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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 36. Go back in thread:
Posted by Phillipa on June 25, 2011, at 16:23:45
In reply to more thougts on social phobia, posted by floatingbridge on June 25, 2011, at 16:19:23
Thinking back weren't you doing better when taking meds? Kind of forgot but wasn't the emsam working? And the benzos also seemed to help. Love Phillipa
Posted by jms600 on June 25, 2011, at 17:49:59
In reply to more thougts on social phobia, posted by floatingbridge on June 25, 2011, at 16:19:23
> My husband and I were talking. He said he's been thinking alot (poor guy), and that he feels I need social support, a group. He says AA and it's satellites may
> not be quite right.
>
> I said yeah. Remember when you had to 'walk me' 12 years ago? He did. He literally had to help walk me around the block. He was my coach. This is where we are again. I am dressed but lying down, waiting for the signal that the family is ready to go walking.
>
> At that time, I was dx'd with social phobia. Wtf? Well here I am again, though now with a sleep aid (ambien worked! But super hangover.), waiting for an appt to an anxiety clinic. They deal with phobias, all kinds, plus anxiety disorders, all kinds. How convenient.
>
> So, what's that expression, about leaving with only the clothes on one's back, or maybe naked as the day that one was born? Something like that.
>
> I am going to have to somehow endure the discomfort that I have. I won't say yes or no to meds right now. That's besides the point.
>
> I love people, desperately need them, but does it have to be so close up? Couldn't I love everyone, or just abide them more distantly.
>
> Life is absolutely laced with irony. I have to face my fears. No one else can.
>
> It's time for my walk.
>
>I still think you should push for Nardil. It's the gold standard for social phobia. I suffer from terrible anxiety/panic disorder, but my p/doc won't prescribe me any - I wish he would.
I know the side effects can be troublesome and the dietary restrictions are a pain, but most people seem to say that they're a small price to pay for the relief Nardil brings.
Posted by floatingbridge on June 25, 2011, at 19:02:08
In reply to Re: more thougts on social phobia, posted by jms600 on June 25, 2011, at 17:49:59
So jms, how are you treating your disorder? It sounds like you are not satisfied with the results. (And thanks for your input. I am 100% unsure as what to do.)
I have spent so much time reading and thinking about depression, I seems absurd given my ptsd, but I don't even understand the basic theoriea of anxiety disorder. What do you think, if I may ask you, as someone living this dx?
fb
Posted by morgan miller on June 25, 2011, at 22:28:48
In reply to more thougts on social phobia, posted by floatingbridge on June 25, 2011, at 16:19:23
FB, have you ever been in a psychodynamic therapy group? If you want personal growth, this is the way to go.
Your fears are likely manifestations of other damaged parts of your psyche. There must be some way to pick things apart, face them, and deal with them. You're right in that facing your fears is the only way to free yourself from them.
Also, there has to be some medication that would make you at least feel better, even if it's only 60 percent better.
Hang in there,
Morgan
Posted by morgan miller on June 25, 2011, at 22:29:05
In reply to more thougts on social phobia, posted by floatingbridge on June 25, 2011, at 16:19:23
FB, have you ever been in a psychodynamic therapy group? If you want personal growth, this is the way to go.
Your fears are likely manifestations of other damaged parts of your psyche. There must be some way to pick things apart, face them, and deal with them. You're right in that facing your fears is the only way to free yourself from them.
Also, there has to be some medication that would make you at least feel better, even if it's only 60 percent better.
Hang in there,
Morgan
Posted by floatingbridge on June 25, 2011, at 22:56:41
In reply to Re: more thougts on social phobia, posted by morgan miller on June 25, 2011, at 22:29:05
Did group therapy cbt/social phobia and dbt/no SI.
I can't not look at the thoughts. It's getting worse. It waxes and wanes hourly.
Yes, I guess some med.
I would say emsam over snri. Even a benzo until I get a doc again. Maybe that would be enough.
Thanks.
Posted by Phillipa on June 26, 2011, at 0:25:57
In reply to Re: more thougts on social phobia, posted by floatingbridge on June 25, 2011, at 22:56:41
FB I feel the benzo will at least calm your thoughts and maybe give a gentle lift. You did it once again if needed meaning wean benzos. Love Phillipa
Posted by morgan miller on June 26, 2011, at 10:13:47
In reply to Re: more thougts on social phobia, posted by floatingbridge on June 25, 2011, at 22:56:41
Sorry your not doing well FB. Would you consider giving Zoloft a try again? I'm just thinking of something mild with less of a risk to throw you off in any way. Zoloft may actually help modify the immune system in such a way that is beneficial for autoimmune disorders. Also, SSRIs are anti-inflammatory for the most part. Ever thought about combining Zoloft with Nortriptyline? I think you tried Nortriptyline at one point, maybe you didn't have a good experience.
