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Is Anyone Allergic to People?

"Imagine being allergic to people..."  It's a catchy phrase.  An antidepressant, Paxil, was the first medication in the U.S. to be approved to treat Social Phobia - or Social Anxiety Disorder.  At the same time the American Psychiatric Association joined with other agencies to (coincidentally?) mount an advertising campaign with this theme.  What is social phobia?  The DSM-IV defines it this way:

  1. A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.
  2. Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.
  3. The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.
  4. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
  5. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
  6. In individuals under age 18 years, the duration is at least 6 months.
  7. The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder (e.g., Panic Disorder With or Without Agoraphobia, Separation Anxiety Disorder, Body Dysmorphic Disorder, a Pervasive Developmental Disorder, or Schizoid Personality Disorder).
  8. If a general medical condition or another mental disorder is present, the fear in Criterion A is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson's disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, 1994)

One way to think of this disorder is that it is shyness taken to extremes.  Someone who is painfully shy - whose shyness causes them to avoid people and interferes with their life - might be diagnosed with this disorder.  Medications and psychotherapy can both be helpful for this disorder.  Like many other disorders, a combination of the two is often more helpful than either alone.  

But "allergic to people"?  This phrase does capture the distress that persons with this disorder go through.  It's not completely accurate - the anxiety is usually only associated only with "unfamiliar people" or "scrutiny by others."  The public information campaign about this disorder may help people feel less stigma and get help.  That would certainly be a good thing.  Just don't take it too literally.  Persons with this disorder are not actually "allergic to people."


The "Allergic to People" Website

The Social Anxiety Network

Social Phobia Resources at About.com's Panic/Anxiety Site

What do you think?

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