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Exposure therapy for social anxiety

social anxiety

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#1 Phiaq

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Posted 18 August 2012 - 09:04 AM


As a social anxiety sufferer I have to do lots of exposure to help me reprogram my mind. This is so painful and stressful that I have to have some chemical support during therapy. I want to do this using a stimulant + anxiolytic combo, while keeping my brain healthy enough to prevent addiction or tolerance or withdrawal symptoms.

The stimulant will help me think quicker and narrow my focus. Social phobics usually overthink situations and as a result we needlessly get distracted by so many signals instead of enjoying the social situation. Stimulants should help us focus on the situation and easily filter out negative thoughts. I could alternate (a combination of) the following supplements.

L-Dopa
L-Tyrosine (+ something to reduce thyroid activity?)
L-Phenylalaline (+ something to reduce thyroid activity?)
Caffeine
Phenylethylamine

To keep calm and take the edges off the stimulating effects, I need an anxiolytic. A relaxed mind should think better. For me, only benzos have noticeable anxiolytic effects. I want to take one in the morning so that it will have completely left my system by the time I go to bed. This should prevent tolerance and withdrawal symptoms because my brain will have enough benzo-free restorative sleep. I’m not sure if and how long this will work though.

For further brain protection and improved function, I want to take cholinergics like ALCAR, different phosphatides, and DMAE.

Exercise, meditation, antioxidants (like curcumin), fish oil, correct breathing, super foods etc. should all help me further realize my goal and protect my brain.

Are there any other supplements I could take for any of the categories I listed above? And would this work for a 5 day of the week exposure program (I won’t use them on weekends)? How safe is the long term use of benzos?

ps. I have to watch out for (glutamate) excitotoxicity. I’ve had some really bad experiences with piracetam and I do have a mild case of HPPD.

Edited by x74x61, 18 August 2012 - 09:04 AM.


#2 Major Legend

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Posted 18 August 2012 - 12:05 PM

First of all with benzos i think you should try different types as people seem to react differently to differen benzos.

Alternatives to anxiolytics could be theanine or picamillion taurine or gaba

I wouldnt take ldopa its not much use with a Peripheral inhibitor anyways.

The supplements you pick are unlikely to produce much of a stimulant effect not for social anxiety anyways, might be better with focus xt or add ginkgo to your stacck alpha gpc is pretty good to but you need to dose before sleep and in the morning.

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#3 noos

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Posted 19 August 2012 - 01:40 PM

Isn't that exposure therapy does not work if you take an anxiolytic?
Anyway, why don't you use a beta blocker?
Or better
http://www.anxietycl...ycloserine.html

Edited by noos, 19 August 2012 - 01:49 PM.


#4 Phiaq

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Posted 20 August 2012 - 06:57 AM

First of all with benzos i think you should try different types as people seem to react differently to differen benzos.

So far I've only tried oxazepam. Which would you recommend I try? I was thinking clonazepam.

Alternatives to anxiolytics could be theanine or picamillion taurine or gaba

Picamillion I haven't tried yet. But the rest have a really mild effect on me. I could use them for mild situations.

I wouldnt take ldopa its not much use with a Peripheral inhibitor anyways.

Don't you mean 'without'?

The supplements you pick are unlikely to produce much of a stimulant effect not for social anxiety anyways, might be better with focus xt or add ginkgo to your stacck alpha gpc is pretty good to but you need to dose before sleep and in the morning.

These are great suggestions thanks!

#5 Phiaq

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Posted 20 August 2012 - 07:04 AM

Isn't that exposure therapy does not work if you take an anxiolytic?
Anyway, why don't you use a beta blocker?
Or better
http://www.anxietycl...ycloserine.html


Yeah it might take longer than normal, but I forgot to add that I have a REALLY bad case of AVPD next to my SA as well. There's no way I can enjoy myself or even function in social situations without an anxiolytic. I would have too many negative thoughts AFTER the events. Thus there would be no fear extinction.

But, I might try starting with benzos and then slowly switch to beta blockers starting with one day of the week, 2 days, 3 days and so on... once I feel comfortable doing so. -- meaning; once I get familiar with the people I'm about to meet.

#6 Major Legend

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Posted 20 August 2012 - 07:35 AM

First of all with benzos i think you should try different types as people seem to react differently to differen benzos.

So far I've only tried oxazepam. Which would you recommend I try? I was thinking clonazepam.

Alternatives to anxiolytics could be theanine or picamillion taurine or gaba

Picamillion I haven't tried yet. But the rest have a really mild effect on me. I could use them for mild situations.

