What to do about severe anxiety disorder and people thinking you're up to something?

[Dave]

Have you seen a psychologist by any chance? GPs are notorious for not keeping up to date with psych meds, and psychiatrists are (for the most part) just walking prescription pads. Meds tend to treat symptoms rather than causes, particularly with depression and anxiety disorders. I've had a long struggle with depression, GAD and social anxiety, and the only lasting relief that I've been able to obtain was from seeing a psychologist and treating the cause of the illness.

Therapies like CBT and EMDR have an excellent track record when it comes to anxiety and depression; often with better success rates than the related pharmacological interventions. I'd personally recommend talking to a psychologist, and seeing where that takes you.

 

[suessmayr]

I need to agree with apparently most of the posters here that benzos are only effective when used "as needed". If you take them daily for more than, say, a month, they often seem to produce rebound anxiety and put you back where you started (with the reservation that you will be even worse if you don't take them.

I also think you should see a psychiatrist and not a GP. GP's are fucken dipshits when it comes to these things. Most bluelighters seem to know more about this stuff than they do. So yeah, see a shrink.

I think a MAOI sounds like a good idea. But they really are the final treatment. You said you've tries SSRI's - what about SNRI's, dopamine-inhibitors, things like Avanza, or tricyclic anti-depressants? I think they would be logical things to try before going straight to MAOI's.

 

[BandOnTheRun84]

Find one that specializes in anxiety. I've been seeing a doc that specializes in anxiety for the past 6 months. He is somewhat liberal with the benzos, but he understands exactly what I need to function in society. I'm currently on 4mg Klonopin and 2mg Xanax a day. It used to be much less, but tolerance issues and what-not.

I can go into a supermarket or gas station without freaking out. I can hang around people I barely know without wanting to bolt.

I was lucky to find this doc, it was life changing. I hope you find something that works for you. Good luck!

 

[S.M.F.G]

Find one that specializes in anxiety. I've been seeing a doc that specializes in anxiety for the past 6 months. He is somewhat liberal with the benzos, but he understands exactly what I need to function in society. I'm currently on 4mg Klonopin and 2mg Xanax a day. It used to be much less, but tolerance issues and what-not.

I can go into a supermarket or gas station without freaking out. I can hang around people I barely know without wanting to bolt.

I was lucky to find this doc, it was life changing. I hope you find something that works for you. Good luck!

I am in the same boat as described above in alot of ways, Im seeing a psycotherapist which helped moreso than the psycologist... Having to agree with the above post benzos if used properly eg: once in a while when things start to get too much but its easy to loose it on the benzos.... I can dig the tollerence thing as my anxiety has caught up2 my 6 mg of xanax per day, but i can function, get my kid ready 4 school walk 2 km a day and keep up housework. im also on a trycilic anti depressant which IMO is far better than SSRI'S or MOAI's i had to juggle lots of different ones till i got onto one that has actualy helped me somewhat (well it feels that way depression wise). Whatever happens friend you can get thru this wil be keepin an eye on tha thread loo foward to hearing any updates

 

[ferinox]

I was honestly shocked to see this thread up again. My anxiety is being controlled very effectively by mirtazapine. I was the one who suggested it to my doctor.

 

[alexthealien]

imo using drugs aren't going to defeat 100% of the problem...but they might help out a lot...but the problem comes when you don't have the drugs...i have social anxiety and as much as i want to take a benzo every time i go out i don't. i limit myself, because i know it's only going to make it even worse in the long run. a lot of times when i do need a drink, benzo, etc...i'll skip it in hopes that it'll make me stronger and the more i do it the better i'll be. if i go on a first date with a girl idk very well, or a speach to a class (even here i try not to unless i really need it) i might take a kpin...but other than that i try to save all my benzos for drug comedowns lol

 

[alexthealien]

those with anxiety...if you don't take your medicines/drugs and you go out somewhere in public what do you fear? what gives you anxiety? what thoughts are going through your head?

