THE EDITOR, Madam:

Naomi Osaka, world’s number one women’s tennis player, recently said that she has Social Anxiety Disorder (SAD) which causes fear in social situations. Persons with this disorder often report having trouble talking to people, meeting new people and attending social events. They often feel very self-conscious and are afraid of appearing stupid or clumsy. They may also feel afraid of being judged or scrutinised by others.

SAD is not the same as being shy, although many persons with SAD could be perceived as being shy. But, how bad can it be? Naomi Osaka would rather pay a fine of US$15,000 than face a few questions from the media.

The symptoms of SAD, if severe enough, can be overwhelming and disabling. It is not unusual for persons with this disorder to turn down promotions, or refuse opportunities for public acclaim and recognition, because of the extreme anxiety they experience in social settings.

Symptoms of depression may also accompany SAD, because of feelings of disappointment, inadequacy, and being misunderstood. Persons may also feel rejected and isolated. Unfortunately, sufferers may resort to substance abuse, to cope with distressing symptoms.

SAD typically starts in childhood or adolescence. The symptoms could contribute to school avoidance or changes in academic performance.

TREATMENT

The good news is that SAD can be treated. Treatment usually involves psychotherapy, especially Cognitive Behavioural Therapy (CBT) or a combination of medication and CBT. The medication which is used for long term is in the group of antidepressants. This is not an addictive medication. There are also various self-help techniques that can be employed. These include learning relaxation techniques, deep breathing, assertiveness training, communication skills and managing negative thoughts.

The first step is to recognise the symptoms for what they are. This condition is not a sign of personality weakness, and not necessarily shyness or low self-esteem, although these could be associated.

SAD is a diagnosable medical condition which, if treated appropriately, can allow persons to live normal and fulfilling lives. If untreated, it could be debilitating and prevent normal growth and development, and enjoyment of life.

DR MAUREEN IRONS-MORGAN

Psychiatrist



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