Extreme social anxiety and high levels of stress, what to do

[Anonymous]

Over the last few years, I have seen a couple of “talk” therapists to address my social phobia, OCD and emotionally issues I have been dealing with for a long time (mom passed away when I was very young, emotional neglect by father etc). Since that didn’t help, I also tried medication for about a year with several different psychiatrists. I’ve tried Xanax, Zoloft, Cymbalta/Remeron, Pristique…. But nothing worked. I barely felt an improvement with any of these and then I stopped because I got tired of experimenting with this stuff. Had varying levels of side effects too. Tapering off was not a problem with any of these as I was on a very low dose with most (though still the doctors thought I should move on to something else due to lack of progress)

My anxiety has been with me for a long time but it’s been getting really intense these days. I have a full time, demanding job and have been under high levels of stress for over a year now. I’m freaking out multiple times per day because of my phobia, because of my job I can’t avoid talking to and in front of people. I really need help and really need to get better but just don’t know what to do. I got on a waitlist with a CBT therapist but it might be a few more months. What should I do? Try meds again? Any recommendations? Wait to try out CBT? I’m reading some books but struggle to find time to finish them. Recently started exercise, maybe that will help a little? I eat and sleep well otherwise. No depression, or at least not severe…

[Anonymous]

Maybe you should look for a job that is less stressful.

[Anonymous]

I would read up on beta blockers for anxiety. They do a great job of relieving the physical symptoms caused by adrenaline, and may help you feel calm (depending on how your anxiety affects your body).

[Anonymous]

I am sorry you are going through this. This is really hard stuff.

Regarding therapy - is it possible you haven't had a therapist who is a good fit? For anxiety, maybe look for someone who can help you do exposure therapy which I believe is the best modality for OCD and Anxiety. This is worth trying again.

Other non-meds ideas for you to consider:

- Strenuous exercise (great anti-depressant)
- Wim Hoff breathing
- Cold showers
- Floatation therapy in Epsom salts to regulate nervous system

Supplements to consider:

- Are you deficient in vitamin b-12?
- Magnesium L threonate is great for calming brain
- Are you deficient in vitamin D?
- Omega 3 supplements good for brain
- Look into supplements that have or stimulate GABA
- CBD Oil (get a high quality tincture from Charlotte's Web)

[Anonymous]

Gabapentin worked great for my social anxiety. I wouldn't recommend taking it for more than 6 months or so but it could buy you some time to get more comfortable with your interactions with people.

[Anonymous]

I agree with PPs about beta blockers and exercise and flotation therapy. I had an extremely stressful job as CEO with social anxiety, especially around public speaking. I would take the beta blockers an hour before an a presentation, or even sometimes in casual social settings - drinks with DH's work colleagues. They work really well in that they relieve anxiety but don't make you feel weird.

Additionally, find what works for you - whether it's running or hot yoga or flotation therapy - and schedule it in as part of your day, non-negotiable. I would do flotation therapy on Sunday night to start my week right, then alternate running and yoga during the week.

Also, maybe experiment on weekends (nonwork hours) with CBD, as PP also recommended.

[Anonymous]

CBT. And exposure. Push yourself to spend little time with people here and there.

[Anonymous]

OP here. The last therapist was not bad, I learned a lot about myself and my family. But it just didn’t help me feel better.

I did try the non-meds too. Still have bottles of GABA, Ashwaghanda, L-theanine (and a couple others that start with L-), in fact pretty much everything in this category. I tried cbd gummies too. I’m taking multivitamins on and off (mostly because I forget).

I can’t change jobs or quit. Also have two kids in early elementary, so in addition to work there are all the demands for parenting. Spouse is in same situation (demanding job, involved in everything at home, just minus the stress and anxiety).

I wasn’t very happy with my previous psychiatrists but didn’t bother much because I understood it’s supposed to be mostly a trial and error process anyway. Do good doctors find you a good match for the meds faster? I don’t have a PCP though I’m looking for one.

[Anonymous]

Anonymous wrote:I agree with PPs about beta blockers and exercise and flotation therapy. I had an extremely stressful job as CEO with social anxiety, especially around public speaking. I would take the beta blockers an hour before an a presentation, or even sometimes in casual social settings - drinks with DH's work colleagues. They work really well in that they relieve anxiety but don't make you feel weird.

Additionally, find what works for you - whether it's running or hot yoga or flotation therapy - and schedule it in as part of your day, non-negotiable. I would do flotation therapy on Sunday night to start my week right, then alternate running and yoga during the week.

Also, maybe experiment on weekends (nonwork hours) with CBD, as PP also recommended.

I gave up my stressful job rather than take anxiety medicines, but I'm intrigued by the beta blockers. Are there side effects or other consequences of using them for something other than what they are intended for? You mentioned taking an hour before the presentation, so you can take as needed (situational) versus needing to take them all the time?

[Anonymous]

Anonymous wrote:OP here. The last therapist was not bad, I learned a lot about myself and my family. But it just didn’t help me feel better.

I did try the non-meds too. Still have bottles of GABA, Ashwaghanda, L-theanine (and a couple others that start with L-), in fact pretty much everything in this category. I tried cbd gummies too. I’m taking multivitamins on and off (mostly because I forget).

I can’t change jobs or quit. Also have two kids in early elementary, so in addition to work there are all the demands for parenting. Spouse is in same situation (demanding job, involved in everything at home, just minus the stress and anxiety).

I wasn’t very happy with my previous psychiatrists but didn’t bother much because I understood it’s supposed to be mostly a trial and error process anyway. Do good doctors find you a good match for the meds faster? I don’t have a PCP though I’m looking for one.

Your primary care doc can prescribe the beta blockers. They will give you a very low dose.

[Anonymous]

I have a script for beta blockers for "public speaking". I take them before big social events or situations where my anxiety has spiked. They really help me a lot.

But if you have anxiety every day definitely speak to a doctor. I know my doctor was very clear I can't take them more than 2 or 3 times a week. I think the issue is that if you take them regularly stopping them suddenly is very dangerous. And I think, but don't know, that if you take them every day the blocking effect may wear off and you need a bigger dose to achieve the same effect.

[Anonymous]

I would cut caffeine and any other stimulants and then exercise like a bandit. Run, yoga, walk, lift weights. Any and all movement will help!

[Anonymous]

Anonymous wrote:I would cut caffeine and any other stimulants and then exercise like a bandit. Run, yoga, walk, lift weights. Any and all movement will help!

Meh. I run marathons and still suffer severe social anxiety. Not a panacea.

[Anonymous]

You need exposure and response prevention therapy. Most other kinds of therapy unintentionally reinforce the anxiety by “examining” it. Find an ERP specialist. There are many in this area.

[Anonymous]

Marijuana is what you need OP. But it legal in DC. Seriously.