make it impossible for to speak in public at all, even to ask a question. What does it feel like?
The feelings of anxiety are similar for both types of social phobia. You find yourself:
- worrying a lot about making a fool of yourself in front of other people
- feeling very anxious before going into any of the social situations that worry you
- going through, in great detail, all the embarrassing things that could happen to you
- unable to say, or do, the things you want to
- after an event, worrying about how you handled the situation. You may go over, again and again, how you might have behaved differently or said different things.
People experiencing both of these types of shyness and social phobia also have many of the same physical symptoms.You may get:
- a very dry mouth
- sweating
- heart pounding
- palpitations (the feeling that your heart is beating irregularly)
- wanting to pass water or open your bowels
- feelings of numbness or pins and needles in the fingers and toes (this happens because you breathe too fast).
Other people may be able to see some of the signs of this anxiety – the blushing, stammering, shaking and trembling. These symptoms can be quite alarming and make your anxiety worse. It can become a self-fulfilling prophecy. You worry so much about looking worried that you actually do look worried. Your worry is your worst enemy.
Medication
Antidepressants:
Medication should be used if a psychological approach has failed, if you do not want to try a psychological approach, or if you are very depressed. The newer antidepressants (SSRIs – Selective Serotonin Re-uptake Inhibitors) have been found to be helpful in social phobia, but may sometimes cause headaches and dizziness in the first few weeks. They usually start to work within 6 weeks, but can take up to 12 weeks to have their full effect. If the symptoms of shyness and social phobia get better, the dose can be slowly reduced over several months. About half of those who start taking antidepressants will get worse again when they stop taking them.
If SSRIs do not help, Monoamine Oxidase Inhibitors (MAOIs) can be tried. These have drawbacks. They tend to lower the blood pressure which can make you feel faint. Some foods, such as cheese and yeast extract, can produce dangerous reactions with these drugs, so you have to follow a special diet which leaves out these foods. Some cough medicines that can be bought at the chemist also produce similar reactions to these foods. There are now some new MAOI drugs called RIMAs (Reversible Inhibitors of Monoamine Oxidase – A). These don’t seem to produce the above reactions, and so people taking them can eat what they like. Other types of antidepressants don’t seem to work very well in social phobia.
Beta-blockers:
These drugs are usually used to treat high blood pressure. In a low dose, they control the physical shaking of anxiety – which can be a symptom of social phobia – and can be taken shortly before meeting people or before speaking in public.
Tranquillisers:
Drugs like Valium were used in the past to treat all sorts of anxiety. We now know that they are addictive and that they do not help in the long run. They should usually not be used to treat a social phobia.
http://www.rcpsych.ac.uk/mentalhealthinfoforall/problems/anxietyphobias/shynessandsocialphobia.aspx
However, media reports paint a different picture when it come to diagnosing a child with shyness and social phobia as a mental illness.
THE MAIL ONLINE REPORT**
Ten years ago, if you described shyness or restless legs as a bona fide illness, people would have laughed. But these conditions are just part of an epidemic of newly-invented illnesses sweeping Britain. Children who are shy or considered moody run the risk of being diagnosed with mental illnesses and given powerful drugs like Prozac.
Experts said mental health diagnoses are likely to increase from 2013 as new guidelines on the definition of mental illness are being drawn up in America and are likely to be replicated in Britain.
Psychologists in the UK fear school-age children could be diagnosed with mental illnesses like ‘shyness and social phobia’ disorder’ if they are quieter among their peers, or depression if a child is temporarily sad or is battling bereavement.
Once diagnosed, psychologists say children are likely to be treated with powerful drugs like Prozac or Ritalin to curb their behavior – without fully understanding the long-term impacts.
Ritalin is already used to help control attention deficit hyperactivity disorder in youngsters under six and about 650,000 children aged between eight and 13 have also been prescribed the drug or an equivalent.
Back in 1993, Roche developed the drug Mannerix to treat ‘social phobia’. It claimed that about 10 per cent of us suffer crippling bashfulness. But the company could not find enough sufferers for clinical trials. Drug-makers were not deterred and in the following years successfully lobbied for shyness and social phobia to become accepted as a condition after launching new sets of trials.
Figures show the amount spent on prescriptions for social phobia by the NHS more than doubled between 1997 and 2002, from £84 million to almost £189 million. Seroxat has emerged as a popular drug for shyness and social phobia. Seroxat however, was banned from use for children in Britain in 2004 because of fears that withdrawal might trigger suicidal thoughts.
THE TELEGRAPH ALSO REPORTED SIMILAR DISASTROUS FINDINGS***
‘Shy’ children are at risk of being diagnosed with mental disorder Pupils who are quiet at school could be diagnosed with “social anxiety disorder” while those who become withdrawn after suffering a bereavement are classified as having a “depressive disorder”.
“In 2013 we’re expecting new criteria for the definition of mental illness to be adopted here in the UK. These criteria will lead to many more children being diagnosed as mentally ill, based on reports of their behaviors.
A shy child could be diagnosed with social anxiety; a sad or temporarily withdrawn child could be diagnosed with depression. These are conditions which are also likely to be treated with medication.
Research has found that children under the age of six are being prescribed the drug Ritalin for attention deficit hyperactivity disorder, prompting calls for the Department of Health to investigate the scale of the problem and the potential long-term damage it may be causing.
Recent figures show 650,000 children aged between eight and 13 are on the pscyhotropic drug, up from just 9,000 two decades ago, while others are taking Prozac for depression or anxiety.
Fears are growing that the number of children diagnosed with mental disorders and prescribed drugs will increase still further after 2013, when a new “bible” of the psychiatric profession is published.
Known as DSM-5, the book widens the diagnostic criteria for many supposed conditions including social anxiety disorder, better known as shyness and social phobia, and will likely be adopted by the health authorities in Britain after appearing first in the US.
The proposed new definition for social anxiety disorder states that it is marked by “fear or anxiety about one or more social situations in which the person is exposed to possible scrutiny by others. In children this fear could be expressed by “crying, tantrums, freezing, clinging, shrinking or refusal to speak in social situations”.
So why is it that psychiatrists are so eager, in the face of so much hostility, to transform these normal patterns of life experiences into symptoms of mental illnesses for which they are then able to prescribe powerful mind altering drugs to kids as young as 6 years old? Watch this video to find out why.
*Shyness and Social Phobia Booklet
**The Mail Online Report on Shyness
***The Telegraph report on Shy Children at Risk of Being Diagnosed