Mental illness is often the result of a complicated interaction between our genetic makeup, lived experiences and the environment we inhabit.
Scientists have yet to precisely identify the root of the difficulties 1 in 5 Americans face in a given year (National Alliance on Mental illness, 2017).
Advances in the area of mental health research are vitally important as they can help to inform new treatments.
Researchers at the Institute of Human Genetics at the University of Bonn in Germany recently discovered that a gene called “SLC6A4” was strongly correlated with someone's chances of suffering from social anxiety disorder (SAD). Initial findings have been published online in the journal of Psychiatric Genetics.
SLC6A4 is involved in transporting serotonin in the nervous system. Serotonin is sometimes referred to as the “happiness hormone” as it is involved in feelings of positivity and wellbeing.
The fact that some people are born with an innate disposition towards suffering from SAD is extremely interesting, particularly given its high prevalence rates in the American population.
Anxiety disorders are amongst the most common mental illnesses affecting up to 18% of the population (Anxiety and Depression association of America, 2017).
What is Social Anxiety Disorder?
SAD is often minimized by people confusing it with “shyness” or simply being introverted. In reality, SAD is an intense and persistent fear of social situations. Those with SAD may experience bouts of anxiety over simple everyday things such as answering the phone or being asked directions on the street.
Whilst many of us may experience mild anxiety over social situations, those with SAD will experience chronic worry before, during and after the social scenario. They particularly fear embarrassment or social rejection.
SAD is often apparent from an early age and first manifests itself in childhood or adolescence. It is also almost twice as common in women as men, with prevalence particularly high in Europe and North America.
Scientists are not fully sure why women are more prone to anxiety but some have theorised that this propensity may be linked to differences in brain chemistry and hormone fluctuations.
Women are also more prone to stress and tend to mull over stressful situations more than men, who tend to pursue more active coping strategies.
So what does Social Anxiety Disorder look like and how is it diagnosed? Here are some of the signs:
Some individuals who suffer from SAD also experience panic attacks.
Panic attacks result from fear of social situations that becomes overwhelming, leading up to a physical response. Although panic attacks usually only last a few minutes, they are extremely unpleasant.
The individual may feel nauseous and experience trembling, palpitations and a shortness of breath. Although panic attacks don’t lead to any long- term physical difficulties they are extremely alarming.
SAD often co- occurs with other disorders such as depression, generalised anxiety disorder and post- traumatic stress disorder.
What Causes Social Anxiety Disorder?
As previously discussed SAD is the result of a combination of genetic and environmental factors. Although certain genes may significantly increase the likelihood of SAD, this may not be enough for the disorder to manifest itself.
Researchers have linked parenting styles to the likelihood of developing SAD. As SAD may have a genetic root, parents may be more worried or anxious, translating poor coping styles to their children.
Getting Diagnosed with SAD
The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, is the tool most commonly used to diagnose mental conditions including SAD. Criteria includes:
Persistent fear of and/ or intense anxiety about social scenarios in which you believe you may be judged or act in a way that's embarrassing.
Avoidance of social situations and/or intense anxiety when present in social situations
Anxiety that's out of proportion to the situation
Anxiety or distress that impedes your daily living
Fear or anxiety that cannot be explained by a different medical condition, medication or substance problem
These criteria should be present for 6 months or more
How is SAD Treated?
SAD may be treated with medications and/ or psychotherapy. Psychological counselling is highly effective for those suffering from SAD. It can help the individual learn ways to deal with stress in social situations and build self- confidence.
One of the more commonly used treatments is CBT (Cognitive Behavioural Therapy). CBT may help the individual to see that their fears are irrational and help them to gradually work up to facing the social situations they fear the most. One tactic that is often employed is role- playing, whereby the individual can practice being in social situations and build up confidence in a safe and secure environment.
SAD can be all- consuming for the sufferer, as being crippled regarding ones social life and interactions limits our ability to form relationships, push our personal boundaries and live a happy and fulfilling life.
It has a remarkably high prevalence rate and many suffers stay under the radar undiagnosed.
SAD responds remarkably well to treatment, however, and if you suspect you may have SAD, please seek out a local mental health professional and learn to tame the anxiety you face daily.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.
Turk, C. L., Heimberg, R. G., & Hope, D. A. (2001). Social anxiety disorder. Clinical handbook of psychological disorders: A step-by-step treatment manual, 3, 114-153.
