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AskPsychiatry
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What Is This Experience Called?
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Hi, if you know me in real life via this very specific experience, no you don't. I am ENTIRELY looking for if there is a name for this experience, or if it's a known phenomenon at all. I've tried looking into it and couldn't find anything, but I'm no psychiatrist.
When I was (maybe) four or five, I woke up on a couch with no memories of anything previous to waking up on that couch. No name, no home, no family, no memories. I woke up a bit grumpy, probably because my back was stiff from sleeping on the couch or something, and then instantly went into panic mode when I realized I remembered nothing.
I was scared of everyone I saw because I didn't know them but they acted like they knew me. Because of this, I went into what at the time I considered 'spy mode'. This was pretending as best I could that I knew these dangerous people, pretending that I trusted them, faking every interaction I had and every movement even when I was alone. I didn't want to get hurt, and I didn't know these people.
These people were my family, but I didn't know (nor did I end up believing) that at the time. I ended up settling into comfortably faking everything, but I still feel a deep compulsion to lie, and often end up doing little 'rituals' (which I am aware aligns with obsessive Compulsive Disorder, but my rituals aren't severe unless I'm going through a tough time, so I don't feel I need to include much detail on it). This was very tiring.
I've never regained those memories, and this left a deep mental scar on me (Generalized Anxiety Disorder, Depression, and undiagnosed but very likely Imposter Syndrome).
I only ended up looking for help once I was maybe 12-13, and while I've gone to talk therapy and currently go to a psychiatrist maybe once a month, I'm interested in knowing if this is a known phenomenon. Considering my family didn't know about this until I was 12-13, there's not many details on what happened before the memory-wipe-thing.
To my and my family's knowledge, I had no concussions, no major injuries, no is there an history of amnesia within my family medical history. I'll add a list of things about me that probably aren't relevant, but could be.
14FTM, (Assigned Female At Birth, but I identify as a transgender guy),
164 Centimeters (5'4''),
60 Kilograms,
I'm Australian (White).
Autism Spectrum Disorder (Diagnosed),
Attention Deficit Hyperactive Disorder (suspected by psychiatrist),
Depression (Diagnosed),
Generalized Anxiety Disorder (Diagnosed).
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2025-06-12T21:58:07
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1l9z68l
| 0 | 1 |
AskPsychiatry
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Stopping Trazadone
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I have been taking 50mg of Trazadone for 2 weeks and want to stop taking it. Do I need to taper? Or can I just quit taking it? I stopped Lexapro a week ago, but I don’t know if I should stop the Trazadone or taper. If I should taper and what that taper should look like.
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2025-06-12T21:24:49
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1l9ydsi
| 0 | 0 |
AskPsychiatry
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Clorazepate
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I am 25 years old and have severe agoraphobia, panic disorder, anxiety, and mild OCD and depression. I have been medicated for the past 11 years. I have tried so many SSRIs and nothing seems to work significantly. Right now I am taking lamatrogine, mirtazapine, fluvoxamine, and Valium and hydroxizine as needed. when I take the Valium (2mg) I see no significant difference. I have tried Xanax and it worked really well for me but addiction runs rapidly in my family and I was also 18 when I was on a daily dose of it.
I expressed to my doctor that I would like to go back on Xanax. He seemed to think that Clorazepate would suit me better.
When I told my friend who is a pharmacist she was shocked as she didn’t even think the medication was still on the market. So I’m curious what others experience as been?
*side note* I hate taking pills and want to be on as little as possible. The goal is to only take 2-3 medications a day.
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2025-06-12T20:13:12
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1l9wmil
| 0 | 0 |
AskPsychiatry
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Looking for Providers: How can I connect with psychiatrists who are skeptical of medication (or open to other treatment options)?
