How common is it for these two disorders to be comorbid? Do most people with ADHD have Social Anxiety, or is it only certain subtypes? From what I've read, it seems like people with the hyperactive subtype are less socially withdrawn and have more trouble with organization, time management, those types of things.. but it seems like the inattentive types have more trouble with depression and anxiety. I'm not sure about the combined type, maybe they it's just a mixture with them because it is, well, combined. I myself have inattentive type and have pretty severe social anxiety plus (atypical) depression.

So, I'm wondering, if the social anxiety is treated with something like an MAOI or a benzo, will this improve the inattentiveness? I'm just having a hard time understanding how it works. I've seen reports of a lot of people with Social Anxiety that have been treated with an MAOI like Nardil or Parnate and they say they have excellent results. But if the MAOIs dont increase your attention/concentration/focus, how can this be true? A lot of my social anxiety comes from the fact that I can't properly attend to conversations, and I miss out on a lot of what is said. It's even worse around a lot of people because I get a lot of interference from hearing a lot of people talking at once. Any ideas?

I think I have social anxiety/ADD as well. If you're on medications you probably won't be able to take and MAOI's and from what I understand benzos destroy cognitive function and short term memory. Im in the same boat as you and not all to sure what to do about it :(

Well, I'm not on any meds right now. I've taken Adderall in the past and it helps with attention and motivation. I still experience quite a bit of anxiety, though, even with stimulants. I quit taking Adderall though. I couldn't handle the rebound effects, and I always found myself having to take too many doses throughout the day to receive consistent results.

I'm actually going to see a psychiatrist on the 25th. I'm not sure if I should ask about addressing the anxiety/depression first or maybe try to get a different med for ADHD instead. I'd really like to try an MAOI first, because even though my inattentiveness drives me insane, the social anxiety is the most devastating thing in my life right now. I'll just have to wait an see what the psych doctor thinks...

Hi Chad,

I have social anxiety and ADD as well. Is not very serious considering that with .5 - .75 mg of xanax a day I can handle a lot of "social pressure". xanax is really helpful to me in some environments and I was worried from what you said.




from what I understand benzos destroy cognitive function and short term memory.

How do you know this?

Specifically for xanax from my research I have not find any serious side effects.

Hi Chad,

I have social anxiety and ADD as well. Is not very serious considering that with .5 - .75 mg of xanax a day I can handle a lot of "social pressure". xanax is really helpful to me in some environments and I was worried from what you said.


How do you know this?

Specifically for xanax from my research I have not find any serious side effects.http://www.benzo.org.uk/vot4.htm

Cognitive Impairment and Long-Term Damage

The many papers published in the 1960s and early to mid 1970s on this subject were largely single dose therapeutic dose studies or low-dose studies for periods of a few weeks. They showed a range of deficits in cognitive function, psychomotor performance and short-term memory problems with no development of tolerance. It was not until the late 1970s and early 1980s (when therapeutic dose dependency was belatedly accepted), that cognitive function and other tests on long-term benzodiazepine users (up to 10 years) were studied both during use and in acute withdrawals. From the mid 1980s to mid 1990s there was an increasing number of studies looking at damage after long-term use and at follow-up periods after discontinuation of up to six years. Several of these studies involve CT scans of the brain looking for structural changes.

Summary

<li>Benzodiazepines produce impairment of cognitive functioning and psychomotor performance e.g. reaction time, vigilance, arousal, judgement, reasoning, speed and accuracy of information processing, visual spatial ability, co-ordination, short-term and post drug long-term memory, 'blackouts' and learned tasks.

<li>These effects are independent of abuse, dependency, non-dependency, normal, healthy, young or old subjects. Impairment increases with chronic use. Development of tolerance to these effects is very slow.

....Followed by a list of 42 studies about this subject...

{all colors and underlining mine}

Hi despirit,

A few ideas from experience from my use of xanax (that probably is the best medication for social anxiety).I had feelings of anxiety before I started taking xanax, but I started taking xanax because of couple of panic attacks I had as a result of the use of Ritalin.

