They don't write checks in public because they fear people watching them write. They don't go shopping. They have problems with authority figures, so they are typically underemployed or unemployed. They don't visit doctors for the same reason, so they are rarely identified and treated.
The mysterious illness that afflicts them is a syndrome called social anxiety disorder. A coalition of mental health care groups said last Tuesday that more than 10 million Americans suffer from the disabling but barely recognized form of social phobia that leads to extreme avoidance of other people. The syndrome "is not just shyness," said Dr. David Sheehan of the University of South Florida College of Medicine. "It's many steps beyond shyness and leads to profound impairment in patients' lives."
Social anxiety disorder patients often turn to alcohol or drugs because those chemicals are social lubricants. People who suffer from it are 13 times more likely to attempt suicide than the general population, seven times more likely to develop clinical depression, and twice as likely to develop alcoholism, said Dr. Jonathan Davidson of the Duke University Medical Center.
But the disorder, once recognized, is highly treatable, Davidson said. Psychotherapy provides great benefit, he noted, but requires a strong commitment by the patient and much work outside the bounds of the therapist's office.
A new drug called paroxetin, which is expected to be approved shortly, is effective in 70% of patients, producing at least a 50% reduction in symptoms. Other drugs, such as clonazepam and gabapentin are also useful, he said.
A short screening test for the disorder includes three questions:
* Does the fear of embarrassment cause you to avoid doing things or speaking to people?
* Do you avoid activities in which you are the center of attention?
* Do your worst fears include being embarrassed or looking stupid?
If your answer to all three questions is yes, there is a 90% chance that you suffer from social anxiety disorder, Davidson said.
For more information, contact the Anxiety Disorders Assn. of America ( 231-9259 or http://www.adaa.org), the American Psychiatric Assn. ( 682-6000 or http://www.psych.org) or Freedom From Fear ( 351-1717 or e-mail FFFNADSD@aol.com).
Painkillers Unlikely to Help Before Exercise
If you take a painkiller before exercising in hopes of warding off later pain or muscle damage, you are probably wasting your time, according to a new study in the most recent edition of Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine.
A team from McMaster University in Hamilton, Ontario, studied eight healthy men who were moderately active in resistance and aerobic training. Four were given naproxen both before and after exercising one leg in a weight training session, and the other four were given a placebo. Midway through the experiment, the two groups were switched; those who had received the placebo in the first studies receive naproxen and vice versa.
The team reported that there was no difference in pain or short-term loss of muscle strength whether the subject received naproxen or a placebo.
Dangers Seen in Some Chinese Herbal Creams
Some Chinese herbal remedies may be more dangerous than they appear, a team from King's College Hospital in London reported in Friday's British Medical Journal. They found that eight of 11 creams for dermatological conditions purchased in British herbal medicine shops contained the prescription steroid dexamethasone.
Furthermore, the concentration of the drug in the creams recommended for children was 5.2 times higher than in those recommended for adults. The concentrations in all of the creams were higher than appropriate for use on the face.
Study Finds Kids Aren't Hurt by Mom's Working
Whether a mother works outside the home during the first three years of her child's life does not have a significant effect on the child's development, according to the largest study of mothers and their children to date.
Psychologist Elizabeth Harvey of the University of Massachusetts used data collected in the National Longitudinal Survey of Youth, a survey of about 12,600 people who have been interviewed annually since they were enrolled in the study in 1979, when they were between the ages of 14 and 22. Beginning in 1986, the children of women in the group were also assessed.
Harvey examined whether the mothers worked during the first three years of the children's lives, how soon they returned to work, the number of hours they worked and periods of unemployment. She reports in the March issue of Developmental Psychology that there was virtually no difference in social and academic development between children of mothers who worked those first three years and children of those who did not.
12-Hour Window Best for Morning-After Pill