Mental Health Meds for social anxiety (I'm so angry right now)

[ebola?]

BUT... I can't figure out either whether being on 2mg sub a day means that the dose is low enough to make additional benzo not dangerous, or whether the fact that I'm on 2mg and get high off it, means that my tolerance is so low that I would get in trouble with benzo added.

Eh...with careful titration, it will be possible to take small enough doses of each to come out okay. However, what if you get unexpectedly impaired and make some judgment errors that lead you to wander into danger? This is pretty common with benzos. . .

ebola

 

[AnrBjotk]

Eh...with careful titration, it will be possible to take small enough doses of each to come out okay. However, what if you get unexpectedly impaired and make some judgment errors that lead you to wander into danger? This is pretty common with benzos. . .

ebola

What kind of danger? Losing control and loading up on carbs?

 

[ebola?]

getting too fuzzy, taking another benzo to get more buzzed, wandering into sloppy partial amnesia, taking another benzo, forgetting you redosed, taking another....and so on and so forth. In a way, benzos can sometimes be really subtle in terms of perceived strength of effect and perceived impairment until you are already in sloppy mess, partial amnesic territory. The main risk is doing some stupid shit, but mixed with another compound, also OD'ing.

ebola

 

[AnrBjotk]

getting too fuzzy, taking another benzo to get more buzzed, wandering into sloppy partial amnesia, taking another benzo, forgetting you redosed, taking another....and so on and so forth. In a way, benzos can sometimes be really subtle in terms of perceived strength of effect and perceived impairment until you are already in sloppy mess, partial amnesic territory. The main risk is doing some stupid shit, but mixed with another compound, also OD'ing.

ebola

That's true. There's no way of foreseeing that though. Maybe. I used to buy benzos illegally and take them once a week, every sunday, so I could sleep through the entire day and thus save money on opiates that day. But maybe if I took them for awake-time, things could happen...
It's moot anyway, I guess. Either I get them or not. Either way it's bad or good. If I don't get them maybe my anxiety will get worse - or maybe not - and maybe if I get them they will help me, or I'll abuse them, in which case I wont get them anymore... I guess.
Guess I'll try the Buspar a little more.

 

[AnrBjotk]

I'm pretty sure my doc mentioned Atarax last time. So I guess that's next on the list.

 

[ebola?]

mirtazapine already exerts Atarax's main effect quite well (histaminergic agonism), so I wouldn't expect much.
Sorry to be prodding, but did you read my suggestions? Are you irrevocably set on trying medications and no other approaches to treatment? If so, why?

ebola

 

[AnrBjotk]

mirtazapine already exerts Atarax's main effect quite well (histaminergic agonism), so I wouldn't expect much.
Sorry to be prodding, but did you read my suggestions? Are irrevocably set on trying medications and no other approaches to treatment? If so, why?

ebola

So atarax is useless since I'm on mirtazapine?
I read your suggestions. But like I said, therapy hasn't worked for the ten years I've tried and even my shrink is giving up. I just want relief so I can try and improve things for myself. For me that's the point: I wanna buy time to create a better environment.

 

[phatass]

hydroxyzine (Atarax) is an weak anxiolytic that acts within half an hour like a benzo but tolerance develops extremely quickly. If you can't get any benzo's (even something like oxazeam or prazepam etc; that have very little rec. value) you could maybe try an SNRI like "effexor" (yes the W/D are horrible, but less so than benzos for sure) with hydroxyzine to take "as needed".

Most psychiatrists do not prescribe benzos (i have my theories on why but that's another story), and very very few of any kind of doctors prescribe opioids AND benzos (especially valium or xanax).

that is from a "chemical" approach, what you probably don't want to hear is that in the long term a good psychologist will probably be more useful, allthough I do absolutely understand that when you have crippling anxiety, and need something "now" a benzo seems 100 times more needed in the short term than anything else

edit: hadn't seen about the mirtazepine

 

[AnrBjotk]

hydroxyzine (Atarax) is an weak anxiolytic that acts within half an hour like a benzo but tolerance develops extremely quickly. If you can't get any benzo's (even something like oxazeam or prazepam etc; that have very little rec. value) you could maybe try an SNRI like "effexor" (yes the W/D are horrible, but less so than benzos for sure) with hydroxyzine to take "as needed".

