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My therapist who uses a CBT approach told me the other day that the only way to truly conquer my fears is to completely get off of my medication and face it head on without chemical help. He is recommending that I titrate off all my meds. I am currently taking 5 (lithium, propranalol (beta-blocker), baclofen (anti-craving med for a past alcohol problem), ambien, and klonopin (benzo). I had actually suggested that I get off all my meds because I don't believe they are helping that much. In short, the negatives (side effects) far outweigh the positives. I will ask him this question i my next session, but if he wants me to get off all meds then that means that my SAD stems not from a chemical imbalance but strictly from major distortions in my perceptions. Is this correct? He doesn't know my history well enough to make that assumption. I have only seen him 4 times. It's already been ruled out that I don't have bi-polar so I don't need the lithium. It makes sense though that since the benzos don't help me relax during a social situation that a deficiency in GABA does not plays a role in my SAD. I'm not even sure what I want to ask in this post. I guess, I am really beginning to think that he is right since I have been through a full battery of psychotropic drugs for several years without much help. Maybe I need to stop trying to fight and hide from my fears, and slowly learn to comprehend that there really is nothing to feel threatened about in simple social interactions. If I appear nervous to someone else, or say the wrong thing, or stammer, or if someone makes a critical comment, then so the hell what. If I learn to let go and just live life and realize that all my negative feelings are caused by me and no one else, then that would eradicate my SAD. No one can hurt me emotionally but myself. If someone says something bad about me then it MY thoughts that cause the pain. No one has power over MY emotions but myself. Maybe the best that I can hope medication to do is offer me another hiding place to escape from the real issue. Bi-polar disorder, schizophrenia, severe depression, yeah there are a lot of disorders that a chemical imbalance makes sense. But, the only time I feel uncomfortable is when I enter a group of people. It's hard for me to see the chemical imbalance in that. I don't know. Does anyone have any thoughts? I just thought I would write what's on my mind now. Thank you in advance for your input.
 

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It sounds like your therapist has a lot of bias against taking medications to treat your mental illnesses. The therapist doesn't go through what you do or can even imagine what we feel like. I remember my CBT doctor suggest me to just put on an audiobook, walk around town and I'd feel more relaxed.

I think at least some of those meds are supposed to help relieve some of the symptoms associated with your SAD. So you can still practice what you learn from CBT and take medication. What I mean is that it's not like they are canceling each other out- they are meant to work together. If you abused alcohol to relieve anxiety or to help you sleep, I'd imagine it be even more important to stay on some meds because it might make you more inclined to drink again.

I know how you are feeling. I'd get frustrated too. I've taken a lot of different meds and nothing seemed to really work for me. I get bad physical pain and fatigue along with my anxiety. I don't really have an answer for what works, but I just don't want you to make too quick a decision like I would do when taking meds. If you don't feel better, maybe try to see if your doc will up the dose of your benzo or try a different one.
 

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If medication works, specifically SSRIS etc then you have a chemical imbalance. Ideally though you use both behavior psychology techniques and medication until you are better, I distrust any psychologist that favors either one. You need a combination to get better, I believe. Good luck.
 

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In short, no. No problem as complex as SA can be determined as being solely a result of one thing in the brain such as a chemical imbalance. How about personality? It cannot be said that personality plays no role in SA. That would be farcical in my opinion.
 

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Take alcohol => supresses SAD
Take drugs => supresses SAD

There has to be some kind of chemical imbalance that causes this otherwise why would alcohol and drugs be used by most SAD sufferers.

The important thing to note that most of the SAD drugs are used to treat depression. The only thing that works is cognitive therapy AND isolating yourself from people that know you have something wrong with you (i.e. go find a new bunch of people to hang around).

LEARN how to small talk and start chatting with strangers...it helps, alot. The initial barrier to approach someone can be broken by saying to yourself that everything happening at the moment in time is due to SAD.
 

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Well studies show that taking both meds and receiving therapy simultaneously is the best approach. 5 different kind of meds seems like way too much though in my opinion.
 

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I find the "chemical imbalance" explanation highly dubious.
 

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the brain is such a complex organ, that you cant just point at one cause. it may be a chemical imbalance that causes one to initially feel the way we do, but at the same time, it's also thought patterns and downward spirals which are to blame. you cant just treat one without treating the other, or you'll spiral.
for example, i'm currently on citalopram, an SSRI anti-depressant. the doctor's and also my counsellor's reasoning behind this, is that i'm not going to be able to break the negative thought patterns (whatever caused them, chemical or other wise), if i'm feeling depressed, as the feeling depressed part can cause more spiraling. so, as the depression can be relieved with drugs, that can break the cycle, and make the recovery process easier/quicker. but it would be pointless being on the drugs without the right type of therapy. as depression feeds SA, and SA feeds depression, why fight one and not the other.
so what i'm getting at, is in my point of view, chemical imballance or not, as a cause, drugs CAN help, if the therapy is right. but also, how is the therapy going to help, if your drugs ARENT? as people are all different, there really is no simple answer.
talking with your doctor about you drug related concerns, and you therapist (or get a new one who understands better? coz some are useless) about you cognitive concerns, and get the 2 treatments working together.
i'm sure you will find the balance in time :)
all the best!
 

