What is Anxiety?

Anxiety is a completely normal feeling that most of us has probably felt in our life. Have you ever had butterfly’s when you are going for a job interview?, or maybe sweaty palms when taking a driving test or some other kind of exam? well these things happen when we feel anxious. Don’t worry these type of feelings are nothing to worry about and in fact it just shows that we are human.

The feelings of anxiety can present itself in many different ways, not just mentally but physically too. It is our body’s way of dealing with fear and worry. Think about this situation for a moment, you have just had a great night out with your friends, and it’s time to go home. You step outside, it’s dark and raining and there’s no-one around. You turn left into an alleyway and suddenly you hear heavy footsteps coming faster and faster towards you. What do you feel? scared? panicky? Kind of breathless? Well this is also anxiety that is making you feel this way.

Whilst in the above situation anxiety is actually a good thing, it is making us aware of any danger that we could be facing. However for some people anxiety can become a real problem. It can overwhelm them and take over their life. They constantly feel jittery and on edge, it affects their relationships, their ability to hold down a job and even the way they behave. They can wake up with a feeling of dread that they just can’t seem to shift. When anxiety becomes this bad it can be very scary.

The feelings of anxiety no matter how big or small are usually triggered by an event. whether it be a current situation you are in like a confrontation with someone or it could be triggered by something big that has happened in your life like moving house or a death of a loved one. The most important thing to remember is that anxiety is a part of every day life and you shouldn’t be worried about it. The more you worry about feeling anxious the more anxious you are likely to feel. If these feelings become too much and happen on an every day occurrence it could be the time to seek medical advice.

"Paxil worked wonders when I first started"

I have been on Paxil for 5 years now. It worked wonders when I first started. For the last two years I have been trying to get off it. Like some of you I tried to quit cold turkey. I ended up in the emergency room with a headache so severe, they thought I had ruptured a vessel in my brain. Depressed by the event, I went back to Paxil. Then I tried to taper it down, from 20mg to 10mg a day, and now I take half of that for last two months, when Itried to quit that, I fell into a depression so severe that I became suicidal, so I went back again. Now a friend (a psychiatrist friend of mine tells me that if I substituted it with Prozac, it will be easier to wean off Prozac. I havent tried because I am afraid of the side effects. I have gained 20lbs, and lost the motivation and spunk I had before. It is sad that the general practitioners dont know about the adverse effects.

I will be trying the Prozac maybe next month. If it works, I'll let you know. Good luck to you all. Whatever you do, NEVER quit suddenly, especially if you have been on it for more than a year.

-- submitted by Dr. Swadud, 39

"I had a sour stomach, and fatigue and reached a point that I could not get off the couch."

Now, to tell my story I have been on Paxil for 3 1/2 years and when I first started it felt an immediate improvement in my anxiety and depression. My attitude was a noticeable improvement to everyone around me. In the 3 years I tried to take myself off many times. I honestly don't remember all the physical side effects that alot of people have mentioned. But, I did experience extreme mood changes and extreme anxiety and depression. So, like everyone else I decided to go back on. Well, in the last 6 months I felt the PAXIL wasn't helping me. I felt I was (am) entering into a deeper depression. I have extreme fatigue, don't feel like working, much less taking care of my home and 3 children and HAVE NO SEXUAL DESIRE AT ALL. Oh, and not to mention the slow but steady weight gain.

One day I heard an ad on the radio saying "Do you want your sex life back" "Tried of feeling ...." The ad then when on to say that these are part of the long term effects of anti-depressants and gave an 800 number to call to see if you qualified to part of the study. Well, for some reason I did not qualify. But started believing that my lack of interest in sex was due to the Paxil. So in December I have slowly started to wean my self off. Again, I can't pinpoint the all the side effects like many people have mentioned. But, I can say that my depression and fatigue is so extreme all I want to do is sleep!

I have been completely off of Paxil the entire month of February and was forced to go t to my Doctor today and he told switched me to EFFEXOR. I now wonder that my feelings my all be part of the withdrawal problems.

I am remembered a period in December over the course of two weeks where I felt somewhat similar. It was December and that terrible flu was going around and I really thought it was that. But now that I am reading and remembering I don't think it was the flu and believe now it was the "withdrawals". I now remember telling my husband, God, if this is the flu why don't I have a fever like everyone else. I remembering one Monday I had such an extreme headache I took Excedrin PM and slept from 8:00am-3:00pm and the went to bed that evening at 7:00pm. And just like Friday, I had the same flu like symptoms. I had a sour stomach, and fatigue and reached a point that I could not get off the couch. I am getting worried that all these flu days were not flu days withdrawal side effects.

