Antidepressant for Social Avoidance/Anxiety?

[are]

I just started Effexor 75mg a week ago.
I feel uncomfortable before and after social interactions.

It doesn't neatly fit like social anxiety disorder. or avoidant personality disorder.
because the things i think aren't irrational. i'm just too fixated on the _possibility_ i made a mistake. even when things go fine i just feely icky afterwards.

But i just told my psychiatrist i'm operating under the assumption I have social anxiety disorder and requested the medication.
We'll see how it goes!

What is your thoughts on this? Some say it's all autism. Some say comorbid autism and social anxiety disorder.
Have you tried medication? How has it worked for you?

 

[Matthias]

It sounds like a lack of confidence to me that would be better treated with talk therapy or self-help books.

 

[are]

I can't do talk therapy - it causes iatrogenic harm. It's contraindicated. Also, why wouldn't both techniques be used simultaneously, then remove one if there's additional capacity and you don't know which did it?


But the side effects from psychotherapy are extreme and intolerable. That might literally kill me.


I'm also doing weight training. I noticed that helped. And I'm doing my own program for exposure that I developed, using VR glasses and AI agents for practicing social skills.


I have significant artifacts - a lot of research. I used probably 100,000 LLM tokens to synthesize it. The SSRI question (Effexor acts as an SSRI at sub-150mg levels), the weight lifting - I was already doing cardio, etc. I just ranked them. It will take a lot of work and a combination of everything I have energy to do.


But if I could learn to behave normally - like actually not be isolated - it would be invaluable. This is the blocker for my life.


And I will remove the antidepressant if I don't need it or it's unhealthy, but I'll have to plan for that due to discontinuation syndrome risks for sure.

 

[Matthias]

I don't know much about drugs. My understanding is that they're mostly short-term fixes to adjust mood, which makes it easier to address the underlying psychological cause of mental health problems. Since therapy is contraindicated, self-help books are a good option. You can find books on emotions, anxiety, self-esteem, confidence, and probably every other psychological problem you can imagine.

 

[Tuffsy]

I had extreme anxiety when I started a new job as a teacher at age 55. It was very scary! My GP started me on an anti-depressant (forgot name) which didn't work, but then he prescribed an SSRI (Zoloft) and this really did the trick for my 3 years of teaching before I had to leave. It then took me another 5 or 6 years to wean myself off these addictive drugs. So they were good at the time.

 

[are]

I don't know much about drugs. My understanding is that they're mostly short-term fixes to adjust mood, which makes it easier to address the underlying psychological cause of mental health problems. Since therapy is contraindicated, self-help books are a good option. You can find books on emotions, anxiety, self-esteem, confidence, and probably every other psychological problem you can imagine.


No i can't use mental health frameworks at all in that way. I don't think in words and narratives. Emotions are labeled outputs not an organizing principle. I'm autistic.

 

[the_tortoise]

I'm also doing weight training. I noticed that helped.

Does this help more than other strenuous exercise like cardio?

I ask because maybe your anxiety could be multi-factorial and involve a sensory processing cause as well as a social anxiety cause?

I remember my OT I saw for sensory processing disorder telling me a story about another adult patient she had (she mostly saw children but also some adults), a guy who had severe anxiety he could find no cause nor useful treatment for....turned out he had pretty serious proprioceptive hypo-sensitivity (under-sensitivity) that caused him a sort of constant background anxiety -- many people who have this and are at all aware of it say that most of the time they feel like they are sort of floating (I have severe proprioceptive hyposensitivity and I have never felt like that - but I can say it is hard to locate my body in space as a rule, which is similar). He did much better with a daily sensory diet of weightlifting and other high-proprioceptive-input activities.

If you have some sensory-driven anxiety at baseline maybe that worsens your social anxiety?

Just a thought because you said weight lifting helps -- I could be so off base ; You know yourself best!