My niece and I have been having an argument about the difference between schizophrenia and phobias. I have social phobia and have been extremely shy all my life. Because there is a history of schizophrenia in our family, she thinks the social phobia could be a symptom of schizophrenia. I disagree. Are they similar in any way and can they be connected?
Social phobia and schizophrenia are two different diagnoses, according to the American Psychiatric Association’s Diagnostic and Statistical Manual, Fourth Edition.
In social phobia, a person suffers from excessive shyness and a fear of being around people in social situations — to the point where it interferes with her ability to function effectively and in a satisfying manner. In schizophrenia, a person has a constellation of symptoms, including a loss of touch with reality, a deterioration in psychological and social functioning, and problems with thinking and with perceiving the world.
What is interesting to those of us who do a lot of clinical work with people who have schizophrenia, is that we often see excessive shyness and interpersonal isolation in this disorder. People with schizophrenia often lead very isolated lives, and often find that their interactions with others are scary or confusing.
Another interesting thing is that some forms of schizophrenia have a genetic component — the vulnerability to schizophrenia can be inherited from one generation to the next. When we talk to the family members of people with schizophrenia, we can often find evidence of some traits or oddities of behavior that would never meet the full diagnosis of schizophrenia, but that share some similarities with it: highly unusual or creative thinking, interpersonal isolation, difficulties conforming with the world. These family members do not have schizophrenia, but it appears they may have inherited some of the same predispositions of the disorder in a much milder form.
So my best guess is that both you and your niece are partially right. You may not at all meet the full diagnostic criteria for schizophrenia, but it could still be possible that some of the extreme social shyness and anxiety you experience is related to the fact that there is schizophrenia in your family, and that you have inherited some genes that make you vulnerable to the stresses and strains of social interactions — genes that also play a role when a person develops full-blown schizophrenia.