Social Anxiety Disorder: Yet Another Made Up Illness

Well, aren't we making the world a better place today? Good thing you haven't lost your resolve... some of us have already given up.

I don't like the way drug companies are pushing their products - the consumer ads, the vists to drs., all that, but...

There really are people who are unable to function because they are so painfully 'shy'. My niece, who is a very beautiful (and I'm not exagerating here, she is a one-in-a-million type) and talented soon to be 21 yr old, will now actually leave her house now that she's on Zoloft.

I'm on Paxil. I hate it (the side-effects are bad), but it keeps me alive.

First you take a drink, then the drink takes a drink, then the drink takes you.
F. Scott Fitzgerald

nice idea of a 'cure' you have for something you seem to know nada about. for a minute i thought i was in the rants and raves section on craigslist.....

Sigh.

Let's not get into "illnss" or not illness.

Social phobia, or anxiety or whatever it be called (and to get called a "disorder" in DSM IV it has to be pretty bad - I have just sounded off on anothe rthread about DSM IV confusion, by the way - so rather than rant again, I will link later) is, at its worst, a quite crippling problem for many people.

The treatment of choice is cognitive behavioural therapy - ie looking at the irrational thoughts which contribute to the anxiety and challenging them, educating the client about anxiety/panic, and getting the client to face feared situations until they de-sensitize to them.

SOME people may need medication - AS WELL AS the other stuff.

You are displaying great ignorance of the topic, Kicky, by dismissing it in the way you have.

When I say crippling, I mean it. I have worked with kids who live in the ferking toilet, for crissake! And people who have not left their homes in years - (and are busy - quite without intention - giving their kids the same problems). This is an anxiety problem with quite a high incidence - and anxiety is the most commonly occurring mental health problem. People who do not go to the lengths described above may, nonetheless, live through years of suffering, and be very disabled.

That being said - prescribing drugs is by no means the best thing to do - and should only be done when the situation is thoroughly assessed by someone with real knowledge in the field - and with a very good understanding of the primacy of CBT in this area.

In Oz, all too many people are just drugged by ignorant doctors. I gather (by reading stuff here, and on Abuzz, and in the US literature) that the USA is even more in the grip of drug mania. For instance, I constantly see quite indefensible drivel written here about depression, and the absolute need for drugs for this. (They may well be needed for some - but other therapies are well demonstrated to help - and to be more protective against relapse - but I rave!)

If prozac (and sedatives) are routinely being prescribed for anxiety, without great assessment expertise - and without full knowledge of the other things which also need to happen - well, that is malpractice.

But - do not, please, throw out the realities of crippling anxiety with the bathwater of of medical ignorance.

Here endeth another in a series of lessons.

Man, I am a bore!!!

Oops - zoloft - whatever....

I tend to agree with you that drugs are too freely prescribed these days ... however, most people taking these drugs would otherwise be walking around like zombies.

The reason for this is that the new drugs are life-saving for most people, and the fact that they are non-narcotic is evident that they are pro-life as opposed to "whassup" life?

Get it?

Here is the rave I spoke of::
Letty wrote:
Er, Deb. What's reification?


To reify means to regard or treat (an abstraction) as if it had concrete or material existence.

DSM IV and ICD 10 and such are useful when treated correctly.

Some diagnoses in DSM are likely "illnesses" in the traditional sense, in that there is a physical component.

Many are - and are only meant as - descriptions of commonly presented clusters of behaviour, affect and cognition. Such classification is useful in research and such, and can tell us a lot about TRENDS for outcome, because of the research that has already been done.

But.....

Let me give you an example of my point.

Conduct disorders are well described in DSM IV. They are descriptions of various levels of naughty behaviours of (mainly) boys.

They are useful, in that good research has been able to be done which tells us that a little fella with conduct problems, fitting criteria for Oppositional Defiant Disorder, at age three, is in need of intensive intervention - because if there is no successful intervention then, he is likely to go on to be a very unhappy, naughty adult who causes harm to himself and others, may well end up in prison and has a reasonable chance of getting pretty depressed in adolescence and may top himself.

Of course, ALL little people at three are oppositional and defiant! Good assessment is needed to filter out the normally naughty little munchkins (whose parents may need education and support if they are finding this too challenging!) from the munchkins in real trouble.

But - too often, said munchkin is taken to a doctor - who is no expert in mental health, and looks at the DSM IVR - makes what may be an accurate assessment - and tells parent "Freddy has Oppositional Defiant Disorder".

