![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by john locke on January 20, 2016, at 19:30:29
Is it even worth the try or should i just go straight to Nardil?
Posted by john locke on January 20, 2016, at 19:31:19
In reply to SSRI even worth the try for severe social anxiety?, posted by john locke on January 20, 2016, at 19:30:29
I can get a Nardil script off the bat, BTW.
Posted by john locke on January 20, 2016, at 19:35:51
In reply to SSRI even worth the try for severe social anxiety?, posted by john locke on January 20, 2016, at 19:31:19
Also I have lots of obsessive, ruminating thoughts, and depression. I might have ADD, but I think that might just be a function of my constant obsessive thoughts.
Posted by SLS on January 20, 2016, at 19:46:33
In reply to SSRI even worth the try for severe social anxiety?, posted by john locke on January 20, 2016, at 19:35:51
Paxil.
- Scott
Posted by Christ_empowered on January 20, 2016, at 19:52:26
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by SLS on January 20, 2016, at 19:46:33
I second SLS...Paxil can be rough to taper, but its got some potent anti-anxiety effects for many people.
You might want some sort of a sedative for the 1st few weeks. If your anxiety is crippling, you may want to consider a sedative for long(er) term use along with some sort of AD.
Posted by SLS on January 20, 2016, at 19:55:17
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by Christ_empowered on January 20, 2016, at 19:52:26
> I second SLS...Paxil can be rough to taper, but its got some potent anti-anxiety effects for many people.
>
> You might want some sort of a sedative for the 1st few weeks.That's a good idea.
- Scott
Posted by john locke on January 20, 2016, at 21:00:02
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by Christ_empowered on January 20, 2016, at 19:52:26
> I second SLS...Paxil can be rough to taper, but its got some potent anti-anxiety effects for many people.
>
> You might want some sort of a sedative for the 1st few weeks. If your anxiety is crippling, you may want to consider a sedative for long(er) term use along with some sort of AD.Thanks! Any suggestions as far as sedatives go?
Posted by john locke on January 20, 2016, at 21:25:39
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by SLS on January 20, 2016, at 19:46:33
Thanks. Doesn't Paxil almost guarantee anorgasma to some extent, though? I couldn't live with that if it were bad enough.
Posted by SLS on January 20, 2016, at 21:44:26
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by john locke on January 20, 2016, at 21:25:39
> Thanks. Doesn't Paxil almost guarantee anorgasma to some extent, though? I couldn't live with that if it were bad enough.
Paxil is generally the worst SSRI when it comes to producing weight-gain and sexual side effects. I'm not sure how often anorgasmia occurs.
Anorgasmia is a common complaint with higher dosages of Nardil. However, for those who stick with it, the ability to orgasm often returns after 3 months or so.
Most people forget that Nardil had been used for OCD prior to the availability of Anafranil and Luvox. You need to be patient when treating OCD. You might find that the depressive symptoms resolve before the obsessive ones do.
Do you experience intrusive thoughts?
- Scott
Posted by john locke on January 20, 2016, at 22:18:54
In reply to Re: SSRI even worth the try for severe social anxiety? » john locke, posted by SLS on January 20, 2016, at 21:44:26
> > Thanks. Doesn't Paxil almost guarantee anorgasma to some extent, though? I couldn't live with that if it were bad enough.
>
> Paxil is generally the worst SSRI when it comes to producing weight-gain and sexual side effects. I'm not sure how often anorgasmia occurs.
>
> Anorgasmia is a common complaint with higher dosages of Nardil. However, for those who stick with it, the ability to orgasm often returns after 3 months or so.
>
> Most people forget that Nardil had been used for OCD prior to the availability of Anafranil and Luvox. You need to be patient when treating OCD. You might find that the depressive symptoms resolve before the obsessive ones do.
>
> Do you experience intrusive thoughts?
