Aswad
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Joined: 4/4/2007
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ORIGINAL: WayHome
Taking them on with sensible cognitive and behavioral therapy techniques could be very useful and also very satisfying for certain Dominants.
I would not advocate trying that without being very confident about the Dom, unless the Dom is a certified and licenced mental health professional.
Been there, done that. In a good way, with good results.
I was surprised to learn that my way of dealing with people in that regard had been codified. They call it "cognitive behavioural therapy", and it's the only thing shown to be more effective (in the general case) than an attentive listener, whether a priest, doctor or good friend. I just call it "helping people".
I've also seen Doms whose notions about therapy are horrifically bad, however. Some to the point where I'd seriously consider having the sub go see Hannibal Lecter instead, with him being the one tied up, of course. And that's semi-joking, of course. But there are some who want to "get at" their subs mental problems who are royal screwups waiting to happen in someone's head.
Not saying one Dom or the other is in either camp, or that it has to be a bad idea.
Just be extra careful.
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From the sounds of it you might want to ask about Buspar. I believe this drug is highly underrated for people like you.
The clinical trials would not appear to bear you out on that, at least not so much as to be noteworthy.
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Most antianxiety meds are basically just sedatives and can lead to all sorts of problems including abuse and addiction which is why Docs are often hesitant to prescribe for chronic use.
No, most antianxiety meds are not that. And the most commonly used approach is to use an SSRI (e.g. citalopram, fluoxetine, etc.) or a so-called 5HT2-antagonist, such as mirtazapine (Remeron), or both in combination.
The systems involved in the actions of antianxiety meds are the serotonergic, dopaminergic and GABAergic systems. Some act on one, some on two, some on all.
Those who act predominantly on the GABAergic system can be addictive, are usually a bit sedating (at least at first), and have some abuse potential (what doesn't? sugar does, as does chocolate, and love.). These are the benzodiazepines, the barbiturates, and alcohol.
The most common ones are those who act only on the serotonergic system.
Some work on the dopaminergic system, which may indicate mild abuse potential in some people, but is rarely a problem when there is no prior history of abuse and addiction. These are less commonly used due to stigma, though.
The most effective long-term medication against anxiety disorders, period, is phenelzine (Nardil). It comes with dietary restrictions, though. But at the right dose, it will usually kill anxiety without any intolerable side-effects. There is a reason they keep producing it for the 15.000 people (almost nothing, for a pharma company) who use it, and that the hospitals have stockpiles (around here, they have literally kilograms of the stuff) of it: if the pharma companies stopped making it, the universities, hospitals and pharmacies would start synthesizing it themselves. It's not addictive, but the first two to four weeks starting up are a bit unpleasant, and it interacts with everything, so the docs have to go over any other meds you might want to take, including OTC stuff. Does the job, tho'.
(For the pharmacologically interested, it is a GABA-transaminase-inhibitor which is metabolized into a monoamineoxidase-inhibitor.)
As for panic attacks, the most effective thing I've found so far is buprenorphine, which is addictive, if used on a regular basis, but if the panic attacks occur that often, it's way better to use a long-term maintenance med and cut down on the short-term meds. The time from putting 0.1mg under your tongue until the panic attack is gone (as in, not in the least bit, and staying that way for about 12-48 hours, even if whatever triggered it remains) was, for nephandi, about 10 minutes, as I recall. After that, she gets a bit drowsy for 20 minutes (no biggie; could sleep if she wanted to, can stay awake and function well if she wants that), and then it's all fine again. About 30% of those who use it may experience some euphoria the first few times, however. More relevantly, though, perhaps, is that it's also a powerful painkiller. A 0.1mg dose (half a sublingual tab) will take away a light migraine or a cleanly broken bone, so further S&M doesn't work for the next 6-12 hours. The D/s works fine, though, as does the sex drive.
Normally, though, the docs will prefer to go the route of an SSRI or somesuch as a long-term therapy (often alongside CBT) and a benzodiazepine (like Xanax) for the breakthrough panic attacks.
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But Buspar is completely different. It has no abuse or recreational potential at all, is taken every day and works in the long term, is non-sedating, and can be very effective for GAD, OCD, and for reducing the frequency of panic attacks. I have seen this drug completely transform people's lives (in a GOOD way).
Yup, it's completely different. In fact, it has very little potential at all, according to some studies. Suffice to say that the producer is not keen on comparing to active placebo any more, last I heard.
It does apparently have a little bit of effect, although I've never met anyone it worked for myself. Some will find their lives changed by it, though. All it takes, sometimes, is that extra attitude that "this will work out, I'm doing something about it now", or the externally induced confidence that allows one to risk a situation where the anxiety might be trigger, and discover that it doesn't that time, and thus start on a course of building one victory on the previous one, much in the style of CBT. In short, it is mostly equal to placebo, but with a slight edge.
Proper diet, exercise and cognitive behavioural therapy will generally give a better result, though.
(And, far be it from me to push the meds on anyone. I just happen to know that bit to a decent extent, so I share what I know. The CBT bits I just do; even having read the literature, it's hard to put it into words, since it was already tacit knowledge. Both are valid strategies, and I use either or both, depending on the person's preferences.)
_____________________________
"If God saw what any of us did that night, he didn't seem to mind.
From then on I knew: God doesn't make the world this way.
We do." -- Rorschack, Watchmen.
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Anxiety Disorder and BDSM-- What should I do? - 
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And while I really dont have 'scening' experience to draw some wisdom out of for you, as I've never 'bottomed', I can give you some standard advice about anxiety. 
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