-- submitted Jane, 37

"Paxil was very beneficial in getting me through a rough patch"

I have been on paxil for over 2 years. At one point I self-upped my dose to 60mgs/day. Paxil was very beneficial in getting me through a rough patch but I don't need it anymore and am trying to wean off. I self weaned down to 30 successfully, but when I went down to 20 I started having mood swings, headache, flu/cold symptoms. I am an attorney and can't afford to not be sharp. I will probably go up to 25 and take it more slowly from here. It sucks that it could take another year before I am free of it.

I wonder if anyone has successfully used st. john's wort to help them wean. What about prozac? I had a friend get off paxil onto prozac with no problems. Is it possible to go to prozac and then get off prozac which doesn't have such terrible withdrawal?

-- submitted by John, 27

"I began taking paxil for anxiety and since have encountered a new host of difficulties"

I began taking paxil for anxiety and since have encountered a new host of difficulties: I am so dizzy as I am writing this that I will make it as brief as possible. I experienced extreme tiredness for months, on paxil, I feel that my whole system has gone into slow motion and I have gained almost thirty pounds, has anyone else experienced this? I am now seeing a homeopathic medical doctor and have been easing off the drug, I am now going through the withdrawals I am beginning to hear others are experiencing such as; extreme dizziness, headaches, more tiredness, feelings of anxiety, disorientation or blurriness and I relate to what one man referred to as brain shocks. I also feel that my heart is beating funny even though my pulse doesn't seem to reflect this. I also feel like I am out of breath some times. My moods have been WILD as well. I am interested to know if anyone feels that this drug has slowed their metabolism down, this was supposed to be an anti-depressant, but gaining weight has not helped my self image very much. I am angry to discover how many others are going through the same things, no doctor ever warned me about all of this!!! Did this drug help me at ALL?

-- submitted by oldjed, 25

"I have been having panic attacks since I was 14 or 15."

I have been having panic attacks since I was 14 or 15. Finally, I went to a doctor a year ago and he diagnosed me with social phobia/generalized anxiety disorder. I waited a year to see another doctor. That was Thursday. It's Saturday now. I was prescribed paxil, without knowing anything about it, except the doctor said "it can be weird at first, but stick with it". I am very grateful for this website, because, after only taking it for 2 days, I am not going to take it again, I don't think. I hate it. I feel very weird. I was usually awkward around people, but know I am paranoid. I feel like I am floating. I feel either apathetic or emotional. I can't even listen to music I usually like. I woke up the first morning and looked in the mirror. My pupils were huge and I felt like I was looking at someone else. My jaw started shaking and chattering. This is unlike me. I am only awkward in social situations. I was in my own bathroom and felt very, very strange. I started crying, thinking "this is not me..." Do NOT listen to people who try and say that your withdrawal is because you are "so depressed". Get real, it is no coincidence that so many people experience weird feelings, immediately after they quit. That is weird and messed up. I think all of these new "cures" for depression and anxiety and all, are weird as hell. I have also noticed that doctors do not take people with mental ilness very seriously. For example, one of my first concerns was "Don't even mention Prozac, because I know a girl who took it and and it made her really weird. She was bipolar and she said she felt better when she forgot to take it." The doctor laughed and said "Ha, well, most bipolar people do feel better when they don't take their medicine". He kind of chuckled again. I was thinking, this is my friend, that was rude. Do not let some doctor tell you why you feel the way you do. They might have more insight than you do into the brain, but you know how you feel. They don't. Anyway, thanks a lot for the information. I was looking earlier, and all I saw was : "May cause drowsiness, constipation, decreased sex drive". I wanted to hear something real. They forget to mention that the drug makes you feel insane. Another good example of the weirdness - I am a cashier, and last night when i was working, I became totally paranoid. I thought everyone was laughing at me, and that they knew I was on Paxil. Weird, huh? Oh, finally, I find it impossible to study like this (the major reason I'm not taking it anymore).

-- submitted by page, 20

"Paxil was prescribed for situational depression"

Since I've been taking it, I do not sleep. Others seem to indicate that it helps them relax, but I am drowsy all day at work, so I fall right to sleep at night. I sleep about 2 hours, and then I'm wide awake. I just wondered if the "happy" part of the drug wasn't an upper since I'm very, very sensitive to uppers. I can't take diet pills for the same reason, and I have to limit my caffeine intake.

