Jack comments on Open Thread: October 2009 - Less Wrong
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This is random and for all sorts of reasons possibly a bad idea- but have you ever thought about anti-anxiety medication? It might have side effects that turn you off of it but it could help you deal with high risk situations.
(I should disclaim: I'm not a doctor, my knowledge doesn't extend past personal experience and a cog sci minor. Obviously, not medical advice, etc.)