Psycho-Babble Medication Thread 300451

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Thoughts on Social Phobia, and possible remedies

Posted by billym on January 13, 2004, at 23:09:14


I wish more people posted about Social Phobia here, because it is a problem that can ruin a person's life. It certainly has mine.

I use the term "Phobia", because I think it is more appropriate than "anxiety". Anxiety is more along the lines of stage fright, GAD, "panic attacks". As a social phobic, I experience none of these. I barely experience "anxiety".

A short list of symptoms might look like this:

1) Long-term pattern of an inability to make ANY friends.

2) When in social situations, symptoms range from a slurred speech, talking too fast or too slow, inability to make any eye contact, hold a conversation longer than a few seconds (literally), unable to think of anything to say, self-consciousness, etc.

3) Inability to form coherent thoughts 'on the fly' as required in a social setting. Often the brain gets 'stuck', you freeze, like a deer in the headlights, you don't know how to react to what's happening around you.

4) Often your inner thoughts are very coherent, but when spoken and expressed to others, they come out as a jumbled mess. Before one gets too far along, one shuts up and learns to keep quiet.

Even if you try your hardest, these things cannot be overcome. Even if you have a positive mindset going into a social situtation, these things will flare up. Often times, you are not even anxious about being around others -- you sometimes look forward to it -- but once you are in the situation, you are like a computer program full of bugs. You are unable to respond to the people around you or connect with them AT ALL. I repeat: AT ALL.

The condition isn't a simple matter of trying harder, trying to meet people, etc. Every time you try, you will fail.

This naturally leads to all sorts of other problems, including feelings of inadequacy, lack of self-worth, loneliness, etc.

If one word could characterize the condition, I would believe it to be "inhibition". Extreme, unremitting inhibition and inability to express one's self around others.

I've tried some of the drugs out there that might work in treating this. For me, alcohol doesn't do much in the way of relieving the inhabition. It's not practical to get drunk every day before work or before class just so you can have a friendly conversation with someone. Pot is not practical either and does not work.

I've tried Lexapro -- it is useless for this condition. Remeron is also useless. I believe Xanax is largely useless as well. They aren't powerful enough. The problem is severe, and too much of whatever effectiveness these drugs offer can be explained away as a mere placebo or psychosomatic effect.

I think of possibilities, and Klonopin comes to mind due to its uninhibitory characteristics. It has to be powerful, and it has to have a proven track record of actually WORKING.

What I think is the core problem is a "fear blockage" in the mind, that prevents a free flow of thought and feeling to express itself. Instead, it is filtered through fear mechanisms that are hard-wired in the brain. No amount of positive thinking or cognative therapy can change it. What might, however, is a drug that would undo those blockages and allow the mind to open up fully -- to the point a person can simply look another person in the eye, say hello, and have a friendly conversation without it blowing up in their face.

If anyone has any success, any thoughts at all, please post.

 

Re: Thoughts on Social Phobia, and possible remedies

Posted by ann72 on January 14, 2004, at 8:01:34

In reply to Thoughts on Social Phobia, and possible remedies, posted by billym on January 13, 2004, at 23:09:14

Billy, I have had social phobia since I can remember. It has gotten worse over the years. Before social situations, I will actually get sick or throw up during the event. So naturally I avoid them all and therefore, have no friends. Until about 6 years ago, I thought I was just "crazy" and that would cause severe depression and even thoughts of suicide. I didnt want to live "alone" for the rest of my life. I did try paxil when it first came widely shown on commercials, and I thought, "oh my God, Thats me". So I went to the pdoc and tried it. It worked well, but almost too good. I completely changed. My co-workers prob. thought I was on illegal drugs..I would go up to strangers and talk and just wasnt afraid of anything. But it was too much. I even said the f- word in front of my boss. Plus, there were many side effects and I was given drug after drug to counter the problems. Finally after about a year, I realized I was taking about 5 diff. meds and I didnt know who I was anymore. So, I just stopped. My fear returned. I was back to slipping in the corner and not talking to anyone. Over the last 2 years, I have been on xanax. It helps with the panic attacks, but gives me no confidence, so I still dont have or want a social life. As a last resort I am thinking of getting on a MAOI like Nardil. But I will have change pdocs, because mine doesnt prescribe it. But I heard that works wonders for people like us.