The act of giving birth is one of the most celebrated in human society. We all know parents who gush about this phenomenal experience and detail the elation they felt in the hours and days following. Popular culture and film are also awash with moving scenes of childhood as couples transition to parenthood against a backdrop of sentimental music and family joy.
What is less often depicted is that once the post-partum dust has settled, the early stages of parenthood can be truly difficult.
Whilst many women suffer the “baby blues” and may be anxious or tearful for short periods of time (usually around one to two weeks) following birth, this can sometimes develop into something more serious.
If symptoms last much longer, or start later into motherhood, postnatal depression is a possibility. Postnatal depression (sometimes also referred to as postpartum depression) is a mood disorder associated with childbirth. It is estimated that approximately 13% of women experience postnatal depression.
Symptoms that you or a loved one may be suffering from postnatal depression include:
What causes postnatal depression?
Unfortunately the answer to this isn’t entirely clear but it is believed to be caused by a combination of factors.
On a physiological level, pregnancy and birth bring with it a whole host of hormonal changes, which may lead to changes in mood. Hormones affect some women to a greater extent than others.
Parents who have suffered from depression prior to childbirth, are much more likely to develop postnatal depression. A family history of mental illness is also a risk factor.
That said, a history of depression does not automatically mean that you will go on to develop depression postpartum. It may be helpful to be aware that you are at risk, so that you can look out for the signs mentioned above.
Aside from this, there are factors relating to the birth process itself that may trigger postnatal depression. These include:
Your home-life may also be influential. Unsuitable housing or money issues may naturally make the transition to parenthood more stressful. Worries relating to work can also hamper your ability to relax and settle into the changes you face.
A strong support network and supportive partner may provide a protective effect against postnatal depression. It is not helpful to spend too much time alone without adult company so if you are feeling isolated it may be helpful to reach out to other parents in the community.
Can men experience postnatal depression?
Although men may not experience the hormonal storm of pregnancy, they may still be subject to its emotional effects. A recent study conducted in Sweden found that 28% of men demonstrated mild levels of depression. Women are routinely screened for postnatal depression while paternal mental health is often overlooked.
The research team added a series of questions to the most commonly used postnatal depression screen, in order to capture the unique symptoms that may be displayed by men. These included working longer hours, irritability and excessive alcohol consumption.
It is not entirely clear whether depression in fathers is a newer phenomenon, or just something which we have only recently begun to explore and detect. Many new fathers face challenges such as trying to balance their work life with their family life as well as decreased sleep and changes in their relationship.
Naturally, depression makes it harder for a new father to invest time in the newborn. Fathers experiencing difficulties should consider that they may have paternal postnatal depression.
How can postnatal depression be treated?
The first step is to speak to your general practitioner. With prevalence rates estimated to lie at about 13%, it is much more common than you think, and health services are trained to recognise the signs and give you the support that you need.
Self-care: It is also crucial at this stage to be kind to yourself. Take care of your primary needs such as getting enough sleep, eating well and doing things that you enjoy. It may feel like you do not have time for this with a young child on your hands, but don’t be afraid to ask others for help.
Talk therapy: As with many psychological difficulties and types of depression, cognitive behavioural therapy (CBT) may be useful. Most experienced therapists will be able to provide a course of CBT and tailor it to the specific difficulties you may be having. Many new parents struggle to live up to the ideal of “perfect parent” and may not have anticipated the difficulties associated with parenthood. CBT can help new parents find a way to think about the difficulties they face and learn better coping mechanisms.
Antidepressants: Antidepressants may also be useful, particularly if the depression is more severe. Some women worry about taking antidepressants whilst breastfeeding but your doctor will be able to provide you with ones that are safe.
One of the worst things about postnatal depression can be feeling alone or unusual in the feelings you are having. This couldn’t be further from the truth and it can help to reach out to national organisations. These can not only provide information and advice but also networks of other parents to talk to.
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British journal of psychiatry, 150(6), 782-786.
NHS, Unknown. “Postnatal Depression.” NHS Choices, NHS, 11 Feb. 2016, www.nhs.uk/conditions/post-natal-depression/treatment/.
Psouni, E., Agebjörn, J., & Linder, H. (2017). Symptoms of depression in Swedish fathers in the postnatal period and development of a screening tool. Scandinavian journal of psychology.