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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by radish on February 20, 2019, at 17:33:51
living with severe social phobia is hell. people/docs don't realize how deeply it diminishes your quality of life. i have no quality of life. i cannot live. it has eroded my self esteem, self-worth, ability to connect with people and form and maintain any relationship, perform in even basic jobs. it affects every aspect of life. its effect on self-loathing bleeds over into other aspects of my life by leaving me unable to actually live and do anything because i just hate myself to my core from the second i wake up to the second i fall asleep. because i cannot talk to anyone. there's a bottle stop in my throat or the part of my brain responsible for sociality is badly damaged.
it makes me unable to think clearly or write. i couldn't persue a writing career because i literally cannot think, write, and talk with colleagues to a normal degree. i think writing uses the same brain processes as talking so that may be why i can;t write, or when i do i take twice as long as other people to produce complete thoughts. i feel i have an intellectual disability. for all intents and purposes i do have one. i can't cognate. i have no mental bandwidth. i can say "hi" "ok" and other very simple, short things but i cannot complete anything more taxing. i cannot explain how to do anything or explain anything with any slight complexity. every minute is pain. feeling stupid and incompetent further erodes my self worth.
i always wonder what i could have become or what i could have accomplished if i were more normal. or what kind of relationships i could have. the feeling of freedom. the ability to live. i feel hints of this person, deep within me. they whisper to me every once in a while. i can hear it if i'm lucky, and then it fades away, consumed by fear.
i go to work and have negative interaction after negative, panic-ridden interaction just to leave me feeling more self-hatred every day. i always hope i will get better. like when i was a teenager i believed that surely by my early twenties i would be better. i am in my late twenties and it's no better. i am getting worse every year. i've been at my current job for 9 months and i do not grow more comfortable with the people there i've known for months. i like these people a lot and want very much to connect and interact with them. but even after months of trying i still stutter and jumble up my words and fail to explain a simple thought to their confused looking faces. it's because i feel sub-human around them and full of fear and panic and just want to run away. during basic friendly work interactions, not confrontations with a bear. this is pathological, not garden-variety shyness.
there's something wrong with me. there is no logical reason for feeling and behaving this way, and i know that, yet it's hard-wired within me. nothing has ever helped except benzodiazepines, for a few hours, to a small degree, in certain circumstances. i feel like i need MDMA or opiods just to be live, breathe, feel normal. but those are obviously not smart options for my daily life.
CBT and exposure therapy are condescending shams for me. exposure therapy can only help if you're equipped to start making positive reinforcing experiences. not further negative, shameful ones. CBT is a one-on-one interaction where you share deeply personal, shameful-feeling thoughts. remember, i cannot function in situations like this, much less one of this intensity. so i feel so sick with intense fear and pain during CBT that I cannot really benefit from it. i generally leave feeling worse than i did going in. therapists/doctors: its stupid, negligent to tell poor people that $100 an hour therapy with a under-qualified social worker will help alleviate a chronic, genetic/endogenous, severe, all-encompassing mental illness. i know all about my negative though patterns, and the idea that i should be trying to train myself from having them is a cruel fucking condescending joke. it perpetuates the idea that its your fault and your full responsibility to brute-force fix alone. which sets people up to feel even worse when it fails. mind over matter isn't a thing in severe mental illness.
one therapist advised i carry a box full of items i enjoy, in the idea that i could open the box whenever i'm stressed. that's a fucking joke. coping mechanisms are a fucking joke. do you know how it feels to finally break all barriers you've built up to access help, and then the help offers you that stellar idea? there's no point in trying to cope when you're genes are so shit that you're better off just dead.i try explaining this to doctors but remember, this requires me to explain something, which i simply am unable to do, cognitively. i cannot get my point across so i cannot get the care or treatment i need. life withers away.
hey thanks for reading, folks!
Posted by baseball55 on February 20, 2019, at 17:53:41
In reply to social phobia is hell and doctors don't get it, posted by radish on February 20, 2019, at 17:33:51
I do think therapy can help, though maybe not CBT, but deeper psychodynamic therapy. Given that it's hard for you to speak, maybe you could bring that posting in to the therapist. It's very articulate.
Posted by radish on February 20, 2019, at 18:03:33
In reply to Re: social phobia is hell and doctors don't get it » radish, posted by baseball55 on February 20, 2019, at 17:53:41
ohh yes psychodynamic therapy is something i am actually interested in giving a go someday. thanks for your reply baseball
Posted by sigismund on February 20, 2019, at 19:33:43
In reply to social phobia is hell and doctors don't get it, posted by radish on February 20, 2019, at 17:33:51
That sounded right to me, about needing opiates or MDMA to feel as you feel you should. And your last 2 paragraphs.
I did a lot of psychodynamic therapy. It allowed me to survive. I adjusted my expectations and can follow my interests. I don't have much time left which is fine by me. The world is an interesting place.
Solitude is so much more painful for the young.
