New solution to an old problem

HUMAN BEINGS have always sought chemical help to ease the awkwardness of encountering other people. Alcohol is the most widely used social lubricant and centuries of experience have proved its value as the indispensable party ingredient.

It is when the drinking begins before the partygoer has left home - a couple of stiff ones for the bus journey - that alarm bells should sound. The commonest treatable cause of alcoholism in young men is social anxiety disorder, according to Professor David Nutt, a consultant psychiatrist.

Other drugs have been tried by sufferers, from cocaine and marijuana to Bach Flower Remedies and homoeopathic medicines. Books on shyness abound and there is a shyness centre (attached to the Hale clinic in London) offering alternative therapies.

But when does an ordinary social difficulty become a medical condition? After all, who has not trembled before a wedding speech or a job interview?

According to Professor Nutt, only those whose lives are in disarray as a result of their shyness qualify as sufferers of social anxiety disorder. Treatment may be needed where social phobia leads to unemployment because the sufferer is unable to cope with colleagues or where it leads to heavy drinking and threatens to break up the family.

"It is a matter of putting together the whole picture from family and friends. That is a decision for the GP," Professor Nutt said.

But sufferers cannot pop an "anti-shyness" pill before a public-speaking engagement and expect to find themselves confident and lucid an hour later. Most will need at least six months' treatment to feel the benefits and the majority will stay on the drug for life. The rest of us, when in need, will just reach for the whisky.