Good Luck-----

 

Re: Thoughts on Social Phobia, and possible remedies » billym

Posted by SandyWeb on January 14, 2004, at 8:29:43

In reply to Thoughts on Social Phobia, and possible remedies, posted by billym on January 13, 2004, at 23:09:14

Oh my goodness, you just described me perfectly. Now if we could only get the doctors to realize that our quality of life is degraded so severely by these issues. Benzos are addictive? Please! And would you say that about morphine to an end-stage cancer patient??

Sandy

 

Re: Thoughts on Social Phobia, and possible remedies

Posted by thinkfast on January 14, 2004, at 8:34:28

In reply to Thoughts on Social Phobia, and possible remedies, posted by billym on January 13, 2004, at 23:09:14

Hey Bill, your definitions fit me to the T. I feel so weak and pathetic because of this. There are only a couple of things that I have found helpful, and therapy is not one of them. Stimulants can be helpfull in social situations. It forces you to be sociable. I'm not sure if this is a healthier alternative to any of the other med therapies, and still has it's side effects. It works wonders for apprehension. For me, the thoughts are still there, but I am able to move on from them and not get 'stuck' on some self-destructive train. I couldn't stand and talk to someone for more than about 30 seconds...then I had to leave. I lasted about 5 minutes with the stimulant. It doesn't sound like a big deal to most, but was quite a revelation for me. The other alternative is sedation, in which you don't really care if your being sociable or not. Although, this doesn't really help the main prob. Very interesting...I'll keep an eye on this post
Happy hunting!

 

Re: Thoughts on Social Phobia, and possible remedies

Posted by thinkfast on January 14, 2004, at 8:36:57

In reply to Re: Thoughts on Social Phobia, and possible remedies » billym, posted by SandyWeb on January 14, 2004, at 8:29:43

Here's an interesting thread.....http://www.dr-bob.org/babble/20020402/msgs/101846.html

 

Re: Thoughts on Social Phobia, and possible remedies

Posted by thinkfast on January 14, 2004, at 8:41:50

In reply to Thoughts on Social Phobia, and possible remedies, posted by billym on January 13, 2004, at 23:09:14

I'm going for a record for the most posts in a row...lol. I read your post again, and I stand with you on the SSRI's and Remeron. Neither of these have worked for my SA, and they seem to increase nervousness...

 

Re: Thoughts on Social Phobia, and possible remedies

Posted by billym on January 14, 2004, at 14:36:19

In reply to Re: Thoughts on Social Phobia, and possible remedies, posted by thinkfast on January 14, 2004, at 8:41:50


Sandy, ann, thinkfast,

I don't know about you, but I really don't like being alone. It's awful having no social contacts, for instance, in college, where I am presently.

Today I'm going to get drunk before a french class -- there's a lot of talking, a lot of interacting that it demands, and after the first few days, I know I'm going to have to interact or I will fail.

They say benzos are "addictive" -- GOOD! I don't care! I'll take addiction, side-effects, whatever, if it means I can tolerate a conversation for more than a few seconds, if it means I can laugh with people and express myself. Anything's better than this. We might as well be locked away in solitary confinement. There's no way out without effective drugs to alieve the fear, pain, and self-consciousness.

billy

 

Re: Thoughts on Social Phobia, and possible remedies

Posted by Metalblade on January 14, 2004, at 17:44:24

In reply to Re: Thoughts on Social Phobia, and possible remedies, posted by ann72 on January 14, 2004, at 8:01:34

