No Klonopin

Well I didn't take the Klonopin last night and I definitely noticed a difference in being able to get to sleep. My mind kept wondering to work related things and I'd have to constantly nudge my brain to try to stay clear of thoughts..It did eventually work and I had a good night's sleep. As far as work goes I did notice a very slight difference, but nothing I can't over come. For the most part I had a pretty good day. I can see I am beginning to fear the manager though. She's not mean or even unkind, but she's not friendly either, and just sort of to the point. My SA brain takes this to mean that she doesn't like me, or I'm doing something wrong, or even worse, that I am annoying her. I just have such an issue with authority figures. *sigh* My practical side knows this isn't true, but I find myself trying to avoid her and getting excited when I know she won't be there. I don't want this to be the case, I will work on it. So my thought on Klonopin is that I am going to take it PRN. There are many situations where I feel like I will need that extra help, but I don't want EVERY day at work to be like that. I do feel like the increased dose of Prozac is doing me a lot of good. I am generally in a very good mood and I've been nicer to my husband. I still have difficulty at the drive through window. I am trying to figure out why. I think it's because it's a slow process and I feel like I have to rush and I get anxious thinking about the line of people waiting to be helped. I'd rather help people in the store, I think because even if the line is long, I can smile at everyone and they can see I'm going as fast as I can. In the drive through, the people can't see that I'm really working and I think they'll think I'm slow, etc. My silly SA brain. Oh well, it's things to work on.

Work today was..

Actually REALLY good. I went in early in the day so I may have got the tail end of action from my benzo. Either way I built some confidence today and that's a good thing. I have been really anxious today about taking the Klonopin. I think I may not take it tonight and see how I sleep and what happens tomorrow. Maybe my increase in dosage of Prozac will be enough..or maybe I can take the Klonopin PRN...I'm not sure yet.

Things I did today that surprised me:

1. Came right in and worked the drive through...and I was only a little nervous. It went fine.
2. Answered the phones a couple of times including once when the patient was upset about something...again it went fine.
3. Took a copy over the phone..something I had never done and involved the phone...and I did fine.
4. I had to call a patient at her house...and did fine.
5. I had to call a doctor office concerning a medication..and I did fine.

So...is it because of the klonopin or the increase of prozac or just because I'm getting better at the job? I have no idea...but I so don't want to be addicted to a benzo....I'm so uncertain.

Why I relapsed.

