Stopping/Controlling Anxiety by Any Method

I know A LOT about mental disorders/drugs to take for them. I am also a recovering addict - I have A LOT of experience with drugs of abuse, but also with anti-depressants/mood stabilizers/anxiolytics(anti-anxiety, which can be/are drugs of abuse). When I have more time I’ll look over this thread and try to offer any advice from my experience that I can.

Apparently, I can’t edit my post, and I didn’t plan on reading anymore, but I went ahead and did, so here is what I was going to include:

Was just reading briefly, some really good stuff posted on here from Bohm and ParaGoomba (sp?) from just page 5 that I read. Although, I do disagree somewhat with your assessment for treating panic disorders from MY experience, ParaGoomba. I’ve always had some anxiety throughout my life, but in college and as I started acquiring physical health problems, and mental health problems, it rapidly increased. For me though, I’ve been through so many ‘panic’ inducing incidents, that when I have a ‘panic’ attack, I don’t panic - to some that may disqualify me from having panic disorder, but I also have had agoraphobia problems, particularly the past 2 years. I’m an addict in recovery, yet throughout my addiction I was able to take benzodiazepine’s on a relatively stable dosage level (especially when compared to other drugs I was taking), to combat this. I had been off the benzodiazepine’s all summer, and I see a legit psychiatrist now who knows I’m an addict in recovery. School started September 1st, and I had a lot of anxiety going into it. I don’t have performance anxiety, I just have generalized anxiety that results in me having the physiological symptoms of a panic attack - rapid heart rate, shallow breath, distortion of reality (like in a movie or tv show where the camera is slowed and all the voices are speaking very quickly and run together), and weakness in my limbs. I was beginning to have these very frequently, sometimes at home while simply eating. So, I talked with my psychiatrist and he had enough trust in me to prescribe me 1mg Klonopin, which have helped dramatically. I haven’t had a ‘panic attack’ since then, and I’ve been more social than I have in so long. I’ve also been more successful in school than I have been in a year or two, although I think that is mainly due to other factors synergistic with the reduced anxiety the Klonopin is providing me. So far, I have managed, for the first time ever, to take a prescription drug as it is prescribed. I honestly can’t tell you how I’m doing it, although as I said I never abused benzodiazepine’s too severely in the past. The treatment has worked perfectly for me, as I expected.

Just a bit of my experience with anxiety very recently.

Thanks for your input EagerToLearn. What were your drugs of choice/abuse? Did you go through any drug addiction program?

Cocaine, heavily, I also sold it. I have back problems, and I slowly progressed into Oxycodone 30mg pills, or ‘roxy’s’ as they’re called down here. Those and hydromorphone or Dilaudid, I got into injecting them, but not every day, mainly snorting the oxycodone. I also had some other devastating physical problems that forced me to leave the school I was in, which absolutely crushed my spirit at a time when I was already a drug dealer, so guess what happened? I spiraled rapidly from a top student to a junkie, although I never landed on the street. My per-day average at my peak summer of 2009 before I went to rehab, was around 500-600mg a day, while taking some Xanax if I was going to go out. At most I’d 10mg of Xanax after having loaded up on Oxycodone the whole day and watch a really dramatic movie, that was my favorite activity. You know what brought the rapid rise of my usage? I had been taken oxycodone for a while, but being forced back into school by my family and trying to perform with my physical and mental difficulties impossible unless I was absolutely jackedd on pain-killers. That led into the summer aforementioned. After I got into pain-killers, I only resorted to the cocaine usage about 3-4 times a year, although those have been binges, also involving intravenous usage of the drug.

I did go through treatment, for 52 days at Lakeview Health Systems. Very, VERY good rehab program. That was a year ago. I went to Narcotic’s Anonymous meetings for the past year, accumulated 3 months here, 4 months there, and I’ve been clean 90% of the time since I got out of rehab. My main problem became the medications I was prescribed for my mental disorders. I was taking Depakote, a mood-stabilizer (although really an anti-convulsant simply used as a mood stabilizer, this is by far the worst drug I have ever ever taken), Paxil, Remeron, and then dropped the Paxil for Wellbutrin, my old psychiatrist messed up badly, sent me into a mixed-state psychosis at which point I made a very serious attempt on my life, somehow I lived, although I was admitted (that was earlier this year).

