
How a month and a half on Paxil taught me to love being shy. - vaksel
http://www.slate.com/id/2143243/?
======
wallflower
"It's really hard. If you can medicalize your faults, you get legal protection
for them. If you can't medicalize them, you're personally responsible for
keeping them in control. That creates a huge incentive for medicalization of
everything in the human condition. And we're all worried about being left
behind in this Red Queen's Race."

From excellent comment from philosophical discussion about Modafinil (the
stay-awake-alert-all-night magic drug).

<http://news.ycombinator.com/item?id=389321>

<http://news.ycombinator.com/item?id=389408>

~~~
Raplh
Hacking personality. Welcome to cyberpunk, what made you think it was all
fiction?

Eventually the artificial line between "medical" and "I feel like it" will
need to be addressed. On the other hand, the world is probably rich enough to
support the kind of experimentation described here "in the noise."

Personally, I expect or rather hope for a drug that will truly help me lose
weight with minimal danger and minimal side effects. I eat too much, almost
enough to qualify for "the biggest loser," but not quite at that level. (If I
lost 100 pounds I'd be thin but OK, they routinely lose 100 pounds or more and
are still zaftig, plus they are shorter than me.)

I'd say as long as I wait for the right drug to lose weight, I can't fault
those who have found it to talk to more girls at parties. Its probably
healthier than becoming a rock star or carrying around cocaine all the time
anyway.

~~~
aaronblohowiak
Wellbutrin helps with appetite as well as depression smoking and ad(h)d. You
should also get checked -- you may be (pre)diabetic.

------
kirubakaran
I found the top comment in Reddit about this topic to be very interesting:

[http://www.reddit.com/r/reddit.com/comments/88i21/how_a_mont...](http://www.reddit.com/r/reddit.com/comments/88i21/how_a_month_and_a_half_on_paxil_taught_me_to_love/c08jqz4)

My personal experience: When I was regularly playing Racquetball and lifting
weights, I didn't find everyday problems - tough as they were - to be
daunting. Then there was a long gap when I didn't have this protection and the
circumstances had much greater impact on my mood. I am starting workouts
again.

~~~
arjungmenon
The comment:

 _If you are male, the best "drug" for social anxiety is weightlifting. (No,
you don't need to be a huge-ass body-builder-douche, if you don't do 'roids
you probably won't be one, you'll look normal and athletic.)

I think probably it's all about testosterone - weightlifting increases the
levels of those and thus makes us feel more "manly" and that just blows away
the insecurity.

I'm not a scientist, so that testosterone stuff is just a guess, but it was
amazing how at the age if 17 it transformed me from a shy, withdrawn, never-
look-people-in-the-eyes teenager to a "real man" - relaxed, confident, one who
talks to people as a real equal. Much of social interaction has hidden traces
of very primitive instincts behind it: the sexual instinct and the fight
instinct, and weightlifting gives you confidence in both (even though you
would still be beaten to a pulp by any 120 pound Thai Box fighter, but that
doesn't matter, you probably don't actually need to fight: it's just the
feeling) which transforms into a relaxed and confident social interaction.

Another way to put it is that as an Aspie, I always felt alien from both the
world and from my body. My idea of "me" is something in my head who tries to
drive my body with a remote control and it just doesn't work well.
Weightlifting got me to connect with my body, it made by body a part of the
"me", and through the body as a medium, it made me connect with the world and
other people. (Probably it's something about strenghtening some under-used
neural pathways that connect the "self" parts of the brain with other parts.)

Now at 30 I'm often too lazy to do it, but whenever I do it for a few months,
my Aspiehood just goes away._

~~~
shard
I always find it strange that when people suggest doing weight training,
there's often a disclaimer that you won't become huge and muscular with
regular workouts. It's like a disclaimer saying that you won't get all brainy
and smart if you study physics or math. I would imagine that if you had the
potential to be a world class bodybuilder, it's worth exploring, just as if
you had the potential to be a world class physicist, it's worth exploring.

About weight lifting helping cure social anxiety, I think it's more than just
testosterone. If you get serious about weights, you start watching your diet.
Eating well is a large component of feeling well, and cutting down on junk and
processed foods makes a noticeable difference in mood and energy.

~~~
manvsmachine
Another factor that comes into play is having regular periods of intense
focus. We all claim to be focusing when we're doing work, but there are still
all those microdistractions that come with the territory. You'll learn very
quickly how to maintain focus if you down want to drop a couple hundred pounds
on your chest.

There was a period of time when I wasn't working out, but I'd go for a drive
late at night when I was stressed. Not a normal drive, mind you; I would blast
up and down the side of a nearby mountain. The physical aspect of driving,
combined with the focus necessary to not go flying off a cliff, had a very
similar effect. I don't recommend this, as it was extremely reckless, but if
you happen to live anywhere near a track, or even a karting facility, I'd
strongly suggest trying it out.

~~~
hussong
Joseph Campbell said it best: "people want to feel alive".