I'm guessing you've had recent success with Emsam. It makes sense to use it again if this is the case.
Why have you gone without any meds? Just to get a clean slate and start over?
Sorry if I'm annoying you with my suggestions.
Posted by floatingbridge on June 26, 2011, at 15:18:00
In reply to Re: more thougts on social phobia, posted by morgan miller on June 26, 2011, at 10:13:47
Hi Morgan,
You are not annoying me one bit. Therapy is in order once I stabilize. I actually like good therapy. Hard to find.
Going to restart emsam. When I get a pdoc and things are more stable, I think amitriptylne (sp!) might be next rather than nort. Just after some consideration
and reading, my first choice.Zoloft and ssri's have lots of merit. I've read your links and posts and looked up zoloft. The anti-inflammatory effects seem considerable.
What are you doing on the med board? I am never sure if it's great to see
someone posting here or not, you know? I hope you're doing o.k. and making continued headway.fb
Oh yeah. The no meds. It kinda'
happened. I have been off snri's for awhile because they weren't helping. Guess I needed to try 'no meds' one more time to figure it out for myself. The anxiety is intractable, and I do not want to continue the benzo route. For me, it seems anxiety is what crashes the system. Emsam reduced my anxiety more than any single agent. It didn't irradicate it. But maybe with that or something like it, I can get it to a more workable level. Other than uber insomnia, emsam physically felt better. Something about my snri, ssri experience to date is that they create alot of physical and emotional blocking without a substantial enough payoff. I do not know why emsam does not. But it's just in the trial stage. I'm hoping to not restart benzos. So, my own personal progress in the midst of disaster.> Sorry your not doing well FB. Would you consider giving Zoloft a try again? I'm just thinking of something mild with less of a risk to throw you off in any way. Zoloft may actually help modify the immune system in such a way that is beneficial for autoimmune disorders. Also, SSRIs are anti-inflammatory for the most part. Ever thought about combining Zoloft with Nortriptyline? I think you tried Nortriptyline at one point, maybe you didn't have a good experience.
>
> I'm guessing you've had recent success with Emsam. It makes sense to use it again if this is the case.
>
> Why have you gone without any meds? Just to get a clean slate and start over?
>
> Sorry if I'm annoying you with my suggestions.
Posted by sigismund on June 26, 2011, at 15:26:19
In reply to more thougts on social phobia, posted by floatingbridge on June 25, 2011, at 16:19:23
>I said yeah. Remember when you had to 'walk me' 12 years ago? He did. He literally had to help walk me around the block. He was my coach.
That sounds nice. Maybe that is what you need? Sometimes in life different mentalities are such that things are really rigid. If you can just say 'You are my coach' that can be liberating.
I am just rambling around here....you know how relationships with kids are not expected to be equal and symmetrical, and this has its purpose.
Free and equal people are sometimes a real strain.
I don't know about social phobia exactly, but sometimes people make me feel SO bad. Not if they are dying or something...that is alright. Certain kinds of social interaction cause me acute pain.
You don't have to respond to this...it's just some rambling half thoughts.
Posted by floatingbridge on June 26, 2011, at 15:40:20
In reply to Re: more thougts on social phobia » floatingbridge, posted by sigismund on June 26, 2011, at 15:26:19
Hi sigi.
Sorry about the teenage thing if I am completing a half thought correctly.
I'm just literally lying around waiting to see if a script is coming through or if I need to dress and present at the clinic.
Very good point about the coach. I think
that little semantic switch opens some windows. Helpful. Thanks.Amazing how another little semantic switch can close tons of doors.
But where is the owners manual?
There is such an immensity to what I don't know, I often forget the little I do.
Posted by jms600 on June 26, 2011, at 15:44:04
In reply to Re: more thougts on social phobia » jms600, posted by floatingbridge on June 25, 2011, at 19:02:08
> So jms, how are you treating your disorder? It sounds like you are not satisfied with the results. (And thanks for your input. I am 100% unsure as what to do.)
>
> I have spent so much time reading and thinking about depression, I seems absurd given my ptsd, but I don't even understand the basic theoriea of anxiety disorder. What do you think, if I may ask you, as someone living this dx?
>
> fbI was on a whole host of meds - 150mg Effexor, 600mg lithium, 40mg buspirone, 600mg Lyrica, 10mg Zyprexa. I still had anxiety and depression, so my doctor decided to cut down the meds that I was taking as they weren't help 100%. Now I'm just taking 225mg Effexor and 600mg lithium. I think he wants a clearer picture on what's working and what isn't. I've been on a lot of meds over the years and most haven't helped a lot. I'm also taking 15mg Valium on an as needed basis.