Since then I’ve been on a steady rise, although it has been an uphill battle. I stopped taking all my medication in the beginning of July and I feel better than ever, besides the aforementioned anxiety medication, which was not declining at all. I relapsed in August, very heavily, and since then I have stopped going to any NA meetings or seeing any therapists besides my psychiatrist once a month. I don’t know what happened, I just got tired of talking about everything. I’ve been in therapy since I was 18 months old because of my childhood circumstances. Since then, something clicked and I’ve returned to my past performance in the classroom, have regained my ambition, have a new outlook on life, etc. I’ve been doing extremely extremely well this semester. I did start to drink alcohol a little bit, definitely not anywhere near the level even approaching what would be termed an ‘addiction’, but I am AN addict, so I decided it’s not worth the risk and have since stopped completely. I honestly can’t tell you how I’m able to take this medication as prescribed, how I have money and I don’t buy drugs, despite the dealer living right next to me.. The year of NA meetings definitely helped. I’m still very close friends with my former sponsor, and I just focus on trying to do something positive every day. I am doing well so far, but I am very very wary of any slip-ups or signs of decline. I was prescribed 45 of those 1mg Klonopins, which I definitely needed last month, but this month I was thinking about cutting down to 30, and all of a sudden my appointment was over with today and we didn’t even discuss it because my psychiatrist thought I was doing so well. I already told my dad I was going to give him the extra 15, and see how I do with the 30, and if I legitimately need the 45, I’ll still have them, but I won’t have immediate access to that many extra pills. I’m sure you know what it’s like to all of a sudden have a whole prescription in front of you.. It’s so much easier to just slip a little and take 2 instead of 1, then next it’s 3 instead of 2, etc. I don’t want to go back down that road.

For what it’s worth, I’ve tried every benzodiazepine on the planet. Of the benzodiazepine, clonazepam (klonopin), for me, was the strongest anti-anxiety drug. I think it’s also the least likely to be abused because of its long half-life. Tolerance also occurs at a slower rate than the other benzodiazepines. I found valium and ativan were useless after a few weeks as I built up tolerance to those drugs relatively quickly. Xanax was almost as good as the clonazepam but not quite. The only negative of clonazepam is it can sometimes aggravate depression if you’re prone to it. Xanax doesn’t appear to have this problem?

You must have a really good psychiatrist if he’s willing to prescribe a benzodiazepine with your addiction history. I was really hoping my guy would prescribe it despite my addiction history along with the Lexapro. But it ain’t happening. I never get a high from benzodiazepines, so I never understood what the problem was with them, even if I had to take 5 mg of clonazepam. But it’s next to impossible to convince any doctor to prescribe that amount. You seem to really understand your addiction and it sounds like you’re heading in the right direction. The move to give your dad the 15 clonazepams shows it. Keeping busy in school or working out, or even pulling your dick might really help to keep you busy and avoid the situations that caused your previous drug problems.

Thanks bohm, I really appreciate what you just said.

For me, everything is about my relationship with the person. Life is about relationships. I am by NO MEANS a suck-up, brown-noser, etc. I have always had more ‘adult’ interests and typically adult/authority figures have always seen a very bright future for me. I am very serious about my academic success. Even in the midst of full-on addiction, I would still put school first (e.g. Not go on a coke-binge because I know that’s going to mess up everything with school, if it’s exam week, even if I really wanted to). I’ve always been kind of a nihilist/existentialist, and I chose to value school first and foremost for this stage of my life, and that’s helped me. (See this is one of those tangents you’ll notice in my posts, lol, I have so many things I want to say every time, I end up saying them all, sometimes not in the correct order).

