Posted by Ritch on August 8, 2002, at 1:19:18
In reply to Re: How Parnate saved my butt, posted by hildi on August 7, 2002, at 16:47:08
> > > Yeah Mitch, I get what your saying-there are many times (while I am taking my SSRI's) that I just BS my way through entire social engagements, and then, on my way home I'll be exhausted from all my 'play acting' and my mouth is sore from grinning too much.
> > > I feel like such a fake- this is with people that I like, sometimes. Then I feel guilty from not being 'real' with them. . . but how could I be real. If I was real I would be a big downer, not laughing or joking with everyone.
> > > It some seem that alot of this could be depression. It takes so much effort to put on this big act that "hey , I'm OK, I am this fun gal". I get totally exausted by social events for this reason- I feel I have to perform.
> > >
> > > However, there are other times, though, when I really do seem to click with everyone I meet. It is almost effortless and I think I feel almost normal- and am actually having fun. These occasions are usually those kind where I don't spend a lot of time with any one person. I think that takes a lot of pressure off of me, too.
> > >
> > > I get scared if I think someone is actually going to be able to see how scared and depressed I really am. I don't want people to know- that is too humiliating and would make me way to vulnerable.
> > > You know, sometimes my SSRI's make me not "give a shit". . .I don't care about being alone sometimes. . .I think they take away my cares too much where i don't feel many things, including the need to inateract with other people. I don't like this part. I want to feel, but now get blown away. What can I take that will allow that?
> > > Hildi
> >
> >
> > Hildi,
> >
> > Thanks for replying. I know exactly what you mean! I am more convinced than ever that it is all bio-chemically based. When I get my bipolar major depressions (when they are poorly treated), the main symptoms are lack of interest in socializing and this tremendous BOREDOM and TIREDNESS with everything (not just social stuff). It is the "interest in everyday activities" element of the depression that is foremost. The next biggest elements that are prominent is "ability to concentrate" and "slowed thoughts" and "fatigue". I have mentioned this here before, but I think that Social Anxiety is deeply connected with that "limbic" or "depressive" ADD that you hear about. That is where SSRI's fail to some degree IMO. They are good at giving you a "thicker skin", but wouldn't it be superior to feel drawn out of your own shell-by being truly *interested* in what is going on out there (wanting to check it out), instead of just having a THICKER SHELL? That is where SSRI's fall short-motivation and interest. Motivation and interest are often attributed to dopaminergic meds. I have tried stimulants and they have helped so-so, but they tend to worsen panic (in my situation anyhow), despite their ability to improve attention and alleviate depression, etc. That is probably why the MAOI's have the overall superior edge for social phobia. They can reduce panic AND increase dopaminergic transmission which tends to promote motivationi and interest. Just a few ideas here. I don't know if my current pdoc will every write for the things. I am half-ass solving this problem with a low-dose combo of Effexor and Wellbutrin right now. However, I think that the MAOI's might be the best meds. You might want to talk to your doc about them anyhow,
> >
> > good luck,
> >
> > Mitch
> >
> >
> Hi Mitch. I did try to talk to my dr. about MAOI's and he wouldn't listen. he is really 'pissed' at me and not open to any of my suggestions. After going off of zoloft because of physical sick symptoms ( shakiness, nausea, fainting spells, more) and maybe hypomanic symptoms (racing thoughts, major irritability, hyper and obsessing over things and thoughts) dr. tried me on celexa and effexor. I hated both of them.
> Well, now he says I'm expecting too much, too bad about feeling like shit and just deal with it. he pretty much just threw his hands up in the air and said "I give Up".
> So, he gave me paxil-which I didn't want, and told me he won't even discuss anything else.
> I am having extreme anxiety attacks on the paxil. I don't want to up the dose because I can't afford it, also I am experiencing a very wierd side effect from paxil CR at 12.5 mg- intense interest in sex!! All I can think about!~ Is this mania?
> I am going to TRY to get the dr. to talk to me tomorrow- I am going to PLEAD with him to give me a benzo-I was really against this (because I'm an alcoholic, 9 years sober) but I have changed my thoughts on this big time. If I am going to be dependent on a med, I want it to be something that at least will help me. I am thinking, if I can do benzos for a little while while I clean my body of AD's I may then be able to try an MAOI.
> The dr. even suggested benzos to me twice. He knows my situation and doesn't think it would be a problem. BUT, he is really acting wierd with me. I think I insulted his manhood or something by questioning him too much, sometimes in fromt of his collegues. This is when his attitute changed tremendously.
> I might be out of luck completely now with this guy. If I cannot get some relief from this anxiety I am afraid I WILL go back to drinking. I used drinking for many years for anxiety. I cannot go it alone.
> HildiHildi,
The reason your pdoc won't write for MAOI's is because of your past drinking history-I feel pretty sure on that one. He is afraid if he puts you on Nardil or Parnate, you might start drinking again and have a fatal interaction with the meds, then his ass is out hanging in the wind. What you might want to do is mention the "safer" (but somewhat less effective) MAOI's such as moclobemide or seligiline, and see what he says about them. You don't have dietary restrictions with those (at the recommended dosages), and alcohol is "ok" as long as it is moderate and low. If that doesn't pan out, you can discuss benzodiazepines (which might work fine). You do have a lot of options.
Mitch
poster:Ritch
thread:115196
URL: http://www.dr-bob.org/babble/20020807/msgs/115633.html