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Author Topic: Social Phobia / Anxiety  (Read 9782 times)

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Offline mmj520

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Social Phobia / Anxiety
« on: March 22, 2009, 10:06:09 PM »
Hi, new to this forum as a poster but have been reading it for the past few years since learning I was HIV+ in July 2005.

Prozac and neurontin are my current meds for depression / anxiety.  Not sure how I feel about Neurontin just yet, second month being on it, but second time.  First was in 2003 before knowing of the HIV+ issue.   

The one medicine that worked well for all  anxiety / insomnia was klonopin, but my psychiatrist decided one day he no longer prescribes controlled substances. Vistaril was substituted and while a great for sleep it is too sedating for anxiety relief during daytime.  I've been afraid to ask the regular MD for it.  I started smoking  indica strain mmj  and that eased any withdrawals from quiting a benzo cold turkey.

At this point, I rarely leave home except for absolutely essential errands and when my roommate forces me out.  Even though I am "doing well" with the control of HIV, the social phobia and the stigma of this mess I find myself in are overwhelming more often than not. 

Offline Miss Philicia

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Re: Social Phobia / Anxiety
« Reply #1 on: March 23, 2009, 02:46:28 AM »
Hi mmj520.  Several things -- first of all is social anxiety disorder you're official diagnosis, or just general anxiety disorder?  Second, you state that your use of neurontin pre-dates your HIV diagnosis so shall we assume your anxiety issues are not related to HIV?  Or is that prescribed for something else, because as far as I know neurontin is more generally used to relieve neuropathic pain.

That's too bad that your doctor has a phobia of klonopin.  I've been on it now for 8 years with no doctor balking at it.  One thing is for sure though is that it's not responsible to have a patient go cold-turkey of a benzo -- they should always have the patient slowly taper off the dose.

If it's particularly social anxiety why hasn't the doctor tried Paxil?  Though an SSRI class med it's used for that commonly.  Also are you attempting specifically Cognitive-behavioral therapy?

I'm not familiar with Vistaril.  I'll also assume that your prescribing psychiatrist is aware of all of the HIV medications you are on and is coordinating interaction potentials for anything.
"Iíve slept with enough men to know that Iím not gay"

Offline BT65

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Re: Social Phobia / Anxiety
« Reply #2 on: March 23, 2009, 09:35:34 AM »
Hey MMJ520,

Welcome to the forums.  I totally agree with Ms. Philicia about it not being responsible for a doctor to just stop a benzo.  The withdrawal from that is horrid (trust me, I've been there).  I had never heard of Neurontin being used for anxiety.  I take it, but for neuropathy.

Again, Ms. Philicia is correct about Paxil.  I have another angle you may want to try.  Some psychiatrists have started using another class of drugs for anxiety-the anti-psychotics (Seroquil, Zyprexa).  Don't balk, I use Zyprexa specifically for anxiety (I take a certain dose every day) and it's got my anxiety pretty much under control.  I don't have to run out of stores, I don't feel like I'm going to pass out or have a heart attack etc.  I also use some tricks to deal with anxiety.  If I start to feel myself getting an anxiety attack while in a store, or driving, or wherever, I tell myself that I'm not going to pass out, I'm not going to have a heart attack, I'm going to be fine etc.  And I really believe it when I tell myself that. 

I empathize with you.  Anxiety is a bitch.  I hope you find some relief/help soon.  Good luck.
  Luv,
Betty
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline positivmat

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Re: Social Phobia / Anxiety
« Reply #3 on: March 23, 2009, 05:57:05 PM »
Hey mmj520,
I don't have a long history with HIV.  I was just diagnosed 1/30/09.  I have been having panic attacks and waking up in the middle of the night.  You might try meditation with whatever meds you are on, the breathing and the focus allows some to let go of the anxiety.  I currently meditate with a group and one of us has severe anxiety and uses the meditation for that reason.  She just went off Xanax and is trying to manage her anxiety that way.  She started while she was medicated.  I am hoping that the meditation will help me with all the intense feelings I have.  Also, forcing myself to go out and be with people and talk to my small support network helps me.  Writing my feelings down here in this forum releases them for me and gives me more perspective and frees me from my pain.  I also really enjoy playing tennis and that is always 2 hours of HIV free thoughts.  I find myself crying a lot - that even helps.  For me the pain is still fresh.  I worry about you that this is going on for so long now.  The effects of depression damages people and disables people, so just be aware that this is what is happening here.  The isolation that you are giving yourself is not always good when it goes on for too long.