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My family member is emerging from a mental health crisis where they threatened self-harm; they are safe right now. In the past, they have been wholly and unwaveringly opposed to any form of formal intervention (due to fear of institutionalization) and are generally opposed to medicines to treat their symptoms (for fear they would diminish their personhood and autonomy). They are diagnosed but untreated for at least depression, anxiety, and ADHD, but also have panic attacks, suicidal ideation, possibly ASD -- going on three years of steadily worsening symptoms culminating in a recent crisis.
I am hoping to identify some professionals (psychiatrists, therapists, health aides, etc.) that would understand their extreme opposition to standard treatments and could potentially offer them well-informed support short of medication, etc. **How would I go about identifying professionals with a documented openness to non-medical intervention? Do you have any other suggestions for encouraging a person with these convictions to speak to a professional?** We are doing our best to keep them safe and honor their wishes, but their struggles seem to call for expertise family can't offer.
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2025-06-12T12:21:17
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1l9l23c
| 0 | 1 |
AskPsychiatry
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Dealing with someone having a break
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A family member has been getting further and further from reality and is experiencing what I think is psychosis. Some examples being thinking they are communicating with spirits; taking instruction from them around what to eat, what to do, hygiene; and thinking everyone is saying bad things about them and secretly hates them but just pretend to like them. This has been going on for about a year.
They do not work and only rarely leave the house.
They will not seek treatment on their own as they don’t think there’s any issue—to them, they’ve cracked some type of code on how to communicate with the extra worldly.
They can also be verbally abusive (nothing physical) unprovoked. This makes dealing with them stressful as they can be unpredictable.
They have previously had milder mental health issues but always seemed to come to their senses on their own. I’m worried about the length of time they have been like this and that the longer they go the harder it will be for them to go back to having a normal life.
So my questions are
1. What would you recommend in terms or getting them help without them hating me.
2. Is it useful/worth it to call out the abusive behaviour or should I just let things go because they aren’t in their right mind.
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2025-06-12T17:10:21
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1l9rygx
| 0 | 0 |
AskPsychiatry
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My memories don't belong to me
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Hi,
I've the feeling that my memories don't belong to me. I'm aware that I'm in the same body since my birth, but I've the feeling that, more than another personality, I'm a new protagonist inside myself.
Several times a day, I've a kind of rejections about "parasitic memories", which occur suddenly. 99 % of these "parasitic memories" concern that other person and many times, I can't do anything like 10-20 seconds, I repeat "shut up" in my head to calm that.
I know that it feels cringe but I'm questioning about myself. Does this mean anything to you ? Thanks.
Sorry for my English, I'm not native.
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2025-06-12T13:20:18
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1l9mawy
| 0 | 0 |
AskPsychiatry
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Question about negative symptoms of schizophrenia
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So i saw online there has been research on negative symptoms of schizophrenia, that there are some antipsychotics that have some or all lot of an effect.
I have also heard that antipsychotics since they lower dopamine, being on this medication can worsen negative symptoms and are designed more for positive symptoms of schizophrenia.
I suffer from schizophrenia, schizoaffective bipolar type. I am looking for clarification if there are a few or some antipsychotics that can improve the negative symptoms that maybe you have read about or have seen work?
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2025-06-12T13:04:56
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1l9lyu3
| 0 | 0 |
AskPsychiatry
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Hypnic jerks and increased heart beats while falling asleep after long term usage of Quetiapine
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Hi I started using Quetiapine in 2018 and withdrew 1 year after it because of hypnic jerks and increased heart beats while falling asleep. It has been 6 years since my withdrawal and I still have the same symtoms. Whenever I take a deep breath I feel a slight tingling in my hands and whenever I try to fall asleep, my heart beats increase gradually and I am getting jolted afterwards.
I'm sure its because of quetiapine and is there a cure for that ? I was taking quetiapine for insomnia.
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2025-06-12T09:37:04
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1l9i7s6
| 0 | 0 |
AskPsychiatry
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Is this medication combination malpractice?