I WAS talking about relationships. My psychiatrist is a good psychiatrist, but definitely was not going to give me any benzodiazepine’s the whole time I saw him, until we developed a relationship, until he saw I had turned a corner, saw that spark in me that was just beginning to ignite, and until the other non-benzodiazepine medications we tried had failed to have any affect. I build relationships with everyone I feel I need to. (Note: this is not solely based on my ambitions or anything like that. I build relationships with everyone I encounter and have any sort of contact with over an extended period of time. This HAPPENS to include professors, deans, authority figures, etc.) Having good relationships with my professors, with the deans, with my teachers in high school, with my doctors and therapists, all that has only enhanced my ability to perform and succeed. At times, yes it has given me a sense of entitlement because I am often able to slip by the rules, in any environment ; ) because of those relationships, but the most important part of a relationship for me is holding up my end of the bargain. I can charm someone all I want to, and I have a pretty good personality when I’m not freaked out, especially when talking to ‘adults’, but I have to show results, which I always have, besides the one or two times I didn’t, which crushed me. I have very very close personal relationships with my friends. My friends are my family. I have drug friends that I would get fucked up with, but I also have ‘real friends’ that I love and would die for. One of which is missing from my life right now because of what happened earlier this year (the suicide attempt hurt her so badly, she hasn’t gotten over it enough to sustain any real conversation/contact with me).

You’re right about Klonopin being favored by psychiatrists because of it’s longer half-life. A longer half-life means less of a rush, and the faster the drug takes affect, the more addiction prone the drug is (e.g. Smoking crack vs. Snorting cocaine). I don’t get a high either, unless I took them with other drugs. Benzodiazepines have always just made me feel ‘normal’, although the fact that my mother breast-fed me while taking them, might have something to do with that, lol.

O yeah, I wanted to say this: I saw your post about your worries about going back to work. Man.. Typing about this is bringing tears to my eyes because I know exactly what it is you feel. I was a top student, got into a top 15 college, performed extremely well, very socially popular, in a good fraternity, selling drugs, living the high life (I thought). Meanwhile, because of my poor work habits I had to rely on things like adderall to keep me up for days at a time to study for exam week, or finish papers, etc. All of a sudden second semester, I’m preparing research for a paper, and I can’t read anymore. I just can’t do it. I retire for the night, thinking I was just tired. Got up, still couldn’t do it. Had to ask for my first ever extension on an assignment, the beginning of the ‘end’. I could barely read the rest of the term and I had to withdraw at the end of the term, having 2 incompletes in my best two classes. I went to eye doctors for a year before I had any concrete diagnosis, and by then what started as a simple muscular deficiency (convergence insufficiency) turned worse, and I still have yet to regain my former eye strength/reading ability. ANYWAYS, after leaving my school, I could not even write the one page entrance essay for going into a school local to where my family lived. I couldn’t do anything because I was so paralyzed. I had a mental-block. I was so damaged at my rapid decline and embarrassment, that I just couldn’t put any thing together. I got through that term with drugs (that one page essay, high as all get-out, was the beginning, lol).

The next term I was in rehab, missed that one. This past term in the spring I started to overcome it, but I had so many problems with the medications, it left me even more traumatized, until suddenly the past 2 months I’ve come out of it firing on all cylinders. I have special lenses with micro-prisms that help me read, although my eyes still get lazy and look messed up (a big cause of anxiety for a person that already had social anxiety issues!), but I’ve adjusted to that. Right now I finished all the work that I missed and the end of last term because I had been admitted after the attempt on my life. I simply could not do it at all during the whole summer, until I got back into school, taking 2 classes, and slowly got into the rhythm of things. The past 6 weeks I worked my ass off all day and all night, finishing the massive amount of work I needed to do, while keeping up with my classes now. This kept the door open for me, this kept the glimmer of hope alive for me to able to go back to the school I originally went to and get the degree I wanted originally. To accomplish the things I set out to do 4 years ago, I had to complete this work, it was do or die, thank god I was able to.

That was important, however, I believe the next 2 months in which I’m going to have plenty of free-time and need to work on my physical health and time management abilities are going to be even more important for my long-term success. If I can keep this up and move back to full-time course load next term and do well, I’m going to try and get back into my original college.

OK, sorry for like the biography, but like I said before, I’m a ‘personal’ person, and I think it’s important in evaluating anyone’s circumstances, or offering help to anyone’s circumstances, to lay out your situation. Hope I didn’t bore anybody!

