Social phobia

Excessive fear of embarrassment in social situations that is extremely intrusive and can have debilitating effects on personal and professional relationships.</P> The symptoms and signs of social phobia include blushing, sweating, trembling, rapid heartbeat, muscle tension, nausea or other stomach discomfort, lightheadedness, and other symptoms of anxiety.

</P> Fearful of crowds she might encounter at the Nobel Prize ceremonies in Stockholm, Elfriede Jelinek, the Austrian author who won the 2004 Nobel Prize in Literature, recorded a speech in Vienna that was delivered in her absence.

Jelinek said: 'I did this because I cannot go to Sweden because of my social phobia.

I cannot stand crowds.' Social phobia can be extremely disabling to a person's work, social and family relationships.

People with this disorder tend to lead difficult and diminished lives.

The emotional toll of the disease is great.

Many people with social phobia have trouble reaching their educational and professional goals or even maintaining employment.

They may depend on others financially and try to relieve anxiety with alcohol and drugs.

In extreme cases, a person may begin to avoid all social situations and become housebound.</P> Effective treatments for social phobias include medications, a specific form of psychotherapy called cognitive-behavioral therapy, or a combination of medication and psychotherapy.

Medications for social phobias include antidepressants called selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs), as well as drugs known as high-potency benzodiazepenes.

People with a specific form of social phobia, called performance phobia, can be helped with drugs called beta-blockers.

Cognitive-behavioral therapy teaches patients to react differently to the situations and bodily sensations that trigger anxiety symptoms.

For example, a type of cognitive-behavioral treatment known as 'exposure therapy' involves helping patients become more comfortable with situations that frighten them by gradually increasing exposure to the situation.