I am not in any way saying that you don't need medication, but meditation and a list of alternate activities and solid support network may help you.  I hope that you can somehow find peace from this anxiety and depression.  I know that it is painful.  Good luck to you,

Matt

Offline mmj520

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Re: Social Phobia / Anxiety
« Reply #4 on: March 23, 2009, 08:01:57 PM »
Thanks for the replies. 
Social Phobia is likely a secondary diagnosis, MDD being the primary.  I am almost certain that is what my disability claim was approved for.  For the time being between 10mg and 20mg of Prozac is adequate to keep the crying spells from happening.  Seems like 20mg Prozac CAUSES anxiety or nervousness.  Mild agitation even if higher than 20mg.  Been on up to 60mg in the past. 
Paxil didn't work well for me... zoloft didn't work well and caused more GI upset. 
Cymbalta worked extremely well for about a month or two, then fizzled out.  Tried Wellbutrin, which I really liked -- enabled me to paint the interior of our condo top to bottom a couple years back.  Very nice energizing effect.  Unfortunately, it caused excess weight loss.  That's the one telltale effect of having HIV for me, that I noticed even before being diagnosed.  Around February of 2005 I suddenly had ZERO appetite.  My license shows me at 165, but 135 is closer these days.  Dropped all the way to 125 in 2008 while starting hiv meds, but found the magic of a certain appetite stimulant. :)

Neurontin for anxiety is off-label ; does take the edge off slightly, not much.  Not as potent as a klonopin 1 mg would be.  The dose of Neurontin I am currently on is very low, 300 twice daily.   

Cutting out alcohol has been really much easier than I ever anticipated.  I will try meditation again soon. for now, this forum will be my new best friend.  Typing out thoughts does indeed release stress and helps to bring things to the surface so they can be dealt with effectively.

I went to ONE evening meeting at our local ASF to learn about reading lab test results.  I was truly scared in the group setting, and it showed.  That dreaded introduction came to me and while I spoke, my mind went completely blank and I just fumbled through quickly and they moved on...  They served dinner even, and ... I was terrified of eating in front of strangers.  The health educator who led the group was very kind and tried to put me at ease, but it was a no go.  Never went back either for followup talk therapy.  I've heard funding is now cut now anyway; not sure I could even see anyone there now.

My pdoc likes to see me monthly for just prozac.  My hiv doc writes prescriptions but strongly prefers I keep the pdoc.  Not sure why.  He really doesn't do much other than write the prozac script.  cut me off the benzo that actually worked and that I was not abusing.




Offline Miss Philicia

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Re: Social Phobia / Anxiety
« Reply #5 on: March 23, 2009, 08:59:28 PM »
1 mg/daily of klonopin is hardly anything serious.  I find that all quite odd.

Your HIV doctor most likely prefers you to see the other doctor because of all the switching around of meds you've done.
"Iíve slept with enough men to know that Iím not gay"

Offline positivmat

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Re: Social Phobia / Anxiety
« Reply #6 on: March 23, 2009, 09:10:05 PM »
You even sound better now when you reply. If the forums are helping and talk therapy is not for you, try getting into a class or somewhere that might make you feel better by allowing some expression to come out. Massage therapy would be good too. I have one friend that I can be really dark with and just laugh my ass off with. It really helps to get out there. If nothing else keep writing here.
Matt

Offline mmj520

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Re: Social Phobia / Anxiety
« Reply #7 on: March 23, 2009, 11:34:09 PM »
I am going to email my hiv doc's NP tomorrow about a benzo for the anxiety.  The Neurontin experiment seems to be proving fruitless overall.  If she says she'd rather not, then it's no. The pdoc won't and the way managed care is alloted, I only have 4 appts remaining for the whole year, and he does not write refills.  I just figured out that's why my hiv doc's NP is always filling gaps for prozac or anti-anxiety med.   

