How a month and a half on Paxil taught me to love being shy.

http://www.slate.com/id/2143243/?

by vaksel • 17 years ago

132 51 17 years ago

slate.com

moe• 17 years ago

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

branden• 17 years ago

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

likpok• 17 years ago

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.

gregoryl4• 17 years ago

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.

Semiapies• 17 years ago

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.

jlees2• 17 years ago

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• 17 years ago

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

blackguardx2• 17 years ago

The brain is way more complicated than that.

paul_houle2• 17 years ago

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.

mrtron• 17 years ago

Do you think the Prozac just distorted your perceptions of reality?

Interesting experiences though - thanks for sharing.

paul_houle2• 17 years ago

That's very possible. No matter how I interpret it, Prozac made my life like a Phillip K. Dick novel.

gregoryl4• 17 years ago

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.

asmosoinio• 17 years ago

Could someone please edit this to make it not break the layout? It's a really long line and makes this whole conversation a pain to read.

Edit: thanks!

Zaak• 17 years ago

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.

wallflower• 17 years ago

"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• 17 years ago

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• 17 years ago

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

ams6110• 17 years ago

I'm reminded of the advice from pg's never-delivered high school graduation address (posted here the other day): don't look for excuses to be lazy. Are drugs like Paxil the "lazy" way to avoid dealing with the realities of social interaction? For some surely not, but I think that for a good number of people they are.

rjurney3• 17 years ago

Thats why you shouldn't use them lazily, as the author did. Taking Paxil as an alternative to therapy is misguided. Taking Paxil, and then working your ass off in therapy is the way it should work. The Paxil opens you up a bit so you can learn social skills with a professional coach, your therapist/psychologist/psychiatrist.

Its just a tool. You still have to work like hell to get over your social phobia. Then you come off the Paxil.

shaunxcode• 17 years ago

"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.

kirubakaran• 17 years ago

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...

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• 17 years ago

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.

shard2• 17 years ago

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.

felipe• 17 years ago

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.

jurjenh• 17 years ago

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....

Eliezer• 17 years ago

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• 17 years ago

Which ones have you taken?

sherl0ck• 17 years ago

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

paul7986• 17 years ago

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!

ilkhd2• 17 years ago

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?

Adam503• 17 years ago

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.

rjurney3• 17 years ago

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?

rjurney3• 17 years ago

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.

How a month and a half on Paxil taught me to love being shy.

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