diagnosis and treatment are difficult because the disorder manifests
itself in many ways. Some fear simply using a public toilet, while
others believe any interaction with strangers will lead to public
ridicule. In addition, many suffer more from secondary symptoms such
as depression, suicide ideation, and agoraphobia, complicating
No one knows for sure what sets off social
phobia, but it may result from a combination of biological
vulnerability-an inborn predisposition to shyness - and some
embarrassing event during childhood or adolescence. And though
social phobia appears to be passed down from generation to
generation, it's not child-raising skills that are at fault.
For those brave enough to come forward, treatment
does exist. In behavioral therapy, participants identify
self-destructive thinking patterns, compare notes with fellow
sufferers, and role-play uncomfortable situations, such as cocktail
parties, that force them to face - and ultimately master-the initial
stages of anxiety they feel in real life.
Drugs such as the betablocker propranolol,
phenelzine, and the antidepressant Prozac also alleviate symptoms,
says NIMH's Wolfe, who predicts that a combination of drug and
cognitive therapy may ultimately prove most effective.