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OK, this is long, but please bear with me!

I've batteled extreme social anxiety since I was born! Throughout high school it developed in to GAD, dysthmia, and seasonal depression as well. I've always been very shy, quite, and uncomfortable in any public or social situation. I've gotten much better while in college made some great strides, but still very uncomfortable. Despite my anxiety, I've always had a great group of friends, OK social life (althought sometimes nonexistent), and do well academically.

I tried Paxil 3 years ago for social anxiety/depression. I switched after a couple of weeks to Buspar due to weight gain, then switched to Wellbutrin due to weight gain. I stayed on Wellbutrin for 4 months, never having a recheck. I stopped it myself when I realized I'd gained 20 lbs and still had major anxiety.

A year later I was prescribed Klonopin + Adderall. I didn't take much because a counselor told me it was a terrible combo. I didn't go back to my GP, but instead explored biofeedback therapy. Definitely helped with a form of ADD I found I had, which helped me focus more on reality and interpret things more accurately, thus decreasing my anxiety since my social skills could improve.

This past fall I was having major anxiety again. It was actually a great deal of general anxiety and stress. I was pushing myself way too hard with school, work, interning, grad applications. I went to my GP's office and saw his PA. I asked for the Klonopin and Adderall since I'd had it before. I actually never really took them consistently took it before, so I didn't know how I'd be affected. Well, I experienced crying speells and spiraled into a quick and dark depression after a few days. I went back and was put on Effexor.

I stayed on for about 6 weeks. I was naseated. Felt flat emotions. I was also gained large amounts of weight, again another 20 lbs. When I went back, I told my PA I was fine, I thought I was, since I was no longer in the scary deep depression from months earlier. He said that I could try another SSRI or Cymbalta, but I probably wouldn't respond well since I hadn't in the past. I agreed and decided to go without meds.

A while later I was experiencing major anxiety. I started taking the rest of my Klonopin daily. It calmed me, but also made me tired, and maybe a decline in mood and some cloudiness. At my next appointment I told my PA about it. He thought that wasn't a good idea to take benzos. I don't blame him, he can't even prescribe them himself, must give approval, he shouldn't be encouraging it for his own sake.

Well, anyway, I started Strattera for ADD, which is working well, but was having lots of anxiety, so made a pdoc appointment. [COLOR=Red]{REMOVED}[/COLOR]
I took my one Klonopin I had saved for months last weekend at a party. It worked well, not too much sedation since I was taking Provigil and Strattera, maybe a little cloudy, but my body wasn't used to it at all, so it's to be expected.

After my disappointment with a pdoc last week (no meds given), I decided to try my luck with a new GP. I asked about of GP of a friend who I know takes Xanax as needed, I wasn't able to get an appointment with him, but will see another GP in the practice. I wanted someone who wasn't afraid to give out benzos. Since this is a partner, I am unsure.

I'm supposed to leave for Grad school in three weeks. [COLOR=Red]{REMOVED}[/COLOR] I'm soo nervous about the social anxiety of a new city, apartment complex, classes, professors,[COLOR=Red]{REMOVED}[/COLOR] I really need a doc to help me out here and try to be understanding. I made an appointment with another GP yesterday, I want to have a backup if the first appintment doesn't work out.

So, I have 2 appointments next week. How should I approach the doctor? I'd like to try a daily benzo, continue with the Strattaram get a script for Provigil, and was thinking about EMSAM. How do I convince them on benzos? I don't even want Klonopin, not completely satisfied, but need something daily, all day. I can prove that I have Strattarra[COLOR=Red]{REMOVED}[/COLOR]Are docs OK with prescribing Provigil off label for depression fatigue, ADD, and benzo fatigu? What about EMSAM? Would this be hard to sell?

I don't want to walk in preaching to my doc about exactly what I think I need/want, but don't have time to wast and can't afford another failed appointment. I'm not sure how to descrube my anxiety symptoms either. I'm afraid of getting another SSRI which I will refuse.

I don't know that emphasizing social anxiety is a good idea, since they may say I need therapy instead of meds, especially since I'm a new patient. I've tried counseling, without success. I don't express my anxieties well enough, plus don't learn well or internalize the advice of other, and feel it's fairly irrelevant. Actually sessions end up with me feeling worse from insults and flaws picked at. I need positives, not negatives in my life. And I don't think the thought pattern is altered by cognitive approaches, I will always be an anxious person, which is why I'd like meds to improve the quality of my life. I don't think they're magic, just will give me the opportunity for self improvement if I find some that help and are tolerable.

Does anyone have any suggestions? I'd appreciate some help and input!





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