Secrets are hard to live with. That might be one reason why gay men are more likely to suffer with social anxiety than heterosexual men. At least those were the findings of a study published in the Journal of Anxiety Disorders in 2006.

Researchers at the State University of New York investigated the occurence of social anxiety in a sample of undergraduate gay and heterosexual men. Gay men reported greater social interaction anxiety, greater fear of negative evaluation, and lower self-esteem than their heterosexual counterparts.

Gay men who were less comfortable and less open about their sexual orientation were more likely to experience anxiety in social interactions.

The study results seem to be borne out by anecdotal evidence too. New Kids on the Block bandmate Jonathan Knight suffered with social anxiety while at the same time keeping his sexual orientation a secret. Author Daniela Grazia talks about her struggle with SAD and coming to grips with her sexuality.

As with most issues, it is likely a combination of factors that cause some gay men to develop social anxiety; sexual orientation is just one piece of the puzzle.

What do you think? Have you or someone you know dealt with social anxiety and sexual orientation issues?

Further Reading

• Jonathan Knight
• Book Review: On the Outside Looking In
• Daniela Grazia

Photo © Microsoft

And I thought the half-marathon I ran last year was a doozy.

Canadian Wayne Cho will be running 26,000 km across the world from North America to Australia to raise awareness for mental health starting in September of this year.

Not sure he can make it? If his track record is any indication, this runner is up to the challenge. Cho logged 8207 kilometres in 2009 when he ran across Canada to raise awareness for anxiety and depression.

For Cho it is a personal mission; his own struggles with generalized anxiety disorder (GAD) compelled him to work to end the stigma surrounding mental illness. He envisions "a sweeping transformation in how mental illness is perceived".

How do we go about ending the stigma associated with mental illness? I believe it is by separating the disorder from the person. It is more difficult to do with mental illness than it is with physical illness, which is why the stimga persists. Mental illness affects behavior, and we tie behavior to personality and spirit.

I like to think about it in this way, when it comes to social anxiety disorder (SAD):

If you walked a mile in my shoes, saw the world through my eyes, and lived your life in my body, you would react and behave in the same way as me. Meaning that it is not my fault; that I am just a person like you dealing with some extra challenges.

This could be true even when thinking of depression, schizophrenia, or any other mental illness.

What do you think? Is there stigma surrounding SAD? How can it be overcome?

Further Reading

• Ballpark Tour Raised Awareness
• Comedy About Mental Health: Funny or in Poor Taste?
• Movie Characters

Photo © World Run for Mental Health

I was just reading an op-ed piece in the New York Times that makes the argument we are over-diagnosing and over-treating social anxiety disorder (SAD). This is not the first time this argument has been made. Christopher Lane wrote a book on the topic.

In the article, Susan Cain outlines the "merits" of introversion. These include:

• Introverts are essential to survival of the species because their contemplative nature balances extroverts tendency to leap before looking
• Introverts make great leaders (Eleanor Roosevelt), scientists (Albert Einstein), artists/writers (J.K. Rowling) and entrepreneurs (Steve Wozniak, who co-founded Apple)
• Introverts generally perform better academically and notice more details when working on solitary tasks
• Introverts tend to be more empathic and have stronger consciences

Point taken. But what do the merits of introversion have to do with the diagnosis and treatment of SAD?

Cain goes on to describe her take on an ad for medication for SAD:

"Imagine that the woman in the ad enjoys a steady paycheck, a strong marriage and a small circle of close friends -- a good life by most measures -- except that she avoids a needed promotion because she's nervous about leading meetings."

Cain notes that based on the diagnostic criteria in the DSM-IV, this woman would be diagnosed with SAD.

"...the diagnosis is warranted when anxiety 'interferes significantly' with work performance or if the sufferer shows 'marked distress' about it. According to this definition, the answer to our question is clear: the young woman in the ad is indeed sick."

Hold on a second.

First, we don't have nearly enough information to determine whether the woman described has SAD; and only a trained mental health professional should be making a diagnosis. Second, is this woman really even likely to go to her doctor? If she is, that is a step in the right direction. Rather than being overdiagnosed, SAD is severely underdiagnosed. People with social fears don't usually seek help.

Cain states that the line becomes blurry between normal shyness and SAD; but it is because of articles like this one. Nowhere in the piece is there a description of what it is really like to suffer with severe social anxiety.

There has never been a debate whether introversion can be a valued personality trait. But, SAD is not introversion.

Cain argues that sensitivity can lead to empathy and leadership if it is nurtured and not excessive. Precisly the point: SAD is excessive sensitivity. It is a hardship; a burden; and a life-ruiner. It is not something to be nurtured.

I do agree with Cain on one point. That we need to encourage those with sensitive personalities to use their gifts.

At the same time, it is important not to trivialize the experiences of those with SAD. People with the disorder do enough of that themselves.

Further Reading

• DSM
• Shyness: How Normal Behavior Became a Sickness
• Shyness versus SAD

Photo © Microsoft

I was speaking to someone recently who was doing some research about social anxiety disorder (SAD) and navigating About.com and my site to find information. In speaking to her, I realized that what I know like the back of my hand is not necessarily obvious to the first time reader.

To help explain how this site works and make it easier for first-time users, I thought I would do a quick run-down of the different areas of the site, what they are about, and what you can find. Here we go...

Overview

I realized talking to a newcomer that even the basic structure of the site is sometimes hard to grasp. About.com spans a huge variety of topics; each topic has it's own section of the main site that is managed by a "Guide" - that's me here on the SAD site. As a guide, we are responsible for managing and writing content for all aspects of our particular area.

SAD Blog

The SAD Blog is featured on the home page of the About SAD site. You can find it in the middle column of the landing page as you scroll down. I generally update the blog once a week.

SAD Articles

Articles on the site span every topic related to SAD. Articles can be found in one of three ways:

1. Tabs: Using the tabs across the top of the home page. Here you will see tabs that say "Symptoms/Diagnosis", "Treatment", and "Coping". Within each tab you will find links to the most important articles on the site.
2. Must Reads: In the left column of the landing page you will see links to the "Must Reads", which are key articles that every first-time visitor should read.
3. Topic Pages: Below the must reads you can find the topic pages, if you want to browse by general topics.

SAD Forum

If you have never visited the SAD forum, you can get there by clicking on the link that says "Forum" underneath the guide picture (the photo of me). Here you can discuss social anxiety problems and solutions with other readers.

Reader Answers

A big part of the site are the reader answers. These are questions to which readers post their responses, such as "What is it like to live with SAD", or "How do you handle public speaking"? You can find all of these in the "coping" tab under "Readers Respond" and "Show and Tell".

Newsletter

If you haven't already signed up for the SAD newsletter, you can do so by entering your email address in the top right corner of the landing page. The newsletter goes out once per week every Monday morning and contains links to new blogs and articles.

I think that is it. Perhaps not the most interesting post this week, but hopefully understanding the structure of the site and knowing what you can find will make navigation a little easier.

As always, I welcome any questions or comments.