And when you're exercising at the limit of what you're physically capable of,
you do feel very alive.

Getting into and pushing through physical pain on a regular basis also makes
it easier to connect to and overcome other pains in you.

------
paul_houle
Personally I'm not a fan of antidepressants. For me, Prozac had the side
effect of extra-sensory perception: I couldn't do anything without having
immediate karmic effects on people I knew who lived hundreds of miles away.
I'd be sitting in bed talking to my wife about (essentially unpredictable)
events that would happen to take place the next day. People think they might
want those kind of powers, but you can count me out. I lasted about a week,
but it took most of a month for the metabolites to wash out of my system.

One tablet of lexapro causes my interest in sex to disappear entirely for a
week. Personally I think this simplifies my life, but three days of
sleeplessness is quite a price to pay.

A friend of mine started taking Effexor, but then we found accounts of how
it's impossible to stop taking Effexor: blood-curdling stories about
pharmacists who'd dissassemble the pills and reassemble them to titrate the
dose down, and who'd still be unable to get the dose to zero. He stopped in
three days, before the damage was done.

Anyhow, all of those drugs affect serotonin metabolism, as do the 5-HT2A
agonists that some people call psychedelics or entheogens. Alexander Shulgin
did a 30-year research program on psychedelic phenethylamines (drugs
structurally related to dextroamphetamine, mescaline and ecstacy) and found
that certain drugs in that family have a synergism with alcohol much like what
the author of that article describes.

~~~
gregoryl
I think I lost you there, can you explain this line for me?

    
    
      A friend of mine started taking Effexor, but then we found accounts of how it's impossible to stop taking Effexor:
      blood-curdling stories about pharmacists who'd dissassemble the pills and reassemble them to titrate the dose down,
      and who'd still be unable to get the dose to zero. He stopped in three days, before the damage was done.
    

Edit: Fixed format as requested.

~~~
Zaak
For me, stopping Effexor after having taken it for a year was 2-3 weeks of
misery. I have heard that for some people the withdrawal is so bad that they
can't stay off the drug long enough for their body to finish returning to
normal.

------
Semiapies
I don't know that this is really that irrelevant. Hacking the brain has been
an interest of some hackers since at least the 80s, and once you get beyond
some over-hyped nootropics, drugs like Paxil _are_ how people are hacking
their brains.

Further, there are a lot of shy geeks out there who might want to try
something like Paxil. Brain chemistry is a very complicated and sometimes
weirdly individual thing, and while there are undoubtedly people who've
benefited from Paxil, I think it's useful to have a clearer narrative of what
the very possible downsides are beyond some rattled-off disclaimers on a
commercial.

~~~
jlees
One interesting downside to SSRIs in general I heard about recently comes via
Helen Fisher's research (<http://www.helenfisher.com/>) - SSRIs suppress the
dopamine systems in the brain, and high levels of dopamine are associated with
the 'artisan' personality type (manic, creative, risk-taking, autonomous).
High levels of serotonin are associated with the 'builder' type (managerial,
traditional, stubborn).

So by taking SSRIs to hack your brain's level of shyness you might actually
end up dampening your entrepreneurial vibes and becoming a middle-manager.
Crazy, huh.

~~~
arjunb
Are there good ways of measuring your dopamine/serotonin levels?

~~~
asciilifeform
No.

<http://www.etfrc.com/ChemicalImbalances.htm>

 _"No experiment has ever shown that anyone has an "imbalance" of any
neurotransmitters or any other brain chemicals."_

~~~
HeyLaughingBoy
That's not what he asked. The question is "can it be measured?" and it can:
<http://www.clinchem.org/cgi/content/full/44/1/155> and
<http://www.springerlink.com/content/tq58032421q41q14/> and
[http://www3.interscience.wiley.com/journal/110436914/abstrac...](http://www3.interscience.wiley.com/journal/110436914/abstract?CRETRY=1&SRETRY=0)

I write code for medical devices for a living; if a substance found in the
body is therapeutically interesting, then someone, somewhere has built an
instrument to measure it :-)

~~~
asciilifeform
The comment author almost certainly assumed that the measurement would have a
_meaning_ \- specifically, that it would determine whether he might benefit
from a drug.

There is no doubt that we can measure the concentration of dopamine or
serotonin in an aqueous solution (and eventually, within a brain.) Whether
there can be any clinical point to such a measurement is debatable.

------
jurjenh
One of the issues that has always bugged me about this is the issue of context
- medicine has a great track record in treating emergencies, but fares quite
poorly with preventative care and chronic illness.

The issue arises when people associate the good track record of emergency care
with preventative treatment - so essentially take what's prescribed as gospel.
Would you take investment advice from a great pig farmer? Dental advice from a
good banker? Art advice from a physicist?

I would imagine that pharma will have to tread very carefully over the next
decade, as the cumulative resuls of drug-trials like these start to create an
interesting track record. However, spin-doctoring is everything....

------
Adam503
I'm surprised 41 comments have been posted and nobody has pointed this out...

From Drugs.com... "What should I avoid while taking Paxil?

Avoid drinking alcohol, which can increase some of the side effects of Paxil."

<http://www.drugs.com/paxil.html>

From rxlist.com "...Alcohol

Although PAXIL does not increase the impairment of mental and motor skills
caused by alcohol, patients should be advised to avoid alcohol while taking
PAXIL...."

<http://www.rxlist.com/paxil-drug.htm>

There usually a pretty good reason for medical warnings. Sherlock here made
that pretty clear. He was warned not to drink alcohol. He drank. The side
effects of the medication became more intense when mixed with alcohol just as
he was told would happen.

If you are warned by a doctor and/or pharmacist not to mix alcohol with a
medication, then don't mix alcohol with that medication.

