Extroverted like me: How a month and a half on Paxil taught me to love being shy.

Extroverted Like Me

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Jan. 2 2001 9:30 PM

Extroverted Like Me

How a month and a half on Paxil taught me to love being shy.

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Horsche / iStock

I dread public speaking. I get nervous on first dates. I hate to be called on in classes or meetings. In short, I'm shy. Not debilitatingly so. I'm guessing many of you are no different.

I've often wondered what it's like to be outgoing—a social butterfly, an extrovert. That's why TV ads for Paxil caught my eye. You've seen them: They promise ease in a pill. An end to social anxiety. Does my degree of shyness warrant medication? It was enough to make me want to see what life was like without being shy. I wondered what Paxil could do for me. Was a smoother, suaver Seth just 20 milligrams away?

Skimming my insurance company's list, I found a nearby general practitioner and made an appointment.

I. The Transformation

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Day 1: After taking my blood pressure, the doc sits me down and asks a few questions. Am I shy? Yes, I'm uncomfortable speaking in groups. Have I suffered from depression? I've been blue but nothing serious. I tell him I've taken the self-test at Paxil.com (example: "I avoid having to give speeches—Not at all, A little bit, Somewhat, Very much, or Extremely") and it said, "Your score suggests that you may be experiencing the symptoms of social anxiety disorder." Of course, it wouldn't surprise me if it always said that.

Seth Stevenson Seth Stevenson

Seth Stevenson is a frequent contributor to Slate. He is the author of Grounded: A Down to Earth Journey Around the World.

He lists Paxil's side effects—headache, nausea, tremor, etc. "The most universal side effect," he says, "is delayed orgasm. For some people, that's a good thing." I nod. He explains a little about the drug itself (it's a Prozac-type antidepressant that later got approved for social anxiety treatment) but concludes, "No matter what anyone says, we basically have no clue how this works." And that's that. He writes out the prescription, for 20 milligrams a day. "If you'd like, we've got some counselors upstairs you can talk to, but it sounds like you just want the drug," he says, and hands over the slip. "It could take a couple of weeks to kick in. Be patient."

I walk around the corner to CVS. Boom: Fifteen minutes with a doctor, $15 at the pharmacy, and I've scored a month's supply of a powerful, mood-altering substance. Back home, I pop my first pill and wait.

Day 2: I'm lying on the couch, wrapped in a blanket, staring at the wall. My head is buzzing. My eyes won't focus. My stomach hurts and I'm shaking. I feel like a slo-mo version of Dr. Jeckyll's violent transformation.

I do not feel outgoing.

Day 3: Ditto.

Day 4: No longer confined to the couch, but head still buzzing. Feeling totally detached from my surroundings. There's a constant lump in my throat (apparently a common side effect), and the shaking is getting worse. Eating cereal, I spill milk from the spoon before it reaches my mouth. When the doc said tremor, I thought it could be cool—give me a little Katharine Hepburn style. Turns out tremors are not so cool.

Day 8: Delayed orgasm, beyond a reasonable point, is not a good thing. I will say nothing further about this.

Day 11: Side effects have mostly faded out, save for the orgasm thing, which is in for the long haul. I'm not seeing any personality changes, though. At a party a few nights ago (among good friends, so not a worthy testing ground), I did notice one thing: After a few drinks, I began to discourse freely on my Paxil experience.

Generally, talking about myself, even with close friends, is my least favorite thing to do (writing about myself is clearly a different [2,000-word] story). So this was odd. But was it the Paxil? The alcohol? Or just that, for a change, I had something to talk about?

II. The Unexamined Life

Day 16: Still no visible change. However, I can't get a lick of work done. Unfinished articles are lying around, waiting for my attention. Motivation has dried up. Coincidence?

Day 25: A pattern is emerging. Since starting on Paxil, I've been drinking like a fish. For some reason, vitamin P combines incredibly well with alcohol. It's more fun to drink than it was before. I want to be drunk every night. I don't get hung over now, and I remain pretty lucid even when sloshed.

Day 27: Paxil is messing with my livelihood. I'm still not getting any work done. Could it be Paxil's antidepressant effects? Perhaps I'm too content to be motivated. Do I require bile and unhappiness to write? I could clearly go the rest of my life on this stuff and never feel down again.

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Illustration by Nina Frenkel

Another scary part: Before Paxil, while working on stories, turns of phrase would pop into my head, fully formed. Lying awake at night, or riding on the subway, poof—a neat arrangement of words would appear from nowhere. And would often show up in the article. It's part of what makes writing fun and surprising. On Paxil, it's gone. The words just aren't coming.

Also, the last few days I've considered cutting down on free-lancing and getting a regular job—consulting or something. Previously, I couldn't imagine a job like this. Regular hours and no creative outlet sounded like a nightmare. All wrong for me. But now, stability, routine, and boredom sounds A-OK. Pleasant, even. An easy way to make a buck and just live my life.

Day 29: A literati book party. My first real test, and it's basically a failure. Upon meeting a gaggle of strangers, I still sprout flop sweat all over my torso, just like before. I still can't introduce myself to people I'd like to meet. I still don't know how to talk in big groups.

But then something magical happens. After deciding Paxil is worthless and downing three glasses of wine, I find I want to talk to people. No, it wasn't the alcohol. I drink at parties all the time—and go from standing alone in the corner to standing drunk and alone in the corner. This time, I'm craving conversation. In fact, I want to talk about myself. And in the midst of a lively monologue delivered to a group of four people (previously unimaginable for me), I recognize the feeling: It's like being on ecstasy! Relaxed, exceedingly comfortable with strangers, completely open. It makes some sense—both drugs noodle with your serotonin. Paxil, like Prozac and Zoloft, is a selective serotonin reuptake inhibitor. SSRIs block reabsorption of serotonin—a neurotransmitter—by your nerve endings, boosting serotonin levels in your brain. Ecstasy tweaks up your serotonin, too. But instead of paying $20 for a night on E, I paid $15 for a month on P. The catch: I seem to require alcohol as a trigger. Not sure why, and I doubt my doc could explain it.

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