You know you are shy or having a social phobia "issue" when you even feel self conscious online in email or forums.  I stopped emailing earlier this year mostly. This forum is like .... even mildly intimidating. 


Offline mmj520

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Re: Social Phobia / Anxiety
« Reply #8 on: March 31, 2009, 03:41:32 PM »
Is anyone else dealing with Social PHobia / Anxiety?

It would be nice to find at least one or two people from this forum to chat with regularly about treatment: what you've tried that worked, didn't work etc.

Neurontin 300mg twice daily and one extra at bedtime for sleep SOMETIMES is working somewhat.  Prozac had to be discontinued temporarily due to excessive bleeding gums and other side effects.

HIV treatment is going well overall.  Saw the hiv doctor himself yesterday morning for a whole ten minutes.  It was determined that I have "Essential Hypertension".  Prinzide was prescribed. 

It brought up a discussion of how much the anxiety disorder affects blood pressure and heart / cardio health. 

160 / 90  84 pulse average reading "relaxed".

Offline Ann

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Re: Social Phobia / Anxiety
« Reply #9 on: March 31, 2009, 09:31:51 PM »
I don't give a shit who knows I'm hiv positive. It's a fucking virus, nothing more, nothing less. Quit giving it the be all and end all power over your life.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mmj520

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Re: Social Phobia / Anxiety
« Reply #10 on: March 31, 2009, 11:31:31 PM »
I don't give a shit who knows I'm hiv positive. It's a fucking virus, nothing more, nothing less. Quit giving it the be all and end all power over your life.

Ann

Social Phobia / Anxiety has been with me since childhood.  Not sure I understand your response in relation to social phobia / anxiety.   

If HIV were completely out of the picture, I would still be dealing with the anxiety matter. 

Offline Ann

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Re: Social Phobia / Anxiety
« Reply #11 on: April 01, 2009, 05:22:45 AM »
Social Phobia / Anxiety has been with me since childhood.  Not sure I understand your response in relation to social phobia / anxiety.  

If HIV were completely out of the picture, I would still be dealing with the anxiety matter. 

Sorry, I (evidently erroneously) assumed the social phobia/anxiety came directly from having hiv. It's pretty common around here, so please forgive me for jumping to that conclusion. Won't make that mistake again.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mmj520

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Re: Social Phobia / Anxiety
« Reply #12 on: April 01, 2009, 08:47:30 PM »
A little humor. 
http://farm1.static.flickr.com/31/47538725_c3fc82d640_o.gif

I endured a checkout counter earlier today.  It was self checkout, but still intimidating with everyone around.  I really like the self checkouts at the supermarket.

This one best describes social phobia as it affects me.  I avoid anything and everything that might put me in this awkward situation.
http://www.angelfire.com/comics/sp-phunnies/images/intros.jpg
« Last Edit: April 02, 2009, 05:34:22 PM by mmj520 »

Offline germanguy675

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Re: Social Phobia / Anxiety
« Reply #13 on: April 02, 2009, 01:42:50 PM »
I have problems with anxiety and depression also.The best combination that has worked for me is 150mg 2xs a day of Wellbutrin and no more (can cause speediness and anxiety if more) and 0.5mg 2xs a day of Clonazepam.This combination has worked for me for years.I don't consider these magic pills and still isolate at times but without these meds I would be in sad shape.Michael

Offline mmj520

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Re: Social Phobia / Anxiety
« Reply #14 on: April 02, 2009, 05:42:57 PM »
Welcome to the forums germanguy675. 

