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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by tensor on November 12, 2001, at 17:13:50
Hi again,
Does anyone have problems with talking in front of people and talking person to person? I'm not talking about the common fear that nearly everybody possess. I have Panic disorder and get treatment for that, Buspar 20mg/day and it helps my anxiety/PD pretty well but the talking problem remains unsolved. This problem arised concurrently with the PD. This is a big problem for me since i'm studying, and to do a presentation is impossible since I completely panic. I have diazepam prescribed for me, but even diazepam falls short when it comes to presentation.
This problem is, for me, a bit strange since i'm a rather social person. I don't know what to do, does anyone recognize this?
I would really appreciate someone to share experiences with...
Posted by JohnX2 on November 12, 2001, at 17:36:40
In reply to Talking(in front of people), posted by tensor on November 12, 2001, at 17:13:50
Hi, Some people can take Inderal to help stop the
heart from racing when put into a nervous situation
such as a presentation. Inderal blocks the
bet-adrenoreceptor that is sensitive to the
anxiety chemical adrenaline. Just a thought.
It will usually give you a few hrs of pretty good
relief from racing heart and sweating if those
are your symptoms.regards,
-john
> Hi again,
>
> Does anyone have problems with talking in front of people and talking person to person? I'm not talking about the common fear that nearly everybody possess. I have Panic disorder and get treatment for that, Buspar 20mg/day and it helps my anxiety/PD pretty well but the talking problem remains unsolved. This problem arised concurrently with the PD. This is a big problem for me since i'm studying, and to do a presentation is impossible since I completely panic. I have diazepam prescribed for me, but even diazepam falls short when it comes to presentation.
> This problem is, for me, a bit strange since i'm a rather social person. I don't know what to do, does anyone recognize this?
> I would really appreciate someone to share experiences with...
Posted by tensor on November 12, 2001, at 17:55:53
In reply to Re: Talking(in front of people) » tensor, posted by JohnX2 on November 12, 2001, at 17:36:40
Thanks for replying,
I've tried Inderal, it didn't help much, maybe too low dose I don't know. It feels hopeless since meds like diazepam should make you overcome fear.>
> Hi, Some people can take Inderal to help stop the
> heart from racing when put into a nervous situation
> such as a presentation. Inderal blocks the
> bet-adrenoreceptor that is sensitive to the
> anxiety chemical adrenaline. Just a thought.
> It will usually give you a few hrs of pretty good
> relief from racing heart and sweating if those
> are your symptoms.
>
> regards,
> -john
>
>
> > Hi again,
> >
> > Does anyone have problems with talking in front of people and talking person to person? I'm not talking about the common fear that nearly everybody possess. I have Panic disorder and get treatment for that, Buspar 20mg/day and it helps my anxiety/PD pretty well but the talking problem remains unsolved. This problem arised concurrently with the PD. This is a big problem for me since i'm studying, and to do a presentation is impossible since I completely panic. I have diazepam prescribed for me, but even diazepam falls short when it comes to presentation.
> > This problem is, for me, a bit strange since i'm a rather social person. I don't know what to do, does anyone recognize this?
> > I would really appreciate someone to share experiences with...
Posted by judy1 on November 12, 2001, at 18:01:38
In reply to Talking(in front of people), posted by tensor on November 12, 2001, at 17:13:50
I'm really surprised you get relief with buspar- if I had to give a presentation I would take xanax subling 15 minutes before the event. Good luck- Judy
Posted by JohnX2 on November 12, 2001, at 19:16:52
In reply to Re: Talking(in front of people) » tensor, posted by judy1 on November 12, 2001, at 18:01:38
Have you tried the SSRI route? Or augmenting
Buspar with an SSRI? Or Serzone. Serzone is
good at zapping anxiety and helping sleep
(except it can make you drowsy). Be careful
mixing Serzone with Buspar though. Serzone will
spike buspar blood levels due to interactions.Another fringe otc supplement for anxiety is 5-htp.
A little controversial.
It is a dud for treating depression, but it did
wonders for my anxiety and sleep at the time.Sorry the Inderal sucked. I just took it when I
had a bad reaction on MAOI's or Remeron and my
heart would race and I would wake up in pools of
sweat. I took 20 mg of Inderal and it stopped these
problems for the evening. The downside was that it
flattened out my mood.Another Idea is the BP med tenex (guanfacine)
or Catapres (Clonodine). I would be surprised if
clonodine didn't help. Just some suggestions.
