Posted by Cairo on July 15, 2005, at 7:29:49
In reply to Can you diagnose me? 14 doctors couldn't!, posted by becksA on July 14, 2005, at 20:37:30
There is a big difference, IMHO, interacting for business and interacting in social situations. Your expectations are more clear ucut and you are discussing things outside of yourself generally. When you interact socially, however, the discourse is more free flowing and therefore less predictable, and you expose your real self more.
I see this with my teen daughter who is diagnosed with Social Anxiety. At school, she does OK when she is in the classroom and the situation is structured; you know what you are supposed to do (listen to the teacher, answer questions with answers you just read in the book or heard). But at the unstructured times (lunch, break), she falls apart. She frets that the kids ignore her, a self-fulfilling situation because they DO because she doesn't talk to them due to her shyness. The conversation veers off in many different directions so she is put in the unknown and terrifying territory of feelings, emotions, sharing personal experiences, etc. She interacts OK with adults and friends she's known for awhile, but with her peers it is a problem.
She was put on Celexa, then Lexapro, but while Lexapro improved her SA about 30%, it caused unbearable fatigue and memory problems (which the pdoc said didn't exist). Adding Provigil helped somewhat, but didn't help her attention much (she has ADD). She was switched to Zoloft with noticeable improvement in the fatigue and memory. Her social interaction improved a bit, too, but there is still residual lack of confidence which keeps her in her "bubble". Just because one med doesn't work doesn't mean that another won't.
We may add Seroquel to augment and to help with sleep if raising the dose of Zoloft doesn't improve that confidence.
BTW, she was put on Librium prn and it did help a bit. For example, she was refusing to go to an after schoolart class but while the Librium made her less resistant to going, that lack of confidence was still not helped.
Sounds like you may need a doctor who really will take the time to find out what's going on with you and look at your medication history very closely. Just because 14 doctors haven't diagnosed you doesn't mean you won't find ONE who will really listen and take on the challenge.
Have you thought about going to a tertiary center such as Mass General, Mayo, etc.? Maybe you are a complicated case that needs experts rather than local docs who like to stay in their comfort zone with diagnoses and meds.
Regarding med poop out, do a search in the Dr. Bob archives and see what comes up.
All that being said, I think CBT is a good idea. It helps many people. My daughter is not one of them, but she has many more diagnoses piled on top of just SA. I think it's worth a try, but finding a good pdoc and med (combo) is top priority.
Good luck!
Cairo
> I'm EXTREMELY frustrated now because I have dealt with this problem that's holding me back, for years, and for the amount of money I've spent on docs and rx's , you'd think I would be better, not worse.
>
> Many of you have read my posts in the past i'm sure and are aware of some of the things I deal with....My latest dx's have been Social Anxiety disorder and apparently my current pdoc thinks i may be bipolar, I was on Lamictal for 6 months at a very high dose...but my anxiety was getting so ridiculously bad, I took myself off it thinking that must have been it.
> (The anxiety was so bad I was taking 12mg of Xanax XR daily), didn't seem to do a thing.
> AFter coming off the lamictal (I was on 200mg daily, and I've been off it completely for about a week now, a little more, after coming off it very (probably too much so), suddenly.
> After coming off it I seemed to be feeling much better taking the less potent Serax, and some adderall , but now the anxiety seems to have returned.
>
> The worst part of this anxiety is not just social, but particularly socially "happy" events....business and serious conversations are not a problem. When it turns into a laughing conversation , something very casual, I feel my face tighten up to the point where I can barely force a smile, (on a bad day of course)....it seems to always be there, somedays worse than others.
> Do I try another mood stabilizer? I have no clue, I have tried juyst about everything in the book...
>
> Thanks
poster:Cairo
thread:527760
URL: http://www.dr-bob.org/babble/20050713/msgs/527919.html