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Hello! I was on these medications, daily:
Desipramine 150 mg
Bupropion 450 mg
Celexa 30 mg
Clonodine .1 mg 2x daily
Gabapentin 100 mg
Hydroxyzine 25 mg as needed
Lamictol 200 mg Propranolol 10 mg as needed
When I went up to 150 mg of despramine, I started experiencing bolts of electricity coursing through my body. I went to drive myself to the urgent care to get checked out out of fear, as I’d never experienced this before. Wiping the snow off of my windshield, I woke up face down on the ground, having passed out.
I went to the ED and explained what happened, but they weren’t able to find anything.
I assumed that I was having seizures, and tried to get ahold of my doctor. I didn’t really know how the system worked so I ended up talking to on call residents and didn’t use my doctor’s emergency number until later. Either someone at the hospital told me the desipramine may be causing it or I did some googling and found out the wellbutrin should not be taken together.
Requesting my doctors txt notes- he put down that I went to the ED for a panic attack (it wasn’t a panic attack- I know what they’re like and it was not a panic attack), that I was refusing to take the desipramine. However- when we were on the phone he was suprised I was taking the Wellbutrin and desipramine, and admonished me for doing so, even though he sent refills in when asked and I clearly didn’t understand his instructions of a med change.
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2025-06-12T01:29:39
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1l9a16u
| 0 | 0 |
AskPsychiatry
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Can psychosis be shaped by childhood trauma?
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Or would that suggest a PD instead?
I have a chronic, baseline issue of thought control and insertion (or, mental fusion) with authority figures. I began to believe whatever they latently believe about me.
It is not conscious when it happens, but it can spiral out of control and lead to a psychotic episode, which have previously lasted for many months. Usually, there’s a part of me that’s controlled, and that I become, and there’s a part of me that is controlling me to try to expose the other person
their perceived crime - but it’s not conscious in the moment.
When it happens in the moment, it’s automatic (but controls my responses), and then I often spend the next few days to indefinitely, believing whatever the other person believed. Sometimes it goes away after a few days and I’ll realize what happened and why it happened; I’ll get access to my actual thoughts.
This happens without any emotional activation. DBT was entirely unsuccessful in the past, and I didn’t realize it was abnormal until my first AP kicked in.
The issue I experience seems clearly related to my trauma - a lack of separation from my mother. Mother was highly emotionally abusive and treated me like an extension of heeled; if I tried to individuate, there was hell to pay. I was also highly perceptive.
I have past diagnoses of BPD, then BPD and schizotypal. Then after a very bad psychotic episode, I was diagnosed with schizoaffective bipolar, and the PDs have been ruled out several times. I have various other symptoms of schizoaffective.
However, there are still some providers who see my past diagnoses, and then really try to fit my symptoms into them. One told me the delusions were trauma-based and not actual psychosis, but he incorrectly believed the psychosis I experienced was only on Vyvanse.
Setting aside the actual diagnosis itself, since I’d have to give a huge history, does the above description and seemingly trauma based origin fit more into psychosis or a PD?
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2025-06-11T22:05:05
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1l95mz1
| 0 | 0 |
AskPsychiatry
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Concerta and Suicidal Thoughts
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My husband (27M) was recently diagnosed with ADHD and prescribed Concerta (36mg). He's been taking it for about a month and a half, maybe close to two months now and they do help his focus. Unrelated to this, we have had some serious stresses in life that have really taken a toll on both of us, but especially on him. It's just been a really difficult time. He has always had extreme emotions on either end of the spectrum, like extreme happiness and very high highs, but also low lows. However, recently when he gets into a bad headspace he has started to say some concerning things like he no longer wants to live, he wants to die, etc. He is like numb when he gets like this, not hysterical or anything, so it is out of character and it's very scary. I have been able to talk him out of these moods each time. When he isn't like this, he is himself - happy, romantic, making future plans, generally good all around. So these low points are not all the time.
