Myron Van Horowitzski wrote:
Are we still talking about S.A.D. here, or have we veered off into Agoraphobia?
That’s the thing, Tracer. I’m having some trouble, too, making the distinction. It sounds like what Myron and Flinx are describing is closer to agorophobia. What I think my problem is, and what the doctors I wrote about in the OP were describing, is mere shyness.
I understand medication (and hopefully, therapy will be the first option before drugs) when someone has a phobia. When someone is incapable of functioning or having a somewhat normal work & social life, which sounds like what M & F describe as Social Phobia, I get it.
Since when, though, is it a problem to “sometimes” get embarassed when you talk to someone and, therefore, blush? That is what one caller described and the doctors enthusiastically encouraged her to seek a doctor who would prescribe medication. To me, this smacks of trying to eliminate all levels of shyness.
Anyone else out there know what the line is and what the clinically-accepted indications are for Zoloft being used to treat SAD? Do you all think that drugs are sometimes used to homogenize people who have minor differences to most other people?
I, for one, just thought that agoraphobia was just the old-fashioned word for Soc. Anx. Dis. Sort of like manic-depression is the old word for bipolarity. Or bipolarism. Or whatever the one-word noun form for bipolar disorder is. I think the reason is, in the olden days when people had Soc. Anx. Dis., it was interpreted that they were afraid of everywhere other than their own house. Now we know that in most cases, it’s fear/anxiety associated with people, which should probably be called demophobia.
Myron, I hope you don’t think I was making light of the condition. Really I was just making light of my own burdensome language expectations. Both SADs are pretty interesting to me, as a certified neurology/psychology dilletante.
Am I reading Hippocrates right?
He’s not just a big box for storing large semi-aquatic mammals, is he?
Here is a summary that I found on the Web of the official DSM-IV diagnostic criteria for Social Phobia, which is the same thing as Social Anxiety Disorder (bolding mine, and I have removed some of the standard DSM boilerplate):
The paragraph in bold, in my opinion, sums it up–if it’s not interfering with your life, we don’t diagnose it as a disorder. This is a pretty common misconception about psychiatry–that it aims to “homogenize” or “fix” traits that contribute to the normal personality. In reality, it only aims to eliminate those that are problems.
But isn’t that subjective? Hell yes, it is! For instance, my short attention span would probably not be a problem at all for most people, and was never much of a problem for me before med school. Now that I’m here, though, it really does interfere with my life (such as it is). As such, I can now be said to have ADHD, and I can be treated. It’s pretty simple, really.
Agoraphobia, strictly speaking, is the fear of being in a place or situation that you can’t easily get out of, or where you won’t be able to get help if you have a panic attack. This does manifest itself by avoiding social situations, crowds, lines, etc., but the fear is not of the people but of the situation. Someone with agoraphobia might not have any trouble being in a small social situation that is easily escapable, but freak out when alone in the car and stuck in traffic on a bridge.
Dr. J
“Seriously, baby, I can prescribe anything I want!” -Dr. Nick Riviera