I've come to the conclusion that my depression which I believe to be Bipolar II is the main problem behind my Social Phobia. I always do well when I first take an antidepressant but then it stops working. Some times it works too well, for instance, Effexor will make me manic. When I'm on that stuff I can talk to anyone but I do crazy reckless stuff on it too. Paxil Kind of makes me Hypomanic but then I quickly get depressed again. I have been Cycling Paxil for 2 years now constantly changing the dose up and down to keep it working. I tried lithium the other day. I bummed like 10 300mg pills off of someone I know that takes it.The lithium keep the Paxil working. I told my doctor this but anything I suggest he totally disagrees on. Its like he has some kind of doctor ego where he can only come up with Ideas and what I think doesn't matter. He just put me on an anti-psychotic called risperdal. Its making me even more depressed and slowing my thinking. I'm changing doctors and finding one that will listen to me. I read a post on here where someone said the key to beating Social Phobia is a controled Hypomania and I belive this to be true.

 

Re: Thoughts on Social Phobia, and possible remedies

Posted by Keith Talent on January 14, 2004, at 21:29:31

In reply to Re: Thoughts on Social Phobia, and possible remedies, posted by Metalblade on January 14, 2004, at 17:44:24

What about tranylcypromine (an activating MAOI) and dextroamphetamine and clonazepam? Would that combination overcome this inhibition you described?

 

Re: Thoughts on Social Phobia, and possible remedies

Posted by jbs on January 14, 2004, at 21:56:01

In reply to Re: Thoughts on Social Phobia, and possible remedies, posted by Keith Talent on January 14, 2004, at 21:29:31

MAOIs have the strongest data for social phobia. Benzos can be helpful to address the physical side effects (butterflies) and maybe the excess ruminations of your social phobia, but for some folks they don't really seem to help 'to get going' socially. I would try 1 or 2 SSRIs +/- benzo, failing that MAOI +/- benzo.

 

Re: Thoughts on Social Phobia, and possible remedies » billym

Posted by Tepiaca on January 14, 2004, at 22:59:06

In reply to Thoughts on Social Phobia, and possible remedies, posted by billym on January 13, 2004, at 23:09:14

hey billym
You have described my life too . This SP came to my life and destroyed it in a hundreds of pieces.
It begins when I was 15 years old . I was a very happy person , with a lot of friends and a lot of conversation. Then everything dissapeared. I lost all my friends and my hability to talk to the people ,even with my parents.
Im 23 right now , after trying all the medicines in the market , including SSRIS , betablockers , AP , tryciclics etc the best medicine I have taken in my life is Nardil .Althougth Im not happy still , Nardil help me to live with this horrible disease. I know Nardil is the way , I only have to find another medicine to take with it.

You should try it ! really
You dont lose anything .It could safe your life

 

Re: Thoughts on Social Phobia, and possible remedies

Posted by thinkfast on January 15, 2004, at 5:12:51

In reply to Re: Thoughts on Social Phobia, and possible remedies, posted by billym on January 14, 2004, at 14:36:19

ammen to the addiction statement!

 

Re: Thoughts on Social Phobia, keith

Posted by thinkfast on January 15, 2004, at 6:13:07

In reply to Re: Thoughts on Social Phobia, and possible remedies, posted by Keith Talent on January 14, 2004, at 21:29:31

That combo could possibly work. I don't know about everyone else, but if I suggested that to my doc he would freak. It was hard enough to get him to let me try concerta. It didn't work for me at that time, but I wasn't on Remeron then. I know how stims effect how I feel now, but I don't know what benzo's will do(don't know anyone to get a 'sample' from) This social frustration is getting worse, and is causing depression. When I go back to the doc I would like to suggest Klonopin or Adderall, but not both at once. I would prefer to take a benzo over a stim, cuz stims make me smoke to much. Any opinion on which would be better would be appreciated. Thanx!