 

[suessmayr]

I find that it's never really thoughts as much as feelings. There doesn't seem to be any real cognitive content to what happens - I just feel dread/doom/fear and feel that I need to bail ASAP.

To the OP - interesting about the Avanza. It was actually my suggestion that you give that a go before MAOI's. How much are you on?

 

[Dave]

alex-- Maladaptive anxiety isn't rational. There may be a focus for it, or there may not. Part of the issue for me was fixating on 'wardrobe malfunctions': fly is undone, forgot to wear pants (seriously), and worst of all: sweat spots on my shirt. The last one was a doozy, because I'd get anxious about sweating, which would cause me to sweat, which then would increase the sweating, thus increasing my anxiety. And so on.

Often though, for me at least, the anxiety wouldn't necessarily have any focus. I'd go to a party for example, find a place to stand, and just pretty well freeze in place. Deer in the headlights. If someone spoke to me, I could respond, and if they had enough skill to keep it going, a small conversation might ensue. More often than not, I'd just not be able to think of anything to say or do. Meanwhile, my mind would be racing, usually with negative self talk.

 

[Legerity]

those with anxiety...if you don't take your medicines/drugs and you go out somewhere in public what do you fear? what gives you anxiety? what thoughts are going through your head?

My anxiety is magnified in social situations but it's pretty much anywhere that the thoughts can start to fly. Usually concern about judgment of others, analyzing past situations, trying to figure out what the "right" decision is, etc. If it's in a group it just becomes worse because I don't really like group dynamics. I like one on one conversations and in groups it usually seems like everybody is just shouting out to have their own voice heard. If I'm eating with others I'll start to become concerned that there's something stuck in my teeth, etc., and just feel more uncomfortable.

The thoughts just come so sometimes all there is to do is not believe them. Although I do prefer to change the direction of my thinking if it is possible.

 

[ferinox]

I find that it's never really thoughts as much as feelings. There doesn't seem to be any real cognitive content to what happens - I just feel dread/doom/fear and feel that I need to bail ASAP.

To the OP - interesting about the Avanza. It was actually my suggestion that you give that a go before MAOI's. How much are you on?

I've been on 30 mg for a couple months. I'm not exactly sure why ADs with specific serotonin actions aren't becoming more widely used. It's much smoother in terms of side effects bc it antagonizes the serotonin receptors responsible for lower sexual function, appetite decreases, and nausea among other side effects. Some serotonin receptor subtypes actually increase anxiety which is why SSRIs can exacerbate anxiety. Mirtazapine has much lower side effects than SSRIs and is much more effective from my experience with it.

Before mirtazapine I tried SSRIs, tricyclics, and bupropion. I'm going to try putting Selegiline in the mix to help me quit smoking and maybe it will reduce some anhedonia symptoms I still have. I don't want to take chantix bc of the possibility it could exacerbate mental illnesses.

 

[Ixchellian]

I'm going to try putting Selegiline in the mix to help me quit smoking and maybe it will reduce some anhedonia symptoms I still have. I don't want to take chantix bc of the possibility it could exacerbate mental illnesses.

Buproprion is marketed as Zyban, as a smoking cessation tool. It works effectively by blocking the nicotine receptors, and fights the quitting-blues by being an NDRI. However, I'm unsure of it's usefulness while being taken with other psych/smart meds.

Just for many of us, it makes cigarettes taste plain nasty, even if we do try to smoke...... and no insane chiantix dreams.

 

[Legerity]

^Have you been able to quit smoking using it?

 

[ferinox]

Buproprion is marketed as Zyban, as a smoking cessation tool. It works effectively by blocking the nicotine receptors, and fights the quitting-blues by being an NDRI. However, I'm unsure of it's usefulness while being taken with other psych/smart meds.