Xanax for me seems to shut down parts of the brain that have to do with internal dialogue, from that I mean that I stop thinking how people will perceive what I am saying and my behaviour in general. I am much more spontaneous and somehow this is much better in communicating with people. Instead of hesitating to say something or no, in fear how others will perceive it I just say it. Xanax helps both with the feeling of anxiety and the ideas that make you anxious. I am not taking xanax all the time, but works so good that when I take it I am less anxious than any person I know.

Xanax helps me in another way in social interactions. When I am talking a large number of disorganized ideas come to my consciousness that is difficult to put them in order. Especially when I have a lot of information about a subject everything comes to mind and have an urge to say everything all at once. There are times that is difficult for other people to make sense.
With the use of xanax it seems that this part of the brain sending all these information is shutting down so my conversation is more coherent.

The above are the positive effects here are the negative


My symptoms of ADD are a general disorganization and an inability to focus on something for a long time especially if I do not like what I am doing. Xanax worsen my concentration, it only helps in the right dose in social environments, this is because I stop paying attention in my "internal processes" and as a result focus more in the social environment as an extrovert will do.

The KEY with xanax is the exact right dose, for best results you need to remember how much anxiety you will have in an environment. Who you will go to meet? Do you feel comfortable around them? Are you going to discuss anything is going to make you anxious?

To say the truth I am not doing what my doctor recommended .25mg 3 times a day because I had irregular effects.

Some times I will still be anxious and others xanax will make me drowsy, less talkative and seemingly stupid.

This is why you need to logically find the exact right dose to "cover" the anxiety, but also not going over the top and start being drowsy. It's always better to take less xanax than you think you will need and have a pill with you to take more if needed. Xanax for me starts to work in as less as ten minutes and I can control better my mood taking the amount as needed.

Take care,

I hope my English make sense.

Thank you a lot Crazy~Feet, It's really good to know.

I am lucky I have not used benzos for a long time. I am wondering if my doctor knows all this, he does not think that long term use of alprazolam in low doses (.75mg a day) is so bad.

Please if you have any other interesting links put them forward.

You are very welcome Nick :) If I find myself in the mood to do more research, I'll certainly post.

And your English is quite good!

NicktheGreek,

Hello and thank you for your responses. I am happy that xanax helps with your social anxiety and I have heard of benzos helping a lot of people. I have some concerns however.

As you say, benzos worsen your concentration if you take too much. Well, I believe I would have a very low tolerance for this drug because my focus is so terrible if I don't have a little caffeine to pick me up for a couple hours.

Also,


# Benzodiazepines produce impairment of cognitive functioning and psychomotor performance e.g. reaction time, vigilance, arousal, judgement, reasoning, speed and accuracy of information processing, visual spatial ability, co-ordination, short-term and post drug long-term memory, 'blackouts' and learned tasks.
I have trouble with most of these already, and I'm afraid of taking anything that could possibly worsen these symptoms.

If you don't mind me asking, what subtype of ADHD do you have? By this I mean, Hyperactive, Inattentive, or Combined? From what I've read, the Inattentive type has more problems with "information processing" in the brain, and I can definitely relate to this. It seems like my brain just "runs slower" than other peoples.

Anyway, I thank you again for your response and I'm glad you are having success with benzos. I have no reason to believe that xanax doesn't help with anxiety, so maybe this is something I could look into. I feel like I'd have to add a stimulant such as ritalin or adderall to help with the "information processing" problems, though. I've heard xanax helps with the rebound anxiety from stimulants, but I've also heard this is really bad for your heart.

Hi Despirit,

you are welcome.

As you say, benzos worsen your concentration if you take too much. Well, I believe I would have a very low tolerance for this drug because my focus is so terrible if I don't have a little caffeine to pick me up for a couple hours.