>
>
> - Scott
>
>
Thank you Scott. If intrusive thoughts means that the same thoughts/worries come into my head over and over again, then yes. For example, I have spent much of the last few weeks feeling crippled and helpless by the worry that I had set myself up for "drug-induced drug-refractoriness" with Nardil as you had explained to me is a phenomenon with psychiatric drugs that is not uncommon at all. This is because I did a short, 3.5 week Nardil trial (which ended about 3 weeks ago) before getting scared and backing out. I know its a largely irrational worry, especially since, if I do try Nardil again, it wont be until September 2016, but the thought that there is a chance that I have screwed myself over is still there, and it just won't leave.Its weird. If i catch myself having not worried about this for a little while (due to the fact that I am worried about other things that don't scare me quite as much), I'll be both pleased with myself for not thinking about it, but also kind of mad at myself for having let my guard down. I really can't get out of my head.
Posted by john locke on January 20, 2016, at 22:24:44
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by john locke on January 20, 2016, at 22:18:54
> > > Thanks. Doesn't Paxil almost guarantee anorgasma to some extent, though? I couldn't live with that if it were bad enough.
> >
> > Paxil is generally the worst SSRI when it comes to producing weight-gain and sexual side effects. I'm not sure how often anorgasmia occurs.
> >
> > Anorgasmia is a common complaint with higher dosages of Nardil. However, for those who stick with it, the ability to orgasm often returns after 3 months or so.
> >
> > Most people forget that Nardil had been used for OCD prior to the availability of Anafranil and Luvox. You need to be patient when treating OCD. You might find that the depressive symptoms resolve before the obsessive ones do.
> >
> > Do you experience intrusive thoughts?
> >
> >
> > - Scott
> >
> >
> Thank you Scott. If intrusive thoughts means that the same thoughts/worries come into my head over and over again, then yes. For example, I have spent much of the last few weeks feeling crippled and helpless by the worry that I had set myself up for "drug-induced drug-refractoriness" with Nardil as you had explained to me is a phenomenon with psychiatric drugs that is not uncommon at all. This is because I did a short, 3.5 week Nardil trial (which ended about 3 weeks ago) before getting scared and backing out. I know its a largely irrational worry, especially since, if I do try Nardil again, it wont be until September 2016, but the thought that there is a chance that I have screwed myself over is still there, and it just won't leave.
>
> Its weird. If i catch myself having not worried about this for a little while (due to the fact that I am worried about other things that don't scare me quite as much), I'll be both pleased with myself for not thinking about it, but also kind of mad at myself for having let my guard down. I really can't get out of my head.And now I am worrying about the fact that I used "worry" in the past tense when it should have been in the present tense. And how this maybe has screwed me over because you all won't understand the post as well and therefore won't be able to give me the best possible advise. So I must go over this in my head a few times, convince myself its not a big deal. But what if it is?!?!? Etc. etc, etc...
Posted by john locke on January 20, 2016, at 22:30:55
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by john locke on January 20, 2016, at 22:24:44
Currently I am not on medication
Posted by KathrynLex on January 21, 2016, at 2:41:44
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by john locke on January 20, 2016, at 22:30:55
It's different for everyone, but SSRI's really helped with my social anxiety. If you're open to the idea, I think it's worth a try. As far as sedatives you might want to try during the first few weeks of taking the SSRI, ask your doctor to prescribe a benzo like Xanax or Klonopin.
Posted by SLS on January 21, 2016, at 6:54:47
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by john locke on January 20, 2016, at 22:18:54
> > > Thanks. Doesn't Paxil almost guarantee anorgasma to some extent, though? I couldn't live with that if it were bad enough.
> >
> > Paxil is generally the worst SSRI when it comes to producing weight-gain and sexual side effects. I'm not sure how often anorgasmia occurs.
> >
> > Anorgasmia is a common complaint with higher dosages of Nardil. However, for those who stick with it, the ability to orgasm often returns after 3 months or so.
> >
> > Most people forget that Nardil had been used for OCD prior to the availability of Anafranil and Luvox. You need to be patient when treating OCD. You might find that the depressive symptoms resolve before the obsessive ones do.
> >
> > Do you experience intrusive thoughts?