Just for many of us, it makes cigarettes taste plain nasty, even if we do try to smoke...... and no insane chiantix dreams.

selegiline actually has more impressive cessation statistics than bupropion. MAO b inhibitors are more effective at replacing dopamine deficit from quitting smoking. It's safe to combine with serotogenic drugs because it's highly selective for the b subtype at low dose levels. For a shotgun approach, you could also include mecamylamine a nicotinic antagonist. That combo would likely be very effective. I would have to check to see if remeron,selegiline and mecamylamine would all be safe in combination though. From the top of my head I don't see why not. When I try I'm only going to use the remeron and selegiline though.

 

[Ixchellian]

selegiline actually has more impressive cessation statistics than bupropion. MAO b inhibitors are more effective at replacing dopamine deficit from quitting smoking. It's safe to combine with serotogenic drugs because it's highly selective for the b subtype at low dose levels.

Impressive..... according to who?
Anecdotal evidence from a few study groups? Your own opinion?

Buproprion already has already proven itself on the market to be a safe tool for quitting, while still being effective for a large reported percentage of patients...... and while also lacking dangerous interactions.

Now for my opinion:
Using MAOI'Ing drugs to quit smoking is akin to using a howitzer instead of a sledgehammer to take down a wall.... but when all that's needed is a reciprocating saw.

.....The right tool for the job, and all that..... just because someone can, doesn't mean they should, or that it's safe for everyone else.

^Have you been able to quit smoking using it?

Yes.
Within 3wks, I lost even the ability to smoke..... to even try would give me an almost instant headache, and usually a cough/gag reflex.
Secondhand smoke just smells really icky, but doesn't induce headache...... which is nice cuz I still like bar food.

The only disagreeable thing I noticed personally, is that buproprion makes it tough to fall asleep if I took it close to bedtime.

 

[ferinox]

Impressive..... according to who?
Anecdotal evidence from a few study groups? Your own opinion?

Buproprion already has already proven itself on the market to be a safe tool for quitting, while still being effective for a large reported percentage of patients...... and while also lacking dangerous interactions.

Now for my opinion:
Using MAOI'Ing drugs to quit smoking is akin to using a howitzer instead of a sledgehammer to take down a wall.... but when all that's needed is a reciprocating saw.

.....The right tool for the job, and all that..... just because someone can, doesn't mean they should, or that it's safe for everyone else.



Yes.
Within 3wks, I lost even the ability to smoke..... to even try would give me an almost instant headache, and usually a cough/gag reflex.
Secondhand smoke just smells really icky, but doesn't induce headache...... which is nice cuz I still like bar food.

The only disagreeable thing I noticed personally, is that buproprion makes it tough to fall asleep if I took it close to bedtime.

Wow you seem to have a little bit of an asshole tone there. Maybe I'm reading your post wrong. I'll give you the studies right here:http://www.medscape.com/viewarticle/448363 and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC351853/figure/fig4/. There is an advantage for selegiline based on the time periods. Selegiline is far more tolerable for me than bupropion though. Maybe you're confusing nonselective monamine oxidase inhibitors with selegiline. Monamine oxidase type b inhibitors like selegiline are far safer than nonselective ones like parnate and nardil in terms of dietary and medication interactions. I've heard many people say that bupropion was awful. It's all dependent on the person. Combining selegiline with mecamylamine would probably prove to be a far better cessation aid than bupropion, that part is my opinion though.

Many people take selegiline just as a smart drug. It's not as dangerous as you're making it out to be. I've been on bupropion and seleginine but never tried to quit smoking on either. I just made my choice on what will work better for me. Bupropion isn't that great at increasing dopamine levels, dopamine has been neglected because of the bs serotonin hypothesis. There's not to many dopamine options on the market. I wasn't pushing it on anyone but some people can't tolerate bupropion or chantix. I was adding another option to the table for those people.As I said I also have residual anhedonia left over which I hope deprenyl will smooth over.

You'll have to type the medscape link into google to view the article unless you have medscape account for the deprenyl link. Any further discussion of selegiline, I'll say deprenyl bc I'm sick of typing selegiline.

 

[Ixchellian]

Wow you seem to have a little bit of an asshole tone there. Maybe I'm reading it wrong. I'll give you the studies right here:http://www.medscape.com/viewarticle/448363 and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC351853/figure/fig4/. There is an advantage for selegiline based on the time periods. Selegiline is far more tolerable for me than bupropion though.