-- submitted by Donna, 48

"I am doing OK but I am addicted to Paxil"

I was diagnosed as bi-polar in my second year of university. I had been suffering with it for many years previous but was good at hiding it. I saw a university therapist for 2 years during which time I tried many different medications. I was on zoloft for over two years. But when the zoloft decreased its effectiveness I was eventually put on paxil which helped me remain relatively stable for over 4 years. But when I moved cities and started a new job I was finding that I was getting panic attacks and having major trouble sleeping. I went to this doctor who told me I should try and decrease my dose. When that did not work I went back and he told me to go off the paxil for 2 weeks to clean out my system and then I should try this other drug. I trusted him. I knew I would get off centre if I went off my drug but I thought if I was careful and did not let myself get out of control I would be OK. I can't tell you how wrong I was!

Day one: I was OK. A bit "high" if anything.

Day two: I was very unstable, crying and shaking like a leaf (I thought it would be the worst of it).

Day three: I was violently ill for three hours straight, I could barely see, move, or function. My mood was beyond low, I was almost ready to jump out my window to make it all stop). A friend came over and helped me to calm down.

Day four: I slept for 12 hours straight. I thought I was just tired from the craziness of the night before. But later in the night I became almost hysterical, I could not sit still, I was sick again for hours, and the incredible feeling of dizziness (almost like you are in another dimension). I eventually ended up in the hospital because I was unable to control anything going on with me and I needed to get help before it was too late. They gave me drugs to calm me and put me asleep so I made it through the night but the next day I was no better.

By this time I had this incredible dizziness, nauseousness, exhaustion, and shakiness. I went to this doctor who originally told me to go off the medication. He did not believe me when i told him what I was experiencing and he gave me valium and told me to leave. Obviously, that was of no help. I had to call my parents from out of town to come and take care of me because there was no way I was able to function.

My break came because of my hospital visit. I got a referral to the psychiatric assessment team. I got in a couple days later and they started to try and help me. They agreed that what was going on was a withdrawal from paxil. I was prescribed Wellabutrin. As it is a drug in the same genre as paxil he thought it was stop the withdrawal symptoms. He was wrong. Five days later (I was at home all this time, missing work, hardly able to function), he put me back on 10 mg of paxil (he hoped that it would decrease the side effects while the other drug started working). On the 10 mg of paxil I was OK. I actually felt beter for the first time in weeks. I was still not feeling good but I could do simple things like dishes and walks. But as I tried, again, to wein myself off it, I got worse. Anything under 10 mgs and I had all the effects again.

Eventually, my doctor put me back on paxil (30 mg) and gave me another drug to stop the panic attacks and help me sleep.

SO I am left here. I am doing OK but I am addicted to Paxil. I know the only way I will ever get off it is in a supervised hospital setting (if that will even work?). I hate this feeling of being stuck on it, like I have lost control over a part of my life. (and yes, I still have the other side effects like weight gain, but I have given up worrying about that).

I was interviewed over the phone for the 20/20 story though I never did see if it was aired. (Does anyone have a copy, or was it even shown?)

I would like to participate in some sort of legal action. Not because I want anything, but because I want people to know about this! I want them to know that it is a good drug while you are on it, but not if you ever need to get off it.

-- submitted by LLB35, 24

"I am so dizzy and nauseous all I can do is lie down."

After reading this I am so shocked! I have been dying for over a week, getting worse, trying to figure out what I have and bingo everyone here is experiencing the same thing! I am so dizzy and nauseous all I can do is lie down. I have a 2 year old and a 6 year old and they just don't understand why mommy is sick. I have gone to bed the last few nights at 7:30 and slept till 6:30 the next morning, napping every chance I get just to get some relief. Now I need to decide if I should take another pill and wean myself slowly, instead of the cold turkey I've been trying. I was misdiagnosed with bi polar disorder about two years ago, now they say I am insulin intolerant and have hormonal problems! Paxil and Wellbutrin are the last two drugs I've been on. I've been feeling better, so I quit. If anyone out there has been successful please email me. I'm desperate.

-- submitted by Klhardin, 30

"Diagnosed for bipolar 7 years ago - was put on prozac, zoloft, lithium, depakote, ritalin and other drugs over a four year period"