Trust me, you didn’t bore anybody. Just be careful not to push yourself too hard and put too much pressure on yourself, in school/life. People with both social anxiety and GAD tend to push themselves so hard in order to please others (due to social anxiety), they sometimes end up fucking themselves over with too much to handle. And the GAD, often makes them less able to handle stuff compared to others. That’s been my experience, anyway.

Bohm, my message to you with that last post, particularly the bit with some of my personal story is that I know what it’s like to come back from drug addiction, particularly drug addiction to ENHANCE performance. That, in my opinion, is the most crippling form, because of what you identified: you’re confidence is crippled without the substance. I’m here to say that I’ve taken a long, dangerous road back to recovery, back to what I used to be. I plan on performing FAR better than I EVER did ON DRUGS, without abusing anything (besides maybe some pens, highlighters, and keyboards : )). I also know many recovering addicts that have gone on to lead some of the most successful careers of anyone that I’ve met.

It can be done. You can do it. One option is to look into some Narcotics Anonymous meetings, that might help you socialize with others, build a sense of purpose and confidence. I believe that having support during these hard times can be very important, and I expect people at any NA meeting around the world to be some of the most supporting, understanding people you’ll ever encounter. I’m sure if you can find meetings, you’ll find several of the regular attendees have the same problems as you, and will be able to help you in your journey. Although, you certainly don’t have to do that, I just know that it can help. The most important thing though, is to just keep trying, and don’t overload yourself right off the bat. Try to ease into it and build on little successes here and there to boost your confidence. It’s all mental, and it can be overcome through a change in perspective, brought about by a change in behavior and results of that behavior.

Keep at it man. I support you 100%. I’ll definitely be a regular poster on here, especially since I found this thread. I’ve always been one to want to help others, but after going through the living hell that I did for so long, one of my main missions in life is to help anyone struggling with the same problems I had, or to help other people gain some sense of empathy and understanding for people with these problems. That’s not to say I have all the answers, or that I’m an authority, I’m just here for encouragement, and as they say in the ‘rooms’, to offer my experience, strength, and HOPE. I believe that you can believe, and all you need to start is to believe that someone believes in you.

http://na.org/

Meeting locator: http://na.org/i … home-content-fm

(If you’re interested, just throwing it out there, I know it helped me and people in there who had never met me supported me through some of my hardest times with open arms every time. I picked up a white chip - meaning that I had relapsed and was starting over on the process of gaining clean time - 7 times in a year. Yet, I stayed honest, stuck with it, and no one looked at me any less, even though I had twice as many white key tags than anyone else during that time, lol!)

*EDIT*

I didn’t see your post when I was writing this one, and yes, that is a danger, thank you for saying that. It’s funny you did because I just posted on my facebook that the next 2 months were going to be the most important months of my life, and essentially that there were no more breaks for me. Not anymore. Well, I do need to have breaks, I’m very good under stress and I survived the 6-week mauling I just went through, that no one in the school expected me to be able to do, but what’s going to happen when I hit a set-back? Am I going to fold? Or am I going to take a step back, re-evaluate, and move forward as best I can. That’s the question for me, because if I’ve learned anything, I know that SOMETHING in inevitably going to go wrong at some point. I may come across as a little intense on here, because I am a very intense person, especially now, because my life is changing and I’m so excited for the future. But I do need to be reminded that not everything needs to go perfectly, that not every little detail is as important as I make it out to be. Thank you. ALSO, I’m mainly trying to please myself, but also I do have a strong desire, mainly subconsciously, to live up to those loved one’s expectations who I let down for so long, particularly the dear friend that is missing. In fact, she is the one that sparked this whole thing, without even knowing she did it, and without even trying to at all.

So based on this thread and my own research on anxiety, I managed to present a reasonable argument to my MD and got a small prescription for Clonazepam. Even though "the industry" is pushing SSRIs (including my doctor), if you read the forums of real people battling anxiety, anecdotally it appears Clonazepam and Xanax are the having the most success. In my own limited reading, anyway. (Reading sites like http://www.soci … port.com/forum/ )

My doctor was wary of giving me any prescription, but in the end put me on a temporary regimen of .5mg Clonazepam pills 2x/day, 1 in the morning and 1 at night. This is only 1mg total per day. I don’t know if that dose will really have any impact? (Yesterday I started it and the only effect I felt was a headache and slightly dry tongue for a bit.)