Everyone's results may vary.good luck,
-john
> I'm really surprised you get relief with buspar- if I had to give a presentation I would take xanax subling 15 minutes before the event. Good luck- Judy
Posted by JahL on November 12, 2001, at 19:31:34
In reply to Talking(in front of people), posted by tensor on November 12, 2001, at 17:13:50
> Does anyone have problems with talking in front of people and talking person to person? I'm not talking about the common fear that nearly everybody possess. I have Panic disorder and get treatment for that, Buspar 20mg/day and it helps my anxiety/PD pretty well but the talking problem remains unsolved. This problem arised concurrently with the PD. This is a big problem for me since i'm studying, and to do a presentation is impossible since I completely panic. I have diazepam prescribed for me, but even diazepam falls short when it comes to presentation.
> This problem is, for me, a bit strange since i'm a rather social person. I don't know what to do, does anyone recognize this?
> I would really appreciate someone to share experiences with...Sounds like Performance Anxiety, a kind of limited form of Social Phobia (which I have), which itself can take many forms.
Does this sound like you?:
""Some anxiety in social situations is normal, but persons with social phobia are so anxious that they avoid social situations in which it occurs or endure them with great distress. Almost always, they are aware of their anxiety about embarrassment or humiliation if their social interaction or performance does not meet their expectations.
Some social phobias are specific, producing anxiety only when the person must perform an activity in public. The same activity performed alone produces no anxiety. Situations in which social phobia is common include public speaking, acting in a theatrical performance, and playing a musical instrument. Even eating with others, signing one's name before witnesses, or using public bathrooms can be viewed as a public performance. Persons with social phobia worry that their performance will seem excessive or inadequate. Often their concern is that their anxiety will be apparent as sweating, blushing, vomiting, or trembling (sometimes as a quavering voice) or that they will forget their train of thought or not be able to find"" (from: http://www.merck.com/pubs/mmanual/section15/chapter187/187c.htm -MERCK MAN.)
I think standard treatment is similar to 'full' social phobia. Meds to consider would be Nardil, SSRIs etc. Perhaps Klonopin is worthy of consideration since yr condition is fairly specific. I take it in combination w/ Lamictal. Sulpiride is the med I find to be of most use against s. phobia; a high-ranking pdoc recently told me that Sulpiride & Amisulpride were 2 of the best treatments they had for this.
Good Luck,
J.
Posted by Alan on November 12, 2001, at 23:05:19
In reply to Re: Talking(in front of people) » tensor, posted by JahL on November 12, 2001, at 19:31:34
Actually I'm with Judy on this one. I suffer from exactly the same thing - Social Anxiety or phobia.
BZD's like ativan, xanax or klonopin are the thing that work best for this because they have an immediate effect at the right dose (they're usually UNDERutilised rather than OVERutilised by the patient). Here's a link talking about it:
http://www.socialanxietyinstitute.org/medication.html
Hope this helps. My job requires me to deal with performance anxiety on a daily basis. One of these should work for you. Rarely do they NOT work and one BZD will work better than others - they are not all the same in their effectiveness on anxiety of all types.
Alan
Posted by tensor on November 13, 2001, at 6:10:02
Hi and thanks for your replies,
John, yes I have gone through a few SSRIs, Prozac, Effexor and now Buspar, I also take Remeron for depression which works well. I now understand(by JahL) that I suffer from social phobia/anxiety. So what I can understand from your answers is that I should try another BZD, as I've understood Buspar would be a better option(if it worked!) than BZD since the BZDs can cause addiction, isn't that problem for you??
Alan, do you take those meds on a long term basis or do you take a dose when there is specific need? And which one works best(for you)?
It is time to see my pdoc once again...
Posted by JohnX2 on November 13, 2001, at 10:30:12
In reply to Talking(in front of people) , posted by tensor on November 13, 2001, at 6:10:02
Addiction to Klonopin is a problem for me,
but I take it for non-anxiety reasons (tension
headaches) and I do a bad job of staying at
the same dose. Generally if you stick strongly
to a dosing regimen the addiction potential on
Klonopin is one of the lowest. A benzo isn't a
bad solution based on all discussed here.
Klonopin is nice because you can take it 2x a
day and it holds a fairly level in your body, so
there are few ups and downs as compared to a shorter
acting med like xananx.Good luck,
john> Hi and thanks for your replies,
>
> John, yes I have gone through a few SSRIs, Prozac, Effexor and now Buspar, I also take Remeron for depression which works well. I now understand(by JahL) that I suffer from social phobia/anxiety. So what I can understand from your answers is that I should try another BZD, as I've understood Buspar would be a better option(if it worked!) than BZD since the BZDs can cause addiction, isn't that problem for you??