Diagnosed for bipolar 7 years ago - was put on prozac, zoloft, lithium, depakote, ritalin and other drugs over a four year period - all with side effects. Did the normal 6-8 week withdrawal and became suicidal. Last medication the pdoc gave was paxil. One evening I forgot to take dosage, woke up in the morning with hand paralysis (I am a professional violinist, BIG TERROR). Took paxil and within 20 minutes could bend fingers. Rapid and mixed cycling became worse to the point that I finally told the pdoc I wanted off - he agreed that I was having an extreme reaction to this drug. After a month the depression got worse and then had a major rapid cycling event in an hour - knew that this drug was bad news. That night began night terrors, slept 1.5-3 hours per night for a month. GI tract stopped functioning, had to eat rice, broth, steamed veggies. If I ate anything solid, it came through the intestines solid (sorry for the graphic detail but true). Would wake up in the middle of the night in hysteria. Then my legs would feel as if they were hooked up to an electrical battery - could feel energy going down legs like what you would see in the old Frankenstein movies. I knew this was dangerous because my mother, who was also bipolar, died in withdrawal from other medications in the early 80's and had the same reactions the month before she died (heart stopped from exhaustion). Worst part was, because of exhaustion, lost temper with colleague because of my terror and his insensitivity to how sick I was (he had been support person). He filed grievance, suspended from work, had breakdown while pdoc out of country. This was all 2 years ago in February. I am just now starting to be "normal" though the pdoc now has diagnosed me as having Postraumatic Stress Disorder from what I experienced. I am using bodywork/massage therapy, polarity therapy, ayurvedic medicine all under the supervision of the same pdoc. He has told me that I am doing incredibly well. I actually think that I am LESS depressed than ever!

-- submitted by Orty, 47

"It was like electricity running through my body, and major anxiety attack and hyperventilation"

I have taken Paxil for 5 years and before that Imipramine for 8 years for a severe anxiety disorder. I was completely house bound, I didn't go out of my home for 6 months. I went to see a psychiatrist as this disorder ran in my family, and was put on Imipramine It was amazing how fast and well this medication worked. I was back to my normal self within a week. Over the next 5 years I would still have episodes of anxiety so I went to a clinic in California (I am from Washington State) that I saw an advertisement for. They were successfully treating anxiety patients by figuring out what chemical it was your brain was not producing enough of, in turn causing anxiety. I tested several different drugs and Paxil worked the best for me. It wasn't until about 3 years after that that I began hearing all the side effects of this drug. I never realized I had side effects until I heard what they were. I am always tired, I mean I could sleep 12 hours and still feel exhausted. I also gained alot of weight and basically had no energy at all. I decided I wanted off the Paxil and I new you couldn't just stop all at once. I started out cutting my dosing from 20 mg to 10 mg for about 2 weeks then I went to 5 mg for a week. This is when the withdraw hit me! It was like electricity running through my body, and major anxiety attack and hyperventilation. Of course this freaked me out and I went right back to 20 mg. I tried 2 more times unsuccessfully. Currently I have cut my dose down to 10 mg w/o any side effects, it has been about 2 weeks since I did it. I did have a period in which I felt extremely agitated, like I was going through major withdraw. This lasted about a week and now I feel fine. My plan is to stay at 10 mg's for 3 months and then go to 5 mg's for about 3 months and then completely go off. I think the main thing I realized is that no matter what you are going to have withdraw symptoms of some sort when you quit taking his medication, especially for the length of time I have. You have to mentally prepare yourself for it and not panic when you start feeling weird things happen. I find that when I start feeling anxious or panicky if I just stop whatever I am doing and completely relax my body and take deep breaths that I can usually deal with it. Another thing to tell yourself is that this isn't gonna kill you or injure you it is temporary and you can overcome it, lot's of self talk is very important.

-- submitted by Sara, 30

"I lost weight on Paxil and my sex drive went through the roof."

I was one of the first to post here so I thought I would comment on some other posts.

I went through major twitching episodes which lasted OVER A YEAR (I was on SSRI's over a 4 year period). Eastern medicine (such as Chinese and Indian [ayurvedic]) explain that the drug may be out of your blood but not out of the organs. Yes 4-6 weeks to be able to switch drugs but the remainder stays in your liver, spleen, kidneys, and BRAIN for up to a year. Therefore, the longer you are on these drugs, the more ingrained they become with the organs in your body and the longer it takes to get out.

My experience with Paxil was atypical. I have been turned into a rapid cycling Bipolar because of the SSRI's. I lost weight on them and my sex drive went through the roof. I feel like I am getting back to normal (after TWO AND A HALF YEARS since my last dose). Yes, I am a bipolar controlling it without medications. What am I using? Polarity Therapy, Ayurvedic medicine, Therapeutic Body Massage (this is INCREDIBLE for those energy twitches and headaches), and orthomolecular medicine (see this month's "Natural Health" magazine for the article on Margot Kidder for further information.

As in other posts, remember that your doctors can't POSSIBLY know everything about everything. They are seeing patients all day and don't have the time to do updated research on EVERY medication that is out on the market. It is up to US to be vigilant and tell our doctors about things like this web page to get the word out. Don't let a doctor talk you out of what your intuition is telling you. THEY are NOT the ones experiencing what you are. You know what your body did before you were on this medication and it is up to you to insist that there is a problem.