 

Re: Thoughts on Social Phobia, keith

Posted by Peoples on January 15, 2004, at 11:53:26

In reply to Re: Thoughts on Social Phobia, keith, posted by thinkfast on January 15, 2004, at 6:13:07

This is my first time posting here...Some posts here described me to a tee: I am 24 yr old with social phobia with severe comorbid depression that also started at 15 (scary,lol) so I thought now I would start. I have tried all the usual meds and most mentioned in this thread with the single exception of Nardil since I am sure that I would mess up at some point with my diet and end up killing myself heh... but I would like to relay what has worked for me: GHB.
The only reason I came out and mentioned it was after reading the insightful thought on addiction (amen to that). The med community and society in general dont understand that as adult human beings we should have the right to make that personal decision, to make that trade-off between either hating life (actually not even living one, as is the case with severe social phobs) and relying on a drug to enjoy it, which is the case with most psychiatric drugs anyhow.
Anyways, back to the point... I discovered GHB on my own after trying everything else and my God it worked. I am now outgoing, dont have that crippling fear of scrutiny or "mental block" in conversations as was decribed and I am now completing college finally with good grades and *gasp* lots of friends. It dissolves inhibitions better than alcohol, but with the RIGHT dosage still leaves you clear-headed and able to function and best of all actually MAKES you want to be social.
It is now a FDA-approved drug called Xyrem, but it is used only for narcolepsy (it is THE most controlled prescrip. drug, although its only sched. 3, wierd i know) ...hopefully that will change soon as I've heard clinical trials are in the pipeline for some psychiatric conditions, but until then I'll have to get mine illcitly :( unless I can find a doc willing to prescribe. I urge you to ask all yours, its worth a try. Of course ymmv, but my the mileage on my odometer is flying by, and its a great ride :)

thanks

 

Re: Thoughts on Social Phobia, Abilify

Posted by Sebastian on January 15, 2004, at 19:22:50

In reply to Re: Thoughts on Social Phobia, keith, posted by Peoples on January 15, 2004, at 11:53:26

I think Abilify works. Going to try that again.

 

Re: Thoughts on Social Phobia, Abilify

Posted by ace on January 15, 2004, at 19:27:14

In reply to Re: Thoughts on Social Phobia, Abilify, posted by Sebastian on January 15, 2004, at 19:22:50

> I think Abilify works. Going to try that again.

what was better Seb, Zyprexa or Abilify?

ace

 

Re: Thoughts on Social Phobia, and possible remedi » billym

Posted by zero on January 15, 2004, at 23:21:58

In reply to Thoughts on Social Phobia, and possible remedies, posted by billym on January 13, 2004, at 23:09:14

Most of what you wrote applies to me also. 1/2 of my Dx is "Social Anxiety Disorder" (the other 1/2 is Bipolar II).

My feeling is that AVPD is no more than the extreme form of "generalized" Social Phobia. But, I do find that some make more of a "qualitative" distinction between the 2 (vs. my "quantitative" one). Everyone is different.

Klonopin (2mg./day) helps me with a part of my SP, but there is another part that is not being addressed, the "motivating part".

Unfortunately, w. comorbid BPII, antidepressants make me hypomanic/"mixed states". Nardil was by far the best of these though. Nardil+Klonopin+Lithium worked for about 3 months, until the hypomanic broke through (ditto Prozac+Klonopin+Tegretol, not quite as good as the Nardil combo. though).

SP/AVPD has severely constricted my life. Wish there was more serious research being done on treatments, instead of just the all-too-common throwing of SSRI's at it.

Best to all.

z.

