Social Anxiety Disorder
Social Phobia:

Why Won't They Listen?

Why can't  "professionals" understand social anxiety disorder (previously called "social phobia")?  

What's going on?  Why can they seemingly understand much more obscure problems, such as Tourette's Syndrome or

These other problems are more noticeable.  They are more overt.  We hide our problem.  We try our best not to show we're anxious.  Usually, we're successful.

We don't look strange.  We don't do unusual things.  Our public behavior is typically quiet.  We don't attract attention to ourselves.

We know there is a war going on inside us.  But, others cannot see it.  Unfortunately, they many times don't believe it, either. 

These professionals do not have any training in anxiety, nor have they themselves gone through an anxiety disorder.  They do not understand you, and they never will.  It is important for you to realize you know more about your pain and symptoms than they do.

This is a very serious problem.   We have people come to clinic who have attempted suicide over their anxiety in the past,  under the care of 'professionals"  who didn't understand anxiety at all.  In some cases, anxiety sufferers have been prescribed medication that virtually "sent them over the edge".  Every day I hear another horror story of what has been done to my people in the past by so-called professionals. 

As of this writing, a young man with an anxiety disorder sits in a psychiatric ward back East because his "caregivers" over a twenty-year period (a) provided him no cognitive-behavioral therapy, which is essential to overcoming anxiety, (b) took him off an effective medication for anxiety, and (c) placed him on a newer, untested "antidepressant" that has a strong potential to cause very negative and powerful side effects for anxiety people.

As his symptoms worsened, he fell into a deep depression, began scratching himself incessantly, developed horrible headaches, became nauseous, and began talking about killing himself.  His "caregivers" response?:  "The medication must be working.  Look at all the side effects!"

The man did indeed try to commit suicide, and would be dead right now, except for the intervention of family and friends.  When they got him to the psychiatric ward, these "caregivers" performed one more little act of barbarism:  They took away his anti-anxiety medication, so that he now has to writhe in agony and pain as the horrible physical effects of this "antidepressant" push him into a deeper depression.

Keep in mind that this is a man who was not suffering from depression.  Because of his "caregivers'" ignorance, he was prescribed an antidepressant to "help" him with his anxiety.  Many of the common antidepressants today DO NOT work for people with anxiety disorders....they make the anxiety worse....so please be careful.  The majority of professionals do not keep up with the research, will not listen to what you have to tell them, and will prescribe medications that will make anxiety and your life worse.  Essentially, they don't know and they don't care.  Why do I say this?  If they cared, they'd start reading the abundant research literature on anxiety done in the 1990's.

A little over 50% of the people who first came to the clinic have had horror stories of being put on antidepressants for anxiety that caused all kinds of brutal and nasty effects.  Several had to be hospitalized because of an SSRI or an SSRI augmentation with another "newer" antidepressant.

This is the United States, 1999.

This is very typical of the understanding of anxiety disorders among professionals in the United States at the turn of the new millennium. 

I enjoy receiving e-mail, but listening to cases like this turns my stomach.....and I can't say anything specific about it, because, if I do, guess who's seen here as being the troublemaker? 

More accurate information seems to exist on panic/agoraphobia than for the other anxiety problems, but those of our people with social anxiety and generalized anxiety experience much more trouble in getting the appropriate people to understand their particular anxiety problem and how to treat it effectively.

For all three anxiety problems, cognitive-behavioral therapy has been shown to work best in helping overcome the anxiety disorders.  No other therapy  comes close.  Breathing exercises, hypnosis, relaxing, imagery, and other more esoteric exercises may be nice and fine.......but they do not overcome anxiety problems by themselves.  Don't settle for someone who is going to teach you to "relax". This is not enough.

In terms of medications, for these three anxiety disorders, the anti-anxiety medications (benzodiazepines) have been shown to be very helpful.  You must check with your doctor/psychiatrist, however, concerning complications and interaction effects.  These medications are generally well tolerated and non-addictive to those who have clinical anxiety disorders.  (Yes, despite what you've heard, research reveals that these medications are NON-addictive to people who have clinical anxiety disorders, as defined by the DSM-IV).  None of our people have ever become addicted to these medications.

Many of our people have spent decades -- and tens of thousands of dollars trying to get someone even to UNDERSTAND anxiety.   Please call up any "professional" first and make sure they specialize in anxiety.  I get e-mails every week from highly-decorated professionals who I can tell from their response know very little about anxiety and the anxiety disorders....and yet they'd gladly take you in to see them......provided you pay and pay and pay.

We sit in a large city of close to three million people.  Our referral options to other professionals here are very close to nil.  Why?  I've beat MY head bloody trying to find professionals who have read the latest journal articles on anxiety, or the latest authoritative books on the subject.  But, even when we send journal articles to other professionals, they seem not to be read or understood.  Yes, my frustration level about this is high.  I am working with PEOPLE who need help and I want and expect them to get better.  We know from research and experience that they CAN get better.......but where can I send people for medical help?

I have anxiety people who are so down and out that they can't hold down a regular job.  How can we get them the help they need?  Even when they save their money for months and months so that they can afford to go to a "professional", the professional is likely to totally misunderstand the diagnosis, and prescribe something the drug companies are pushing, instead of what we know from research and clinical practice works. 

Perhaps you can understand my frustration.

As you can tell, we are not a full-fledged anxiety clinic.  Why?  I can't find professionals in the right areas who know how to talk about anxiety, let alone know how to treat it appropriately.  

Yes, to all of you who write, I do want to have an inpatient anxiety clinic here in Phoenix where you can come, and we can avoid all of the above problems.  Right now, however, we are two or three professionals and support people short.....because we can only hire anxiety specialists (people who understand anxiety and know how to treat it).

I wish I could tell you things were getting better.  In the five years we have been here, things have only gotten worse.   We used to be able to refer to a professional in Tucson (100 miles away), but he is no longer taking new clients.....we have no one to take his place.

I beat my head against the wall for 20 years myself, trying to find someone to help me overcome my social phobia......I never did find any outside help.  And now, I am equally frustrated for all the people I work with........

I hope one day this sad and pitiful chapter in psychology/psychiatry will end.