Psychiatry & Psychology--General/SAD

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QUESTION: or more than a year, i have been diagnosed with bipolar disorder. My most recent attack was manic. It is hereditary for us to be bipolar since my cousins on my mother's side and my eldest sister is also bipolar. My psychiatrist gave me medications such as Olanzapine 10 mg and DIVALPROEX SODIUM 500 mg taken once daily. My problem is i'm being too queit:like i don't talk at all.And i don't feel being conversant with people, especially with my old friends. Sometimes my mind goes blank and im having difficulty understanding.I know that im a quiet person before, but this time i don't really talk.Way back in college when i wasn't still bipolar, I made friends, txted a lot, and even courted a girl and had a gf. Now i can't even court a girl coz i'm have struggling ti have even short conversations. I beleive i'm having social anxiety disorder, or a form of personality avoidance.i've read it on wikipedia. The Article says "Sociability is closely tied to Dopamine neurotransmission. Misuse of stimulants like amphetamine to increase self-confidence is common." How true is this? Does my medication (Olanzapine and Divalproex) also contain Dopamine? What should i do to improve my sociability?? And oh, i smoke 2-3 sticks of cigarettes a day.Tnx

ANSWER: Hi Roy

First, congratulations for getting the BD under control. Yes, there is a small genetic component.

I agree with you that it's a social anxiety disorder, but have to mostly disagree with the comments on dopamine and amphetamine use.  (Even if it were true, your medications are not amphetamine-like, and the control of your BD is much more important.)

Why don't you see if there's a support group for people being treated for BD, and if there isn't, you could suggest to your psychiatrist that one be started.  And if you can find a clinical psychologist, many of them do provide training for dealing with SAD.

The smoking is irrelevant, but the latest research suggests that each cig reduces your life expectancy by 20 minutes.

All the best to you, and please feel free if you have a follow-up.

Alan

---------- FOLLOW-UP ----------

QUESTION: thanks for being the expert in agreeing with me that it's social anxiety disorder..:) The problem is, i can find a clinical psychologist or therapist. Is not there a drug to cure S.A.D.?I'm trying to find a short cut. What alternative ways can i do to cure S.A.D.? drinking alcohol?(like what's stated in wiki)

Answer
First let me contrast your two problems. BD is real and potentially debilitating if not largely controled by medications that restore the normal neurotransmission function. SAD is merely a recently-made-up term for what most people have to an extent: some degree of awkwardness around making friends, especially guys with gals. And it does not respond well to drugs including alcohol. Your two problems should not even be used in the same sentence.

One approach to alleviating so-called SAD is called Social Skills Training, designed to analyze interactional judgement errors and replace them with good conversational skills and, if lacking, appropriate assertiveness. Sometimes there are suggestions about getting involved in activities of interest (hobby groups, religious ones, etc.) that may attract similar people, or even hiring a matchmaker or dating service if common in the culture.

Of course, small-talk does not follow a script, so you need to be perceptive about social cues, and aware of some response options. And to understand that it improves with experience, and eventually finding the right group or individual has a large component of luck and chance.    

You sound sufficiently insightful to be able to manage this on your own, although knowing what to look for, you might be able to find the right hands-on guidance.  Good luck with it.

A.  

Psychiatry & Psychology--General

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Alan Auerbach

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Taught psychology for 30 years, authored four textbooks. Specialize in introductory and industrial/organizational psychology, but will tackle wider range of areas.

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