> >
> >
> > - Scott
> >
> >
> Thank you Scott. If intrusive thoughts means that the same thoughts/worries come into my head over and over again, then yes. For example, I have spent much of the last few weeks feeling crippled and helpless by the worry that I had set myself up for "drug-induced drug-refractoriness" with Nardil as you had explained to me is a phenomenon with psychiatric drugs that is not uncommon at all. This is because I did a short, 3.5 week Nardil trial (which ended about 3 weeks ago) before getting scared and backing out. I know its a largely irrational worry, especially since, if I do try Nardil again, it wont be until September 2016, but the thought that there is a chance that I have screwed myself over is still there, and it just won't leave.
>
> Its weird. If i catch myself having not worried about this for a little while (due to the fact that I am worried about other things that don't scare me quite as much), I'll be both pleased with myself for not thinking about it, but also kind of mad at myself for having let my guard down. I really can't get out of my head.I don't think those qualify for intrusive thoughts. They are not alien to you. They are more like ruminations or obsessiveness.
Are you a perfectionist?
Perfectionism is a no-no for depression and obsessiveness. Perfectionism is mostly learned. It can be unlearned. I was successful at doing this. I guess it is a desensitizing process of sorts.
I would not worry about refractoriness to Nardil. You were not on it long enough.
If you wish to keep Nardil for later, you can first try Paxil or Effexor. Although not indicated for OCD, several clinical studies of Effexor reported positive results. You might consider going for Effexor first, Paxil second, and then to Nardil if necessary. Effexor is more often effective for depression than is Paxil. Paxil is generally more apt to produce weight-gain and sexual side effects, although these do not occur with everyone. I don't remember experiencing these things when I took Paxil 30 mg/day. I would say that Paxil is more of a sure-thing for anxiety disorders when compared to Effexor. OCD usually responds to higher dosages taken for longer periods of time.
These are my impressions only:
1. Effexor
++++ depression
+++ GAD
++ social anxiety
++ OCD
+ weight-gain
+ sexual side-effects2. Paxil
+++ depression
++++ GAD
+++ social anxiety
+++ OCD
++++ weight-gain
+++ sexual side-effects3. Nardil
++++ depression
+++ GAD
++++ social anxiety
++ OCD
+++ weight-gain
+++ sexual side-effects (sometimes transient)
- Scott
Posted by SLS on January 21, 2016, at 6:57:26
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by KathrynLex on January 21, 2016, at 2:41:44
Hi, KathrynLex.
> It's different for everyone, but SSRI's really helped with my social anxiety. If you're open to the idea, I think it's worth a try. As far as sedatives you might want to try during the first few weeks of taking the SSRI, ask your doctor to prescribe a benzo like Xanax or Klonopin.
Which SSRIs did you find to be most helpful for treating social anxiety disorder?
- Scott
Posted by john locke on January 21, 2016, at 13:12:40
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by KathrynLex on January 21, 2016, at 2:41:44
> It's different for everyone, but SSRI's really helped with my social anxiety. If you're open to the idea, I think it's worth a try. As far as sedatives you might want to try during the first few weeks of taking the SSRI, ask your doctor to prescribe a benzo like Xanax or Klonopin.
I second Scott's question: which SSRI's did you use?
Also, would you mind going into more detail about your symptoms of anxiety before and after being on these SSRI's? What did it "feel" like when you were on them. Did you feel like yourself?
Posted by john locke on January 21, 2016, at 13:14:25
In reply to Re: SSRI even worth the try for severe social anxiety? » john locke, posted by SLS on January 21, 2016, at 6:54:47
> > > > Thanks. Doesn't Paxil almost guarantee anorgasma to some extent, though? I couldn't live with that if it were bad enough.
> > >
> > > Paxil is generally the worst SSRI when it comes to producing weight-gain and sexual side effects. I'm not sure how often anorgasmia occurs.
> > >
> > > Anorgasmia is a common complaint with higher dosages of Nardil. However, for those who stick with it, the ability to orgasm often returns after 3 months or so.
> > >
> > > Most people forget that Nardil had been used for OCD prior to the availability of Anafranil and Luvox. You need to be patient when treating OCD. You might find that the depressive symptoms resolve before the obsessive ones do.