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...If I appear nervous to someone else, or say the wrong thing, or stammer, or if someone makes a critical comment, then so the hell what...
:ditto :yay :agree

I love this sentence. I bet you could come up with a whole list of "so the hell what" sentences.
 

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Chemical imbalance is a marketing term used to sell meds. As for meds, yes, they can help. We know so little about mental illness and its biology it seems absurd to take some sort of reductionist approach towards treatment.
 

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In my own case, I feel that it is caused by a chemical imbalance. I never suffered from it until 2002 when I was almost 42 years old. It hit with a vengeance and without warning. I suddenly began having panic attacks and irrational mood swings. I remember watching "Sister Act 2" and crying through the whole thing. I would stare at the phone every time it rang, too afraid to answer it because I "knew" who was calling. Coincidentally, this is just about the time that menopause would set in if I was female. Anxiety was then intensified by my anticipation of anxiety. Followed by depression. I was in therapy for a while and he determined that there had not been any traumatic event or environmental cause. I went on paxil which did not alleviate the anxiety but did dull it down to the point where I could learn to cope with it. I'm currently almost anxiety free but do understand my triggers and how to avoid them.
 

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Chemical imbalance is a marketing term used to sell meds. As for meds, yes, they can help. We know so little about mental illness and its biology it seems absurd to take some sort of reductionist approach towards treatment.
I tend to agree. Doctors and therapists are all too eager to diagnose you with a "chemical imbalance." I totally do NOT think I have one, and I've asked for them to prove it to me that I do. I say if it's a biological problem, then prove it to me biologically, but they don't....(I tell them I understand I might be wrong, which is fine, but I want proof--one way or the other) They just clam up.

I do take xanax once in a while, but only because it works (sometimes) in the situation I'm in. My brain isn't causing the anxiety, I LEARNED it. So I believe I have to UNLEARN it. It's so bad tho, that I have to use a little medication to do much at all. I use medication for the behavior part, not the thinking part. I don't believe there's anything wrong with my brain, it's how I use it.

I do not believe SA is a "chemical imbalance".
I think it's a combination of irrational thinking, obsessive worrying, low self-esteem, and a view of oneself that is heavily influenced by what we think others think of us.
In a way we focus so much on ourselves, (altho it's not selfish, like a narcissist), but what we should be focusing on when it comes to ourselves is our own opinions, feelings, and thoughts. Make them count, give them weight--not other people's!

PS: I think if a person is depressed, that should be helped first. I just said to make your own opinion count, but if you are depressed, your own opinion might be a sucky one, in which case, get help with being able to think positively about yourself in the first place.

I hope no one is too offended by my anti-medication stance. I took Paxil for 3 yrs and felt, not better, but like a zombie. And then I tried welbutrin, and ended up in the ER 3 times in a week because of a toxic reaction to it and it wasn't flushing out of my body. I don't have good luck with meds. I believe whatever works for an individual, should be used. But it should be the person's choice, and not forced on them.
 

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I agree with many of the insightful comments made on here so far. (Thanks everybody for posting--it's really helpful!) Medication will never be the sole answer in treating SA or any other mental illness. That said, medication may be necessary to treat some of the symptoms so that you are able to do the necessary work to attack the core issue. (By this statement I guess I revealed my belief that the "core issue" is not a chemical one; maybe this is not true for other mental illnesses, but I think it holds for SA.) Obviously, depression goes hand-and-hand with SA, and I think medication may sometimes be necessary to treat the depression. But that's just the first step. The real work begins with CBT and other therapeutic interventions to treat the thinking patterns. I myself have never taken medication for depression or SA. Even without it, though, I've been able to make progress against SA. However, it has taken me a long, long time, and I sometimes wonder if I would have progressed faster if I had taken medication at some point (along with therapy).
 

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chemical imbalance? sure I think so. Combined with years of avoidance and perceived traumatic experiences. It starts off as a problem and soon becomes a habit.
 

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The only thing that works is cognitive therapy AND isolating yourself from people that know you have something wrong with you (i.e. go find a new bunch of people to hang around).
Interesting. It feels right to me and it makes sense that we need to essentially start again with new people.

Can you tell me how you know it works? Did it work for you? Have there been studies showing it?
 

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Because of the effects drugs have had on me, I believe SAD in some people is at least partly caused by the physical goings on inside the brain (wether this is actually a 'chemical imbalance' i dont know), not completely just the psychological goings on. of course just how closely the physical and psychological aspects of a brain are connected, science is yet to find out.
 
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