 

What is GHB ???? (nm) » Peoples

Posted by Tepiaca on January 16, 2004, at 17:51:26

In reply to Re: Thoughts on Social Phobia, keith, posted by Peoples on January 15, 2004, at 11:53:26

 

Re: Thoughts on Social Phobia, Abilify » ace

Posted by Sebastian on January 17, 2004, at 9:17:02

In reply to Re: Thoughts on Social Phobia, Abilify, posted by ace on January 15, 2004, at 19:27:14

A mix

 

Re: Thoughts on Social Phobia, Abilify

Posted by cybercafe on January 18, 2004, at 22:20:40

In reply to Re: Thoughts on Social Phobia, Abilify, posted by ace on January 15, 2004, at 19:27:14

> > I think Abilify works. Going to try that again.
>
> what was better Seb, Zyprexa or Abilify?
>
> ace

abilify makes you want to do more, zyprexa makes you more relaxed

 

Re:controlled hypomania » Metalblade

Posted by ramsea on January 19, 2004, at 5:47:38

In reply to Re: Thoughts on Social Phobia, and possible remedies, posted by Metalblade on January 14, 2004, at 17:44:24

Very interesting. As a bipolar with social phobia problems, I have to agree. When I am hypomanic I am a people-magnet. I get offered jobs and projects, friendships come to me, social networks appear with me in them----and then, very scarily, the hypomania shuts up like a telescope and I am very alone, burdened with the links I've made and the responsibilities and promises to do things with others that I simply cannot live up to anymore. It makes me feel an abject failure. If I never experienced hypomania I would just be a more stable and content recluse, rather than a person who has made a grand splash and who now has to leave this and that project/group, quit jobs, drop friends or be dropped (for lack of being available and coming through with the same fun personality). What a thing to have to endure!!!!! Ever notice if you don't start something there is no failure in that, but if you start aPH.D say, and do really well at first, and then have to drop it due to depression/social anxietym forever after that you will be described by that failure? People will ask what you did during such and such time--Worked on Ph.D. Or folks who know you will know you did this. And ever after it's, "Oh, how sad you weren't able to finish it." So you become pathetic just because your rotten hypomania didn't last out long enough to finish a ptoject. If you figure a way to keep it going, please lemme know.

 

Re:controlled hypomania

Posted by Metalblade on January 19, 2004, at 7:12:29

In reply to Re:controlled hypomania » Metalblade, posted by ramsea on January 19, 2004, at 5:47:38

Well, every one is different but for me Effexor makes me hypomanic and some times just plain manic. That for me keeps it going but I can't control it. I get crazy on that stuff. Its like crack for Bipolar people at least for me anyway. I have just now started to experiment with Lithium and the results are exceeding my expectations. The only problem is I need to find a Doc that has experience with bipolar people. Its pretty bad when you go to a doctor and he tries every thing under the sun and you’re the one who figures out what is wrong with you. I guess its time to go hunting for a new doctor. I have found some good links that I find interesting. One is a study suggesting a connection between Bipolar II and Social Phobia.
http://www.biopsychiatry.com/bipolsp.htm
http://www.biopsychiatry.com/lithaug.htm
http://www.floridapsych.org/news998.htm

> Very interesting. As a bipolar with social phobia problems, I have to agree. When I am hypomanic I am a people-magnet. I get offered jobs and projects, friendships come to me, social networks appear with me in them----and then, very scarily, the hypomania shuts up like a telescope and I am very alone, burdened with the links I've made and the responsibilities and promises to do things with others that I simply cannot live up to anymore. It makes me feel an abject failure. If I never experienced hypomania I would just be a more stable and content recluse, rather than a person who has made a grand splash and who now has to leave this and that project/group, quit jobs, drop friends or be dropped (for lack of being available and coming through with the same fun personality). What a thing to have to endure!!!!! Ever notice if you don't start something there is no failure in that, but if you start aPH.D say, and do really well at first, and then have to drop it due to depression/social anxietym forever after that you will be described by that failure? People will ask what you did during such and such time--Worked on Ph.D. Or folks who know you will know you did this. And ever after it's, "Oh, how sad you weren't able to finish it." So you become pathetic just because your rotten hypomania didn't last out long enough to finish a ptoject. If you figure a way to keep it going, please lemme know.

 

Re: great links, thanks good luck (nm) » Metalblade

Posted by ramsea on January 22, 2004, at 9:27:31

In reply to Re:controlled hypomania, posted by Metalblade on January 19, 2004, at 7:12:29


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