> > >
> > > Do you experience intrusive thoughts?
> > >
> > >
> > > - Scott
> > >
> > >
> > Thank you Scott. If intrusive thoughts means that the same thoughts/worries come into my head over and over again, then yes. For example, I have spent much of the last few weeks feeling crippled and helpless by the worry that I had set myself up for "drug-induced drug-refractoriness" with Nardil as you had explained to me is a phenomenon with psychiatric drugs that is not uncommon at all. This is because I did a short, 3.5 week Nardil trial (which ended about 3 weeks ago) before getting scared and backing out. I know its a largely irrational worry, especially since, if I do try Nardil again, it wont be until September 2016, but the thought that there is a chance that I have screwed myself over is still there, and it just won't leave.
> >
> > Its weird. If i catch myself having not worried about this for a little while (due to the fact that I am worried about other things that don't scare me quite as much), I'll be both pleased with myself for not thinking about it, but also kind of mad at myself for having let my guard down. I really can't get out of my head.
>
> I don't think those qualify for intrusive thoughts. They are not alien to you. They are more like ruminations or obsessiveness.
>
> Are you a perfectionist?
>
> Perfectionism is a no-no for depression and obsessiveness. Perfectionism is mostly learned. It can be unlearned. I was successful at doing this. I guess it is a desensitizing process of sorts.
>
> I would not worry about refractoriness to Nardil. You were not on it long enough.
>
> If you wish to keep Nardil for later, you can first try Paxil or Effexor. Although not indicated for OCD, several clinical studies of Effexor reported positive results. You might consider going for Effexor first, Paxil second, and then to Nardil if necessary. Effexor is more often effective for depression than is Paxil. Paxil is generally more apt to produce weight-gain and sexual side effects, although these do not occur with everyone. I don't remember experiencing these things when I took Paxil 30 mg/day. I would say that Paxil is more of a sure-thing for anxiety disorders when compared to Effexor. OCD usually responds to higher dosages taken for longer periods of time.
>
> These are my impressions only:
>
> 1. Effexor
> ++++ depression
> +++ GAD
> ++ social anxiety
> ++ OCD
> + weight-gain
> + sexual side-effects
>
> 2. Paxil
> +++ depression
> ++++ GAD
> +++ social anxiety
> +++ OCD
> ++++ weight-gain
> +++ sexual side-effects
>
> 3. Nardil
> ++++ depression
> +++ GAD
> ++++ social anxiety
> ++ OCD
> +++ weight-gain
> +++ sexual side-effects (sometimes transient)
>
>
> - ScottThank you Scott. You are so very kind and helpful.
Posted by john locke on January 21, 2016, at 13:18:14
In reply to Re: SSRI even worth the try for severe social anxiety? » john locke, posted by SLS on January 21, 2016, at 6:54:47
> > > > Thanks. Doesn't Paxil almost guarantee anorgasma to some extent, though? I couldn't live with that if it were bad enough.
> > >
> > > Paxil is generally the worst SSRI when it comes to producing weight-gain and sexual side effects. I'm not sure how often anorgasmia occurs.
> > >
> > > Anorgasmia is a common complaint with higher dosages of Nardil. However, for those who stick with it, the ability to orgasm often returns after 3 months or so.
> > >
> > > Most people forget that Nardil had been used for OCD prior to the availability of Anafranil and Luvox. You need to be patient when treating OCD. You might find that the depressive symptoms resolve before the obsessive ones do.
> > >
> > > Do you experience intrusive thoughts?
> > >
> > >
> > > - Scott
> > >
> > >
> > Thank you Scott. If intrusive thoughts means that the same thoughts/worries come into my head over and over again, then yes. For example, I have spent much of the last few weeks feeling crippled and helpless by the worry that I had set myself up for "drug-induced drug-refractoriness" with Nardil as you had explained to me is a phenomenon with psychiatric drugs that is not uncommon at all. This is because I did a short, 3.5 week Nardil trial (which ended about 3 weeks ago) before getting scared and backing out. I know its a largely irrational worry, especially since, if I do try Nardil again, it wont be until September 2016, but the thought that there is a chance that I have screwed myself over is still there, and it just won't leave.