The best SSRI I found for anxiety was Seroxat. It didn't treat my anxiety completely but it did help a little. Trouble is out of all the SSRIs I've tried Seroxat had by far the worst side effects. Terrible weight gain, total loss of libido, and excessive day time drowsiness (which started to effect me at work).
I do not know what your full symptoms are or what you have tried in the past, but you could also give consideration to atypical antipsychotics (or low dose typicals e.g. haloperidol) as well as looking at anticonvulsants.
Posted by sigismund on June 26, 2011, at 16:03:16
In reply to half thoughts » sigismund, posted by floatingbridge on June 26, 2011, at 15:40:20
Some people just give you the jerks, and some people don't.
(Does thinking of yourself as you mean you are borderline?)
That's about all I know.
After all this time I should be able to say something more profound about it all.
Posted by floatingbridge on June 26, 2011, at 16:06:45
In reply to Re: more thougts on social phobia » floatingbridge, posted by jms600 on June 26, 2011, at 15:44:04
Oh. Yeah. I see what you're doing, I think. Where is an maoi in your treatment map with you and your doc? Does he want to wait a little more? And how are you with that?
I have only tried to AP's to date with very negative results. In desperation I brought the class up again, like risperdal, only to have my doc shoot it down.
I hesitate to retry an snri or that sort
now because after 12 years (the last three dedicatedly) they haven't helped much, and the sides are not worth the
trade today. And I have finally withdrawn. Withdrawing from medication is usually difficult, so I am trying to keep my treatment possibilities open to maoi's while I have it.
Posted by floatingbridge on June 26, 2011, at 16:22:52
In reply to Re: half thoughts » floatingbridge, posted by sigismund on June 26, 2011, at 16:03:16
Yes about the inability to sum up anything profound to say. But there is something to be said about refraining from speaking.
Or dashing about words like borderline. It can indicate a severity or trend, but maybe like that old Zen thing about pointing at the moon.
No trip to the clinic today. They just called and cannot dispense emsam. I understand. But since my husband and I have now discussed all this very openly and 'relapse' has been officially declared, what difference would a patch make tonight? So the big hospital organization which is how meds are often done will clear away a spot for me tomorrow with a primary there. I don't have to go trotting out any emergency terms since there is no harming of anyone involved.
Is it difficult for folks to get treated for things of any sort where you live? Where I am, it's impacted and spilling over.
Posted by sigismund on June 26, 2011, at 18:15:47
In reply to Re: half thoughts » sigismund, posted by floatingbridge on June 26, 2011, at 16:22:52
>Is it difficult for folks to get treated for things of any sort where you live?
Oh yeah sure. Something like you have, yes.
Of course you can get a doc to prescribe Nardil or Parnate but to find out what is really wrong and do something about it is really hard.
This bloke helped me more than anyone else....
http://www.nutritionmedicine.org/index.php?id=46
Posted by Phillipa on June 26, 2011, at 20:05:39
In reply to Re: half thoughts » sigismund, posted by floatingbridge on June 26, 2011, at 16:22:52
FB oh shoot!!!! Got something for sleep tonight? Love Phillipa
Posted by floatingbridge on June 26, 2011, at 20:56:32
In reply to Re: half thoughts » floatingbridge, posted by Phillipa on June 26, 2011, at 20:05:39
Yes. Ambien, which works. I look forward to sleep. Today slept 7 hours, but pain woke me up.
I figured out why the pain is so wicked and everything is worsening. It's been one week today that I removed my last patch.
Please remind me not to do things like
that. I mean just flat out say:dear fb, don't f*ck with your meds. They are helping you with pain and cognition
more than you know.
No need to be polite about it. It's pretty official and can go down into the infinite hyper-googlable cross-indexed search engines of Dr Bob and infinity until the Armageddon and we all lose power and rediscover the grand invention of paper.
Posted by Phillipa on June 26, 2011, at 21:38:48
In reply to Re: half thoughts » Phillipa, posted by floatingbridge on June 26, 2011, at 20:56:32
FB well now you know and that's the most important fact but a cyber smack will be in order if you even mention stopping again!!!! Love Phillipa
Posted by floatingbridge on June 26, 2011, at 22:05:37
In reply to Re: half thoughts » floatingbridge, posted by sigismund on June 26, 2011, at 18:15:47
sigi, I didn't see this post before. Thank you.
Posted by morgan miller on June 27, 2011, at 1:52:47
In reply to Re: more thougts on social phobia » morgan miller, posted by floatingbridge on June 26, 2011, at 15:18:00
Maybe we need to be blocked emotionally some, seems like everyone else walking around is.
