Presentation

[Dana38]

I have a presentation next week that I am extremely anxious about. What makes it worse is I have to go last so I will have hours while other people are presenting to panic over it. I plan on taking a .5 klonopin and some melatonin the night before so that I can sleep. Then a .5 Xanax about an 20/30 minutes before I think it will be my turn along with .20 mg propanol. Hopefully this will keep my panic and racing heart away. Has anyone had any success taking Xanax and propanol for presenting?

[b1b1b1]

I have taken Valium (a good solid dose) and it has worked. This is so difficult, but I think you have a good plan. If you have never taken the combo of propranolol and xanax before, I would check with your doctor and maybe try a test run to see how the combo affects you.

[Dana38 in reply to b1b1b1]

Totally doing a test run. Make sure I don’t turn into a zombie

[QuarkyOlympian in reply to Dana38]

I've used diazepam and propranolol in combination for over a decade with no adverse effects. They work in very different ways, with benzodiazipines affecting the GABAa receptors in the brain and in so doing they enhance the brain's ability to calm down. In a nutshell, GABA is what's known as a global inhibitory neurotransmitter, which means it tells brain cells NOT to fire - as opposed to excitatory neurostramitters which tell brain cells to send a signal to the next brain cell. By enhancing the brain's ability to use GABA, benzo's (in your case xanax) help the brain to be less active, which is especially useful when the activity is anxiety provoking thoughts.

Propranolol, on the other hand, is more of a body medication in that it works to block the effect of arenaline and noradrenaline (epinephrine and norepinephrine), which are released from the adrenal glands and affect a vast range of functions to enhance awareness and strength in situations where you are under threat.

This is grossly oversimplified, but if you have or are likely to be using these meds for any length of time it is highly advisable to read up on their "mechanism of action"; and whilst I've generalised, using dizepam as an example of benzodiazipines and propranolol to represent all beta blockers, it's essential to understand that there are numerous types of both and that each variation works in ways that differe slightly or significantly - this is especially true of beta blockers.

I know my answer is far more involved than what you were probably looking for, but I always try to encourage people to understand what they are taking and how they work; not least so that you can use them wisely and to best effect.

Personally, in addition to severe anxiety, I also have a physical condition which causes muscle spasms and spontaneous surges in aderenaline release, so my situation is a bit more complex than some; I also did a psychology degree four years ago, used the opportunity to better understand both my conditions and the meds I take - because I also have to take various pain meds, other muscle relaxants AND levathyroxine for hypothyroidism. So you can well imagine that I like to be clued up on what the hell I'm putting into my body.

One related thing that I'll throw in but feel free to ignore it - because I am most definitely NOT saying that relying on medication is a bad thing - is that both through studying psychology and years of therapy I have reached a stage where I can sometimes harness my anxiety to my advantage by accepting that my brain is going to obsess over x y or z and using really simply CBT techniques I can sometimes replace the attacking negatives with helpful thoughts. Where presentations are concerned, I can usually replace the fear of judgement and screwing up with an obsession about the actual content, which results in fixation on the subject matter such that I can spend two days rehearsing and refining it such that the negatives don't have much chance to take control because I'm too busy going over the details.

I used to rehearse in front of a mirror, but now I do it using my webcam, and over the years this has greatly reduced anxiety about how other people are perceiving me when I'm actually presenting, and has reduced the fear of my own voice - both of which are purely down to the fact that I have now seen myself on camera so much that it's almost like watching someone else, and this sometimes comes to mind when I'm actually giving a presentation and can sometimes be so powerful that it's almost as if I'm disembodied. I've practiced this so much over the years that, in combination with going over the presentation to the point where I could do it in my sleep, I have reached a stage now where it's sometimes like I'm on autopilot.

Of course this takes a long time to achieve so please please don't think I'm trying to imply that your anxiety is unwarranted; I know only too well that anxiety is largely irrational and having been controlled by it for most of my life I would be a basket case without medication. It's simply about doing the best we can. For context, I also perform my own poetry and I never get anxious about that; it's only when it's intellectual stuff that can be "objectively" judged that I can find myself debilitated by anxiety. I do understand why this is but it would take three times as much as I've already written to explain.

One thing I will say, though, is that when I was at uni, because I had no choice but to get special dispensation because of my physical conditions, it made it much easier to discuss my anxiety issues with my lecturers, which resulted in my usually being allowed to go first. If this is an option for you, it's one that is well worth taking. If it's a workplace thing and you don't want your employers or colleagues to know about your anxiety, if it would not look out of place to do so, one strategy I would employ to help moderate my anxiety whilst waiting for my turn, is to take notes about the other presentations. This could be about the actual content or things you notice other people doing whilst they present. If you can frame this as research for next time, it might help you to feel less anxious about yourself, whereas if you frame it as direct comparison with yourself on that day, it will be more likely to make you even more self conscious.

The point I'm really getting at here is that in focusing outside of yourself your brain will have less opportunity to obsess about how you will do in your own presentation. These skills do take time to learn, but one of the biggest problems with anxiety is a negative relationship with time which can keep us stuck in self-defeating cycles. By training our brains over time, by developing dozens of tricks and techniques, it is possible for even the most anxious of people to meet challenges that they never thought possible. The fundamentally important foundation, though, is adjusting our relationship with time. I didn't intend to go into that because it's got nothing to do with meds, but having been crippled by anxiety for most of my life, if something I share can help someone even a little bit then it's worth it. Just remember that whilst I have one psychology degree and will soon have another, I am by no means an expert; all of my learning has primarily been motivated by wanting to get out of hell.

To retunr to your question about meds, though: in short, though it's always wise to check with your doctor, there should be no problems combining benzos and propranolol (I don't know about other types of beta blocker) as long as you stick to sensible doses and, of course, never mix them with alcohol. That should go without saying, but when anxiety is driving us to the absolute limit, a quick "steadier" can seem very tempting.

One final thing to add is how wise it is to do your utmost to get a decent night's sleep before the event. I'm sure that everyone here knows how lack of sleep can worsen our anxiety, but it can become a self perpetuating problem, so the melatonin the night before sounds like a good plan.

I hope this is more helpful than patronising. And good luck with the presentation.

[yankeesmom]

Hi Dana..

I have been taking Klonopin for a very long time although I only take it at night to sleep 0.5 mg.. I have now added 10 mg of Melatonin which helps me sleep...I have never added a xanax or any other sleep or anxiety medication with Klonopin you have to be concerned about slowing down your heart and your breathing. I was even told not to take an advil PM or any other sleep meds with klonopin. . If I were you I would ask the Dr about adding Xanax and propanol after taking klonopin and Melatonin. Im not a Dr but you will be putting alot in your system in less then 24 hours. Be safe and ask the Dr... I hope this helped you...