You're right, that is just your impression.... and since you don't know me, and have never met me....... I suggest keeping your personal opinions of others under wraps or by PM.

Maybe it's just me, but I like to see citations when conversations start getting this technical. There's been a rash of drug-experts on the boards with degrees from the university of wikipedia, ctrl-c/v-ing around regurgitated erowid citations..... and doing it while either sounding like professional chemists, or just drug-enthusiasts tuning their brains like sports-cars....

My bad for trying to weed out plagiarism and faulty information.

And no, I haven't confused confused the types of MAOI drugs. Selective or not, they're still far more touchy than other, more stable, options.

 

[ferinox]

You're right, that is just your impression.... and since you don't know me, and have never met me....... I suggest keeping your personal opinions of others under wraps or by PM.

Maybe it's just me, but I like to see citations when conversations start getting this technical. There's been a rash of drug-experts on the boards with degrees from the university of wikipedia, ctrl-c/v-ing around regurgitated wikipages, all while sounding like professional chemists.

I apologize, It just seemed like you were completely convinced that I was pulling them completely out of my ass. I got defensive accordingly. I indicated I was unsure whether you were being arrogant or just asking for evidence. I'm sorry and you do have to be careful online about who you listen too. I'm just going through a ton of bullshit and you didn't deserve the brunt of my irriatibility. I did link to studies on the cessation rates and explained that MAO b inhibitors are safer. I can link you to the evidence on that as well if you would like. I would hope that people that failed with bupropion or chantix would try deprenyl bc it does have quite compelling evidence building. The important thing is people quit smoking which is far more harmful than deprenyl or bupropion.

 

[ferinox]

My bad for trying to weed out plagiarism and faulty information.

And no, I haven't confused confused the types of MAOI drugs. Selective or not, they're still far more touchy than other, more stable, options.

I just apologized before you made that edit. I said your tone was assholey, I said nothing about you as a person. That is your opinion,by the way, about the safety if MAO b inhibitors on low dosages which is what I recommended. It's not faulty information. It's not like you're backing up all your claims with a ton of citations. I would rather see somebody take deprenyl with medical supervision than have somebody risk suicidal ideation from chantix. Where the hell does plagiarism come into this mix? You can't trust your judgement either when you're angry. My bad for giving people additional options to quit smoking without presenting 50 studies.

Here's a study on deprenyl combined with ADs:http://www.ncbi.nlm.nih.gov/pubmed/9167831

The adverse effects were typical of AD monotherapy. Isn't it funny how you're accusing me of making unfounded claims? but I'm the only one producing any evidence in this discussion to back my claims.

Here's a study that indicates low dose deprenyl is safe and tolerable:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2249821/
The study I posted above on deprenyl and smoking cessation also indicate deprenyl was well tolerated at the 10 mg dose level. It said hypertensive crises are only caused by higher dose levels.

 

[Ixchellian]

See how the misinterpretation and lack of psychic ability works both ways on the internet?

It doesn't matter if you tacked the word "tone" onto the end, if your main descriptor is "asshole".
What matters is the apology and correction with links... since that's usually too big order for most egos to get around. You swallowed enough pride to do so, and the ability or willingness to do so is a valuable life skill that imho is lacking nowadays.

- I provide citations when I need to support or critique very technical data.... and I don't do that here in TDS often at all. This isn't the Advanced Drug Discussion forum. If you use the search-button right, you'll find I do provide links or notes as needed to support my premise.... or if it's my own lay experience, I include a disclaimer to that effect.

And this line of conversation between us is over. You're touchy and upset lately; I'm very coarse and exhausted; along with that, shitty timing & inferrential empathy just doesn't work on the internet.

Let's save everyone else's time by not clutterfucking this thread with techy-minutae, intellectual property discussions, and generally getting pissy with each other..... because that's exactly where it'll go if we keep at it.