Adrenaline surges can sometimes be a good thing. An attack of the nerves may even stimulate thoughts and enhance performance at school or work. But when shyness is so real that it transforms itself into stark fear of others, it becomes pathological.

Only recently recognized as a proper illness, social phobia belongs to the family of social anxiety disorders, which "includes a spectrum of conditions, from the mildest to the most serious," says Christophe André, a psychiatrist at the Sainte-Anne hospital in Paris.

On one level there are nerve attacks, in situations where an individual feels intimidated, which can be intense or more discrete. "When these moments become chronic, one can speak about shyness," explains the psychiatrist. The personality of such shy individuals fails to evolve, and they tend to be left behind in their personal lives as well as in their professional careers.

"One notch higher, there is social phobia," says the psychotherapist, a specialist in anxiety problems and the author of Fear of Others (Odile Jacob, 2000). This is a persistent fear of one or various situations in which the person is being observed by other people, and in which the fear of being humiliated or embarrassed becomes very strong. Such people experience a marked fear of others and a deep lack of self-confidence.

Palpitations, headaches, sweating, stomach pains, a dry mouth, blushing, stammering and shaking are just some of the symptoms associated with social phobia. Focusing on these symptoms usually makes things even worse. People with social phobia also tend to anticipate the worst-case-scenarios, imagining potential mistakes and letting them build up. These irrational fears are often a source of intense distress.

It is estimated that one to two percent of the world's population suffers from severe social anxiety, and "one person in ten suffers from anxiety to a detrimental effect," says Christophe André. Most studies show that 30 to 50 percent of people think of themselves as shy. "These are small, internal inhibitions which are rarely visible on the outside," he adds. Many of the people suffering from severe forms of anxiety are less well-educated, and they are often single and unemployed. Shy people tend to get married later on in life and rise less rapidly to positions of responsibility in their jobs.

The causes of social anxiety remain unclear. Experts think that genes might be a factor, but do not believe it is the only reason. Upbringing can play a major role. Family units that are inward looking, with parents who over-protect their children and limit their contacts with the outside world, can amplify inhibitions.

Societies that put a high price on individualism and performance can have the same effect. "Shyness can be a handicap in a highly competitive environment," says André.

This quest for excellence at any cost is common in schools today. "Teachers are perfectly capable of spotting a shy child who has real problems, but unfortunately there aren't any guidelines to follow in such situations," says the psychiatrist. "But it is at that moment that it is easiest to intervene," he says.

The moment when regular shyness can develop into a phobia or extreme timidity is usually during adolescence, in junior high or high school. It is then that parents and teachers -- of boys and girls alike -- should be most vigilant. "Social tolerance for shyness varies, depending on the sex," André says. "Amongst children, this illness is regarded differently, depending on whether it affects a boy or a girl."

Read the original article in French.

Photo - D.J.Scalet