Drugs for social anxiety?

February 17, 2018 11:26 PM

Are there drugs you can take for social anxiety and still be able to socialize "normally"?

I have had anxiety pretty much my entire life. I've done a lot of therapy and done the work too--exercises, CBT, DBT. I'm on Zoloft which has made a huge positive difference in my life. (I went on it for depression and found it alleviated a ton of anxiety too.)

But I still have social anxiety flares, pretty much only about gatherings of more than about 6 people. It's worse in winter. I'm fine one-on-one, in small groups and I even enjoy making small talk in elevators these days! Yet all my self-talk and prepping for big parties etc. does not make enough of a difference. I have to go to a party tonight and I am dreading it so much that the only thing keeping me from backing out is guilt toward my partner. (He would have to answer where I was and probably tell a white lie for me. He has had to do this way too many times already.)

Like many people, a drink at a party takes the edge off and makes socializing more bearable. I'm also older and more sensitive to alcohol, so if I have more than one drink (seriously ONE), I tend to get a headache the next day and feel tired. Even one drink leaves me feeling tired.

Is it possible to use something like xanax to be okay with a big group social event? I've never taken a drug like that before, so I don't know if it zonks you out or makes talking to you weird... I also live in one of the states where marijuana is legal. I have considered getting a low dose pot mint or something like that to take the edge off, then sticking to non alcoholic beverages. I have sometimes just done parties totally sober but I don't think I could do that and not appear to be kind of miserable. (I am a woman, so gendered pressures apply imo.)

What would you do if you were me? Any specific drug suggestions? How should I talk to my doctor about this if a prescription is the answer?

posted by anonymous to Health & Fitness (17 answers total)

Xanax affects different people in different ways. I've known slurry sleepy Xanaxers and I've known wholly alert and unaffected Xanaxers. In my personal experience, I'm just fine on Xanax until I sit down, and then I conk out right away. But if I take one and keep moving, you'd never know I'd taken a benzo.

I'm one of the weirdos who has an anxiety reaction to marijuana, so my advice is useless there.
posted by xyzzy at 12:03 AM on February 18, 2018 [2 favorites]

You may need to try different anxiety meds and try them on your own BEFORE you go out. I take Ativan (literally the smallest amount cut in half) for my anxiety and medical conditions when I go out. All it does is make me feel calm and calms some of my medical symptoms. No one would EVER think I was on anything. I feel totally like myself, just not having my anxiety flare. I tried Xanax and I felt like a tired zombie and kept losing track of time. Though I could act fine. I hated it. Xanax doesn't "feel" like anything when I take my super low dose.

So if I were you I would talk to your doctor, and get a few pill samples of a low dose of a few meds. Try them in a low-key environment and of course make sure you know how they may affect your driving. Do not mix them with alcohol.
posted by Crystalinne at 2:15 AM on February 18, 2018 [3 favorites]

Also I see you're asking about this for tonight? I personally would not start a new medication not knowing how it would affect me. Too bad you're "home with a cold" tonight. Then talk to your doctor so you can manage this.
posted by Crystalinne at 2:20 AM on February 18, 2018 [1 favorite]

I'm a bit like you, and have been a lot more like you in the past.

I still dislike parties a lot. Like you, I function OK in small groups or one-to-one. But I've stopped worrying too much about them.

As a guest, you're not expected to mingle and make small talk with random strangers unless (a) it's your party, or (b) it's a work-type networking thing. There's absolutely nothing wrong with being one of those people who spend the party chatting with their partner or one or two people who make you feel at ease. Your partner ought to be doing their bit to help you find a situation that you're comfortable with. And if it's all a bit too much, you can presumably leave early. Again, your partner should be backing you up - presumably they want you to be having a good time.

I wouldn't use cannabis to calm anxiety without knowing in advance how a particular type and dosage was likely to afffect me - there's always a risk of making the anxiety worse.
posted by pipeski at 3:59 AM on February 18, 2018 [2 favorites]

I take Zoloft and it works great.
posted by thelastpolarbear at 5:38 AM on February 18, 2018 [1 favorite]

Ritalin, prescribed for ADHA, makes people more open and able to socialize.
posted by 3dd at 5:40 AM on February 18, 2018

Klonopin is worth a try. I have a prescription that I use mostly for occasional symptoms similar to restless leg syndrome. But also to help stop racing thought affecting sleep, and occasionally for social anxiety. It’s an interesting drug in that it probably won’t make you sleepy if you take it for social anxiety and are out with people. It just puts you more at ease. But if you took it just sitting at home when not feeling anxious, it would probably make you sleepy.

I generally only ever take 1/4 of a 1mg tablet.