Posted by atypical on February 20, 2019, at 23:15:46
In reply to social phobia is hell and doctors don't get it, posted by radish on February 20, 2019, at 17:33:51
Have you tried Nardil for at least 3 months at 60 mg?
Posted by radish on February 21, 2019, at 17:11:25
In reply to Re: social phobia is hell and doctors don't get it, posted by atypical on February 20, 2019, at 23:15:46
no, but i really want to try nardil though. i have for years. i will try it some day. i have a appointment with pdoc tomorrow and i'm going to ask for it for a third time. no more ineffectual, baseless drugs please.
Posted by atypical on February 21, 2019, at 20:37:56
In reply to Re: social phobia is hell and doctors don't get it, posted by radish on February 21, 2019, at 17:11:25
I hope you get the Rx and give it a try. Pdocs who are afraid of MAOIs should consider the suffering they are prolonging by withholding a potential drug that might reduce one's suffering.
Posted by Radish on February 21, 2019, at 21:02:34
In reply to Re: social phobia is hell and doctors don't get it, posted by atypical on February 21, 2019, at 20:37:56
My thoughts exactly. Do no harm. That entails actively working to prevent negligence. Of course I cannot conveys these thoughts to a doctor without coming off arrogant and combative.
Posted by atypical on February 22, 2019, at 6:32:48
In reply to Re: social phobia is hell and doctors don't get it, posted by Radish on February 21, 2019, at 21:02:34
Do you keep a list of all the meds you have taken? I have a table I created that lists all of them with their family indicated (e.g. SSRI), their doses, their level of effectiveness (I use a 1-5 rating), side effects (1-5 rating), and length of time taken. I give it to the pdoc anytime I change to a new one, usually because I have relocated. This is the most useful thing to any new pdoc and helps demonstrate, usually, that there are classes of meds that you haven't tried yet. Maybe it will help your existing pdoc consider MAOIs. If not, try going to a university-based practice where pdocs seem to be more open to a variety of treatments for various reasons.
Posted by Lamdage22 on February 22, 2019, at 8:01:46
In reply to Re: social phobia is hell and doctors don't get it, posted by atypical on February 22, 2019, at 6:32:48
Nardil sent me into psychosis
Posted by radish on February 22, 2019, at 9:46:55
In reply to Re: social phobia is hell and doctors don't get it, posted by atypical on February 22, 2019, at 6:32:48
thanks atypical. yeah my pdoc knows my meds history. i saw him today and he's having me increase my dose of moclobemide, and in a month i'll see him again. he said the next step could be "an actual maoi," but that moclobemide was the same thing anyways. even though its having no positive effect on me and might be making me feel more depressed, and i told him that. it seems like everything i say he just writes off immediately.
and every time i see him he harps on exposure therapy. i work full time, i graduated university, and have generally been interacting with people my whole adult life, so my daily life is exposure therapy! the fear and cognitive impairment from genetic(?) SP never decreases! it just seems to get worse the longer i go on living with a damaged brain. so it's a pretty flippant recommendation. its depressing and demoralizing to be disregarded by the professional who is supposed to help you.
but i guess its promising that he may prescribe nardil, so we'll see.
Posted by rjlockhart37 on February 22, 2019, at 15:13:36
In reply to social phobia is hell and doctors don't get it, posted by radish on February 20, 2019, at 17:33:51
i know somewhat of that feeling, when i was in high school i could barely....i smiled, and maybe knew a few people that liked me, but when i got into later classes, i would get confused or have no energy to have a stable conversation. People....there was a person in my english class that i was trying to explain something to his question about homework or some project, i dead ended on sentence and could not answer properly, he asked me whats your grade in here, in sarcastic tone.
i think you learn to stimulate yourself into talking, or getting a motivation or euphoria about talking bout something with people. I was in a haze-glooom aroun people at work, my mood was not good, nothing...a flat mood with only taking instructions. I think you have to look forward to talking. The thought process, let me tell you i still have trouble with thought process and memory loss, i would be talking with someone and completely forget or couldn't recall an event i was gonna talk about. You have to get yourself stimulated and motivated to talk, or converse with people. Think of something in the mind that makes you enthusiastic, anything a memory, or an interest. Depression makes things lose intrest in everything, nothing feels happy, your not happy even to talk to people, and that's why it impairs social ability, that and also anxiety your describing
write an letter to your doctor before you session, fax it in, and write exactly what's going on, that you have thought impairment, and depression that makes you not interested or in a bad mood, to make socializing miserable, that or the social anxiety. Therapists have told me what to do, then when i did their exercises i couldn't hold enough energy or structure to do them. I don't go to therapists anymore, i've had alot of trauma happen, i don't tell my doctor anything much more and i do my own thing. Prep yourself like an event your gonna go too, get prepped as getting ready race at a track meet, that adrenaline before a sports event could help you
It could be a neurotransmitter depletion and would need a medicine to increase serotonin, or dopamine, or norepinephrine to help you motivate to talk. Write you doctor a letter, and write wrote like in this post.