I wouldnt take ldopa its not much use with a Peripheral inhibitor anyways.

Don't you mean 'without'?

The supplements you pick are unlikely to produce much of a stimulant effect not for social anxiety anyways, might be better with focus xt or add ginkgo to your stacck alpha gpc is pretty good to but you need to dose before sleep and in the morning.

These are great suggestions thanks!


Sorry my initial response was sloppy. I'm not perfect like some of the other smarter members here... lol

Yes benzos are surprisingly different from one type to one type, valium might cause headaches and nausea in some people, but be perfect for others. Do play around, you've also got Xanax and Lorazepam too.

Picamillon (however you spell it) is rumoured to actually be quite strong, bacopa is meant to be anxiolytic too (but you're right they are all mild compared to even low dose benzo or a little alchohol) high doses of taurine is surprisingly sedative to me

Yes I meant without. I mean ldopa + peripheral inhibitor is basically mild sinemet which causes a lot of problems lie tardive dyskinesia that could be permanent, its not worth the risk, and personally it doesn't do much for anxiety anyways. Feel free to search the net for reviews on ldopa, unless you are looking to build muscle...

#7 noos

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Posted 21 August 2012 - 03:34 PM

Isn't that exposure therapy does not work if you take an anxiolytic?
Anyway, why don't you use a beta blocker?
Or better
http://www.anxietycl...ycloserine.html


Yeah it might take longer than normal, but I forgot to add that I have a REALLY bad case of AVPD next to my SA as well. There's no way I can enjoy myself or even function in social situations without an anxiolytic. I would have too many negative thoughts AFTER the events. Thus there would be no fear extinction.

But, I might try starting with benzos and then slowly switch to beta blockers starting with one day of the week, 2 days, 3 days and so on... once I feel comfortable doing so. -- meaning; once I get familiar with the people I'm about to meet.


I also worry after events.
I think you should try the beta blocker first.
Have you considered fluoxetine or other SSRI ?
.

#8 Phiaq

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Posted 22 August 2012 - 12:03 PM

Isn't that exposure therapy does not work if you take an anxiolytic?
Anyway, why don't you use a beta blocker?
Or better
http://www.anxietycl...ycloserine.html


Yeah it might take longer than normal, but I forgot to add that I have a REALLY bad case of AVPD next to my SA as well. There's no way I can enjoy myself or even function in social situations without an anxiolytic. I would have too many negative thoughts AFTER the events. Thus there would be no fear extinction.

But, I might try starting with benzos and then slowly switch to beta blockers starting with one day of the week, 2 days, 3 days and so on... once I feel comfortable doing so. -- meaning; once I get familiar with the people I'm about to meet.


I also worry after events.
I think you should try the beta blocker first.
Have you considered fluoxetine or other SSRI ?
.


I've tried propanolol before. I had a racing mind with a calm body and a surprisingly calm voice... my heart rate was so constant it was bothersome. I didn't have much opportunity to experiment around with my thoughts though... didn't learn anything from it. Is it something I have to take constantly day and night or only when I need it?

As for SSRI's, I'm too afraid I'll damage my serotonin system.

#9 noos

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Posted 22 August 2012 - 01:50 PM

propranolol you take on ocassion.
why will an ssri cause damage?

#10 Phiaq

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Posted 22 August 2012 - 02:08 PM

propranolol you take on ocassion.
why will an ssri cause damage?


I don't know. There are lots of horror stories on the internet. I don't trust SSRI's because their function depends on altering your serotonin system.

propranolol you take on ocassion.
why will an ssri cause damage?


I don't know. There are lots of horror stories on the internet. I don't trust SSRI's because their function depends on altering your serotonin system.

#11 noos

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Posted 23 August 2012 - 07:48 AM

propranolol you take on ocassion.
why will an ssri cause damage?


I don't know. There are lots of horror stories on the internet. I don't trust SSRI's because their function depends on altering your serotonin system.

propranolol you take on ocassion.
why will an ssri cause damage?


I don't know. There are lots of horror stories on the internet. I don't trust SSRI's because their function depends on altering your serotonin system.


Anything that is not food alters your system.

And what is wrong with that if that is what you need? Do you want to make a difference or not?

Edited by noos, 23 August 2012 - 07:50 AM.


#12 jadamgo

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Posted 24 August 2012 - 03:41 AM

What behavioral anxiolytic techniques are you using during the exposure? (E.g. defusion, mindfulness, deep breathing, etc.)

