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!

 

[Jumpinbare]

I take 225 mg of efexor for my narcolepsy ( it suppresses sleep paralysis, which goes with narcolepsy. My paralysis was so extreme it was preventing me from breathing.)

It hasn't touched my social anxiety a bit. I still have to force myself to interact socially, and I never come away with a sense of good feelings from social interactions.

 

[vergil96]

i'm just too fixated on the _possibility_ i made a mistake. even when things go fine i just feely icky afterwards.

Sounds like anxiety, 100%

 

[are]

Sounds like anxiety, 100%

Yeah it really does. I'm just saying I don't like have these thoughts others do. I just feel the anxiety sometimes. There's no like thing there that can be fixed like an idea about myself. But it's still social anxiety whatever causes it. 100%.

That's why i went for the antidepressant i was like look this can't hurt. Hopefully that just goes away.

 

[Judge]

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?

It's part of the process, for better AND worse. Better known as "drug therapy". Where there are no guarantees of what a medical professional prescribes for you. Where ultimately you as the patient must be on the front line in terms of evaluating whether or not a medication is working for you, or if it is making things worse. Some meds will work better than others, while some made my condition much worse. So it pays to be able to articulate your observations to your physician the best you possibly can.

Many years ago I was given a cardiac medication as a "beta blocker" for essentially what you have outlined in your post. While it definitely subdued my pronounced symptoms of social anxiety, it also turned out to be potentially damaging to my heart. While it ultimately helped me get over extreme nervousness in social interactions, it also left me for a time with irregular heartbeats. Luckily they were PACs, considered to be relatively benign. Something I hardly ever experience any more.

The medication in question (Metoprolol) remains controversial....but is still on the market. Luckily these days patients have many more pharmaceutical options than years ago.

Don't be too discouraged over having to try out multiple medications. It's just part of the process...

 

[Autistic Yoda]

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.

Same experience. Zoloft reduces shyness.

 

[velociraptor]

I tried this approach (meds). Did not work at all. Therapy is what made the difference. Had to identify bad habits and replace them with better habits. Not all the way there yet, but doing much better.