"Before a social occasion,
I feel nauseous and dizzy, can't think straight, I can't
breathe, sweat, blood rushes to my head and I go bright
red, I tremble and want to get away... I feel as though
I have no control over my body or what I'm going to say...
Cigarettes, whiskey, standing outside in the cold to cool
my face down — these things work for about five minutes."
— An anonymous post on socialphobiaworld.com, a support
group website for social anxiety sufferers
"The kid's just shy," they might
say, but for young social phobia (also called social
anxiety) sufferers, a profound fear of humiliation and
rejection can set them on a lifelong path of missed
opportunities, unmet potential and even desperate drug
and alcohol escapism. Social phobia differs from normal
shyness in that it has real physical symptoms, like
nausea, rapid pulse and trembling, and sufferers usually
feel helpless to do anything about it.
Shyness itself is extremely common
— Stanford Professor Philip Zimbardo's classic
1970s study found that more than 80% of people were
shy some of the time. However, more extreme forms like
social phobia are hard for observers to differentiate
from ordinary timidity. Due to the nature of the condition,
an unusually high number of cases are believed to go
undiagnosed. Accordingly, estimates of the condition's
prevalence vary wildly, but many experts reckon 7-14%
of the population suffers from social phobia.
Dr Tatyana Barankin, Director of
CME, Child Psychiatry Division, at the University of
Toronto says social anxiety is dreadfully under treated.
"It's the most trivialized and underdiagnosed psychiatric
disorder," she adds, "this is a very closeted condition
— it's very difficult for a family physician to
pick up on." She believes that parents all too often
dismiss social anxiety as a passing phase — a dire
mistake in her view: "I don't say 'it's something children
will outgrow,' because untreated conditions often become
chronic."
Furthermore, our propensity to
take a wait-and-see approach with social phobia could
cause needless anguish for a child: "It's like swimming
against the flow of the river, social anxiety takes
up so much energy," she says. "It could be treated with
cognitive behaviour therapy or in very severe cases
medications are very effective." Drug treatments include
selective serotonin reuptake inhibitors and monoamine
oxidase inhibitors.
Just how tough is social
phobia on kids? Dr Barankin recalls an eight-year-old
patient telling her that while speaking in front of
classmates his "heart is going as fast as a washing
machine." She feels for those kids with undiagnosed
social phobia, who so often slip between the cracks:
"They may later develop problems with job interviews.
They're very self-conscious. They're also sensitive
to rejection and disapproval. In every situation there
is an intense fear that they won't measure up."
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