March 22, 2012 -- Rebecca Cagle has heard that the smell of coffee can calm people in uncomfortable settings.
But she has no way of knowing if a whiff of roasted java could ease her feelings of shyness. Cagle was born without a sense of smell.
It wasn't until she was 25 years old when the Tennessee woman realized she was lacking a sense of smell. While hiking one day with her parents, they complained about a strong odor coming from a creek bed. "I realized then that I had no sense of smell," said Cagle, now 52. Since that stunning revelation, social gatherings have been difficult for Cagle, she said. She sometimes feels she can't relate to people in the way that most others can -- without being able to share the experience of smell.
Now a new study has found that people born without a sense of smell experience higher social insecurity and are at increased risk of depression than those who have functioning olfaction.
Approximately 14 million Americans suffer from some sort of lack of smell, according to the Anosmia Foundation. Now researchers from the University of Dresden Medical School in Germany have analyzed the questionnaires of 32 study participants with anosmia and found that participants born with isolated congenital anosmia, or ICA -- a lack of the sense of smell since birth in otherwise healthy people -- worried more about social situations than the control group.
Those with congenital anosmia reported worrying about their own body odor, were more likely to avoid eating with others and showed slightly higher scores for depression than those who could smell.
"ICA patients differ only slightly in daily life functions related to olfaction," study authors wrote. "These differences are increased social insecurity, enhanced risk for depressive symptoms and enhanced risk for household accidents."
"People will ask me if I like the smell of their perfume or ask me if I can smell something that they are smelling and I cannot relate to what they are talking about," said Cagle, who said she drove with bad carbon monoxide emissions coming into her car on two different occasions because of a leaking exhaust system.
"I cannot smell if something is on fire," continue Cagle. "I cannot smell if I have bad breath or body odor. All of these things are dangerous, or can be offensive, to me and others around me."
What makes these patients interesting when evaluating them in a clinic is that they have never known what it is like to smell, so it can be difficult for a physician to even ask them questions about it, said Dr. Eric Holbrook, of Massachusetts Eye and Ear Infirmary with Harvard Medical School.
"One common comment that I hear from adults who come to me with this problem is that they remember that they would lie to friends about being able to smell a strong odor while in a social gathering," said Holbrook. "This seems mundane to people who can smell, but it stresses how these patients feel like they don't fit in at times."
Usually people who are most affected by lack of smell are those who could smell at one point and then lost the ability to smell, said Dr. Allen Seiden, director of the Taste and Smell Clinic at University of Cincinnati. Otherwise, those who have never experienced smell may not experience such feelings of loss.
Rachel Perrone, a 38-year-old mother of two who was born without the sense of smell, agreed that she doesn't know what she's missing.
"People talk about how smells can nostalgically bring you back to childhood," said Perrone. "I don't have memories of how my grandma's house used to smell or anything like that. Smell is the strongest trigger of memory they say, and I guess I missed that, but otherwise, it's one of those things that I've never known any other way."
In fact, Seiden said most people with the condition only seek medical treatment or information at the prodding of a family member.
"They have grown up without a sense of smell, and so the lack of smell has no real bearing on their interaction with others or their environment," Seiden said.
"It's hard to miss something viscerally, but it sounds like smell would be nice as a memory tool," said Perrone. "I wish I had that."