Up until now I didn't realize someone with SA disorder could relapse and that the severity of the disease waxed and waned. I thought that as long as I stayed on my Prozac, I would be "normal". Well now I know you can relapse even while being on medication. It happened to me. I believe 2 events in my life that happened recently caused my relapse. The first event happened last September. I had a rotation at Kroger. Basically I would serve as a student intern for one month, then the next month I would go to another location. I had never worked in a retail pharmacy and our school doesn't focus on retail pharmacy, so I wasn't very knowledgeable on the workings of a retail pharmacy. But if you know me, you know I put my all into everything I do, and I thought it would be fine. The day before I was to start, my husband's mother lost her battle with relapsed lymphoma. I was very sad, but I HATE to be pitied and I didn't feel like I needed to say anything to my preceptor about it. Afterall, I wouldn't need to miss any days of work so I didn't think it mattered. What I didn't realize was that my mind was elsewhere that first day and I failed to write down the day she wanted my project to be due. I worked with her fine for about a week, and then she went on her yearly vacation for about 2 weeks. She came back the day my project was supposed to be due, only I didn't have a project done because I thought it was due the next week. She was so mad, and I was devastated. I stuttered a little and apologized but she thought I was arguing with her for some reason and she reprimanded me for it. For being "disrespectful" and for not having the project. Since she didn't really get to know me and now I didn't have my project done, she formed her own opinion of me and it wasn't good. Since that day things went down hill. I was a nervous wreck, always expecting to do something wrong, I couldn't think straight and I would ask her questions she felt were silly questions and she would let me know that she felt my knowledge base was seriously lacking. I left the place in tears everyday after that and lost sleep over it. For a normal person they probably wouldn't care, but me with my SA and fearing rejection and criticism, especially from someone with authority, I was a constant nervous wreck. I dreaded going there everyday and rejoiced on my last day when it was all over. But I can't forget about it. I still think about it, even now. I think about what I could have said to her, I think about ways I could have stood up for myself and I'm disappointed in myself, like always.
The next big event that I feel contributed to my relapse happened this year in April, so just a few months ago. I have worked for a hospital all through pharmacy school, and I loved it. I feel like I'm very good at what I do and naturally when an opening for a pharmacist position became available, I applied. Graduation was just around the corner. I thought for sure I would get it, I had been a great employee for 3.5 years. I was very dependable, got along with everyone, and had a desire to do well, all the time. Well a larger than usual number of people applied for the position, people with experience, people with residencies, it was fierce. Anyway I waited over a month of agonizing over whether I was going to get this job and the day I found out the result, I was on rotation with a girl who also applied for the job. She had no hospital experience and certainly hadn't worked at this hospital for 3.5 years like I did. I found out I didn't get the job the same time she found out she did. I can't explain nor convey the devastation I felt. I wept and wept and wept. I questioned why I ever decided to become a pharmacist, went over all my faults over and over again and basically hated myself. I felt like I let myself down and that I was a failure. That was one of the worse pains I've felt in awhile. Someone got hired over me that had no experience and had the same level of education as I did. So these 2 events have caused my SA disorder to relapse. I did eventually get a job at a retail store and considering the only retail experience I have had was so horrible, I am obviously terrified. I'm constantly afraid of making a mistake or asking a stupid question. I'm also losing sleep thinking about work. So last Friday I decided to go to a new doctor and he was great. He wants to temporarily increase my Prozac dose to 40mg per day and put me on Klonopin (a benzo) short term. His goal is to get me down to my original dose of 20mg. He also wants me to start cognitive behavioral therapy with a therapist which I plan to do. I'm hoping that with effort on my part, and God's help I can overcome this. My SA never really goes away, but I'm hoping to get it to a level that I can function with.

From the beginning part 2

So I left off talking about decided to go to college in my hometown due to my fears. That is just what I did. I did end up meeting my husband there, so I am sure it was meant to be. Anyway undergraduate college was much like highschool. I didn't participate in any clubs and to this day I regret not joining a sorority. I didn't live in the dorms. I didn't really experience college the way most people do. I do truly regret it. I was on Paxil off and on during college. When I was off it, I was not even able to walk through the student center during lunch time because I'd be afraid of everyone looking at me. When I was on the drug, I was able to actually eat by myself if I wanted to. I still had the problems with withdrawals though, and I wasn't the most responsible when it came to taking my meds. I held a part time job all through college and did pretty well with it. I graduated college in May of 2007 and married my husband in June 2007. We then moved so I could attend pharmacy school, and we bought a house. So BIG BIG BIG changes for me, and everything went pretty well. I was still taking prozac 20mg per day and I think I was just so happy to be married and out on my own, I didn't have much anxiety. I didn't participate in pharmacy school activities that much, but I'm married and wanted to spend more time with my husband. About a year into pharmacy school, I switched from Paxil 20mg daily to Prozac 20mg daily. I wanted something that wouldn't be as harmful if I were to get pregnant. I wasn't planning on getting pregnant, but just in case, plus I hated the withdrawals. I had a VERY rough week when I made the transition, but I made it through. In fact, my anxiety was pretty well controlled until about 2 months ago. A few months ago I relapsed...I relapsed bad.

