Health - Most effective benzo to combat Social Phobia + GAD?

[hemalitun]

SWIM has been diagnosed with both Social Phobia (primary) and Generalized Anxiety Disorder (secondary). SWIM's anxiety is most crippling -- approaching panic -- during specific social situations, but these episodes occur only periodically. SWIM also suffers from low-to mid-level anxiety (often about nothing in particular); though not as physiologically pronounced as their socially-related anxiety, it has proven just as burdensome, for it seems to never go away. Throughout the entire course of an "easy" day, SWIM feels as though their body is in a fight-or-flight mode, with feelings -- typically vague -- ranging from those generally uncomfortable (as good as it gets) to those of absolute physical crisis. SWIM describes an "easy" day as one without anxiety triggered by an uncomfortable social encounter, for such encounters can lead to full-blown panic attacks.

One self-defeating practice that contributes to SWIM's extreme day-to-day discomfort is their obsessive fear of fear: of a panic attack potentially occurring, or that their condition might be gradually worsening. SWIM thinks about their anxiety incessantly -- more or less all day, every day -- which surely can't help their predicament.

SWIM has cut out caffeine, nicotine, and all other stimulants from their diet; they exercise regularly and make sure to spend time with their dog (which SWIM finds relaxing). They have been practicing cognitive behavioral therapy, rather unsuccessfully, with a psychologist -- SWIM believes that the therapy might prove more effective if they were being treated with some sort of medication. Currently, SWIM self-medicates with opioids and benzodiazepines (specifically xanax and valium). They find the opioids to be most effective, followed by xanax; valium seems to hardly help at all.

To get to the point, SWIM expects to soon receive a prescription for some type of benzodiazepine to combat their anxiety, but wonders, given their specific symptoms (relatively infrequent but highly crippling panic attacks in certain social situations; generalized, incessant anxiety of mild to severe intensity), which benzo would likely produce the most effective results.

The shorter-acting benzos -- Xanax in particular -- work wonders for SWIM's short-term social anxiety, but once they wear off, SWIM is again left with persistent generalized anxiety of varying intensity. A longer-acting agent (such as ativan or klonopin) might suit SWIM's needs, but SWIM also wonders whether those medicines would be strong enough to adequately suppress their more severe anxiety in certain social situations.

Sorry for the long post and thanks in advance for your input and advice.

[blackdb1]

Swim has GAD, SAD, panic disorder, and ADHD. Swim is on suboxone for his opiate maintenance along with 4mg Klonazepam a daya dn 1.5mgs of alprazolam a day. The klonopin definately works better for the GAD and also for the social! Xanax is swims preference for sleep and panic attacks.

Hopefully that answers your question somewhat!!!??? Swim thinks either a medium length benzo or a fast acting and a long acting med.

[JaWill88]

swim is on the sub as well. swim must agree clonazepam much better for GAD and SAD. xanax is much more hypnotic so is way better for sleep, and short acting=more intense effect, so seems better for the panic attacks.

[tstegal1]

SWIM can definitely understand what SWIY is going through. He has severe social anxiety disorder (even just posting on this forum causes him stress). His doctor gave him a script for xanax and paxil. The paxil just zombied swim out so he quit taking it. The xanax worked though. It doesn't cure the problem (swim still is extremely nervous even on the xanax but it does allow him to overcome his fear enough so that he can somewhat function in society). Without the xanax he couldn't even leave the house.

Xanax, however, makes swim very drowsy. So here's what swim does. He takes his xanax and then also drinks one of those 5-hour energy shots which combats the drowsiness of the xanax without diminishing its effects. I know SWIY said he gave up the caffeine but maybe the caffeine/xanax combo might help.

On a side note, SWIM lost a job opportunity a few days ago because the manager said, and I quote, "We don't hire nervous people."

Just keep your head up, keep truckin', and never give up hope

[hemalitun]

Caffeine use, especially long term, definitely and significantly worsens SWIM's anxiety, so they don't think energy shots would be a good idea.

Anybody have feedback on their experiences with Diazepam as a treatment for GAD / Social Phobia? Does anyone else share SWIM's perception of its relative ineffectiveness?

hemalitun added 263 Minutes and 12 Seconds later...

SWIM visited their doctor today and was again prescribed an SSRI (Zoloft) -- despite their continued protests and long-standing skepticism of antidepressants in general.

SWIM is suffering and doesn't know where to turn.

hemalitun added 189 Minutes and 53 Seconds later...

Another thing: SWIM just read that Valium can take quite a long time to take effect (between two and four hours). Can anyone assess the validity of this claim? If it's true, it would explain a large part of SWIM's dissatisfaction with the drug, as it would mean that they had been dosing at the wrong times.

Again, sorry for the multiple questions, and thanks a lot for your help.

[tstegal1]

Valium hits SWIM pretty fast, maybe about 10 minutes for it to start taking effect. Swim still finds xanax to be more relaxing though. I'm not sure about Valium, but xanax can be taken under the tongue (let it dissolve if you can stand the taste) and it will hit you much quicker.

Best of luck!

[sirdrugalot]

swim would say clonazepam for unlike diazepam its not as sleepy and its very good for going about your dayily duties and interacting with people. for bursts of anxiety swim would say xanax as its very quick acting (about 5 min) it has a short half life, its also nice and strong. but its very morish be warned.