>
> Alan, do you take those meds on a long term basis or do you take a dose when there is specific need? And which one works best(for you)?
>
> It is time to see my pdoc once again...
Posted by geno on November 13, 2001, at 20:12:26
In reply to Re: Talking(in front of people) » tensor, posted by JohnX2 on November 13, 2001, at 10:30:12
>
> Addiction to Klonopin is a problem for me,
> but I take it for non-anxiety reasons (tension
> headaches) and I do a bad job of staying at
> the same dose. Generally if you stick strongly
> to a dosing regimen the addiction potential on
> Klonopin is one of the lowest. A benzo isn't a
> bad solution based on all discussed here.
> Klonopin is nice because you can take it 2x a
> day and it holds a fairly level in your body, so
> there are few ups and downs as compared to a shorter
> acting med like xananx.
>
> Good luck,
> john
>
> > Hi and thanks for your replies,
> >
> > John, yes I have gone through a few SSRIs, Prozac, Effexor and now Buspar, I also take Remeron for depression which works well. I now understand(by JahL) that I suffer from social phobia/anxiety. So what I can understand from your answers is that I should try another BZD, as I've understood Buspar would be a better option(if it worked!) than BZD since the BZDs can cause addiction, isn't that problem for you??
> >
> > Alan, do you take those meds on a long term basis or do you take a dose when there is specific need? And which one works best(for you)?
> >
> > It is time to see my pdoc once again...I say fuck all these psyc meds. I do ghb., I could talk in front of the nation when im on it.
geno
Posted by kitty-layne on November 13, 2001, at 21:55:58
In reply to Re: Talking(in front of people) » tensor, posted by JahL on November 12, 2001, at 19:31:34
> Does this sound like you?:
> ...Some social phobias are specific, producing anxiety only when the person must perform an activity in public. The same activity performed alone produces no anxiety. Situations in which social phobia is common include public speaking, acting in a theatrical performance, and playing a musical instrument. Even eating with others, signing one's name before witnesses, or using public bathrooms can be viewed as a public performance. Persons with social phobia worry that their performance will seem excessive or inadequate. Often their concern is that their anxiety will be apparent as sweating, blushing, vomiting, or trembling (sometimes as a quavering voice) or that they will forget their train of thought or not be able to find"" (from: http://www.merck.com/pubs/mmanual/section15/chapter187/187c.htm -MERCK MAN.)Sounds a lot like me. But it sounds like quite a large number of people I know. How do you know if you have an anxiety disorder, not just normal anxiety?
-
--kl
Posted by JGalt on November 13, 2001, at 22:15:27
In reply to Re: Talking(in front of people), posted by geno on November 13, 2001, at 20:12:26
In a previous message "geno" posted:
> >I say fuck all these psyc meds. I do ghb., I > >could talk in front of the nation when im on it.
Right on brother! I didn't know there was any other G-birds on this forum. Good to hear that there is!
Posted by JohnX2 on November 13, 2001, at 23:26:12
In reply to Re: Talking(in front of people) geno, posted by JGalt on November 13, 2001, at 22:15:27
Sorry to spoil the party boys, but mr. govmnt
doesn't want people to enjoy themselves even
in non-harmful ways. Although booze and smoking
is legal and they can really *uck you up. Strange?
Could it be the PACK money, nah...-john
> In a previous message "geno" posted:
>
> > >I say fuck all these psyc meds. I do ghb., I > >could talk in front of the nation when im on it.
>
> Right on brother! I didn't know there was any other G-birds on this forum. Good to hear that there is!
Posted by JahL on November 14, 2001, at 9:09:53
In reply to Performance anxiety » JahL, posted by kitty-layne on November 13, 2001, at 21:55:58
> > Does this sound like you?:
>
> > ...Some social phobias are specific, producing anxiety only when the person must perform an activity in public. The same activity performed alone produces no anxiety. Situations in which social phobia is common include public speaking, acting in a theatrical performance, and playing a musical instrument. Even eating with others, signing one's name before witnesses, or using public bathrooms can be viewed as a public performance. Persons with social phobia worry that their performance will seem excessive or inadequate. Often their concern is that their anxiety will be apparent as sweating, blushing, vomiting, or trembling (sometimes as a quavering voice) or that they will forget their train of thought or not be able to find"" (from: http://www.merck.com/pubs/mmanual/section15/chapter187/187c.htm -MERCK MAN.)
>
> Sounds a lot like me. But it sounds like quite a large number of people I know. How do you know if you have an anxiety disorder, not just normal anxiety?I'm no expert but I imagine something becomes a disorder if it deleteriously affects yr quality of life. IMO this whole thing is about *degrees* of suffering.
