For some college students the transition to college brings with it more than the typical feelings of freshman uncertainty. Social anxiety disorder or social phobia, is a silent affliction that burdens many college-age men and women. Haunted by unbearable thoughts of humiliation and embarrassment, sufferers shut themselves off from the outside world. And the university experience that is a joy for so many, becomes a nightmare.
"I don't want to talk to anybody when I am in school, even if I do, I would keep wondering - does he or she not like me? ...I've never been to any party or club," says Katy*, who goes to a medium sized university in the East. She was diagnosed five years ago with social phobia, which along with social anxiety disorder, is the third most common mental illness according to the Social Phobia/Social Anxiety Network.
Katy's plight, though lonely, is not a solitary university experience. Jonathon Berent is a psychotherapist and the author of "Beyond Shyness: How To Conquer Social Anxieties." Berent has worked with thousands of patients suffering from social anxiety disorder and has heard many stories.
Katy, who is early on in her college career, can identify with the scenario, "I failed two classes in the past because I couldn't start or finish school work."
The sad situation may seem extreme to some who are unfamiliar with social phobia, but the problem goes way beyond typical shyness. Berent explains, "What happens with social phobia is a person learns to become hypersensitive to what they perceive as rejection and humiliation. Then what happens is that mode of thinking and focusing on the rejection triggers off in many cases a panic reaction, which is a physical reaction."
A social phobic who experiences a panic reaction may feel shortness of breath, dizziness, and in some cases the individual can pass out. Katy has dealt with dizziness at times, but for her the affliction is primarily mental.
Social phobia seems to rear its ugly head when students reach their teens, sometimes setting in more severely when students head off to college. Though not often diagnosed during childhood the problem does have its roots there.
Sheila*, a fourth year university student studying anthropology says, "I think I've been shy since I was very little. I don't remember too many moments not being shy. I remember in elementary school if everyone else got a piece of paper or something, and I happened not to get one, I would not raise my hand and get one." Katy shares a similar past. "Recalling my childhood, I've always been kind of afraid of people."
Berent says many times parents and others view shyness in children as just a phase. Professionals, teachers and moms and dads often believe that a child will just "get over it." But some don't.
Unfortunately for Sheila her shyness wasn't just a phase -- the problem festered. "Now it seems worse because I am almost 22 years old and I should be over this."
Some evidence suggests that there may be a genetic predisposition to shyness. Often parents of extremely shy children have dealt with the same problem themselves, but Berent cautions social phobics from blaming their genes. "There's a genetic predisposition to everything in life. The worst thing you can do is say I was born like this and there is nothing I can do about it."
What sufferers can do about it is seek help. Unfortunately seeking help for a social phobic is often a cruel catch 22. How can someone who is afraid of going out in public seek help? How can universities help suffering students if they don't know who those students are? The disorder is so severe for some that they are even afraid to communicate over the phone. Berent says, "99 percent, I think, do not come for help because they don't want to expose themselves. Most suffer in silence."
"There was a freshman in California, he calls me up and says he's going to kill himself, he has no friends no girls like him. And then he calls me a few weeks later -- he's joined a fraternity and he tells me he got an award as the most social incoming freshman," says Berent. "The answer -- six pack therapy," he adds.
Of course this method of "therapy" can be extremely harmful as it can lead to alcohol dependency as well as deepening depression, which is the most common byproduct of social anxiety disorder.
In fact, there is no cure for social phobia, but there is now a drug - Paxil -- that treats it. Although it has given some social phobics hope, Berent is concerned the drug isn't addressing the entire problem.
"Clinical and social shyness are very much emotional problems. Drug companies are trying to take an emotional problem and turn it into medical condition. A lot of people believe that if they take medicine that they'll get better, but that's not necessarily the case. I believe it's important to use medicine the right way."
Berent says the "right way" is to use medicine to deal with panic attacks, which he believes are merely a symptom of a greater problem. In addition to taking Paxil, he believes the student should engage in cognitive behavioral therapy to address the cause of the social anxiety.
Sheila says she isn't particularly positive. "I think I should get help with this, but it seems quite hopeless. Some people are shy and accept it as part of their personality, but I see it as something that hinders my happiness extremely. ...I've never had a boyfriend -- most likely as a result of my shyness and being unsure of myself."
Katy echoes the sentiment of Sheila and many other sufferers who feel alienated and out of place. "Everyday when I go to school, I keep wondering, wouldn't it be nice to have more friends, to go to parties, or even have a boyfriend - like a normal girl."
*Name withheld to provide anonymity.