> >
> > Its weird. If i catch myself having not worried about this for a little while (due to the fact that I am worried about other things that don't scare me quite as much), I'll be both pleased with myself for not thinking about it, but also kind of mad at myself for having let my guard down. I really can't get out of my head.
>
> I don't think those qualify for intrusive thoughts. They are not alien to you. They are more like ruminations or obsessiveness.
>
> Are you a perfectionist?
>
> Perfectionism is a no-no for depression and obsessiveness. Perfectionism is mostly learned. It can be unlearned. I was successful at doing this. I guess it is a desensitizing process of sorts.
>
> I would not worry about refractoriness to Nardil. You were not on it long enough.
>
> If you wish to keep Nardil for later, you can first try Paxil or Effexor. Although not indicated for OCD, several clinical studies of Effexor reported positive results. You might consider going for Effexor first, Paxil second, and then to Nardil if necessary. Effexor is more often effective for depression than is Paxil. Paxil is generally more apt to produce weight-gain and sexual side effects, although these do not occur with everyone. I don't remember experiencing these things when I took Paxil 30 mg/day. I would say that Paxil is more of a sure-thing for anxiety disorders when compared to Effexor. OCD usually responds to higher dosages taken for longer periods of time.
>
> These are my impressions only:
>
> 1. Effexor
> ++++ depression
> +++ GAD
> ++ social anxiety
> ++ OCD
> + weight-gain
> + sexual side-effects
>
> 2. Paxil
> +++ depression
> ++++ GAD
> +++ social anxiety
> +++ OCD
> ++++ weight-gain
> +++ sexual side-effects
>
> 3. Nardil
> ++++ depression
> +++ GAD
> ++++ social anxiety
> ++ OCD
> +++ weight-gain
> +++ sexual side-effects (sometimes transient)
>
>
> - ScottYes I am the definition of a perfectionist. It is quite crippling. If I do something wrong I look back on it over and over again, and go through all the things I should have done better. I think it's the fear of my mind that causes the perfectionism, if that makes sense. How did you overcome your perfectionism? Also, would you please give me an example of what intrusive thoughts might be? Would it be like a PTSD patient having flashbacks?
Thanks,
John
Posted by ed_uk2010 on January 21, 2016, at 14:30:45
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by john locke on January 21, 2016, at 13:18:14
Hi there,
In terms of efficacy, Nardil is probably superior to SSRIs for severe social anxiety 'on average', but that doesn't mean it will be superior for you.
Equally importantly, SSRIs are better tolerated than MAOIs 'for the average person', and are always tried first.Paroxetine (Paxil) is certainly one of the options, but escitalopram (Lexapro) causes fewer side effects and is a very sensible first choice. It isn't officially approved for SAD in the US, but it is elsewhere, and is clearly anxiolytic. Sertraline (Zoloft) is another potential choice, but I do believe escitalopram is a bit more calming.
Posted by rjlockhart37 on January 21, 2016, at 22:46:50
In reply to Re: SSRI even worth the try for severe social anxiety? » john locke, posted by ed_uk2010 on January 21, 2016, at 14:30:45
Prozac enhanced some of my social abilities, but it's not sedating like paxil, some people need to be calm serogenic feeling from paxil or luvox
it's stimulating and it does help anxiety in "some" ways im on 80mg it's highest dose but it works with keeping me dropping into the dark place
Posted by KathrynLex on January 23, 2016, at 22:54:19
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by john locke on January 21, 2016, at 13:12:40
> > It's different for everyone, but SSRI's really helped with my social anxiety. If you're open to the idea, I think it's worth a try. As far as sedatives you might want to try during the first few weeks of taking the SSRI, ask your doctor to prescribe a benzo like Xanax or Klonopin.
>
> I second Scott's question: which SSRI's did you use?
>
> Also, would you mind going into more detail about your symptoms of anxiety before and after being on these SSRI's? What did it "feel" like when you were on them. Did you feel like yourself?