We’ll see how it goes. May give Yoga a shot, too.

commanderblop,

I’d have to agree about clonazepam and xanax as the best medications. They were for me. Cipralex (Lexapro in the US) is arguably the best SSRI. For me, I found the clonazepam dosage only worked when I took at least 1 mg but eventually that wasn’t close to enough. And after a few years, even the clonazepam needed augmentation with opiates.

What really pisses me off, is to know that there is absolutely no way that I will be able to work in my field with the lexapro alone, as I’m scared shitless just thinking about going to work but I have to pretend I don’t have that much anxiety (which I don’t if I’m not at work), so I don’t mess up my wife, parents and so I can get my license back.

Can you elaborate on this?

Do you mean 1mg per day, .5 at night, .5 in morning?

Or 1mg in one shot, probably in the morning?

In the beginning, was it good on its own, or were you always using it in some sort of combination?

Also, did you take it daily? My pharmacist said to give myself a break on the weekend — no Clonazepam — to keep my tolerance down longer.

You should follow the doctor’s order. That’s what I’m supposed to tell you. My warning to you. But if you’re as fucked up as I am/was here’s what I found:

I only got relief from clonazepam from about 1 hour after taking it and it lasted for ~4-8 hours (depending on dosage used). I found that taking it just before bed is a total waste of the drug. Why would I need it when I’m sleeping? I never had that much trouble sleeping, unless my anxiety was high. I would take the dose as needed. 1 mg (or more) all at once. Eventually after 8 years my dosage increased to ~2 mg twice daily (during my work shift or class time). Some days I would take zero dosage and other times (stressful) I took up to 2-3 mg all at once. I basically adjusted dosage to my anxiety level.

Some psychiatrists will tell you that this is a bad way to take it since it may lead to faster tolerance and greater likelihood of dose escalation. It may be true for some (many?) but it wasn’t the case with me. What I found is the more frequently (e.g. daily usage, low dose) I used it, the more tolerance I build up. I managed to delay tolerance by using high doses when needed and refrain from using it at other times, like before going to bed. I don’t need anxiety relief while I’m sleeping. That’s just me. You may respond differently.

When I went to my previous psychiatrist and told him about my clonazepam and opiate dependency/addiction, he suggested that tolerance occurred because of the way I was using it and that I should take a smaller dose 2-3 times/day. I tried that approach. It didn’t work for me. I just ended up with greater tolerance as frequent daily use made it less effective. I’m not 100% certain, but that’s what I believe happened and I ended up upping the opiate dosage even higher. Realistically a 1-1.5 mg dosage (all taken at once) had some impact on my anxiety my first 1-2 years. After that I had to use 1.5-2 mg all at once to have a major impact on my anxiety. If I took 0.5 mg it was almost useless, except maybe for the first few days I used it.

My mistake was to believe some of the studies suggesting that tolerance to anti-anxiety effects doesn’t occur. It does, in my opinion, but not to the same level as opiates.

I take my medication the same way bohm described his usage. I’m prescribed, in theory, 45 pills a month, to take 1 in the morning, every morning, and a half later in the day whenever I feel like it. It’s set up that way because I have class in the mornings, and the rest of the day is free. However, I am my most comfortable in class, so I rarely take one in the morning. Some days I don’t take any at all.

When I was so completely overloaded with work and extremely frustrated so much that I couldn’t think, I knew I had to take some. I’m an addict, so I TRY to only take some when I have to. When nothing else is working, when I can’t calm myself down, when I’m completely uncomfortable, and when nothing is changing for the better.

Do you have any history of drug use or with being prescribed benzodiazepines or any other addictive medication? I ask because, yes, that is how both bohm and I take our medication, but both of us ended up in rehab.. So it may not be the best example to follow.