Again from my experience xanax seems to supress specific parts in my brain that seem to be over activated in social situations, from that does not mean that would negatively effect all the parts of the brain that have to do with concentration. I am saying this because when the dose of xanax is exact right it slows down the parts of the brain being over activated and does not effect my concentration in any negative way.

Here is what I think is happening, If you have similar experiences (although you may not have hyperactive ADHD as me) xanax may help you in a similar way.

In some social environments I feel self conscious, energetic in a bad way and anxiety. Part of this comes from bad experiences (as a result of ADHD) over the years that made me to unconsciously set really high standards of my social performance that makes me even more self conscious and anxious.

Although will sound weird at times xanax made me reach these high standrads. I think this happened because I am used to be anxious in social environments and be energetic in a bad way. Xanax covers the anxiety, but leaves me with the extra energy. When on xanax I would try to find the environment that will usually give me the most anxiety (go out and meet new people) I will adjust the dose and having a cool attitude and at the same time energy that will equal the anxiety I would normally feel. So the weird is that the most anxious the environment the most the energy I would feel and my normal behaviour from ADHD will get better.

If you feel the self-consciousness, anxiety and be energetic in a bad way (getting mentally tired from social interaction) probably xanax would be helpful to you.

Crazy~Feet is right of what she said about benzos and the brain. I did not find all the research because of my doctor, searching for alprazolam instead of benzos in general and because the effects of xanax seem innocent (it just relaxes you)

So far I have not find any research that proves that xanax is toxic for the brain, although probably is. I reread a study saying that people taking 2-4 mg xanax daily (it seems alot to me) for two months did not have bad effects in the brain after checking 6 months and 3.5 years later. It seems scary though that the people making the research thought that with only 2 months use of xanax they could measure mental deficits 3.5 years later.

My opinion is to try xanax, but have it only for rare social situations that you will have to attend and will give you alot of social anxiety. Set clear standards of when you will take xanax and really stick to it. Xanax except from the bad effects on the brain that might have, the withdraw is really a hell after continuous use (I have read it, but I have not the least experience of it, quitting after three months of use).

I understand that because of SA you do not feel very good So for long-term use is probably better to try a SSRI like Paxil.



For your other question as I said before I have hyperactive ADHD. Here is an article from wikipedia that is pretty close to my experience.

...It's like being super-charged all the time. You get one idea and you have to act on it, and then, what do you know, but you've got another idea before you've finished up with the first one, and so you go for that one, but of course a third idea intercepts the second, and you just have to follow that one, and pretty soon people are calling you disorganized and impulsive and all sorts of impolite words that miss the point completely. Because you're trying really hard. It's just that you have all these invisible vectors pulling you this way and that, which makes it really hard to stay on task.

The last example of my ADHD is an english test (IELTS) I had last month.
The test has four sections with this order reading, listening, essay, speaking. My best part is speaking as I have been couple of times in USA I had the opportunity to get better in speaking. By the time that the speaking part of the test my brain was so burn out I was barely able to communicate getting a 4/8. I had the opportunity to retake this part of the test and I got my usual I had in the pretests 8.5/9. Unfortunately this happen all the time. Is difficult to focus on one subject and my concentration burns out so quickly that is really difficult to function without medication.

Anyway


Take care.

A lot of doctors have stopped prescribing Xanax.

UPJOHN drug company first advertised it in the 1980s as being non-addictive. But some people get into some real problems with it. (And Ativan.) This is due to how fast they release (fast) and wear off (fast; causing withdrawal, then one must take more when the anxiety comes back; there can also be bad "physical" withdrawal" symptoms).

Tolerance can escalate quickly.

It made me very sick, and my Doctor got me off it. (e.g. headache, vomitting, stomach pains, panic, etc.) She has not prescribed it to her patients since 1998.

Better to treat the anxiety with an SSRI and education/training.

If you are really crippled with Anxiety, you may want to read the book: Waking The Tiger by Peter Levine. He teaches how to discharge anxiety and put it under your OWN control.