-- submitted by Orty, 47

Black or White, All or Nothing

One of the great downfalls of anxious people is their tendency to think in "all or nothing" terms. This is the essence of the pessimistic mindset.

The pessimist has a marked inability (through accumulated habits of thought) to see things as they are: a mixture of good and bad, simple and difficult, positive and negative. To such people, an endeavor with a downside is not worth undertaking. A relationship with a flaw it rotten through and through. A misbehaving child or a trying spouse is all bad, all the time. Such a perspective overwhelms and creates a sense of hopelessness. Hopelessness begets anxiety and depression.

Such pessimism is not realism. Far from it. It is skewed, unwarranted thinking. Pessimists, for example, talk about how "my whole day is ruined" because of one negative event. But if forced to sit down with paper and pen, such complainers could find plenty of good - in fact, probably much more good than bad.

The most devastating aspect of "all or nothing" pessimism relates to events that may or may not occur in the future. "If that were to happen," the inner voice says, "it would be terrible. I couldn't stand it." Of course, that's not true. You could stand it. You might be miserable for a time or face a daunting challenge, but that's not the same thing as being unable to face it. But we convince ourselves and become fretful.

We're not forever stuck in our mindset. Thankfully, optimism is a learned discipline. What we must do is gain a more realistic vantage point, to cease our steady focus on what's wrong. We remind ourselves again and again that things are usually not as bad as they seem. That few things we encounter are unmitigated evils. That we really have more inner strength - even more life options - than we normally acknowledge.

When a pessimistic thought arises, challenge it. Ask yourself if it is truly rational. Would a disinterested bystander conclude the same thing? In other words, make the pessimistic thought prove itself - don't just swallow it as dogma. Make the thought answer logical objections that someone might bring against it, just as in a court of law. "All or nothing" thinking withers up under such scrutiny, because it's based on faulty reasoning.

Through repetition, we form our habits. The ice skater falls repeatedly until learning to glide over the ice. So it is with habits of thought. Cultivate the tendency to reject "all or nothing" and you'll become more optimistic, better able to face what life dishes out.

This is not a pie-in-the-sky philosophy that everything will turn out OK no matter what. That is naïve and presumptuous. True optimism - an attitude shorn of "black or white" assessments - helps us live well and find greater happiness.

It puts a lens over anxious eyes that they may no longer see such a distorted world.

A Roadblock to Recovery

"What am I doing in Dallas?" I asked myself the question almost daily for the duration of my stay there. Not that there was anything wrong with Dallas. There’s plenty right with it. It’s just that I was homesick for the Michigan – for family and friends, for familiar sights. After only a couple of months in Texas, I was ready to go home.

I had finished one semester of grad school in nearby Denton when I decided to quit and enter the job market. My wife was working inhuman hours at the hospital to get me through school and support our three kids. Enough was enough. I was going to give her a break.

Trouble was, I bristled at the idea of staying in Dallas. In the back of my mind, I think I really hoped no one would hire me. A job means roots, and I didn’t want to plant roots there.

There were some symbolic attempts to find work -- a phone call here and there, an occasional interview. But soon I was spending consecutive days doing light chores at home rather than job-hunting. And I was getting depressed, because I knew I was shirking responsibility.

It was only a couple of weeks later when a jolting panic attack turned my life inside out. I was stunned. For days, I woke up every morning terrified at the prospect of another day. Those days became weeks. Then a month passed without any improvement in my wretched condition. "How long is this going to last?" I wondered. "How long CAN it last before I lose all of my marbles?"

Of course, looking for a job was a low priority at that point. I was in serious trouble. My life was ebbing away as I watched in bewilderment. My wife was scared. She agreed to pack up and move back to our home town – my safe haven.

Why am I relating all of this? To make a point. Many people with anxiety problems have a vested interest in staying anxious. They have a disincentive to get better. Their anxiety is an unhealthy investment that pays dividends in one form or another. For me, it was a ticket back home. It precluded my getting a job and staying in a town that I didn’t want to settle in.

Was I consciously staying anxious so I could gain these things? No. But the joyous prospect of moving back home proved a hindrance to my recovery from this episode. What I really needed was to get a job, not pack up my family and move across the country again. Had I entered the workplace, I believe I would have felt better before long. It’s possible I would even have adopted Dallas as my new hometown, and done so gladly. Instead, I retreated to the Michigan, whipped, defeated – and still anxious.

Other sufferers, I’m convinced, have their own disincentives to recovery. Maybe their anxiety furnishes an excuse to avoid doing something unpleasant. It routes them away from a challenge they’d rather not face. And so they slacken a little. They don’t do everything they can to get over their problem. They’re not entirely in earnest about moving forward and getting through it.