I agree wellbutrin / clonazepam is a good combo, I was on it for over a year with great success.  My pyschiatrist does not prescribe controlled substances anymore though.  Anything that is regular and ongoing, I have to see the Psychiatrist monthly because he does not give refills.  It's a bit much for prozac and Vistaril like I was doing for a while.  I understood the monthly visits when I was taking clonazepam.  9 months off the stuff at this point and my symptoms came back along with high blood pressure.   My anxiety is essentially untreated right now.  Neurontin is an experiment as I mention above.

Vistaril is an antihistamine like benadryl that is used in place of benzos apparently more and more. 

Offline mmj520

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Re: Social Phobia / Anxiety
« Reply #15 on: April 02, 2009, 05:53:01 PM »
Hi mmj520.  Several things -- first of all is social anxiety disorder you're official diagnosis, or just general anxiety disorder?  Second, you state that your use of neurontin pre-dates your HIV diagnosis so shall we assume your anxiety issues are not related to HIV?  Or is that prescribed for something else, because as far as I know neurontin is more generally used to relieve neuropathic pain.

That's too bad that your doctor has a phobia of klonopin.  I've been on it now for 8 years with no doctor balking at it.  One thing is for sure though is that it's not responsible to have a patient go cold-turkey of a benzo -- they should always have the patient slowly taper off the dose.

If it's particularly social anxiety why hasn't the doctor tried Paxil?  Though an SSRI class med it's used for that commonly.  Also are you attempting specifically Cognitive-behavioral therapy?

I'm not familiar with Vistaril.  I'll also assume that your prescribing psychiatrist is aware of all of the HIV medications you are on and is coordinating interaction potentials for anything.
  He isn't really familiar with those medicines is what he told me when I told him twice since I've seen him. 

Offline Miss Philicia

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Re: Social Phobia / Anxiety
« Reply #16 on: April 02, 2009, 06:30:51 PM »
So how do you avoid any drug interactions?  If he's not familiar with them he certainly has access to medical literature -- that's a sad excuse and if he's not doing his job perhaps you should find someone that will.  At the very least he can pick the phone up and confer with your HIV specialist, but in the end the patient must insist on such things.
"Iíve slept with enough men to know that Iím not gay"

Offline mmj520

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Re: Social Phobia / Anxiety
« Reply #17 on: April 05, 2009, 10:09:31 PM »
My personal feeling is that mental health should be monitored by the hiv doctor since it is so complicated.  He ends up reviewing for interactions, not the pdoc.  He noted Celexa was possibly causing a low white blood cell count, he did tell me to mention that as he knew I had an appt with the pdoc.   We switched back to prozac at that point, now I am off that entirely.  Psychiatrists just write prescriptions, I see mine less than five minutes per appt.  The first thing the hiv doc asks when he comes in the exam room is "how is your mood".  He's always way more concerned with that because there has been little else serious thankfully.  Hypertension is new, and whether it's caused by the anxiety or not, it's there and he wants to treat it.   I haven't yet started the med for that.  Monitoring the pressure and it has indeed stayed high. I filled the prescription, just haven't started.

Gabapentin is working at 300mg twice daily.  I've taken a third for sleep twice to avoid using benadryl and it's worked well for insomnia as well.  The short half life makes it necessary to space out the doses just right. The overlap in the afternoon early evening if I forget it in AM is nice.  Very mellow.  Almost Klonopin like, without the overpowering sedation that can linger due to long half-life.

Desensitizing to certain situations is helping.  Some things work, some don't.  This weekend was good.





« Last Edit: April 05, 2009, 10:13:20 PM by mmj520 »

Offline Ann

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Re: Social Phobia / Anxiety
« Reply #18 on: April 06, 2009, 06:07:30 AM »
Hi MM,

It's great to hear that you're having some success. Hope your good weekend carries on to a good week.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mmj520

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Re: Social Phobia / Anxiety
« Reply #19 on: April 08, 2009, 12:06:41 PM »
Hi MM,

It's great to hear that you're having some success. Hope your good weekend carries on to a good week.

Ann


I probably misinterpret things more often than not.  I need to really get to a point where I "don't give a shit" but I am not quite there at this time. 