I'm still doing better. Tweaking meds, trying to hit the gym or run outside, and sticking with my paleo-ish diet. I have bad days, like laying on the couch and napping bad days, but I don't think they are a biproduct of depression. I still need to figure out what is mysteriously going on with my mind and body. It could just simply be whacked out neurotransmitters and maybe an impaired hypothalamus/pituitary/adrenal axis. I'm actually hoping adding sertraline back into the mix(i'm taking it along with lexapro) will further help to restore HPA axis function, that is, if it has been impaired as a result of chronic stress/depression/anxiety.
I just decided to come back here and see what was going on. I admit, when I'm doing better, I tend to want to spend less time on the computer.
I really hope you find some relief soon FB.
Morgan
Posted by floatingbridge on June 27, 2011, at 11:53:39
In reply to Re: more thougts on social phobia, posted by morgan miller on June 27, 2011, at 1:52:47
> Maybe we need to be blocked emotionally some, seems like everyone else walking around is.
>: J
> I'm still doing better.
Yay(!). Glad to hear this.
>Tweaking meds, trying to hit the gym or run outside, and sticking with my paleo-ish diet. I have bad days, like laying on the couch and napping bad days, but I don't think they are a biproduct of depression. I still need to figure out what is mysteriously going on with my mind and body. It could just simply be
whacked out neurotransmitters and maybe an impaired hypothalamus/pituitary/adrenal axis. I'm actually hoping adding sertraline back into the mix(i'm taking it along with lexapro) will further help to restore HPA axis function, that is, if it has been impaired as a result
of chronic stress/depression/anxiety.
>Thanks for the update. I am interested in how you are working with your situation. I'm glad you are taking good care of yourself.
> I just decided to come back here and
see what was going on. I admit, when I'm doing better, I tend to want to spend less time on the computer.
>Yes!
> I really hope you find some relief soon FB.
>
> MorganThanks Morgan. I will. I am now out of the bedroom and in the living room. Sometimes progress seems small, but it's there.
: J
Posted by floatingbridge on June 27, 2011, at 13:53:26
In reply to Re: half thoughts » floatingbridge, posted by sigismund on June 26, 2011, at 18:15:47
Well, sigi, yeah. My husband called my ex pdoc. It's come to that, someone having to discuss my treatment. So pdoc calls back and says Nardil. So, yes, the prescibing can be done. But remind me to look at my practice kindness wallet card because I could just smack that man after 2 years or more asking him for a maoi. It's a bit late.
And do you think I want to take a single thing today? I cannot abide the thought of another medication. I have my tiny norco pile and my once a day ambien. I am exhausted.
The corporate med place called today. That's good I guess, but I've gone into hiding from doctors. Yeah. I'll get there this week. Show up. Get looked at, checked off, record complete. I just don't see how I can ever start anything. It's like thinking about touching a distant galaxy.
I still have an appt at Stanford for their anxiety clinic. I will make that as much out of curiosity as 'hope'. Maybe curiosity is a better stance to cultivate.
I am very glad you received (and found) some effective care. I had a good tcm person. I really don't know anymore. You sound like you've walked the line w/ some success.
> >Is it difficult for folks to get treated for things of any sort where you live?
>
> Oh yeah sure. Something like you have, yes.
>
> Of course you can get a doc to prescribe Nardil or Parnate but to find out what is really wrong and do something about it is really hard.
>
> This bloke helped me more than anyone else....
> http://www.nutritionmedicine.org/index.php?id=46
Posted by sigismund on June 27, 2011, at 14:14:39
In reply to Re: half thoughtsn » sigismund, posted by floatingbridge on June 27, 2011, at 13:53:26
That doc I mentioned was good on lots of things, but not with sleep.
I don't know...it's just my impression from reading your words.....but it is that you are not so much depressed or socially phobic as sick. I don't know what sort of sick. What are we talking about? Pain, fatigue, anxiety, insomnia? And the results of drug treatment, the damage it does. That too, I suppose.
Looked at that way Nardil does not sound like such a good idea. If I had to take a decent AD, I'd take that though. So I dunno.
My feeling about depression is squewed/scewed/(sp?) by the fact that for me it is despair. The idea that you could have depression without despair was news to me.
Posted by floatingbridge on June 27, 2011, at 14:42:55
In reply to Re: half thoughtsn » floatingbridge, posted by sigismund on June 27, 2011, at 14:14:39
sigi, I dunno. For me and treatment, all of the above. Anxiety first? It is awful. For you? Sleep most intractable?
Umm. The term existential depression. It was used once. Is that useful to you? The doc looked kinda' sad and sober when he said it. Said maoi's were the best. But I think there are some things for some people that science can't really touch. At this point. Hence the sober look, like, sorry lady, my very good science no longer provides a map.
Wow. A spelling question. I know the word, but not the spelling.
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