(copied over from old review system)
posted by gordonjohnson008
social anxiety background
when i graduated high school, i had low self-esteem, no self-confidence, no social skills, severe depression, severe acne, terrible social anxiety, and virtually no social life. I was suicidal. I knew something had to change, badly...
6 years later, i'm doing great. I have an amazing engineering job, live by myself on the west coast, have an extremely active and successful social life, am in great shape and am training for a marathon. Life is pretty good.
Being on 10mg of paxil makes me incredibly stable mentally and comfortable socially. Due to the skills i've picked up on paxil and klonopin, i may now be ready to quit meds entirely.
other treatments
klonopin, buspar, inderal, seroquel, parnate, nardil, emsam, lexapro, zoloft, st. John's wort, gaba, l-theanine, breathing techniques, exercise
in order of effectiveness:
Klonopin: Excellent, but intense drowsiness and memory problems. Quit this because it interfered with my work and i worry of the long-term effects.
Nardil: Very good, quit too early on to really evaluate due to unbearable side effects (unable to urinate, deathly tired, severe insomnia, etc.), hard to be on this with a normal college undergraduate's lifestyle due to the dietary restrictions
lexapro: Very good, made me significantly more tired and lethargic than other ssris so quit for that reason
paxil: Very good, exactly the right balance i needed, mild side-effect profile. Conquered depression completely and blunted sa to a very manageable level (i.e. 50% diminished or so). Great stuff.
Parnate: Good, quite activating, gave odd drowsy/insomnia cycles
zoloft: Good, did not seem to do as much as paxil for sa, worked like a charm for depression, similar s/e profile
st. John's wort: Okay, great for depression, very mild side-effect profile, but doesn't really do anything at all for sa
breathing techniques: Okay, didn't really do much for me. My problem wasn't my breathing but rather underlying fear of social situations. So these techniques just treated the symptoms i guess.
Gaba/l-theanine: Okay, helped quite a bit the first few days and then after that very minimal benefit. Drowsy/headaches from gaba, no s/es from l-theanine.
Buspar: Poor, did it do anything? Does it do anything? I'm not sure. Wasn't on it long
seroquel: Poor, made me stupid and sleepy, could not function at all. Why the hell my pdoc perscribed this antipsychotic to me i do not know, so i switched psychiatrists promptly.
Emsam: Very poor, very activating! Made me more nervous, was not on it long, very expensive, good for lethargic depression i guess
(so paxil is not the most effective med i've tried, but due to the side-effect profile it has the greatest effectiveness-to-usability ratio and is my med of choice)
treatment experience
the difference makers have been paxil and klonopin (with a couple cups of coffee a day to keep me awake during the week ). These medications allowed me to experience normal social interaction almost instantly. After being on them for a few years, i built up an aresenal of social skills and a high social iq. They also helped me develop naturally during my college years into the rounded person that i am today.
I gradually tapered down the meds. Now i'm only on 10mg/day of paxil and it helps me immensely. It's all i need. I no longer rely on klonopin (i haven't taken any in 2010). In most social situations these days i feel at ease and do great. Sa isn't 100% gone, but it's gone to the point that i am in control of my own social destiny (maybe 50% to 75% gone).
Besides medication, i've been aided by my positive outlook, dogged persistence, and rational thinking. Rational thinking is important. I take a step back and ask myself why i am so anxious, what is there to be anxious about. And then i feel silly because i really am okay and i realize my worrying is irrational. I realize i am doing great and should not really be anxious about social situations anymore. And this gives me confidence.
The normal starting does for paxil is 20mg/day. I'm on 10mg/day because it's all i really need to get the positive effects. Taking any more than this makes me tired, and i have a demanding engineering job where i need to be focused and full of energy every day. I've been on ads for ~6 years now, since my freshman year of college. I've tried nardil, parnate, paxil, zoloft, emsam, st. John's wort, klonopin, etc. I've found 10mg paxil to give me the greatest positive boost with the least amount of side effects.
Klonopin was clutch for allowing me to venture into new social situations fearlessly, without trepidation. I could stand in front of the class and give a speech, no sweat. Heck, i actually enjoyed it. With klonopin's aid i met my first girlfriend, got involved in student government, and went from being socially reserved to being very outgoing and making dozens of new friends. It was an amazing transformation. Now, i possess those same skills and outgoing tendencies without having to take klonopin at all.
I thought i would be on meds for the rest of my life. When i had summer internships in college, i realized there was no way i could continue to be on klonopin and still be successful as an engineer; it made me too drowsy. Therefore, i dropped down to just being on paxil. Now that i work full-time, i'm also in this boat. And i've realized that paxil is all i need now. I've gradually decreased my dosage down to just 10 mg/day.
Now, i'm thinking of dropping even the paxil. Though 10mg/day is a low dose, there are still some side effects. I need about 9 hours of sleep a day to feel fully rested. I still yawn some during the day and drink a cup of coffee or two during the day, which i would prefer not to rely on. There is mild urinary hesitancy which is annoying, and it makes me sweat a ton. So there are some minor side effects i'd mostly classify as annoying. In addition, it's unclear what the long-term effects of being on ssris really are. Some people have been on them for over a decade and seem fine, but others recount horror stories of ssri side effects that remain even after termination. I am particularly worried about memory and cognition-related side effects.
I see being on an ssri like paxil for many years as risky. Previously i was willing to take that risk, but now i think i may be able to drop the paxil and still function alright. I am probably going to go med-free for a couple months and see how i do. And if i feel my life is in order and i am doing pretty well without the med, awesome. If not, i'll go back to the 10mg and know that i am committed to taking a dependency on paxil, which may be risky, but which i feel is justifed based on the quality of life improvements it provides.
In sum, i'd like to thank paxil and klonopin for helping me realize a normal social existence and an amazing collegiate experience. I bid them adieu, and take comfort in knowing they are still there if i ever need my crutch again, but hope that is never the case. I will work towards that end. Here's to sobriety.