It feels like everyone knows just by looking at me, which those closest to me assure me is not the case. One mistake I feel I made after learning of being positive in 2005 is over disclosure.  Some people just didn't need to know.  How does one conquer this and strip the power from the virus?

My psychiatrist has never once suggested anything like  social skills training: http://www.minddisorders.com/Py-Z/Social-skills-training.html   


SSRI meds and sleepy "anti-anxiety" meds aren't the  sole answer........  at least not after years of hoping for better results. Paxil, Zoloft (200mg - highest dose) for 3 months), prozac, Cymbalta, Effexor, Celexa, Lexapro have all been tried. Ativan, Klonopin, Valium. 

Changing Pyschiatrists means starting over and explaining everything all over again. Medicaid "carves out" the mental health portion of my coverage.  If it were integrated with the HMO it might actually be better.  In a perfect world huh ?

 
« Last Edit: April 08, 2009, 12:13:04 PM by mmj520 »

Offline mmj520

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Re: Social Phobia / Anxiety
« Reply #20 on: April 15, 2009, 05:48:52 PM »
http://farm4.static.flickr.com/3555/3445948998_0968bd2456_o.jpg 
"Support Group for Social Phobics" Empty room
Had to search all over to find this image. Pretty much tells the story. 

Offline denb45

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Re: Social Phobia / Anxiety
« Reply #21 on: April 15, 2009, 07:05:07 PM »
I don't give a shit who knows I'm hiv positive. It's a fucking virus, nothing more, nothing less. Quit giving it the be all and end all power over your life.

Ann

 ;)
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline Dwayn20

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Re: Social Phobia / Anxiety
« Reply #22 on: April 17, 2009, 12:00:54 PM »
I am the same way been battling since I was very young.But coming from the country we only went to doctor when you were allmost dying.So when I became older it was one of the reasons I was discharged from the Army.Been on many types of medicines.What I hate with dealing with the charity hospitals they put you on some control substance then two years later were sorry we cannot write the prescription anymore.then your screwed.Are they change the doctor every 3 to 6 months And they don,t now there nose from there ass.They clearly are not ID Doctors.I understand they have to learn but sad butt true a lot of times I know more than them.I am not trying to upset anyone I am just stating facts.
Scooter



Social Phobia / Anxiety has been with me since childhood.  Not sure I understand your response in relation to social phobia / anxiety.  

If HIV were completely out of the picture, I would still be dealing with the anxiety matter. 

Offline planonstaying

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Re: Social Phobia / Anxiety
« Reply #23 on: May 15, 2009, 09:09:14 PM »
I have generalized anxiety issues  and  social phobia.  it predates hiv.  Benzo withdrawal can be fatal and it is irresponsible of your Dr just to pull it imo. I read neurontin is given off label for depression and I also read studies say it  is ineffective. I take wellbutrin and Lyrica for neuropathy. The lyrica  helps with the anxiety. It is  mildly sedating but not  like a benzo and the wellbutrin has helped me get up and get out of my own way.

I do care who knows i have hiv. i work with 6000 people. I'd guess from watching and listening 1000 of them could compete for most ignorant human in a work enviroment  .  I have heard people claim  you can catch it from a cough, I heard someone say they'd demand to know if someone in there area had hiv so they could take precautions. I've heard the they deserve it because they are addicts and queers etc etc etc.   
 Of the 1000- 1500 people I see daily I am sure a couple dozen  are miserable enough to  try to share that misery.    So, yeah I know it's just a virus but, that doesn't change the fact if they all knew my work day would be more difficult and i would face harassment  and  that quiet discrimination people can get away with.  That's why  there is a law in this country because the  harassment and discrimination is real even if it is just a virus.  The world is an imperfect place and I am not naive enough to  believe   there arent places disclosure would have consequences.  With friends etc  I have np and  have no shame around it because it is just a virus. If someone had an issue with it I'd be better off w/o the friendship.   
If someone tells you  potential consequences of a behavior  it  doesn't  mean they jude you or mit    they may just give a shit about you

 


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