Posted by Caper on May 16, 2004, at 2:30:01
In reply to social phobia insomnia, benzophobic dr., HELP ME, posted by erik98225 on May 15, 2004, at 5:01:07
Hi Erik,
I couldn't help being drawn to your message. You sound so much like I was about a year and a half ago. Depression and PTSD gave me such anxiety and insomnia that when I discovered alcohol I thought "This is GREAT! It's affordable, legal, and I can get as much as I want!" But it's a cruel, evil trap. Whatever happens you need to stop the alcohol, even if it means an in-patient detox program. I started out like you, drinking a moderate amount for sleep and ended up drinking 6 bottles of wine or a litre of vodka a day- and this progression took only about 9 months. I gained about 60lbs myself, til I switched from wine to hard liquor. Don't let this happen to you!
As far as sleep goes, have you ever tried trazadone? It's technically an antidepressant, but it's so sedating that it usually cannot be used for that because few people can tolerate the therapeutic dosage. It's not considered addictive and is also very inexpensive. There are really quite a few meds out there that are not technically "sleeping pills" but will definitely put you out for the night!
As far as your psychiatrist, if he's diagnosed you as "alcohol dependent" then he is supposed to treat it- and NOT by making you suffer with no meds. Alcohol withdrawal can be quite dangerous really- heart rate, blood pressure go up, chance of seizures exist. (Not meaning to scare you, just to give you things to remind your doctor!) Some docs seem to have "detox" and "withdrawal" confused. Detox is a controlled stopping of the alcohol use. Withdrawal is just letting the patient suffer.
If your doc has diagnosed you as alcohol dependent then he needs to TREAT it, not just let you suffer. His concern might be that you will mix alcohol and benzos with potentially fatal consequences. But if he's willing and you're willing, I've heard of people getting only a few days worth of Ativan, Valium, Librium or whatever at a time. Yes you'd have to keep picking up scripts every few days, but it should help the doc be sure you are taking the pills as prescribed, not using them all up in one day for a "high". He can also slowly taper the dosage of the benzos to make sure you don't become addicted/dependent on a benzo in place of alcohol.
This can work for some people, but others need an in-patient detox program to start off with. This is valuable in two ways: First: they give you benzos and slowly taper them based on how bad your physical and mental withdrawal symptoms are. Second: a general psychiatric admission would give you a chance to come up with better meds than you are on now, since they are obviously not working as well as they should- otherwise you'd be able to control the social phobia AND be able to get regular sleep without alcohol.
As a last resort, I have to admit that I once went to a new doctor and did not admit my alcoholism- only my PTSD and sleep problems. I got a fairly generous prescription for benzos, but decided to check into a short term detox program anyway. (When I realized I doubted my ability to stay off the alcohol even with Valium at my side.)
Anyway, I'm not advocating lying to doctors, but I think an un-medicated detox is just plain cruel and pointless. It happened to me too and it's one of the worst memories of my life.
Bottom line (sorry, I know I ramble, but I just have very strong feelings about this subject) is maybe you need a psychiatrist who is more educated on substance abuse. He should at least have given you information on detox programs!
One last thing: you say you know "you deserve it". That is not true. No one picks up the drink thinking "let's get addicted, that would be so cool!" You were right when you said you were self-medicating- you were trying to feel better, not do something bad. Try not to beat yourself up too much about that okay?
I'm all the way across the country from you so I can't help out with doctor referrals, but I wish you the best of luck. If you want to know anything about inpatient detox, feel free to ask. I'll be glad to answer any questions I can.
Best of luck,
Caper
Caper@playful.com
> I have social phobia and have always had a heck of a time getting to sleep. It takes a long time to fall asleep, but once I am asleep I sleep like a baby.
>
> A few months back I discovered that 3-4 beers in the evening makes me fall asleep fast and gives me a feeling of peace like nothing else can.
>
> I was stupid enough to discuss this with my doctor, so now I have alcohol dependence in my medical records.
>
> While drinking I gained 30 pounds, hated the hangovers, and decided last week that this needs to stop.
>
> I am now two days into the horror that is alcohol withdrawal.
>
> I have been awake for 37 hours.
>
> Alcohol withdrawal will make your worst case of the flu feel like an orgasm.
>
> I know I deserve it -- it's my punishment for beating up my liver -- and I know it passes, but the thing is, I drank alcohol because it worked.
>
> I am convinced that I have the "overactive brain" component of alcohol dependence (I don't have a link, but I know I read about it on this board... I drank alcohol in an attempt to calm down the brain to a more normal state.)
>
> Benzos are alcohol pills, and alcohol is a liquid benzo.
>
> I have mentioned this to my doctor many, many times, and told him that the drinking was a desperate attempt to self-medicate, but he simply WILL NOT write a prescription for benzos "because they are addictive".
>
> Yes, they are addictive. Big deal. Would you deny morphine to a terminally ill cancer patient just because he might get addicted to it? And isn't it better to be addicted to benzos than addicted to alcohol?
>
> I take Paxil 20mg. It was effective for the social phobia until the drinking rendered it useless, but it never did anything for me in terms of helping me fall asleep.
>
> Can anyone knowledgeable give me some information I can discuss with my psychiatrist
> to convince him that a benzo is right for me? Anyone have any suggestions for a psychiatrist who is willing to prescribe benzos? (I'm in the Bellingham, Washington area)
>
> Any comments, suggestions, or information would be greatly appreciated. I'm at my wit's end here.> I have social phobia and have always had a heck of a time getting to sleep. It takes a long time to fall asleep, but once I am asleep I sleep like a baby.
>
> A few months back I discovered that 3-4 beers in the evening makes me fall asleep fast and gives me a feeling of peace like nothing else can.
>
> I was stupid enough to discuss this with my doctor, so now I have alcohol dependence in my medical records.
>
> While drinking I gained 30 pounds, hated the hangovers, and decided last week that this needs to stop.
>
> I am now two days into the horror that is alcohol withdrawal.
>
> I have been awake for 37 hours.
>
> Alcohol withdrawal will make your worst case of the flu feel like an orgasm.
>
> I know I deserve it -- it's my punishment for beating up my liver -- and I know it passes, but the thing is, I drank alcohol because it worked.
>
> I am convinced that I have the "overactive brain" component of alcohol dependence (I don't have a link, but I know I read about it on this board... I drank alcohol in an attempt to calm down the brain to a more normal state.)
>
> Benzos are alcohol pills, and alcohol is a liquid benzo.
>
> I have mentioned this to my doctor many, many times, and told him that the drinking was a desperate attempt to self-medicate, but he simply WILL NOT write a prescription for benzos "because they are addictive".
>
> Yes, they are addictive. Big deal. Would you deny morphine to a terminally ill cancer patient just because he might get addicted to it? And isn't it better to be addicted to benzos than addicted to alcohol?
>
> I take Paxil 20mg. It was effective for the social phobia until the drinking rendered it useless, but it never did anything for me in terms of helping me fall asleep.
>
> Can anyone knowledgeable give me some information I can discuss with my psychiatrist
> to convince him that a benzo is right for me? Anyone have any suggestions for a psychiatrist who is willing to prescribe benzos? (I'm in the Bellingham, Washington area)
>
> Any comments, suggestions, or information would be greatly appreciated. I'm at my wit's end here.
poster:Caper
thread:347048
URL: http://www.dr-bob.org/babble/20040515/msgs/347339.html