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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by misterd on June 11, 2008, at 0:23:41
To all of you out there is babble alternative land... has anyone been successful in managing their social anxiety without drugs??? Thanks!
Posted by Lao Tzu on June 11, 2008, at 5:28:36
In reply to Anyone successful in managing their Social anxiety, posted by misterd on June 11, 2008, at 0:23:41
I have suffered for many years with social anxiety. It's much much better now, but I'm on all kinds of medication and supplements. I still have a touch of it, but not to the degree I had it only three years ago. You sound like your opposed to meds. I can understand that. There are no GREAT meds for social anxiety, but I have discovered that the RIGHT medication (for you) that helps your depression will often help with social anxiety, but it may not totally eliminate it from your life. Also, I am bipolar, and bipolars usually have problems with their dopamine pathways, oscillating between having too much or too little dopamine. There is probably something wrong with dopamine and serotonin levels in people who have social anxiety, and perhaps gabaergic pathways too. Typically, if you did decide to see a family doctor about your social anxiety, he or she would recommend an antidepressant drug, but this might not be the complete solution in many cases of social anxiety. The only thing I can say is that if your social anxiety is causing panic attacks and making your everyday life a living hell, medication might be the only way to solve it. If you are experiencing states of extreme anxiety, especially around people, accompanied by irritability and overstimulation (with panic attacks) and then periods of having very little energy or motivation and hard to focus on things, chances are that something is wrong with dopamine and/or serotonin metabolism. If your social anxiety is making your life excruciatingly difficult to function around other people, and I mean everyday, then I can only recommend you see a psychiatrist, NOT a family doctor. However, if you don't want to see a doctor and take meds, then there are some supplements that may be able to help you, like 5-HTP or Saint John's Wort, kava kava (low dosage. Too much in one day can cause stimulation) vitamin B3 (Niacin), vitamin B6, magnesium/calcium complex, omega-3 fish oil, and B12 (for energy. Take a very low dosage in the beginning by cutting pills into 4 pieces. Typically, B12 comes in 1,000mcg. I feel that this is too much to take in the beginning. Get a pill cutter and cut the 1,000mcg tablet into 4 pieces at 250mcg each. Take this for a couple of weeks and gradually increase it. Some people do good on 500mcg, others on 800mcg per day. B12 will help a lot with energy). I am sure there are other supplements but these are just a few that might be helpful. Remember, if you have periods of feeling overstimulated (including panic attacks)and racing thoughts, followed by periods of low energy, lack of motivation, and depressed mood, there may be problems with dopamine and serotonin, and medication might be necessary. Good luck and hope you feel better soon.
Posted by Lao Tzu on June 11, 2008, at 7:23:53
In reply to Anyone successful in managing their Social anxiety, posted by misterd on June 11, 2008, at 0:23:41
There are a couple of amino acids that are helpful for anxiety. They are taurine and glycine or a supplement called Magnesium Glycinate. If you take glycine or Magnesium Glycinate, you might get better results if you take either one before bedtime, not in the morning because you might feel listless during the day. So there are a number of supplements to help you with your anxiety. They are 5-htp (best taken at bedtime) or saint john's wort (take one or the other because they both help with serotonin); vitamin B3, Vitamin B6, B12, zinc (start off at low dose, say 15mg. You might have to cut the tablet with a pill cutter); kava kava (an herb), omega-3 fish oil (With fish oil, I would suggest starting off with 1 or 2 capsules per day because in my experience, too high a dosage of fish oil makes me feel lethargic); magnesium/calcium complex, taurine, and glycine OR magnesium glycinate. The key is to experiment a little to find the right combination of supplements that makes your social anxiety symptoms more managable. You might want to keep a journal and write down all the combinations you try. If a particular combination doesn't feel comfortable, then try another combination by adding or subtracting a particular supplement from your regimen. Some combinations work great together, others don't. It can be frustrating and it takes time to figure all of this out. Usually, you'll have to take a cocktail of supplements to help your anxiety. Stick with what works and don't give up too soon. If you feel too lethargic or listless during the day, you probably are taking too many supplements together or your taking too high a dosage of a particular supplement. You might want to add or subtract supplements from your regimen or lower the dosages until you feel more comfortable. It can be a pain in the butt to figure out, but in the long run it is worth it, I assure you.