Most psychiatrists do not prescribe benzos (i have my theories on why but that's another story), and very very few of any kind of doctors prescribe opioids AND benzos (especially valium or xanax).

that is from a "chemical" approach, what you probably don't want to hear is that in the long term a good psychologist will probably be more useful, allthough I do absolutely understand that when you have crippling anxiety, and need something "now" a benzo seems 100 times more needed in the short term than anything else

edit: hadn't seen about the mirtazepine

I was on Effexor for about a year. I just couldn't take it though. Apart from making me practically impotent, it didn't "do" anything for my depression. By the time I discovered heroin and sub I started weaning myself off Effexor slowly. It was hell anyway though, but with extremely slow tapering I got through it. I'll never "do" Effexor again. Awful, awful stuff.
I'm glad I'm off SSRIs and SNRIs. Remeron is only for sleep, and the sub takes the brunt of the depression. I just need something for the anxiety and I'll be close to "normal".

 

[phatass]

There are two main exceptions to what I said about medications:
1. Benzodiazepines may be used as adjuncts to facilitate exposure therapy. The trick is to employ such only temporarily and sporadically, and you need to teach yourself that you are becoming more comfortable in social situations, not that a drug is 'fixing' what ails you. Sparing use is necessary for the benzos to retain efficacy w/o increased dose. Also, benzos neuropharmacologically hinder the ability to learn new associations in one's environment (this is a mild manifestation of the blackout amnesia seen with high doses), so benzo doses must be quite limited. All this is empowering: it's great to know that you are mastering engaging the world healthily and comfortably, rather than requiring some 'exogenous shock' to do so.
2. Beta-blockers tend to be mildly to moderately effective. They suppress the physiological correlates of anxiety, which play a role in the body-mind feedback loop of self-monitoring that undergirds much of the experience of anxiety. They tend to retain efficacy and are not habituating.

This is what worked wonders for me.

ebola

^^This

 

[AnrBjotk]

^^This

Sounds good to me. If it was up to me, I'd collect one benzo a week - one to take for every night class I have, and the rest of the week I'd stay inside. As for beta blockers... aren't they bad for the heart or something? But I could bring it up to my doc. Doesn't Inderal also block "stage fright"? If it would stop me from shaking, sweating and being "frozen" I'd take it.

 

[dopemaster]

I have noticed a couple things people said and would like to add some input.

First of atarax aka hydroxyzine is and antihistamine which I take during pollen season for allergies. I really have never noticed any time of anti-anxiety properties too it. That is pretty much off-label prescribing for anxiety in the OP's case.

Secondly I have been on a high dose of benzos for ten years and they have never ceased to work for my anxiety so I dunno wtf people and doctors say about them not working after a while. Over the years my dose has not gone up very much at all. Once I got to the point where I needed to be I was fine.

That being said I suffered from lifelong panic disorders though the cause was most likely due to post traumatic stress from my childhood.

Third the maintenance drug that is extremely dangerous with benzodiazepines would be methadone not suboxone. Is there a possibility your doctor does not know their shit or have you been labeled an addict? Being labeled an addict is a surefire way to not be prescribed narcotics. If that happens a person can always choose not to release their medical records to a doctor.

Most importantly I am definitely not at liberty to give you medical advice or dose advice as everyone's body reacts differently to drugs. I can really only relate my experiences and you can infer what you want from them.

 

[spork]

^That last bit is extremely important to remember. Psychiatric medications differ so much from person to person in their effects. It might take a lot of trial and error and lots of patience as well to find the right treatment or combo that works for you.

 

[AnrBjotk]

I have noticed a couple things people said and would like to add some input.

First of atarax aka hydroxyzine is and antihistamine which I take during pollen season for allergies. I really have never noticed any time of anti-anxiety properties too it. That is pretty much off-label prescribing for anxiety in the OP's case.