Are you one of those people? Are you holding back in your recovery efforts because you see anxiety as the lesser of two evils? If so, it is time to face that thing you would rather not face, whatever it is.

Be assured that any gains you or I derive from anxiety will all prove losses in the end.

The Conflict Within

Many anxiety sufferers, especially those with persistent worries and obsessions, fight constant inner battles. Those conflicts are usually between the emotions and the intellect. The content of the mental struggle may vary, but the pattern is the same: A troublesome thought arises and the emotions are galvanized into a fight-or-flight mode. The intellect, however, tries to shut the emotions down, recognizing the worry as baseless. But the emotions do not give up so easily. They fight on. The agitated feelings oppose the intellect’s assertions and keep the sufferer in a state of alarm.

The longer and more furiously this goes on, the more the intellect is worn down and gradually succumbs to these fears. While it was once offering such reassurances as, "This is silly, there’s nothing to worry about," it now says things like, "Well, I don’t know, maybe there is something to worry about here." The paradox is that the more the intellect openly engages the emotions, the stronger they become. The stronger they become, the fainter the intellect’s reassurances become – the fearful feelings effectively drown out the voice of reason.

Clearly, the intellect must win if we are going to be emotionally healthy people. The intellect is the arbiter of what is right and wrong, reasonable and unreasonable. While the feelings enrich our lives and make us more authentically human, they easily lead us down the wrong path. We can multiply examples of this unhappy fact. There’s the woman whose feelings of neediness push her back into a physically abusive relationship. Or the teen who adopts reckless behavior to win the approval of his peers. Everywhere we see examples of havoc that results when feelings drive a person’s life.

The bottom line is this: We cannot live well unless the intellect – the rational faculty each of us possesses -- rules. This is doubly true of anxiety sufferers. The feelings of dread and panic cannot be permitted to carry the day. We know better than to heed irrational worries, but we do so because they become so emotion-charged, so arresting. So what do we do?

The secret is to allow these feelings to burn themselves out. The intellect must stop engaging the fearful impulses in open conflict. They must be allowed to simply spend themselves and dissipate over time.

Let’s say an obsessive worry arises. The emotions begin to flare. Instead of engaging them in open conflict, try sorting out in your mind what your feelings are telling you and what your intellect is telling you. Remind yourself that your intellect is less likely to mislead you than your emotions. Make a decision – a firm act of the will – to follow your intellect, no matter how intense your feelings are. This will take some self-discipline, but you must do it.

It may be helpful to ask yourself what belief your feelings are trying to impose upon you. At the bottom of every worry is a belief, such as "I am in terrible danger" or "I am on the verge of insanity." The intellect may reject it, but the feelings behave as if you really do believe it in your inmost being.

Having determined the belief that is being presented to you by your worries, take a short reality check. Ask yourself these questions about the belief that your emotions are presenting to you:

• Dispassionately considered, is this a rational, sensible belief?
  
  
• Does it look foolish written down on paper?
  
  
• Would I recommend such a belief to another person?
  
  
• Would an emotionally healthy person entertain such a belief?
  
  
• In my stronger, more clear-headed moments, would I think it worthy of belief?
  

After this brief inventory, end the inner struggle right then and there and go about your business. Don’t spend any more time thinking the matter over. You will feel a prod to analyze and dissect the worry further, but you must refuse to do this -- uncomforatable as this may be. The feelings, of course, will rage on. Let them. Don’t fight them anymore. Don’t analyze them. Just keep doing whatever you were doing before the anxiety started. Or find something else to do.

As this drama is playing itself out, it’s important to tell yourself that it’s OK to feel anxious for a while. Your feelings will fire off all their artillery until they are exhausted. In time, the worries will fade. That’s the good news. Anxiety that is not fought against tends to drop off – cancelled due to lack of interest.

This is not easy to do, of course. You may have to remind yourself to hang in there, using statements like:

• "I’m not going to let my feelings do my thinking for me."
  
  
• "This is an irrational worry, and I don’t argue against irrational worries. They don’t deserve my attention."
  
  
• "I’ll just feel some discomfort for a time, but then it will subside. It’s OK."
  
  
• "I know I don’t really believe what my feelings are telling me is true, so I’m going to act like I don’t – no matter how I feel."
  
  
• "Regardless of what my emotions are telling me, this is really no big deal. It’s only anxiety."
  

So don’t let your intellect and emotions battle any more. You’ll be the loser if you do. Instead, let your feelings punch themselves out. It’s the only way to win the anxiety war.

What Exactly Is Social Anxiety?

