'Shyness' can cripple lives says Dr Christian Jessen
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Why do some medical conditions attract little interest and sympathy while others are permanently "cool" and attract celebs to front campaigns?
Many areas of mental health include the former, which was illustrated when actress Catherine Zeta-Jones announced that she suffers from a bipolar disorder, and a Twitter comment suggested she was probably just hormonal.
The Daily Mail recently ran an article on the drugs regulator, Nice, evaluating the use of antidepressants for social anxiety disorders. But instead of properly describing the condition and its resulting disabilities, the article described it simply as "shyness", saying the antidepressants helped people "talk to strangers". There is huge prejudice about mental health problems, and ill-informed descriptions like this only worsen the situation.
Social anxiety is much more than just shyness. It is characterised by an intense fear that comes on in social situations and impairs ability to function. The generalised disorder typically involves a persistent, intense, chronic fear of being judged by others and humiliated by one's own actions. Physical symptoms include excessive blushing, sweating, trembling, palpitations, nausea and stammering. Panic attacks can also occur.
Some critics have expressed concern that using drugs to treat such conditions is pandering to the pharmaceutical companies' plan to "medicalise" normal human behaviour. That is missing the point.
This is not normal human behaviour; it is a recognised condition with defined diagnostic criteria that results, in severe cases, in a total inability to function effectively in social situations.
There is an ongoing suspicion of the pharmaceutical industry that I feel is over the top. Doctors have moved away from treating conditions such as anxiety and depression with drugs alone, and now more often combine a pharmaceutical approach with talk therapies like cognative behaviour therapy or systematic desensitisation, where appropriate. In social anxiety, most patients report that their best treatment successes came via this approach, so the idea of treating "shyness" with drugs now doesn't seem so ludicrous. It's the emotive, unfair choice of words that does.
The sad thing is that whatever decision Nice comes to will be irrelevant. A quick newspaper campaign, and a few stern letters to local MPs, and Nice decisions are more easily overturned than a Robin Reliant.
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