>I had a lot of success with Prozac and Lexapro. (While I know many people who found Paxil and Zoloft to be useful for anxiety, I didn't tolerate either one of them very well. Both made me horribly dizzy, and I couldn't continue taking either one.)
Before taking medication, I had a lot of difficulty in social situations because my mind was racing with questions like, "What if I say something embarrassing? What if I inadvertently offend someone? What if I do something awkward and spill my drink on someone?" This constant stream of questioning and worrying would often times prevent me from going to social gatherings at all. I also canceled plans at the last minute because even thought I liked the idea of going, the questions would start up and I couldn't stand the thought of making a fool out of myself.
These thoughts came with physical symptoms like sweaty palms, a quiver in my voice, a racing heart, an inability to focus...which of course made things infinitely more difficult.
After taking medication, I felt very much like me, but the volume had been turned down on some of my social anxiety. It went from a 10 (being the highest number) to about a 4. So the anxiety was still there, but instead of being at the forefront of my mind, it got shifted to the background, and I found it much easier to interact with people. The physical symptoms of my social anxiety also went away, and I became happier because I was making connections with people.
Having been on so many different medications, I think it's worth trying just about anything because finding the right SSRI can really improve the quality of your life. That being said, listen to your body, and if you take an SSRI and you don't feel like yourself, then try a different one. And you may ultimately decide that SSRI's aren't for you, but at least that's one more avenue you tried.
I hope this is useful, and whatever you decide to do, I hope you find what you need to help with your social anxiety.
Posted by Christ_empowered on January 24, 2016, at 11:29:04
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by john locke on January 21, 2016, at 13:18:14
hi. If you can avoid Rx meds, please do. I mean, they're always there if you need them--shrinks and the Rx meds the prescribe aren't going away anytime soon--but please consider other alternatives first.
Counseling can be helpful, but even those people often work w/ shrinks. So do therapists, usually.
I hope natural stuff works for you. I do Orthomolecular (yes, I'm pushing it on you). I do it with meds (I have severe Bipolar I, so meds aren't optional), and I seem to be making more progress than I ever did without the vitamins.
Its basically...high doses of C, high doses of B complex, high doses of either niacin or niacinamide, and then vitamin E (preferably natural form), sometimes minerals, etc. You can customize it fairly easily.
Other people know a lot about herbs and such...I'm just big on OM. My nervous breakdown was so severe I was never supposed to recover. It took time, but with meds, vitamins, improved family relationships, some low key counseling...I'm doing much, much better than expected.
But yeah...please do try to avoid Rx meds, if you can. If you do need them, consider going to a family doc first, a shrink only if necessary.
Good luck!
Posted by John locke on January 24, 2016, at 18:00:41
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by Christ_empowered on January 24, 2016, at 11:29:04
> hi. If you can avoid Rx meds, please do. I mean, they're always there if you need them--shrinks and the Rx meds the prescribe aren't going away anytime soon--but please consider other alternatives first.
>
> Counseling can be helpful, but even those people often work w/ shrinks. So do therapists, usually.
>
> I hope natural stuff works for you. I do Orthomolecular (yes, I'm pushing it on you). I do it with meds (I have severe Bipolar I, so meds aren't optional), and I seem to be making more progress than I ever did without the vitamins.
>
> Its basically...high doses of C, high doses of B complex, high doses of either niacin or niacinamide, and then vitamin E (preferably natural form), sometimes minerals, etc. You can customize it fairly easily.
>
> Other people know a lot about herbs and such...I'm just big on OM. My nervous breakdown was so severe I was never supposed to recover. It took time, but with meds, vitamins, improved family relationships, some low key counseling...I'm doing much, much better than expected.
>
> But yeah...please do try to avoid Rx meds, if you can. If you do need them, consider going to a family doc first, a shrink only if necessary.
>
> Good luck!Thank you CE I appreciate your caring response
John
Posted by John locke on January 24, 2016, at 18:06:02
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by KathrynLex on January 23, 2016, at 22:54:19
> > > It's different for everyone, but SSRI's really helped with my social anxiety. If you're open to the idea, I think it's worth a try. As far as sedatives you might want to try during the first few weeks of taking the SSRI, ask your doctor to prescribe a benzo like Xanax or Klonopin.
