Posted by Billb on August 11, 2000, at 15:42:55
In reply to Re: Cam and Others, Social Anxiety Cocktail Evaluation, posted by AndrewB on August 11, 2000, at 12:38:02
>AndrewB, thanks so much for your response. You might be sorry you asked (due to the length of my respose. Answers attached.
>
> I have more questions than answers for you. Please bear with me here and please excuse me for this rapid-fire succession of questions. I'm just trying to be helpful.
>
> Can you describe the 'flavor' of your social anxiety. For example, do you have panic attacks, blushing, sweating or physical symptoms when in a socially stressful situations. Is your social anxiety tied to specific social situations.> > The flavor of my SA is near panic attack when in social situations. This includes facial trembling, blushing, sweating, heart rate increase, voice shaking, etc. I have anxiety at work (in meetings or in interactions with superiors). I even have to work hard to control my anxiety at my daily meeting with the 12 people who work for me, who I know well. The thing that drove me to seek help was the facial trembling which I began to think was impacted my career (which has been somewhat successful). The facial trembling causes the selfconsciousness and this seems to bring on the other symptoms.
Outside of work, socially, I feel significant anxiety around other adults, even when my wife and I go out to dinner with intimate friends. The more people we are with, or the less intimately I know them, the anxiety skyrockets.
Do you feel detached from others. Do you have a strong sense of shame combined with low self esteem. You get the idea, describe what your social anxiety feels like to you.
> >Yes, in general I feel detached from others and I feel much more comfortable alone (other than knowing that I am missing out on life). I do have a strong sense of shame and low self esteem (I am coming to realize). When around others, I feel and intense pressure to say or do the right thing and to not be rejected.
>
> Without medication, do you have any sleep problems- over or under sleeping.> > Yes, without medication I would go to sleep quickly but would wake up every night around 1 AM and could not get back to sleep. I was averaging 3-4 hours per night.
>
> Did buspar help you?> >Buspar seemed to have no effects, positive or negative. At the time I started to worry about taking multiple drugs.
>
> Paxil improved your sexual function. In what way. Isn't this unusual. Where would you rate your mood now on a scale of 10? How much has paxil improved your mood.> > Paxil improved my sexual function because it allows me to last longer, and my wife enjoys this. Also, my climax is more enjoyable, I think because I am firing out of 2 barrel vs. 1 for the first time in a long time. A positive improvement does seem unusual but many people have reported that paxil makes it difficult or impossible to climax and they have report unusual orgasms. My response may be a variation of that. My mood prior to paxil was -2. Paxil helped my depression and my mood was about a 6. When I added adrafinil my mood increased to an 8 and confidence increased.
>
> Why are you taking piracetam. For cognitive enhancement? Do you have cognition problems. Has it helped. By the way, adrafinil and piracetam may share, in part, the same biological mechanism of action.> > >I have not taking piracetam but I have read about it and I was considering it, possibly for and alternative to adrafinil (when I was having difficulty optaining the adrafinil) for improved mental alertness. I was curious if people have had effective results with piracetam. The trazodone really gives me a good night sleep but makes me foggy in the morning hours.
>
> Have you tried any other arousal agents or stimulants besides adrafinil (i.e. Welbutrin). What was your response.> > Not for a few years. When I did, it was a diet pill (one of the stimulating phens). I was taking it for weight loss but it did increase my physical and mental energy and improved my mood/confidence. However, it made me more apt to lose my temper quickly.
>
> And perhaps the most important questions of all; in what way has adrafinil helped your social anxiety, how much social anxiety remains, and what is the kind of anxiety that remains?> >When I had the adrafinil in my system (with Paxil and traz for sleep) I felt more mentally alert and confident. I was more apt to speak up in meetings, out of apparent instinct, rather than the usual gut wrenching decision making process that usually proceeds speaking up. I felt better. When the left my system the paxil was still better than no medications. What type of anxiety remains when I am taking adrafinil? A similar, yet much less intense form than without.
>
> The reason I ask all these questions is because there are a lot of directions you can go medictation wise to treat social anxiety. The answers you provide though may give a clue as to what anti-anxiety med or combo will work best for you.
>
> > bless you> I have finally got my social anxiety under control, but relief hasn't come for me via the standard anxiety meds. I offer my expereince as encouragement to others. Relief for your social anxiety most likely is out there but it helps to understand your sub type of social anxiety and then be willing to experiment with different meds. Fortunately most anti-AD meds are quick acting and trials can proceed rapidly. Your response to adrafinil is significant and perhaps is a clue towards gaining even a more robust response.
>
> > I really appreciate your thoughts and time. I would welcome any recommendations to obtain a normal life. I have told you more than anyone, about my problem.
> Best wishes,
>
> Bill
poster:Billb
thread:42531
URL: http://www.dr-bob.org/babble/20000811/msgs/42624.html