Posted by Radish on February 22, 2019, at 16:47:47
In reply to Re: social phobia is hell and doctors don't get it, posted by rjlockhart37 on February 22, 2019, at 15:13:36
Thanks friend! I totally agree feeling so depressed and anergic makes it even harder to talk and think. I think thats a big reason why alcohol helps, it improves my mood, so I have the reward system in place that makes me want to talk to people even if its still difficult. (Unfortunately even after several drinks Im still pretty damn socially anxious!)
That guy was a jerk. By dead ended on a sentence the nice do you mean your mind went blank and you couldnt finish your thought? I had that happen a lot when my boss was listening while I answered phones for an old job. Feels so awful.
Yeah the therapy exercises are pretty worthless for me as my issues kind of override the ability to utilise them effectively. Im sure theyre ok for more specific, minor issues, but not when I have a brain deficiency of some sort that affects virtually every aspect of my life.
Thats a good idea, to write something to my doc. I am vastly better at writing than talking... of course my anxiety tells me doing that would be awkward, but its no doubt in my best interest...
I appreciate all the help in this thread. I know I sound like I have a really bad attitude and I hate sounding like that. Im just sort of at my limit of frustration hence all the negativity.
Posted by atypical on February 22, 2019, at 18:23:23
In reply to Re: social phobia is hell and doctors don't get it, posted by Lamdage22 on February 22, 2019, at 8:01:46
I am sorry to hear that. Nardil gave me my stability back. Everyone is different.
Posted by Lamdage22 on February 23, 2019, at 8:18:08
In reply to Re: social phobia is hell and doctors don't get it, posted by atypical on February 22, 2019, at 18:23:23
Yep, I am one of the 1 in 100 unfortunate people that get psychosis from it...
Posted by Lamdage22 on February 23, 2019, at 8:18:58
In reply to Re: social phobia is hell and doctors don't get it, posted by Lamdage22 on February 23, 2019, at 8:18:08
I was just pretty damn angry. Maybe I have reason to be. I don't know.
Posted by Radish on February 23, 2019, at 13:09:32
In reply to Re: social phobia is hell and doctors don't get it, posted by Lamdage22 on February 23, 2019, at 8:18:58
No doubt that would make me angry as well. Was it permanent?
Posted by Lamdage22 on February 24, 2019, at 5:45:45
In reply to Re: social phobia is hell and doctors don't get it, posted by Radish on February 23, 2019, at 13:09:32
I am still on a high dose of Neuroleptics, so in a way, yes it was permanent. I got two (or even3) problems now. Not just Depression/Anxiety but Depression, Anxiety and a tendency towards psychosis. So I am not thrilled by this!
Posted by atypical on February 25, 2019, at 2:43:25
In reply to Re: social phobia is hell and doctors don't get it, posted by radish on February 22, 2019, at 9:46:55
Not familiar with Moclobemide. Might not be available in the U.S. It does sound like an "MAOI light." I am encouraged that your doc is aware of this and might have you try a "real" one. But it is not the "same thing." I suppose protocol would indicate maximizing the dose of the Moclobemide, barring any significant side effects. There usually is a minimum effective dose for many meds.
> thanks atypical. yeah my pdoc knows my meds history. i saw him today and he's having me increase my dose of moclobemide, and in a month i'll see him again. he said the next step could be "an actual maoi," but that moclobemide was the same thing anyways. even though its having no positive effect on me and might be making me feel more depressed, and i told him that. it seems like everything i say he just writes off immediately.
>
> and every time i see him he harps on exposure therapy. i work full time, i graduated university, and have generally been interacting with people my whole adult life, so my daily life is exposure therapy! the fear and cognitive impairment from genetic(?) SP never decreases! it just seems to get worse the longer i go on living with a damaged brain. so it's a pretty flippant recommendation. its depressing and demoralizing to be disregarded by the professional who is supposed to help you.
>
> but i guess its promising that he may prescribe nardil, so we'll see.
Posted by bleauberry on March 30, 2019, at 11:17:13
In reply to social phobia is hell and doctors don't get it, posted by radish on February 20, 2019, at 17:33:51
In my world, social phobia is actually a lyme-related thing, and responds to anti-lyme treatments. Specifically, anti-Bartonella treatments.
It's not all in your head. It's not your life events. You didn't do anything wrong. It's most likely a stealth infection.
This sounds totally bizarre and profound if you've never heard it before. I get that. Happened to me too.
I just recovered from the worse anxiety and worst social phobia ever. Calm and peace are here again. No prob being in a crowd. What did it? A couple months of Rifampin + Minocycline + Ceftin.
If you aren't sure of anything I just said, google it and start researching. Anxiety is almost always treatable with anti-microbial, anti-inflammation strategies, which is what anti-lyme is, whether you have lyme or not doesn't matter.
Posted by Radish on April 7, 2019, at 15:52:02
In reply to Re: social phobia is hell and doctors don't get it, posted by bleauberry on March 30, 2019, at 11:17:13
Very interesting bleau. As always I would like to read more but I never know where to begin.
This is the end of the thread.
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