At the age of 11 Janet's natural shyness turned into full-blown social phobia.

To her parent's distress she became increasingly anxious about going school. One day Janet clung to her mother and simply refused to go to school at all. Janet's developing social phobia kept her at home for several years until her parents realized that her crippling shyness was actually an illness for which treatment was available.

Social phobia is not about shyness. The symptoms include overwhelming anxiety and an acute self-consciousness in everyday social situations. Many of the fears of being judged and found wanting, as well as humiliated and embarrassed, translate into real physical symptoms like nausea, heart palpitations, sweaty palms and a feeling of being separated from oneself and others. The body becomes a vehicle that cannot be trusted in public.

The difference between social phobia and a case of crippling shyness lies in the degree of severity. Where sufferers of social phobias are often aware that their fears and anxieties are irrational they feel helpless to rise above them.

Efforts made to control the outward signs of the disorder result in repeated failure. Blushing, profuse sweating, trembling and difficulty talking serve only to reinforce fears of embarrassment.

Social phobia affects up to 5.3 million adult Americans according to the National Institute of Mental Health. The disorder typically begins in childhood and there is evidence that genetic factors play a role. Treatment includes carefully targeted psychotherapy and/or medications.