Social Anxiety Disorder (social phobia) is the largest anxiety disorder and the third largest mental health care problem in the world today, yet most people know little about it. People with this disorder are often labeled as "shy", "aloof", "unsociable" and even "rude", but inside they can feel trapped in their shell by this debilitating problem. The latest government data show that social anxiety may affect up to 7% of the population at any given time - the chances are we all know someone struggling with this disorder, and yet we're not even aware of it.

So, what exactly is social anxiety? It is a fear of social situations that involve interaction with other people: more specifically, the dread of being negatively judged and evaluated by other people leading to feelings of inadequacy, embarrassment, humiliation, and depression. If a person usually becomes anxious in social situations, but seems fine when they are alone, then "social anxiety" may be the problem. The feelings that accompany this disorder include intense fear, nervousness, automatic negative thinking cycles, racing heart, blushing, dry throat and mouth, trembling, weak knees, and muscle twitches. People with social anxiety know that their anxiety is irrational, yet the thoughts and feelings persist and cannot be willed away. Social anxiety is often confused with panic disorder, but people with social anxiety do not experience panic attacks. Most people who have panic attacks seek medical help, believing they are having a health-related problem (like a heart attack), but people with social anxiety realize that it is anxiety and fear that they are experiencing.

In public places, such as supermarket queues, doctor's waiting rooms, work meetings or travelling on buses, people with social anxiety feel that everyone is watching, staring, and judging them. They have great difficulty relaxing, "taking it easy", and enjoying themselves in public. In fact, they never fully relax when other people are around. The anxiety is often so distressing it becomes much easier just to stay away from social situations and avoid other people altogether. Even when they're around familiar people, a person with social anxiety may feel overwhelmed and have the feeling that others are noticing their every action and criticising their every word. People with social anxiety usually experience significant distress in the following situations: being introduced to a stranger, being teased, being the centre of attention, being watched or observed performing a task (sometimes as simple as writing their own name), meeting people of authority, making eye contact with someone, and performing any number of activities in public (making a phone call, talking, eating). The symptoms vary among individuals, and may be a generalized anxiety (overall fear of social situations) or specific (fear of performing a certain activity in public, such as eating).

Since few socially-anxious people realize they are suffering from an actual treatable disorder, they tend to keep their problem to themselves. It would be distressing, after all, if everyone realized how much anxiety they experienced in daily life. It becomes a sort of catch-22 situation - their fear of what others think keeps them from seeking help for the anxiety. If they do finally reach out to mental health professionals, however, treatment of the disorder has a high success rate. Research indicates that, after cognitive behavioural therapy, up to 90% of people with this problem report a changed life - one that is no longer controlled by fear and anxiety. There is hope for sufferers, a doorway into the world of people and healthy day-to-day social interaction.

Managing Anxiety: Expectations Are Killers

STAY AWAY AT ALL COSTS - DON'T LET YOUR EXPECTATIONS GET THE BETTER OF YOU.

We do not want to "set ourselves up" ahead of time for feelings of failure and defeat. We do not want to try to "force" or "pressure" anything into happening on a particular rigid time schedule.

For example: "Today, I will go to work, march into the bosses' office, and get that raise I deserve so much."

Maybe this is a true statement, but there are too many things beyond your control in this statement that have nothing to do with overcoming anxiety.

You are setting yourself up for a fall, and it is likely that you will have one.

Maybe your company no longer is giving anyone raises. They do like your work, and they do not want to lose you, but perhaps company policy dictates that no raises are being given for the next six months.

If you take this personally and allow yourself to feel defeated, you are sabotaging yourself. Don't do it. This is not something to be taken personally.

It is NOT a slap in the face to you. This would occur to anyone asking for a raise during this time.

Or, consider this irrational expectation: "Tonight I will go out and meet someone..."

This is a big, bold, unrealistic expectation. Why? Yes, you can go out and "meet" someone, but what you mean is you want to meet someone interesting that may turn out to be a friend or a lover.

The trouble is, again, you do not have control over WHO is going to be "out there". If you have some scruples, and are really looking for a quality person who shares your interests, you have limited your chances tremendously.

This particular expectation is usually a real killer: you expect way too much, and all of it is out of your control. You are setting yourself up for defeat if you carry this expectation out.

Instead, a healthier, productive outlook is to generally increase your social activities in areas in which you have a legitimate interest. Your interest in the activity should come first, and your focus should be on having a good time that evening - not on any of the people who might be there.

If your FOCUS is on slowly expanding your social activities - and not on other things - you have automatically increased your chances of reaching your goal.

Yes, this is another paradox. the more and more (and desperately and desperately) you seek something and "expect" something, the more and more elusive it becomes.

