High anxiety:
Help is available to treat this psychiatric disorder

Social anxiety disorder (SAD) is a condition affecting over 10 million Americans. It is the most common anxiety disorder and the third most common psychiatric disorder in the United States, after depression and alcoholism.

Ricky Williams, running back for the National Football League's Miami Dolphins, has undergone the ebbs and flows of SAD and is now dedicated to speaking out about his battle with this condition to alert people to the availability of treatment options. SAD can be socially and economically devastating to an individual and can have lifetime consequences, Williams warned.

Affecting up to 13.3% of the population, SAD usually begins during the mid-teens and often becomes progressively worse, resulting in a lifelong condition. Jerilyn Ross, president and CEO of the Anxiety Disorders Association of America, explained, "Social anxiety disorder is not the same as shyness. It is an intense, paralyzing fear of social or performance situations. The person has a very morbid fear of any kind of negative evaluation, any criticism, a fear of being judged in public situations, and, unlike shyness, he gets acclimated to it." Only about 5% of people who have SAD are diagnosed and receive treatment, which is why Williams stresses the need to educate the public about not only the symptoms but the tribulations inherent to such a psychologically debilitating disease. "My life has changed so much for the better. If I can help two people, three people, let alone two or three million people, see that life with social anxiety disorder can change for the better, then I'm definitely doing my part in my lifetime to help," Williams said. His own life has been a series of psychosomatic ups and downs, with his teenage years marked by acute shyness. However, it was only during his second year in the NFL that he "hit rock bottom." After breaking his ankle, which landed him at home for the second half of a season, he began to realize his fear and subsequent inability to leave his house. "I had this notion that I know now was obviously wrong, that everyone was looking up, staring at me, and judging everything about me. And it was the most painful, frightening experience ever. But almost everywhere I went, it was such pain that I'd rather just not go anywhere."

SAD involves both physical and emotional symptoms. Physical indications of the disease include an extreme sense of blushing, sweating, trembling, rapid heart beat, or even panic attacks in which the patient feels he or she is going to pass out or "just go crazy," Ross said

Janey Barnes, the therapist who diagnosed Williams with SAD last February, described her first impressions of her patient as clearly indicative of an anxiety syndrome: "He could hardly look me in the eye. In fact, he simply couldn't look at anyone and carry on a conversation. He was extremely self-conscious and had a very low sense of self-esteem." Barnes talked to Williams for the first time in January, and in February, he began therapy and medication to treat his diagnosis.

Two types of treatments are available to those suffering from SAD. In cognitive behavioral therapy, diagnosed patients are taught how to recognize the thoughts, the messages they are giving themselves, and the misinterpretation of cues from other people. The other treatment is pharmacotherapy. The first and only medication that has been specifically approved for SAD is Paxil (paroxetine hydrochloride, GlaxoSmithKline), but selective serotonin reuptake inhibitors are also helpful.

Williams recalls that SAD became a serious problem when "it was costing money, it was costing friends, it was costing a lot." It got to the point where he could not visit his mother for fear of going to airports. He would cancel interviews and autograph signings to avoid social interaction. However, after receiving treatment for his condition, he became fit to speak in public, including giving a presentation on SAD in Atlanta. Williams asserted that his difficulties in combatting SAD were compounded by his constant presence in the public eye: "It was really hard because, as I said, the perception of me was really altered by a lot of fans and a lot of my teammates because they couldn't understand what I was going through."

Williams, a Heisman trophy winner at University of Texas, was traded to the Miami Dolphins from the New Orleans Saints in March 2002. The trade represents a fresh start in terms of dealing with his condition as well as a new beginning in his professional football career. Williams is optimistic about the new environment, predicting, "Along with therapy and medication, I think Miami is really therapeutic for me."

To learn more about SAD, visit the Anxiety Disorder Association of America Web site at www.ADAA.org.

Kristen Pollina

Kristen Pollina. High anxiety: Help is available to treat this psychiatric disorder.

Drug Topics

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