In social phobia for example, one's reaction to social stimuli would be *irrational, disproportionate and more intense than is reasonable or comfortable*. The anxiety is a *phobic* response. If anxiety impinges upon yr life to the point at which your social life (& life in general since it's v hard to get through the day w/o coming into contact with people)-or any facet of it, such as public speaking-is adversely affected to a significant degree, then you could be said to be suffering from some form of (social) anxiety disorder.
In the case of public speaking, some degree of nervousness is to be expected, is desirable even, but if such an activity were to induce say, panic attacks, then clearly you have a problem.
The Q to ask is; does my anxiety *significantly* reduce my QOL?
Do I feel comfortable in public?
Also, social phobics tend to suffer from an *irrational conviction* that they are being obsessively scrutinised by others, hence the deep self-consciousness.
Rgds,
J.
Posted by Sigolène on November 14, 2001, at 11:03:17
In reply to Talking(in front of people), posted by tensor on November 12, 2001, at 17:13:50
You can take Inderal 20mg before talking in front of people. It has been a miracle for me, I can now talk in front of 100 people with it !!
Sigolene
Posted by tensor on November 14, 2001, at 11:20:42
In reply to Re: Talking(in front of people), posted by Sigolène on November 14, 2001, at 11:03:17
Posted by Sleepy on November 14, 2001, at 13:55:56
In reply to Talking(in front of people), posted by tensor on November 12, 2001, at 17:13:50
This is a little odd, but thought I would just toss it out there. I grew up with a fear of talking in front of people, then overcame it in college (those pesky presentations in grad school helped). I'm bipolar though, and for some reason things like getting up in front of people touches off manic episodes. Now I STILL can't go to a party or have a one on one conversation with someone I don't feel completely comfortable with. And I still freak out at social events unless I duck out periodically for "breathers." In the past I've had a couple of very extreme bouts of agoraphobia. I'll always be socially awkward and have a lot of anxiety when it comes to being in a roomful of people. I can't have a conversation with another mother while I wait outside of my son's school building! But I can get up in front of an auditorium full of people, no problem. The only thing I can figure is that when I'm doing a presentation I'm not myself. I look at it as a performance and for some reason that makes all the difference. I guess because it's not personal. Go figure!
~SleepyHi again,
>
> Does anyone have problems with talking in front of people and talking person to person? I'm not talking about the common fear that nearly everybody possess. I have Panic disorder and get treatment for that, Buspar 20mg/day and it helps my anxiety/PD pretty well but the talking problem remains unsolved. This problem arised concurrently with the PD. This is a big problem for me since i'm studying, and to do a presentation is impossible since I completely panic. I have diazepam prescribed for me, but even diazepam falls short when it comes to presentation.
> This problem is, for me, a bit strange since i'm a rather social person. I don't know what to do, does anyone recognize this?
> I would really appreciate someone to share experiences with...
Posted by Peter on November 17, 2001, at 2:49:03
In reply to Already tested, no result :( (nm), posted by tensor on November 14, 2001, at 11:20:42
If inderal doesn't work for you, don't forget there are other beta-blockers that help the physical manifestations (shaky voice, sweaty palms, etc.) of SP. Atenolol (Inderal) works quite well for me. SP is part of my diagnosis - there was a point in the past when I couldn't leave the house for fear of meeting new people or being in new situations. Panic was also a problem, and the thought of having panic attacks would of course exacerbate my not wanting to meet new people or go to new places, etc. I've been on a daily regimen of klonopin for about 3 years now, and I've never taken over 2mg in an entire day-sometimes I take as low as .75mg in a day. And, if it's of any help, I too was very concerned with the addictive potential I'd been hearing about, especially since I was a heavy drug abuser for years. But it really works - it's safe and long-acting. As long as you taper off of it, there shouldn't be any unmanageable withdrawel to worry about. As for the beta-blockers, they help me in addition to the klonopin because, while the klonopin is a CNS depressant and it relaxes you physically and mentally, the beta-blockers target the outward physical annoyances of SP, as I stated above. I've gone through many SSRIs also, which have proven quite effective for SP, but they didn't work well for me for a number of reasons regarding my personal diagnosis. Hope this helps, and good luck.
Peter
Posted by tensor on November 17, 2001, at 16:16:49
In reply to Re: Already tested, no result :(, posted by Peter on November 17, 2001, at 2:49:03
Thanks, I will soon try Klonopin, on monday I hope. I will let you know then, if it works for me..
/Tensor
This is the end of the thread.
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