Yes. Let’s be really clear.
Because nothing seems really clear if you’re someone who just doesn’t want to go …
Yes, who doesn’t want to … or can’t just easily … go. To work. To class. A meeting. That job interview. Even out for coffee. Or Shopping.
There are a thousand reasons you might not be able to go. You might be too tired, too busy, not interested … or too stressed, or depressed.
You may be too introverted or shy or … just too worried about what others will think of you, about how you seem to them, about whether or not you’ll do or say something embarrassing, or worse, yet, humiliating.
Humiliating is the worst
It’s a dread and a fear that you can’t shake if you have social anxiety disorder. Reassurance doesn’t help. Self-talk falls flat.
And it’s different than being introverted or shy. Social phobias and anxiety are often mislabeled “introversion”… but they’re not the same. We’re pretty complex — sensitive to the number of people around us, whether we know them, how they perceive us.
If you’re an introvert, you draw your energy from quiet time with your own company.
If you don’t know the people around you and feel uncomfortable, you may be shy — but once you get acquainted, you may be someone who comes out of your shell and chats them right up.
But if you have social anxiety, it means a sense of vague, but intense, fear rises inside you in social settings where you feel you will be observed, or noticed, or scrutinized. It could be by people you know or … by people you don’t know. You may believe that everyone is talking about you, criticizing you, even ridiculing you.
It can be so difficult that you find it hard to speak at all. Your palms may grow sweaty, your voice may crack …you may blush deeply over and over…where they can see it.
You wish you could control it, because the reaction you experience and the fear that you’ll make a fool out of yourself … and that others will notice and not want to interact with you is far worse than just getting acquainted with someone. It’s crippling. You’re frozen. Wishing for an escape.
You feel like such a jerk.
How to Escape from Social Anxiety??
If you talk to a friend or counselor about it, they may ask, “so… what is it exactly that you’re afraid of?”
Well…how do you answer that..? Is the anxiety you feel something that just happens that you can’t prevent?
I’ve met lots of people who don’t even realize they have social anxiety. They never had a name for it. They believe it’s just the way they are, and they try to live with all the “can’ts.”
But I know others who dread entering an elevator with someone of the opposite sex, or who die a thousand deaths before walking into a classroom of students they haven’t met before, or who will cancel plans rather than experience the misery they feel when attending a gathering.
Social anxiety just makes life so difficult.
It holds you back in so many ways — from your own family, from making friends, from raising your hand in school to being able to sign up for classes, or talk to a professor. From entering an elevator with people in it.
Fast forward and you see it holding you back from using your native intelligence –to express your ideas, talk to a coworker, or to your boss … or the mortgage loan people or your server at a restaurant. If you can get to the restaurant.
It can ruin your life.
And put you at risk for developing other things that can ruin your life … like depression, alcoholism, and cardiovascular disease. Geez!
Most people who labor under the pain of social anxiety would get rid of it in a New York minute…if they could.
Treatment for social anxiety has been along the same lines as treatment for any anxiety-producing condition. Antidepressants and anxiolytics – medications that reduce anxiety — along with therapy have been the treatments used for the last 50 years or so. But, unfortunately, these have been only partially helpful.
Why isn’t treatment more helpful…?
About 1/3 to 1/2 of all people with social anxiety disorder don’t respond to the treatments that are out there for it –SSRI’s, venlafaxine and cognitive behavioral therapy. Even when you wait for 8 to 12 weeks to get the full benefits. All evidence-based treatments, for sure, but with inadequate relief for most.
That’s why it’s so exciting to see innovative treatment available for social anxiety disorder with impressive results from the absolute gold standard of clinical trials: a double-blind, randomized, placebo-controlled crossover trial — recently published in the journal Neuropsychopharmacology. IV ketamine treatment has novel actions in the brain that reduce anxiety and fear fast.
Ketamine Treats Social Anxiety Disorder
Ketamine switches on mRNA to switch on DNA to turbo boost BDNF, as you can read here. And it works rapidly to slide the G proteins off their lipid rafts in the cell membranes, as described here. Those G proteins have to be off the lipid rafts to do their job improving signaling between the synapses and neurons.
And…ketamine also blocks NMDA receptors AND improves glutamate levels, which you can learn more about here.
So far, we know about these four actions of ketamine in the brain. And ketamine is kicking bootie and taking names across the anxiety spectrum: PTSD, OCD, phobias, and now social anxiety disorder,
Jerome Taylor and his colleagues set up an elegant proof of concept study with just enough patients to give it power. Eighteen adults with social anxiety disorder, as described in the DSM-5, were given either a ketamine infusion or placebo infusion…and their responses were measured 3 hours after the infusion, and multiple times over the next 14 days. A great sample of real-world, complex people, some on and some off meds — just like in real life.
Then, 28 days after their first infusion, they came back in and got the other infusion; if they had a ketamine infusion first, they got a saline placebo the second time, and vice versa. Turns out that 17/18 patients knew when they got ketamine instead of saline, so the blinding wasn’t perfect. But there are always limitations to studies, and opportunities for refining the questions we ask and the methods we use the next time around.
Ketamine treats social anxiety. Ketamine was safe, generally well-tolerated, and worked. People responded to ketamine, and they had significantly greater reduction in anxiety that lasted up to 28 days, compared to when they were treated with placebo. Fear, avoidance, social anxiety, and social avoidance all fell significantly.
Of course, study results are often reported in the most conservative terms. We always need and want to know more. But this trial provided fine evidence that ketamine is effective in reducing social anxiety. Hopefully, this kind of anxiety reduction can lead to more social activities and opportunities for people who so suffer so terribly. Hopefully, this study will open the doors to more inquiry.
Isn’t that outstanding??
We always love to see clinical trials and studies that put ketamine through its paces. We love to hear of others who find ketamine to be effective in treating mood disorders.
Because here at Innovative Psychiatry, we see it every day. In fact, within our practice we see a strong 80% positive response to ketamine even in people who’ve failed everything.
We like to say that they didn’t fail — everything failed them. If you feel like what you’re doing isn’t working, you’re not alone. You may have one thing — depression, maybe, or bipolar disorder — or you may have a lot of things — PTSD, anxiety, and OCD.
…We’ve always been on the cutting edge.
We’re not a pop-up clinic. We’re not a johnny-come-lately.
We’ve developed our approach over the past 20 years to help those who suffer the most…and are desperate to find relief. We stay up at night to find solutions that are novel and innovative, that will allow you to function again and find joy in your life with the advanced treatment options that we offer.
We’re the only psychiatry practice in Connecticut that’s daring enough and forward-thinking enough to bring you a menu of advanced treatments in a beautiful outpatient office with its own library of research articles that supports everything we do: IV ketamine treatment, TMS, reducing inflammatory factors, improving nutrition and enhancing the gut microbiome.
We have advanced treatment options for you
If you’ve been suffering with a treatment-resistant mood disorder like depression, social anxiety, phobias, panic attacks, PTSD, bipolar disorder, and OCD, please call us. Let’s set up an appointment to figure out if IV ketamine or another innovative approach is right for you.
We don’t take over your medication management or therapy — we offer advanced solutions to enhance what you’re already doing — with the doctors you’re already working with. So you can finally leave social anxiety, depression, bipolar disorder, PTSD, and OCD behind.
We want you to feel better… and we believe we can help.
We’re closed for the holiday but we’ll be back to schedule appointments right after the New Year. Put us on your calendar.
To the new emergence of your best self,
Lori Calabrese, M.D.