It can turn into a depressive nightmare, and your progress against social anxiety can be halted. So, FOCUS on moving ahead for yourself, healing yourself, expanding your social circle very gradually for yourself, and you will be moving in the right direction.

"withdrawal was one of the worst weeks of my life, nausea, confusion, rage, sadness, incredible dizziness and horror"

Just wanted to follow up with my post from last week. I took my last dose of Paxil on a Thursday, with dizziness starting to take place on Sunday, becoming worse through Thursday the following week. It is now Saturday and I feel I've come through the worst of it. The withdrawal was one of the worst weeks of my life, nausea, confusion, rage, sadness, incredible dizziness and horror that it went on for five days relentlessly. I was bed-ridden, and feared it would never end. I have been successful in getting off of this poison and would never take it again. I found that my experience with prozac was much more positive in treating my depression and did not have the horrendous withdrawal. And I encourage all those who are having trouble getting off this medication to get lots of rest and persist through it. My withdrawal took about nine days, and I still have a little lightheadedness here and there, though it's been manageable. Good Luck to you all!

"diagnosed me with this social anxiety disorder and gave me a large stack of paxil"

I started working in a retail business about 2 years ago and started eating more and smoking more after gaining about 40lbs I became concerned and went to my doctor with no physical exam and just asking a few questions he diagnosed me with this social anxiety disorder and gave me a large stack of paxil sample packs and gave me instructions on bringing my dosage up from 10 to 40 mgs. in just 12 days after being on 40mgs for about 4 days i had no energy any more just getting out of bed in the morn was a battle and my head became foggy and I had to stop and think about everything that always just were just every day life things I could not even drive. I decided this was not the drug for me and stopped taking it I guess I just assumed that if there were any problems with this that the doctor would have warned me about it or there would have been some sort of warning on the package. this is when my horror began 2 days after quitting came the loss of apatite sweating nausea and all the other things i have been reading about after missing two days of work I was fired from my job and a means to support my wife and son. after a week of sever withdrawals I went back to see my doctor and he told me that he had never heard of any adverse withdrawal effects its been three weeks since I have still bad effects nausea , vertigo cant drive if its not obvious writing and typing are a struggle I feel as though my brain has been fried the people who have had there lives ruined by this drug need to get together and sue smithkline beecham for doing this to us

-- submitted by robert arnson

"I started taking Paxil about 5 years ago for depression"

Believe it or not but this is my third time to wean myself off of Paxil. I started taking Paxil about 5 years ago for depression. I took 20 mg a day for 2 years. I decided to get off and went cold turkey. It was not a pleasant experience to put it mildly. I had severe nausea, dizziness and was extremely distressed emotionally. I felt like I would never feel right again. After a couple of grueling weeks I felt better. I got back on it again about a year later because I had started getting depressed again and the Dr. encouraged me to. I took it for about a year and got off again. Same lousy symptoms getting off. Oh how we forget! I got on it again because I was having panic attacks. The Dr. told me that this was the best medicine for the panic attacks and that studies show that there are no long term effects from staying on the medicine indefinitely. I thought I possibly had mitral valve prolapse, but in fact it was panic attacks because the Paxil immediately took the symptoms away. Which at the time was a good thing. I just wonder how good it is for your body if it causes such a toxic reaction when you quit taking this drug. I've been on it a year and have just had it with this medication. I have put on 30 lbs. and feel horrible. The Dr. said that for some reason people who have been on it for a while sometimes experience weight gain. In my case I feel like it makes me hungry. I also feel like it gives me a feeling of complacency about my eating and weight gain, even though at times I feel disgusted with myself. Anyways, I've been off for 5 days and feeling lousy. I've been extremely nauseated, hot and cold (my hands have been like ice cubes), dizzy, and I feel like an emotional wreck. I ended up taking 10 mg today because I have a party scheduled at my house in 2 days and have too many things to do. My plan is to get through the next 2 days as best I can on the least amount of medicine possible. After that I will continue to refrain from the medicine and get off of this for good!!!!!!!!!!!!! I am going to hire someone to clean my house and I told my husband that he and the kids are on their on for the next week. I had him read all the testimonies so he would understand better. I don't think he really understood how bad I felt until he read what others were experiencing trying to get off this medication. The last 2 times I got off I tried to maintain my same pace with the kids and school and the house and tryed to put on a 'good face' when all I wanted to do was tell people, "Hey I feel like you know what so just get out of my blanketey blank face!" It was brutal. The last couple times I got off I remember after a couple weeks I felt better and after about a month I was back to normal. The first week is really rough. It's hard to get off this medicine but I have done it and I will do it again!

-- submitted by Dr. Marso