My advice to you, regardless of your drug use history (but ESPECIALLY if you have a history of drug abuse), is to take the .5mg when you feel like you need it. Don’t get on a regular schedule with these medications, because like bohm, I found this ineffective, and it also increased my tolerance the quickest. Take the .5mg when you need it, when you’re in the situation I described above. Wait an hour, (like bohm also said, it takes about an hour to notice real benefits if they’re going to come because of the drugs long half-life). IF, after an hour you have had no reduction in your anxiety, or you feel you haven’t received sufficient reduction in your anxiety, go ahead and take the other .5mg. If you don’t have any history of using benzodiazepines, I’m fairly confident that your anxiety will be reduced to a manageable level after this point.

I was prescribed 1.5mg a day, and to take a whole one at a time, but I know the best way to tell, and not over-medicate, is to approach it slowly. Now obviously, if you’ve been doing this procedure, and sometimes the .5mg is working for you, and sometimes you need to take the other .5mg and all of a sudden you have a bad panic attack, then go ahead and take the 1mg dose. Like bohm said, adjust your dose to your anxiety level, but always try to make sure you err on the side of caution. Drug addiction is very serious and often times starts out in seemingly harmless situations.

What I try to do now, is make sure that I have pills left over, or run out exactly when my prescription is supposed to be used up regardless of how I use them on day-to-day basis. This last month, I had 4 left over at the end of the month, something I had never accomplished. Now that I don’t have as much stress, I am starting to slip and just take a whole one, but I suppose I can excuse myself because I was in new and very uncomfortable circumstances.

I hope that will help you some.

*EDIT*

Tolerance to Benzo’s MOST CERTAINLY DOES BUILD UP. I was very good friends with a guy that I was in rehab with, and he was taking doses of 25 xanax bars at a time, 50mg of Alprazolam (Xanax) AT ONCE, and wasn’t receiving benefit. Tolerance is your biggest enemy when it comes to medication. In the past, I’ve been able to take up to 20mg of Xanax and not pass out, and that wasn’t even my main drug of choice.

This is a very recent study. There are a few other similar ones. You think many of us with social/performance anxiety issues just happen to come by accident on a dick-pulling forum or do we suffer from both? Fuck, the thought of suffering from SAD/GAD/BDD and maybe Asperger’s is a scary thought. But there does seem to be some relationship for me.

Clin Psychol Rev. 2010 Dec;30(8):1040-8. Epub 2010 Aug 14. Relationship between social anxiety disorder and body dysmorphic disorder. Fang A, Hofmann SG.

Department of Psychology, Boston University, Boston, MA 02215, USA.

Abstract
Social anxiety disorder (SAD) and body dysmorphic disorder (BDD) are two separate, but conceptually overlapping nosological entities. In this review, we examine similarities between SAD and BDD in comorbidity, phenomenology, cognitive biases, treatment outcome, and cross-cultural aspects. Our review suggests that SAD and BDD are highly comorbid, show a similar age of onset, share a chronic trajectory, and show similar cognitive biases for interpreting ambiguous social information in a negative manner. Furthermore, research from treatment outcome studies have demonstrated that improvements in SAD were significantly correlated with improvements in BDD. Findings from cross-cultural research suggest that BDD may be conceived as a subtype of SAD in some Eastern cultures. Directions for future research and clinical implications of these findings are discussed.

Relationship between social anxiety disorder and body dysmorphic disorder - PubMed

If I didn’t have problems with BDD before when I was a normal, good looking kid that had some insecurities.. I certainly do now since my eyes are fucked up all the time.. Being misaligned and what not. It has kept me isolated for the past 2 years, but you know what? Despite all the problems I have, I feel better and more confident in my social interactions than ever right now. I’m only expecting things to continue improving from here on. I was thinking to myself the other day, that damn all these girls are talking to me and there’s openings to flirt with them and ask them out all of a sudden, and then I realized that this was happening only because I was actually paying attention instead of looking at the ground and trying my best to ignore everyone, and to have everyone ignore me.

The thought is only scary if you let it scare you. If you’ve already had the problems, but just now identify them, what’s different? Only your perception, not reality.