I also have ADHD and take Vyvanse and it has done wonders for me. I didn't notice a drastic change in my mood when I started taking it, besides feeling less overwhelmed. So I'm not sure if it is possible that his thoughts are due to his new medication, or if this is something completely unrelated or just due to our stressful situation right now. We are not in our home country at the moment so I'm not sure if he can call his doctor. Or what I should do. I feel lost because although he is happy at the moment, there is this looming worry and I'm a little out of my element. It hasn't gotten to the point where I needed to call emergency services, he doesn't have a "plan" or anything, but his thoughts and the things he's saying at times are still worrisome. He spoke with a psychologist on the phone about 3 weeks ago and I'm not sure what was said there.
Should he stop his meds for now? Should I do something? I know he needs to speak with a doctor but we aren't in our own country at the moment and when he is in a good headspace he doesn't see the urgency of it. So some advice or maybe just some insight would be helpful.
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2025-06-11T21:09:12
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1l949d9
| 0 | 1 |
AskPsychiatry
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Tardive dyskinesia
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This one side effect is probably the biggest one that most of us fear...Especially us obsessive types who literally put off treatment for years because of this one side effect...So how common is it really...The Internet if you look hard enough can make it look more common than what it is...How often have you seen it in your whole professional career and have u seen it with newer agents like abilify? Many thanks
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2025-06-11T18:50:23
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1l90snc
| 0 | 0 |
AskPsychiatry
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What is a psychiatrist apt like?
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I have my first meeting with a psychiatrist in a couple of weeks, I’ve had psychologists before but never psychiatrists. It’s virtual. What is it like? What’s the difference? What kind of questions do they ask? Anything I should prepare for / know? Thanks!
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2025-06-11T20:15:21
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1l92y1f
| 0 | 0 |
AskPsychiatry
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False Deja Vu/memories, need help
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Okay, so over these last few months I've been dealing with a lot of anxiety and OCD, and I seem to be dealing with a lot of false Deja Vu and false memories.
So say I'm in the middle of heightened anxiety, and I see an image that causes distress or correlates to what causes my anxiety in some way. I initially feel a strong sense of recollection and deja Vu upon seeing said image, but can't actually recall a time where I saw said image or tie it to any particular memories that I know are real.
What are the chances that I really did see said image? Especially if:
The image triggers anxiety/distress
I can't actively recall a time where I saw the image
I struggle to conclude whether or not I've actually seen it before, never reaching a conclusion
Later when the anxiety subsides, my sense of recollection weakens or disappears and,
I had an epileptic seizure shortly before seeing the image
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2025-06-11T21:13:40
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1l94des
| 0 | 0 |
AskPsychiatry
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interupting antidepressants
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Hello. I am on medication since like 2 years ago I think. I take meds for anxiety, depression and psychosis. I followed what my psychiatrist told me as some moods changed and adjusted to the changes he made in the treatment. My depression was really bad. One week ago, I didn't sleep home for 2 days and forgot my meds for depression so I didn't take them. Then, encouraged by somebody who said I take too many pills felt like I can stop taking it and see what happens (only the antidepressant). I had feelings like my head hurting or my body getting really warm but I was okay. And a couple of days ago I managed to cry finally for real, like I couldn't cry before. Someone else told me that some pills can stop you from crying, is that real?. The point is that moment shifted my entire existance. Meaning the dark cloud that was always there, the voice in my head that knew nothing is ever going to get better and that life is always gonna be so miserable crumbled down and I was able to see into a new reality, where I would enjoy living. I was finally seeing like trough a smoke filter into how is possible to experience everyday life from a positive angle. AND I could feel it coming for real. I've been happier since then, more in my body and attuned to my inner states and more present, connected to reality, not my blockages.