If you aren't using them, start using them. Unless you're using flooding, you have to train yourself to loosen up under even the most difficult circumstances for the exposure therapy to work. Otherwise you're just rubbing salt in the wound.

BTW, they just started selling D-Serine. You know what I'd suggest for your anxiety? Fuck the benzos, beta-blockers, picamilon, theanine, SSRIs, MAOIs, and all those stimulants you mentioned. Here's what you need:

Number one, make sure you know cognitive/behavioral anxiolytic techniques. Insist that your therapist teach you some.

Number two, get some aniracetam. (Other noots will not subsitute for aniracetam's unique anxiolytic/stimulant effects. It's both a short-term adaptogen and a memory formation enhancer.) Take aniracetam, 500-3000mg about 1-3 hours before every exposure activity.

Number three, and this one is optional, get some D-Serine and take it with the aniracetam. I can't advise you on dosage. D-cycloserine was proven to speed up fear deconditioning in humans receiving exposure therapy for anxiety. D-serine will work even better as it's a stronger agonist. It will speed up the effectiveness of your therapy.

If you're too anxious to survive the exposure session, fiddle with the aniracetam dosage. Some people find that 300mg works great. Others need 3000mg.

Best of luck. I'm mostly recovered from SA, and exposure was the only thing that really worked. Pardon the cliche, but it really is true: pills don't teach skills.

#13 Phiaq

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Posted 24 August 2012 - 07:56 AM

Anything that is not food alters your system.

And what is wrong with that if that is what you need? Do you want to make a difference or not?


If it works for people, then that's great, but I just don't want to take any more risks. I already am in bad shape because of HPPD. Come to think of it, benzos are a big risk too and I probably will stop using them.

Edited by x74x61, 24 August 2012 - 07:59 AM.


#14 Phiaq

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Posted 24 August 2012 - 08:14 AM

What behavioral anxiolytic techniques are you using during the exposure? (E.g. defusion, mindfulness, deep breathing, etc.)

If you aren't using them, start using them. Unless you're using flooding, you have to train yourself to loosen up under even the most difficult circumstances for the exposure therapy to work. Otherwise you're just rubbing salt in the wound.

BTW, they just started selling D-Serine. You know what I'd suggest for your anxiety? Fuck the benzos, beta-blockers, picamilon, theanine, SSRIs, MAOIs, and all those stimulants you mentioned. Here's what you need:

Number one, make sure you know cognitive/behavioral anxiolytic techniques. Insist that your therapist teach you some.

Number two, get some aniracetam. (Other noots will not subsitute for aniracetam's unique anxiolytic/stimulant effects. It's both a short-term adaptogen and a memory formation enhancer.) Take aniracetam, 500-3000mg about 1-3 hours before every exposure activity.

Number three, and this one is optional, get some D-Serine and take it with the aniracetam. I can't advise you on dosage. D-cycloserine was proven to speed up fear deconditioning in humans receiving exposure therapy for anxiety. D-serine will work even better as it's a stronger agonist. It will speed up the effectiveness of your therapy.

If you're too anxious to survive the exposure session, fiddle with the aniracetam dosage. Some people find that 300mg works great. Others need 3000mg.

Best of luck. I'm mostly recovered from SA, and exposure was the only thing that really worked. Pardon the cliche, but it really is true: pills don't teach skills.


I know all of the techniques you mentioned. If only I could use them effectively during exposure. Anxiety and low self-esteem/worth always get the better of me. This is something I'll have to work on.

Like I said I suffer from HPPD symptoms and piracetam only made it worse - so I shouldnt take aniracetam. D-serine sounds interesting, will it be safe for me?

#15 jadamgo

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Posted 24 August 2012 - 07:52 PM

Aniracetam does not work via a similar mechanism to piracetam. In some ways, it has the opposite effects. Nonetheless, I would understand if you were too shell-shocked to consider trying it; that's a reasonable concern.

Serine is a glutamate increaser. It should be more than safe for you.

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#16 noos

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Posted 28 August 2012 - 03:45 PM

Aniracetam does not work via a similar mechanism to piracetam. In some ways, it has the opposite effects. Nonetheless, I would understand if you were too shell-shocked to consider trying it; that's a reasonable concern.

Serine is a glutamate increaser. It should be more than safe for you.


Can you please explain the difference between pira and aniracetam?

..............

Mg?

http://www.ncbi.nlm....ubmed/22016520/

Edited by noos, 28 August 2012 - 03:46 PM.






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