Social anxiety disorder.(WOMEN'S HEALTH ADVISER)

Social phobia, or social anxiety disorder, is a chronic, disabling fear of public situations that can limit one's personal, academic, and professional potential.

Researchers think the disorder has both biochemical and societal under-pinnings. Serotonin dysfunction is assumed to be present in social anxiety disorder, because it has a high rate of comorbidity with other serotonin dysfunction disorders: Up to 90% of patients also have depression, another anxiety, or panic disorder. The early socialization of girls to be quiet and nonassertive may also play a role in the development of the disorder; about 70% of those affected are female.

Diagnosis

Among affected women, about 70% develop the disorder before age 25, but it can occur much earlier, with 50% reporting symptoms by age 15. Social phobia is associated with being female, younger, single, and of lower socioeconomic standing.

Patients experience intense and persistent fear in at least one type of social situation. These may include public speaking and work-related situations, but also such seemingly simple interactions as eating and drinking in front of others, attending any gathering, or meeting new people. The fear can induce palpitations, sweating, blushing, and tremors.

Women can go to great lengths to avoid the situations that provoke these symptoms. A key diagnostic criterion is self-awareness. Patients understand that these fears are unreasonable but are powerless to control them.

Social phobia is a chronic disease. One study showed that only 38% of women experienced full remission after 8 years of treatment. Comorbidity with other mental disorders, poor physical health, and suicidal ideation are poor prognostic signs. Alcohol abuse is present in about 50% of affected patients, who use it to ease feelings of anxiety.