If the supplements alone don't work, you still might consider seeing a psychiatrist to see what he/she can do with medications. Be patient is all I can say. In addition, talking to a therapist can greatly help you to deal with situations that might be adding to your social anxiety. He/she will give you insight into how to deal with stresses in your life. Good luck.
Posted by Lao Tzu on June 11, 2008, at 15:04:13
In reply to Anyone successful in managing their Social anxiety, posted by misterd on June 11, 2008, at 0:23:41
Kava kava is an herb from the pepper family, of which the root has psychoactive properties. I have found that it did help with social anxiety somewhat, but probably it is better for generalized anxiety. It's worth a shot anyway, but I would suggest taking the recommended dosage on the bottle because too much of it can give you a stimulating feeling, which might not be good for anxiety. What else? Either 5-htp or saint john's wort may help you sleep better at night, which is always good for anxiety. Some people get nauseous on 5-htp so watch out for this side effect. Taurine and glycine are helpful for anxiety, not specifically social anxiety, but they may help take the edge off. I think you can take taurine during the day, but like I said, I would take glycine at bedtime. It should help the next day (I think), or instead Magnesium glycinate at bedtime. Be careful with magnesium supplements. Too much at any one time might leave you feeling kinda numb and "zoned out." I take 200mg once or twice a day, and that seems to help me, but everyone is different and require different amounts of nutrients. A low dose of zinc might be good to add also as this seems to help with anxiety somewhat. I only take 15mg per day, but some people take a lot more than that. I think it is recommended to take anywhere from 25mg-50mg for most people. I can only tolerate 15mg. Some people say GABA helps with anxiety, but in my personal opinion, I think GABA is utterly useless, especially for social anxiety. Just my opinion. A low dosage of fish oil may be helpful too. All in all, there are no great remedies specifically for social anxiety. In some cases, you have to treat the underlying depression, which may be the cause of the anxiety, with antidepressant drugs. Hope this helps.
Posted by Lao Tzu on June 11, 2008, at 16:33:22
In reply to Anyone successful in managing their Social anxiety, posted by misterd on June 11, 2008, at 0:23:41
Here I am one last time. If your confused about all the supplements that MIGHT help you, here's what I might do to start off. I would probably try to keep it simple in the beginning.
vitamin B3 (Niacin) and B6 before work or school in the morning. I would probably take a little extra B3 in the afternoon if I really needed it. You can buy 100mg tablets at the grocery store.
Kava kava before work, school, social event
Taurine (I find 1,000mg helps me)
Magnesium glycinate at bedtime
5htp at bedtime
I'm not saying that this is what I think you should do. This is just a suggestion, that's all. I don't know what your situation is and I'm not an expert so don't take this information as gospel. I do have years of experience as a fellow sufferer. I think that counts for something, but if you are really suffering and the supplements don't help you that much, then you might consider seeing a doctor and/or therapist. Good luck.
Posted by misterd on June 11, 2008, at 20:35:49
In reply to Re: Anyone successful in managing their Social anx, posted by Lao Tzu on June 11, 2008, at 16:33:22
Lao Tzu, Thank you so much for all the great information. I am currently taking 1.5mg a day of klonopin and plan on tapering off. Cons of the drug are overtaking the pros. I have in the past used Prozac, however it turned on me after 1 year of working and seemed to create more anxiety. I also have recently tried lexapro, however could not tolerate a tiny dose of 1mg a day so had to stop after a few weeks. I am currently working with a psycholgist to ween me from klonopin and work on the Social Anxiety. I am not anti drugs, I just seem to have had more problems with them than benefits. I have been using either an ssri or a benzo for the last 10 years and would like to see what life is like med free. Don't get me wrong, if their was a magic pill that cured SA without side effects I would take it in a second. However I don't think this is going to happen anytime soon. So I'm going to concentrate on meditation, excercise, supplements and therepy. Hopefully it works! Just curious what medication are you taking that is helping with your SA? Have you tried inositol? Thank you again for all your suggestions and advice!!!