~~~
rjurney
You can't follow the directions of the medicine you're testing if you're out
to villainize an entire class of life-saving medications to support the moral
weakness theory.

I hate to say it, but this article is trollish. He isn't depressed. He doesn't
have social anxiety disorder, he's just shy. He doesn't get therapy or join
toast masters, he just pops the pill and then gets drunk all the time.

And it doesn't work wonders for him. Who woulda thought?

------
shaunxcode
"Bitterness, anger, jealousy, sadness: They all make me happy."

Exactly. Coming full circle to the point you actually derive happiness from
what you once eschewed is probably the most important thing you can ever teach
yourself to do.

------
Eliezer
I have never taken a single neuroceutical that did what it was supposed to.
Ever. Including caffeine. Eventually I gave up and decided not to try messing
with my brain chemistry in any way ever again ever.

~~~
rms
Which ones have you taken?

------
rjurney
I had a similar, but more positive experience on Paxil, and I think my
experience is more typical than the author's, which is why it is in widespread
use.

I was always very shy, and had problems opening up to others. I was isolated
and depressed, so I saw a psychiatrist. I took Paxil and had intensive (and
expensive) therapy, and over the course of a year I opened up and learned to
enjoy other people. After that I did not require the Paxil, and I am much more
outgoing.

The side effects were not much fun: sweating, inability to orgasm or to feel
orgasms, insomnia, etc. and yes Paxil made me love alcohol too. The side
effects of depression however were much worse, and Paxil addressed those.

In combination with therapy it totally changed my life, and probably saved it.
Its not a recreational drug, however, and the author seemed to use it as such.

------
felipe
It's sad that our society values and rewards extroverts so much, that
introverts like the author feel the need to alter their minds in order to fit
in.

The very existence of the tweeters and facebooks tell something about that
need to reward extroverts.

------
likpok
From what I understand (to some extent personal experience), drugs like Paxil
can be very helpful for people with certain problems. Unfortunately, there is
a significant cost, and the gain may require more than just low-grade
$disorder to really be felt.

I guess it depends on your specific case.

~~~
gregoryl
Very much so. Sometimes you have little choice but to take the drugs.

It was once explained to me that depression is somewhat like a deep pit, with
slippery sides that get steeper and steeper....once you are in a certain
depth, you need a rope to get out.

Over the last year or two, I have begun to really understand how true that can
be, learning to control how deep my moods get, and use the people, world, and
experiences around me to keep myself from going beyond that self-salvageable
depth.

------
moe
Summary: Taking drugs to alter your personality is a bad idea.

~~~
branden
Taking drugs that have a net negative effect on your personality is a bad
idea.

------
paul7986
From 18 to 24 or so I was on tons of various anti depressants. In my
experience I found them all to be placebos! I was no different on them or off
them. Either way I really could never be myself around people I hung around
with; anxiety-ridden & silly OCD stuff(I can laugh at now).

For me talking about anxiety and OCD stuff was the biggest help. So many
people go through the same thing but you think your the only one and are
afraid to talk about it, because oh no people may think Im crazy. Yet were all
the same! Though even after talking about my issues it generally took some
years and feeling comfortable in my own skin was the end all cure.

Im not saying anti-depressants don't work, but for me they were pointless.
Time and talking about my issues with friends/others was my cure!

------
sherl0ck
I don't know guys, but after take a long run, I usually in high mood, and
ready for everything, yes that include talking to some strangers.

but then again, I am to lazy to do a long run periodically

------
ilkhd2
By the way, not very well known but benadryl (OTC antihstamine) and
Chlortrimeton (OTC antihstamine) are some of the oldest substances, known to
have serotonin and norepinephrine reuptake inhibition features. In fact Prozac
was synthesised from benadryl, in attempt to make it more potent
antidepressant. Chlorpheniramine was researched by swedish scientist, who won
Nobel prize (not sure for what exactly), in 1950-s and was found to have SNRI
effects. But I beleive these will never be researched again - it hurts
potential profits for Pharma.Who needs month of supply of antidepressant for
$10, when you can sell it for 200?