Klonopin day 1 and 2

Sunday 6/12/11 was my first day on Klonopin. Well sorta, I took 0.5mg the night before(Saturday). At the advice of my doctor I will be starting with 1 tablet per day and then increase to 2 tablets per day. My sleep was amazing. I fell right asleep and did not have a hangover affect the next day. No racing thoughts or waking up the middle of the night with dialogue from work going on through my head. I do generally sleep better on the weekends though, since I tend to worry less. The next morning church went well, I generally worry about walking in and everyone looking at me. Not so bad this morning, and I even suggested me and W go to the young adults Sunday school class after church. This is big for me because for the past few weeks I haven't been wanting to go, ever since my SA relapsed. We are new at this church which makes it WAY worse since people are constantly coming up to us during the class and introducing themselves (you know being totally normal and nice!) but it just makes me a nervous wreck. Well I can honestly say I was as carefree during Sunday school as I've ever been. My research tells me that the duration of action of Klonopin is about 12 hours, and I could definitely tell it wasn't working as well late Sunday afternoon and evening. I was getting anxious about work the next morning. I haven't noticed a difference since increasing my prozac dose yet. (20 to 40mg)

Monday 6/13/11-I again had great sleep last night. Work went well today, but I don't know how much I can attribute to the Klonopin. The people that I really like and feel comfortable working with were there when I got there, and I didn't have to do anything new or scary and spent most of the day doing modules on the computer, so not much interaction with patients or customers. I haven't decided if I want to increase my Klonopin to twice per day. If I can just take one at night to help with sleep, and that can maybe help get me through the morning at work, since once I get to work and sort of get into a routine, my anxiety goes down a bit. I haven't decided..I have no idea how tired it would make me if I took it during the day, but so far I haven't had any side effects of either the Klonopin or the dosage increase of the Prozac. If anything my mood has been better. On a negative note, I was supposed to call to schedule my therapy session today and I totally forgot!! I will have to make sure I do it tomorrow....oh how I hate calling to make appointments.

What does my Social Anxiety disorder look like?

Like I said this disorder can manifest in different ways, but with common themes. I am going to list how this disorder affects me.

1. The big one. I am afraid of social gatherings, parties, etc where I will have to conversate with people I may not know very well. I am afraid of saying the wrong things or looking stupid or being judged. I know this is irrational. These types of situations are made 10 times worse if I have to go alone, but even if I can bring my husband or someone else I'm comfortable with, I still experience anxiety.

2. I try to avoid situations where I may be the center of attention. For example, I try to avoid going into a store if I'm the only customer. I prefer to go shopping in busy stores where I can just blend in. I also experience anxiety if I need to ask an employee where something is, and usually avoid doing so. Also I hate to walk into a room where people are already seated. My heart will pound and I will be seated as soon as possible to avoid people looking at me.

3. I feel anxiety if I think I'm being judged. This one is a little strange. If my husband is doing the dishes and I hear the clanks of the dishes I get anxious. Inside my head I feel as if I should be doing the dishes and I am being judged because I am not. Same would go for the vacuum cleaner, etc.

4. The Phone. The phone is my nemesis. I have had a life long fear of talking on the phone. I have no problem with very close family members such as my dad and husband, but anyone else I get anxiety if I know I have to call someone. Especially making appointments or ordering food. I will agonize over it for awhile and try to plan out exactly what I'm going to say. At this very moment I need to call to cancel a magazine prescription and I'm dreading it. This definitely affects me because I screen every phone call, and even if family members call that I don't talk to very often, I won't answer and will make up excuses as to why I didn't answer. I don't even like to listen to my voice mails. I will often delete them without listening to them.

5. If things start going wrong for me, it's like a domino affect. For example if I make a mistake at work, I will likely fall apart and make more mistakes...and in turn even more mistakes. Especially if someone has reprimanded the mistake or noticed it, and now they are watching me, that makes it worse and it's situations like that that might cause a panic attack.

6. Public speaking. This is an obvious one I'm sure since even people that don't suffer from Social anxiety disorder get nervous when public speaking. I will agonize for days though.

7. Sleep disturbances. For the most part I sleep just fine. If my disorder is exacerbated for any reason, my sleep will suffer. I will have trouble falling asleep because I will be analyzing everything I did in a particular situation, and thinking that I could have done something better, etc. and thinking I was being judged or criticized. I will often wake up thinking about these things, or dream about them.

