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Stepping out of social phobias.

Stepping out of social phobias

There are few people who do not, at times, get nervous in social situations, say while speaking in public. But in some instances, fears of public scrutiny and potential humiliation become all-pervasive and make a normal life impossible.

"Social phobias" can revolve around specific situations or extend to most interpersonal encounters, says psychiatrist Thomas Uhde of the National Institute of Mental Health (NIMH) in Bethesda, Md. "For the most part," he contends, "the public doesn't appreciate the extent to which a social phobia disrupts a person's life." One woman, for example, avoided speaking and writing in public for 15 years. She could not even write a check when others were around and was unable to work.

Her condition dramatically improved, says Uhde, after receiving drug treatment in an NIMH study of social phobia. Preliminary findings, according to study director Cheryl A. Shea, indicate that phenelzine, a drug that increases the amounts available of several neurotransmitters, and psychological training both provide relief from symptoms of social phobia. The researchers provided 12 weeks of treatment to 65 middle-class subjects, most with specific fears of public speaking, writing, eating or using public bathrooms. About one-quarter had more widespread fears of social situations. Some subjects received a type of psychological retraining, in which they explore the irrationality of their fears with psychologists, practice feared activities and then reenter social situations. Others received either phenelzine or alprazolam, a drug used with severely depressed patients. A fourth group was on a treatment waiting list and received no treatment.

Two months after the treatment ended, only patients given psychological therapy or phenelized were rated as significantly improved by independent physicians, says Shea.

Phenelzine appears to be effective wiot about 80 percent of social phobics, says psychiatrist Michael R. Liebowitz of the New York State Psychiatric Institute, who has conducted several phenelzine studies. Short-term phenelzine therapy may not wipe out social fears entirely, adds Liebowitz, but it allows patients to talk to other people, develop skills and build close relationships, often for the first time.

"With the proper treatment, we can make tremendous changes in the lives of these patients a very short time," he says.
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Title Annotation:treatment with phenelzine
Author:Bower, Bruce
Publication:Science News
Date:May 21, 1988
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