> >
> > I second Scott's question: which SSRI's did you use?
> >
> > Also, would you mind going into more detail about your symptoms of anxiety before and after being on these SSRI's? What did it "feel" like when you were on them. Did you feel like yourself?
> >
>
> I had a lot of success with Prozac and Lexapro. (While I know many people who found Paxil and Zoloft to be useful for anxiety, I didn't tolerate either one of them very well. Both made me horribly dizzy, and I couldn't continue taking either one.)
>
> Before taking medication, I had a lot of difficulty in social situations because my mind was racing with questions like, "What if I say something embarrassing? What if I inadvertently offend someone? What if I do something awkward and spill my drink on someone?" This constant stream of questioning and worrying would often times prevent me from going to social gatherings at all. I also canceled plans at the last minute because even thought I liked the idea of going, the questions would start up and I couldn't stand the thought of making a fool out of myself.
>
> These thoughts came with physical symptoms like sweaty palms, a quiver in my voice, a racing heart, an inability to focus...which of course made things infinitely more difficult.
>
> After taking medication, I felt very much like me, but the volume had been turned down on some of my social anxiety. It went from a 10 (being the highest number) to about a 4. So the anxiety was still there, but instead of being at the forefront of my mind, it got shifted to the background, and I found it much easier to interact with people. The physical symptoms of my social anxiety also went away, and I became happier because I was making connections with people.
>
> Having been on so many different medications, I think it's worth trying just about anything because finding the right SSRI can really improve the quality of your life. That being said, listen to your body, and if you take an SSRI and you don't feel like yourself, then try a different one. And you may ultimately decide that SSRI's aren't for you, but at least that's one more avenue you tried.
>
> I hope this is useful, and whatever you decide to do, I hope you find what you need to help with your social anxiety.Thank you so much Kathryn this was certainly helpful. Of course I can totally relate to how you were feeling before on medication in terms of social situations. Might I ask what yor regimen is now and how it is working out for you?
Oh also one other thing. If you ever went off these medications that were so helpful with social anxiety, did you feel more socially competent than you had before one them? It is a big wonder of mine as to whether tho less medications can be helpful in terms of improving social anxiety even after you get off them, simply because they allowed you to be in more social situations.
Best,
John
Posted by KathrynLex on February 3, 2016, at 2:35:36
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by John locke on January 24, 2016, at 18:06:02
Hi John,
Sorry for the delay in my response. Right now I take Klonopin (3 mg), Prozac (40 mg), and Xanax as needed. The amount of Xanax I take varies, but it's never more than 2 or 3 mg. And the Xanax is for anxiety attacks vs. social anxiety. (Of course, being in social situations can sometimes trigger an anxiety attack.)
I've gone off my medication twice. The first time was pretty successful. A little bit of my social anxiety returned, but it wasn't nearly as severe as it had been before. I didn't need medication again for about 2 years, and then some events in my life triggered my anxiety again. I went back on medication, and tried to taper off about a year ago. That time it didn't go so well because I simply wasn't ready. (A word of caution: the withdrawal you feel from certain medication can FEEL like anxiety or cause anxiety attacks, but that's not the same thing as your anxiety coming back.)
I'll be completely honest with you. Medication has really helped me, and without it, it's quite possible I'd be house bound. My anxiety is that severe. So I'm grateful there are different types of medication that can help me cope. But in an ideal world, I wouldn't have to take anything. In some ways, the medication has diminished the confidence I have in myself to cope with my anxiety on my own. And while it's certainly possible to stop taking medications, some of them are very, very difficult to taper off of, which is a really unpleasant process.
Some people genuinely need medication to help with debilitating forms of anxiety, which is why I don't like to discourage anyone from at least trying it. Because for me, I'll take the diminished confidence and unpleasant tapering over not being able to leave the house. I don't know how bad your social anxiety is, and it's entirely possible you could really benefit from medication. I just want to let you know there are drawbacks, and you sound eager to make a very well informed decision.
As always, I wish you the very best.
Kathryn
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.