Talk honestly to your doctor. Just say you’ve dealt with social anxiety for a long time and you’d like to try something. I doubt any but the most overly cautious or unsympathetic doc would see this as “drug seeking behavior.”
posted by The Deej at 5:52 AM on February 18, 2018 [2 favorites]

Beta blockers, like propranolol, work really well for some people. My social anxiety is more related to agoraphobia, so it didn't help me with the worst of it, but if I ever managed to get out, I did find that it was easier to talk to people and the like.
posted by elsietheeel at 7:08 AM on February 18, 2018 [7 favorites]

Lorazepam (Ativan) is a as-needed anti-anxiety medication. You just take it in situations where your anxiety can't be controlled or if you're having an acute panic attack.

Per reports from friends, no-one can tell when I've taken it. My experience of taking it is that it just sort of walls the anxiety off, so I'm aware that it's there, but I'm not really feeling it and it's not getting between me and what I'm doing. It does not make me sleepy or dopey or foggy. I absolutely can't drink if I've taken it (or I more or less pass out), but for me it's a wonder anti-anxiety. YMMV.

As far as I know, it can safely be prescribed / taken on top of a Zoloft prescription. Talk to you doctor about it.
posted by crush at 7:38 AM on February 18, 2018 [1 favorite]

You might also try Buspar (buspirone), which is an all-day anti-anxiety drug, rather than a benzo that has an immediate, short-term effect. Personally, I would be reluctant to use a benzo on a regular basis to get through social events (as opposed to, say, a grueling funeral or similar extreme case). They are effective, but they definitely have their risks.
posted by praemunire at 8:08 AM on February 18, 2018 [1 favorite]

Xanax is a magic pill for me, I feel no physical or mental side effects but it turns the anxiety center of my brain right off, just like crush describes their Ativan experience above. I have probably told the story here before about the first time I took it for flying, the plane had significant turbulence, and my only reaction was "all this shaking is making it hard to finish my crossword puzzle".

That said, +1 that everyone reacts differently to meds and I wouldn't try anything for the first time going into a big social event.
posted by Flannery Culp at 8:25 AM on February 18, 2018 [2 favorites]

Same as Flannery Culp - I competed on a TV game show on 1/2 a Xanax recently, and spent a full 10 hours at the studio around crowds of strangers. It cuts my anxiety without dulling my senses. but definitely try it in controlled situations first to see how it works for you.
posted by themissy at 10:35 AM on February 18, 2018

P.S. I know that if OP chooses to take benzodiazepines - Xanax, Valium, Ativan, Klonopin - for your anxiety that you won't drink with them because you've mentioned that you don't like drinking anymore.

But for anyone else who may come across this question, please never mix benzos and alcohol. It could well kill you. (Don't mix them with anything, honestly, unless your doctor and your pharmacist tells you its okay. Booze and benzos and opioids in various combinations are killing a lot of people via smaller doses than you might think.)

And please note, I am not anti-benzo. I take Xanax nearly every day. But I also know that the stuff could kill me if I am not careful. That's all.
posted by elsietheeel at 2:34 PM on February 18, 2018 [5 favorites]

I take Klonopin for this exact purpose. I don't know why people freak out about benzos, I've been doing this for 12 years. I doubt I would have been able to get through grad school, for one thing. I don't have a family history of substance abuse, though.
posted by AFABulous at 4:56 PM on February 18, 2018

FWIW, I know several people who use CBD oils/tinctures for SA, and report great success in relieving the stress. It's not difficult to mail-order the stuff if you happen to live in a not-legal state.
posted by Thorzdad at 7:03 AM on February 19, 2018 [1 favorite]

OP lives in a legal state.

I've found that the CBD tinctures don't work on my social anxiety (I've tried CW Hemp's Everyday Advance, which tbh, I didn't find worked at all and it was absurdly expensive), but I did have a good experience with the CBD/THC Recover gummies from Kushy Punch.

You can cut them into teeny tiny pieces and kind of micro dose them. I was surprised by how strong they are but at small doses I felt very comfortable and calm.

They also have CBD only if you want to try that route first. It may well be that my weird brain chemistry doesn't process CBD the way other people do.

(I'd probably still try the Kushy Punch CBD-only gummies before the CW Hemp tincture, both for price [$20 for the former and $140 for the latter] and for taste. CW Hemp, even the chocolate mint flavor, tastes...very much like what it is.)
posted by elsietheeel at 7:16 AM on February 19, 2018

Yeah, CW's products are crazy expensive. My son has great success dealing with his anxiety with hemp-direct's 1000mg CBD oil. It's less expensive than CW, and they usually run a discount on their website.
posted by Thorzdad at 8:12 AM on February 19, 2018 [1 favorite]