Social anxiety disorder gets spotlight – Duke expert pushes for understanding of common illness

WASHINGTON — A Duke psychiatrist is at the front of a national push to shed light on a debilitating disorder that causes millions of Americans to cut themselves off from human interaction.

Social anxiety disorder, also known as social phobia, affects more than 10 million people in the United States, according to the Anxiety Disorders Association of America. It is characterized by a disabling fear of public scrutiny and anxiety about being humiliated in social situations.

“Imagine what it would feel like to be allergic to other people,” said Jerilyn Ross, president of the association. “Because that’s what this is. This is where you have a physiological reaction to being around other people and would do anything you could to avoid it.”

Jonathan Davidson, a professor of psychiatry and behavioral science at Duke University Medical Center, is part of a coalition of mental health practitioners who launched a national awareness campaign Tuesday. Although the association said social phobia is the most common anxiety affliction in the United States and the third most common psychiatric disorder after depression and alcoholism, only 5 percent of those who suffer from it nationwide receive medical treatment.

The condition can be treated through psychotherapy, drug therapy or a combination of the two.

A study by Davidson found 3 percent of North Carolinians had received treatment for the disorder. But many psychiatrists haven’t been trained to recognize the signals, and sufferers don’t realize that what they are feeling is more serious than the common rapid heartbeat and sweaty palms most people get when giving a big speech, he said.

“This is a group of people suffering from neglect in the medical community,” Davidson said. “Only when people are no longer able to tolerate their fears do they seek help and discover that their problem is treatable.”

Davidson and his colleagues are supplementing a national billboard and poster campaign -entitled “Imagine Being Allergic to Other People” — by distributing test questions to psychiatrists who can then determine if their patients suffer from social anxiety.

Doctors should screen patients who have exhibited suicidal tendencies, depression or alcohol and drug abuse, he said, because they are much more likely to develop social anxiety disorder. Often, these multiple sufferers grow so fearful of interaction with even their doctors that they shut off treatment for all mental conditions, creating a snowball effect.

David Sheehan, author of “The Anxiety Disease,” recalled a patient from Boston who became so socially anxious in his teens that he studied maps in search of isolated spots. He dropped out of college and moved to a remote village in Nepal so he could avoid people, returning only when his family begged him to get help.

“A lot of people reading this will say, `So you get nervous talking in front of people. I’ve felt like that. What’s the big deal?’ ” Sheehan said. “This is not a matter of shyness. It has a profound effect on people’s lives.”

Social phobia can wreak havoc, Davidson said. An intense fear of not only interviewing for jobs, but also of ascending to higher posts that require people skills, often means social phobics never climb career ladders. Still others remain unemployed and never move out of their parents’ homes. And many are so paralyzed by fears that they never marry or date, he said.

“Dating, physical attraction, is often a huge challenge,” said Davidson. “It is not as if they don’t want human closeness. The phobia gets in the way.”

The condition often takes root in the teen-age years, Sheehan said. Many college students, in particular, suffer from intense fears of speaking up in class and participating in the collegiate social scene, he said. In some extreme cases, students literally have become recluses, eventually dropping out of school altogether.

“It happens a lot at Duke, it happens a lot at UNC,” said Davidson, who added that college students don’t typically realize the problem until after they’ve left school. “It can happen in any college setting. Many of my patients, years later, remember that their first symptoms appeared while giving a class presentation.”

Herald-Sun, The (Durham, NC) Date: February 24, 1999 Page: C4 Copyright, 1999, The Durham Herald Company