Munchkins who DO qualify for such a description usually have very troubled families - who feel really bad and to blame for Freddy. But - now? Freddy is ILL! Freddy CAN'T HELP IT! It's not my fault!

Trying to work effectively with a family who now have a child with an ILLNESS - via the means which may work - like family work, work on attachment repair, and assistance with good behavioural management can be hell. "Why do you want to see us? It's nothing to do with us! You are trying to blame me! I want a pill!"

Such families will find a doctor who WILL drug the munchkin.

This is an example of reification at work.

Whereas pills - and lots of other stuff - (psycho-education, practical support etc) likely WILL help a person with schizophrenia - especially if detected early and treated well at the beginning.

Which drugs and which conditions are you speaking of, Misti?

It is likely that there IS a physical component in some anxiety - eg through brain changes and lack of learning of self-soothing strategies in poor attachment and trauma in infants - mebbe through some inheritance of a "hair-trigger" nervous system.

Some depressions do manifest with severe anxiety as part of the symptoms.

I know there are really people who suffer from social anxiety disorder....
but to agree with kicky ( a little bit ;-) ) it is SOOOO easily cured for about 70% of people with this so-called disorder.
Our society today strives for some idea of perfection so much so that if you even hesitate to go out the door for what ever reason , you must have something wrong that needs medication. Period. We have no room for re-learning things or adjusting to situations... you are either about to do it right away and perfectly or you go see a shrink, gets meds , then act like you are perfect.
What happened to good old fashioned back-bone?
Why have we allowed things like this to happen? It is just all to easy to think that something you may feel strange about doing the first time.. or any time for that matter.. is a direct cause of social anxiety disorder.
People with that disorder REALLY do not leave thier house. They do NOT lead lives.. they go no where, do nothing and are living in a hell. But they are few and far between compared to what the drug companies are telling you.
According to Pfizer.. if you get nervous around a strange crowd of people.. you need thier meds... If you are nervous at a high stress job.. you need thier meds...if you are nervous meeting new people.. you need thier meds...
etc..
If I didnt have this small moral bone in my body.. i would close my eyes real tight and wish I could own Pfizer.. 'cuz DAMN they make alot of money. ;-)

I agree that the the happy drugs may be over-prescribed and done so without proper coinciding counseling, but I think they are also an important advance in medical treatment. I think I suffer from mild social anxiety, myself, I have considered taking something for it, but haven't as of yet. I would want to try counseling first.

Yes - according to Pfizer - cos they make lots of money that way. Hence this over-medicalizarion crap.

To be fair, though - properly educated professionals wil NOT be swayed by this crap, and will NOT diagnose a "disorder" unless it is really way out of whack.

Mind you - finding the properly educated professionals! Man.

I was at an anxiety disorders conference 10 years ago - 90% of the ferking doctors who are firts line treatment gor this stuff here in Oz - were TOTALLY ignorant of the most effective and well researched treatment options, and just drugged people!!!!!!!!!!!!!!!!

It is a little better now - but an, as you may have noticed - it makes me furious.

The worst bastards won't admit their ignorance, either. Grrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr.

Make sure the counselor is aware of CBT, Li'l k.

I canna stand hard-line CBT folk meself - but it is the best package, as long as it is wrapped up with a decent, warm, sceptical and funny human being!

I confess, I use EMDR myself with lots of kids - they love it - and it works.

I think it is just a weird form of CBT, though. With smoke and mirrors.

Kids love that.

Um, what's CBT?

Also ,Li'l k - sedatives can actually interfere with the therapeutic process.


We sometimes use 'em - to help at first - and sometimes ongoing - but VERY rarely.

If you are having therapy, you have to be very careful with doseages.

It can interfere with the desensitization.

Cognitive Behaviour Therapy.

See my first post.

Er - to be fair, anti-depressants are NOT "happy drugs".

In addition to the first class information which The Well Belovèd Cunning Coney, i would like to add some personal observations. Agoraphobia is a genuine and a genuinely crippling condition. Apart from those with this as a "stand-alone" mental health disorder, those who are chronically depressed (i started out melancholic, became depressed, and now suffer from bi-polar disorder--they keep changin' the rules) often display a classic agoraphobia, venturing forth into the world only when pressed by necessity. I speak from experience, and the experiences of others. Kicky has a legitimate criticism to level at those who exploit "newly popular" mental illnesses, which would include not only those who are mentally "hypochondriacal," but thoughtless practitioners and drug manufacturers, as well. There's lots of money to be made, and often the course chosen is to run up the tab, roll some pills, and to hell with the sufferer.

Two cents, American.