Secondly I have been on a high dose of benzos for ten years and they have never ceased to work for my anxiety so I dunno wtf people and doctors say about them not working after a while. Over the years my dose has not gone up very much at all. Once I got to the point where I needed to be I was fine.

That being said I suffered from lifelong panic disorders though the cause was most likely due to post traumatic stress from my childhood.

Third the maintenance drug that is extremely dangerous with benzodiazepines would be methadone not suboxone. Is there a possibility your doctor does not know their shit or have you been labeled an addict? Being labeled an addict is a surefire way to not be prescribed narcotics. If that happens a person can always choose not to release their medical records to a doctor.

Most importantly I am definitely not at liberty to give you medical advice or dose advice as everyone's body reacts differently to drugs. I can really only relate my experiences and you can infer what you want from them.

I certainly have been labelled a addict. That way I get the sub for free for as long as I need them.
So, I know chances are slimmer, if not non-existing, that my doc, or any doc, will give "narcotics" or benzos. However, if I have tried and failed all the other drugs (which seems unlikely, really) then surely benzos should be tried. As a last resort, providing that they do not cause respiratory failure or such.

Could we try and compile all the drugs imaginable? I know there are list on wikipedia, but I'd love an annotated list. Like:

Buspirone: New medication, purported to work like benzos without the addiction and drowsiness. But rarely effective.
Atarax: Antihistamine with anxiety reducing side effects.
Inderal: Heart medication with anxiety reducing side effects.
Effexor: SNRI for depression and anxiety.
Remeron: Antidepressant for depression and anxiety (in my case No anxiety effect, apart from Extreme anxiety when "WDing" from them.)

 

[Hector]

I've tried so many medications for anxiety and depression i've lost count and i've yet to find one that helps in the long term. At the moment i'm on Lamictal to treat my epilepsy which also acts as a mood stabliser but it does little to treat my anxiety. Recently, in my search for the holy grail of anxiety relief i've come across some rave reviews about the MAOI drug Nardil. Type it into google and you'll find lots of testimonials from social anxiety sufferers claiming it's a wonder drug.

I'm trying to get it prescribed but finding a doctor who is willing isn't an easy feat. I spoke to my doctor and he said he hasn't prescribed it in over 25 years. There are a lot of dietary restrictions, unpleasant side effects including hypomania and fatal drug interactions. Nevertheless, i'm willing to take the risk and as an adult i believe i have the right to make that decision. If the doctors won't help, i might have to help myself. Believe me i've tried many alternatives, i've practiced CBT techniques, read countless self help books, sat with the fear by regularly putting myself into anxiety provoking situations and i've self medicated with disastrous results most likely only making my anxiety worse.

At the moment i'm rarely leaving the house, i'm in that victim, all is hopeless mindset. I've given up completely several times before but failed. I'm ashamed to admit that but when the pain becomes too much and you don't have the resources to cope it seems like the only solution.

I don't want to just exist, i want to live my life but when you're governed by fear which i recognise is mostly irrational try convincing my stubborn head otherwise. Perhaps i just have to accept that this level of anxiety is what i have to learn to live with but that's easier said than done.

 

[Transcendence]

Just my two cents: I've relied on benzodiazepines to control my now crippling anxiety. Mine is not so much social, but more somatic (if that makes any sense). I've gone through a lot of different benzos. They all help enormously at first. Earlier in the year I received a long term prescription for clonazepam, something I thought that no psychiatrist would readily prescribe.

At first it was pure relief. After a couple months they stopped working as well, and by six months I might as well have been taking pez. That's when I stopped. Benzos are so appealing for those of us who are bombarded unceasingly with anxiety. They stop it instantly and effectively, no fucking around. And then they stop working. And then you increase your dose. And then that stops working. After a while your doctor will no longer increase your dose out of fear of losing his medical license. Then you are stuck on the highest medically acceptable dose and even that stops working. And it's extremely difficult, almost impossible for some, to wean off at that point because your GABA receptors are so down regulated at that point.

I've been on that path, I've seen others on that path. You don't want to walk it. Really.