7. Stuttering. I have a mild stutter. I believe this is related to my Social anxiety disorder because I'm thinking of what I want to say faster than I can physically say them. Especially in a situation where I feel I may be judged, I will be trying to say something to explain what I doing, etc. and I will stutter.

8. Hair pulling. I went through a bout of trichotillomania when I was about 16 where I would pull out the hairs around my part. I would only do this when I was anxious about something, but it got so bad you could see my hair was thinning. I did eventually stop this on my own, but I will still find myself trying to do it. Now I pull hairs from my face and under arms. It feels like a great release of frustration to me. The "feeling" I get is even better if I can get the entire root of the hair. I know someone people who do this actually will eat the hairs. I don't do this, but I do find pleasure in rubbing the root on my lips. I feel like this is the weirdest thing I do.

Despite all this, most people probably wouldn't know I suffer from social anxiety disorder, except of course my poor husband. I do most of the things I hate to do, simply because I have to for work, etc. I am just miserable the whole time. I feel like I'm in a constant state of "fight or flight" during most of these situations that I can't avoid.

From the beginning part 1

My first memories of this disorder were when I was a very small child, maybe 4 or 5. I would become painfully shy around new people, or even family members that I had not seen in a while. I would literally hurt inside, and even at this young age, I would anticipate their arrival and worry about it, although I didn't know I was worrying at the time, I just felt like I had a belly ache. I also didn't like to talk on the phone as a young child, this is something that would become a common theme in my life. I also embarrassed easily as a child...I had to dress and act in ways that would draw as little attention to me as possible.
The disorder became worse in middle/high school. In 6th grade we had to play volleyball...I was petrified of playing volleyball, not because I wasn't any good at it (which I certainly wasn't) but I was scared to death of upsetting my team mates when I messed up. I would agonize over gym period all day. I also even had nightmares involving having to play volleyball. Around this same age and maybe a little older, I would even be afraid to check the mail if people were walking by my house at the same time. I would have to look around and make sure no one was coming, then I'd run out, get the mail, and run back in. I can remember thinking during my middle school years "I'd be happy if I could just go to school and come straight home for the rest of my life" I had no desire to do anything social at all. I didn't have many friends at all, I wasn't disliked or bullied, just ignored. I suppose at the time I was ok with that, but looking back I wish I had had the strength to do the things I really wanted to do, like try out for the cheer squad.
High school started off very similar, but this year things would change for me, some good and some bad. My mom had seen a news story on tv about a drug called "Paxil". It had just been labeled for use in social anxiety disorder and the story involved interviews with people stating the drug had changed their life. My mom made me an appointment with a psychiatrist shortly there after. I thank God everyday I had a mom who cared about getting me some help. The drug wasn't necessarily the God send I had been hoping for, but it was a start to helping me face this problem. I was 14 when I started taking Paxil. Nowadays when an adolescent is prescribed an antidepressant, there is a black box warning for a change in behavior when you begin the drug, including suicidal thoughts and actions. I didn't have suicidal thoughts, but I certainly experienced a change in behavior after beginning the drug. I started hanging out with an older boy I had met on the internet and he got me into things I would never have done had it not been for the drug. My shyness was much better, but I guess that, coupled with being an teenager, I had a rough year. I got into a lot of trouble. Eventually, said boyfriend went to prison (for a long time!) and I returned to my normal self. I took Paxil all through high school and it did help me, but I was not totally better. My fear of rejection and criticism still kept me from doing things that I truly wanted to do, so I led a basically anonymous existence. I never had any bad experiences, I was just part of the surroundings. I doubt most people from my high school would remember me. I eventually graduated and attended college in my home town. I graduated 2nd in my high school class and most likely could have gone to some very good colleges, but again my fears kept me from doing so. I was much more comfortable staying home where I could live with my parents for awhile, I liked being where I was comfortable.