Posted by Lao Tzu on June 12, 2008, at 8:04:28
In reply to Re: Anyone successful in managing their Social anx, posted by misterd on June 11, 2008, at 20:35:49
I tried inositol a long time ago. I don't quite remember if it was all that great, but I'm sure the dosage you take is very important. I was going to suggest inositol too, but I haven't had a lot of experience with that supplement, so I really don't know how well it will work for your anxiety. It is said that for some people it works great, but you may have to take many grams of it, and also I don't know how well it works all by itself. I've always believed that you need more than one nutrient to feel better. A combination of supplements usually is necessary, and the dosages of each supplement are important too. For many years, I was desperate for a great SA med. I resorted to taking lorazepam (Ativan), which worked beautifully for me, especially when I took it AS NEEDED, like when I would go to meetings at work. I was always fearful of being in a room full of people, but the lorazepam (1-2mg) was a godsend in those situations. I felt awesome, but I realized that it would not be a good idea to take it continuously everyday because you build a tolerance to it over time, and then eventually, it doesn't work very good. And if you take it continuously everyday, you could get symptoms of depression over time from it. I learned the hard way. One day, I decided to take Ativan all the time, and my first doctor at the time didn't have a problem with it. It worked great for about two years, but I noticed over that time that I gradually needed a higher dosage of it during company meetings. If you take it everyday, it can really get out of hand, and you may find yourself really abusing it. So, in the final analysis, lorazepam is not a good drug for taking everyday. It works beautifully if taken as needed for extreme anxiety-provoking situations, and that is it. Take this as gospel. Klonopin, on the other hand, supposedly is okay to take everyday as a maintainance drug. If this works for you, that is great. I did try Klonopin for about two weeks, and I felt it was rather weak compared to lorazepam, but I realized the stronger the benzo, the greater the addictive potential, so I guess it's much better to take a very low dosage or weaker benzo so that it just takes the edge off but doesn't feel too good. My current doctor gave me a very low dosage of Xanax when he put me on Zoloft, only .25mg. This was a good strategy because it didn't make me feel as wonderful as lorazepam, but it took the edge off of my social anxiety. He is a very good doctor. Once I got stabilized on my meds (risperdal, zoloft, provigil, and lamictal) he refused to refill my Xanax. I was totally pissed off, but now I realize that he was right to do this. Xanax and Ativan are addictive. Eventually, I just relied on my meds and my supplements, and even though I still miss the lorazepam, I don't really need it now to function okay. There is life after Xanax or Ativan, believe me. In the very beginning when I was having panic attacks, the lorazepam was absolutely necessary. But now, I am completely free of panic attacks. Now, just to let you know the full story. I am taking 4mg per day of Risperdal because I started having psychotic symptoms three years ago on top of my social anx and depression. My doctor gives me injections every two weeks, and after a year of being on such a high dose of risperdal, my social anxiety is less of a problem than it was before the risperdal. However, a doctor will only give you that much risperdal if you have psychotic symptoms. If you just have anxiety, he probably would only give you .5mg-1.0mg of risperdal. That will definitely help with anxiety, but it is not a cure for social anxiety. More scientific research is definitely warranted for this disorder. They say that certain MAOIs like Parnate or Nardil have been prescribed for social anxiety, but usually a doctor will only prescribe an MAOI when all other meds (antidepressants) have failed. I wish you the best of luck with your therapy and your supplements. You have a friend here.
Posted by nolvas on June 13, 2008, at 2:37:13
In reply to Re: Anyone successful in managing their Social anx, posted by Lao Tzu on June 12, 2008, at 8:04:28
There actually haven't been that many studies relating to anxiety disorders and Inositol. I was sucked in and tried 6 - 10 grams of Inositol a day for 3 months, about 2 years ago. It had absolutely zero panic reducing effects for me. I wouldn't even consider taking it again it was that disappointing. Everyone is different though, so if you wish to try it, then buy it in bulk, it's closely related to sugar and it has a reasonably pleasant taste.
Posted by Sigismund on June 13, 2008, at 18:01:42
In reply to Re: Anyone successful in managing their Social anx, posted by nolvas on June 13, 2008, at 2:37:13
There was some talk here about gotu kola and social anxiety.
I have no experience with that, but wonder if there is anything in it.
I have tried LEF Ashwaganda which has been helpful, though not specifically for SA.
It just puts me in a better frame of mind.
Posted by nolvas on June 16, 2008, at 14:45:28
In reply to Re: Anyone successful in managing their Social anx, posted by Sigismund on June 13, 2008, at 18:01:42
Without a reasonable amount of studies you can only rely on anecdotal evidence. There's some evidence possibly that Gotu Kola is useful for treating anxiety, but without more detailed studies you are hedging your bets somewhat that it may work significantly well, there's little indication of what dosage and active ingredients when choosing Gotu Kola as well.
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