How shyness and other normal human traits became sickness

In addition to providing extensive documentation from the American Psychiatric Association archives, Lane includes previously confidential material from the drug companies themselves that present a worrisome history of the antidepressant Paxil.

That drug came onto the marketplace in 1996 despite the fact that its makers earlier had considered shelving it because of poor performance and early signs of side effects in clinical trials. Using a memo circulated among drug company executives, Lane presents evidence that a lot of information about the drug's poor track record was withheld from the public.

When Paxil became the first drug approved by the Food and Drug Administration for the treatment of social anxiety disorder in 1999, however, its makers launched a $92 million awareness campaign on the theme "Imagine Being Allergic to People." This and other advertising campaigns helped change the way Americans think about anxiety and its treatment.

"Every marketer's dream is to find an unidentified or unknown market and develop it. That's what we were able to do with social anxiety disorder," a product director for the drug told Advertising Age magazine. In 2001, with 25 million new prescriptions written for Paxil, the drug's U.S. sales alone increased by 18 percent from the year before.

Although psychiatrists insist that the line between ordinary shyness and social anxiety disorder (SAD) is sharply defined, Lane points to psychiatric literature that repeatedly confuses them, putting patients at risk of over-diagnosis and unnecessary, sometimes harmful treatment.

A professor of English in Northwestern's Weinberg College of Arts and Sciences, Lane previously directed a psychoanalytic studies program in Emory University's psychiatry department.

Long interested in psychology, he presents evidence of a burgeoning backlash to psychiatry's current trends in the form of analyses of novels including "The Corrections" by Jonathan Franzen and "The Diagnosis" by Alan Lightman, as well as the film "Garden State" by Zach Braff.

Lane was awarded a Guggenheim Fellowship to study psychopharmacology and ethics, and audited medical courses.

He invited psychiatrists and pharmacologists to review his book, particularly a chapter on rebound syndrome. That term refers to a boomerang effect experienced by some patients on discontinuing Paxil that is more intense and dangerous than the turmoil that caused them to take the drug in the first place.

In examining the American Psychiatric Association archives, Lane -- who argues that psychiatry is using drugs with poor track records to treat growing numbers of normal human emotions -- even came across a proposal to establish "chronic complaint disorder," in which people moan about the weather, taxes or the previous night's racetrack results.

"It might be funny," he says, save for the fact that the DSM's next edition, due to be completed in 2012, is likely to establish new categories for apathy, compulsive buying, Internet addiction, binge-eating and compulsive sexual behavior. Don't look for road rage, however. It's already in the DSM, under intermittent explosive disorder