Posted by Dr. Bob on December 19, 2003, at 19:57:32
In reply to Looking to turn my life around (social anxiety), posted by mrgeek on December 19, 2003, at 10:12:00
> Hello, I'm new to posting here. I've found a lot of good information though and everyone seems very friendly so I thought I might be able to get some good opinions.
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> Sorry if this ends up being a book, I'll try to keep it concise.
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> First off, I know that I have social anxiety. I self-diagnosed myself during my senior year in high school. I went to my doctor and briefly described my symptoms to him. He put me on a trial of Paxil. It definitely did something to me which "improved" my mood, but nothing for my anxiety. In one instance I recall sitting at a table during lunch with a group of about 10 people. I proceeded to tell the entire table about how I was "so happy" because I was on antidepressants for social anxiety. In retrospect, I feel like a complete idiot. This coming from someone who used to obsess over whether or not people were judging the way he ate soup. Needless to say, these were not the results I was looking for. My doctor next put me on Zoloft, which was the most successful SSRI i've tried, but it was still giving me basically the same effect as the Paxil. Also, the sexual side effects of both were something I could not deal with. After this I tried Celexa, which I stuck with the longest. I think the only reason for this was because I started college and I felt like I needed something If I was going to do good at all. It gave me anxiety attacks, made me even more irritable than normal, and continued with the sexual side effects which in turn took a toll on my confidence. It was bad. Coming off it was probably the worst time I have ever had in my life. I didn't do it right, I just stopped taking it. Since then I have been off any kind of drugs for 2 years. After my failure with SSRI's I was hopeless. I thought they were the only possibility and I figured I just had to deal with this on my own. I never went back to my doctor about my anxiety.
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> 2 years later: I got kicked out of college after my second year. Both semesters of this year I stopped going to classes about half-way through the semester. I failed everything. Time and time again I would try to convince myself that I just wasn't supposed to be in College, that I wasn't smart enough for it or something along those lines. After I got kicked out of school, I continued to live in the town my school was located in. Both to be near my girlfriend and because of a lease I had commited to before I was kicked out. I had intentions of getting a job, but I just could not bring myself to seek viable employment. The only jobs I am interested in are ones that deal with computers (something I'm very good at), or ones with little to no social interaction required. Anyway, I basically isolated myself in an apartment for about 4 months doing nothing. This lead to the worst and scariest episode I have ever had where I scratched my wrist and hand up with a broken CD. I threw objects around my room and broke things. I felt so out of control for the short period it was going on. Worst of all, my girlfriend was there witnessing the whole thing. We had been together for a rocky 4 years, rocky I believe due to my anxiety problems. Now she has left me because she doesn't think I have any goals in life and doesn't think we are right for each other. This has absolutely crushed me, but I can't blame her. I need to do something.
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> Since I'm out of school I have no medical insurance, but I've recently applied for a state-run health program that I should be accepted to without any problems. I am so eager to see my doctor. I want to get reffered to a phychiatrist so badly and just spill everything in my head out. I've spent the past two months doing research on my disorder and i've come to understand it a lot better. I've come to a few interesting conclustions about myself, which I believe to be true.
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> First off, I agree with anyone who says SSRI's are for the most part useless for social anxiety. I don't think they are the right drug and even if they do bring some improvement, it's either because they're indirectly acting on the problem or just simply numbing you emotions down so you dont give a crap.
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> I believe my problem has specifically to do with some sort of dopamine problem in my brain. I have no clue if theres too much of it, too little, or if it's something to do with the receptors. Heres what I do know:
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> A night or two of sleep deprivation for me, will virtually completeley elimate my anxiety. I feel confident, outgoing (albiet tired), and basically happy about life. I've scoured the internet in search of studies that examine the effects of sleep deprivation as an antidepressant. The few studies I've been able to find all point to the fact that sleep deprivation results in an increase in dopamine levels in the brain.
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> My mother is a smoker. She has been my whole life and while she was pregnant with me. I also have reason to believe that both her and my father smoked marijauna while she was pregnant with me, as well as when I was growing up. Again, it is well-accepted that Nicotine and THC raise dopamine levels in the brain, hence the good feelings the drugs are associated with.
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> Next, I have read that Zoloft inhibits the reuptake of dopamine moreso than other SSRIs. Now while I have also read that SSRIs dont really affect dopamine enough to matter anyway, perhaps this is why it was the most successful drug I have tried.
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> Additionally, I have very recently come to realize that I may have a moderate case of ADD. I always though that I was simply lazy or had poor work ethic, but I have taken a few online tests for ADD and all suggest that I show the symptoms of it. Again, those with ADD are suspected by professionals to have problems with their dopamine.
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> Now I understand that the brain is an extremely complicated organ and theres way more to it than just saying something might be wrong with my dopamine levels. I have read about the success people have had with Klonopin and various MAOIs, which both seem to primarily effect GABA. However, I have also read about many who have taken drugs used in the treatement of Parkinsons disease as well as Ritalin, Adderall, and other ADD drugs with great success.
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> I guess what this long post is boiling down to is: Does anyone have a recommendation for what drug I should ask my doctor about when I finally have insurance available? I am very intrigued with the possiblity that Ritalin or Adderal may do some good for me, but I have also hear so many good things about Klonpin. I want to stay away from MAOIs at all costs, because I don't think I could live without cheese in my diet >:)
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> Anyway, sorry for writing a book even though I promised I wouldn't. Any opinions, questions, insights, etc, etc are more than greatly appreciated. Just browsing the posts on here have been one of my only sources of hope for a better life over the past month. Thank you
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poster:Dr. Bob
thread:291739
URL: http://www.dr-bob.org/babble/20031219/msgs/291739.html