My question is, why did I start to feel better after I stopped taking them, because like, they're antidepressants?? Is it just my mind experiencing the shock of having it removed? And it will go back to feeling worse? I never felt so good and I see actual hope for me. I of course worked more on my feelings and faced some things which probably contributed to all this but my shock is that for 2 years I was in the darkest times and the moment I stop taking some pills, things lead to a sudden shift into good. Before that,I couldnt really reach the emotion behind my dreadfulness of living, the pain.
I lied to my psychiatrist today. I cannot tell him because he's gonna want to make me take them again and I don't want to. I wanna see how it goes without them and if things get worse I'll start taking them again. But I read that when you start taking them the depression might get worse
So I am afraid of this, what I'm doing, on my own with no proffesional help. But I also had to take half a pill from a sedative because the whole pill that he prescribed me was too much and I was sleeping half of the day. I made the change but I told him about it and he said it is okay. But I cannot tell him about this
Can you give me some advice or explanation for what I'm experiencing please? I don't wanna do this alone and I don't wanna tell people here either cause they'll judge me and they'll think it is a bad idea when in fact it feels right and I feel better about it.
Should I take it again? I'm afraid that I won't be able to feel this deeply again
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2025-06-11T20:17:58
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1l930ds
| 0 | 0 |
AskPsychiatry
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Anxiety is ruining my life. I wake up every day and wish I didn’t. I’ve been suffering from severe treatment-resistant Anxiety, depression, PTSD, and OCD. I have tried 25+ medications & TMS and was hospitalized 15 times for suicide attempts. What’s left to try?
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I’m a 21-year-old male who has treatment-resistant Anxiety, Depression, PTSD, OCD, ADHD, and ASD.
Every day, I have severe anxiety that never ends. Every night, I have nightmares and vivid dreams that make my sleep terrifying and not restful. I have tried 25 medications. I do not smoke, drink, or use drugs, nor have I ever. I’m 6’3” 200 lbs.
The only things that gave me substantial relief were Xanax & Ativan, but I can’t get those prescribed anymore because my psychiatrist can’t prescribe controlled substances across state lines (I moved from Montana to NJ). I also can’t take a benzodiazepine long-term.
I'm currently taking Adderall (10 mg), Cymbalta (40 mg), Risperdal (2 mg), Seroquel (200 mg), Gabapentin (3,200 mg), Metformin (750 mg), Tiagabine (4 mg), propranolol PRN (40 mg). Additionally, I am enrolled in EMDR & CBT therapy and have previously tried IOP Therapy, which included DBT.
SSRIs: Zoloft, Prozac, & Lexapro
SNRIs: Cymbalta, Effexor
NDRIs: Wellbutrin
Stimulants: Adderall & Ritalin
Non-stimulant ADHD meds: Strattera
APs: Seroquel, Abilify, Risperdal
Mood stabilizers/Anti-epileptics: Gabapentin, Lamictal, Lithium, Depakote
Novel-action antidepressants: Mirtazapine, Ketamine
Benzos: Ativan, Xanax
Others: T3 (cytomel), Hydroxyzine, Prazosin, Trazodone, propranolol, Clonidine, Tiagabine
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2025-06-11T14:44:20
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1l8uimh
| 0 | 1 |
AskPsychiatry
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Gf advice
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My gf has severe medication resistant major depressive disorder. Her insurance company is Blue Cross Blue Shield and doesn’t cover ketamine therapy. She’s tried a million meds and has seen four different psychiatrists now, not including the ones she saw during inpatient/outpatient therapy in the past. Her current physiatrist just left their office for a new job. She feels hopeless and has gone through multiple stints of not taking her medication bc they don’t work to begin with. On top of this she’s had a really tough time with the side effects of some of these medications. I want to help in whatever ways I can.
Does anyone have specific recommendations for this? What has helped? Any tips on helping track down a better psychiatrist? Anything would help.
Edit:
She goes to therapy regularly and has seen multiple therapists and psychiatrists in the past. The common consensus is depression + anxiety but there has been one that said bipolar or borderline.
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2025-06-11T14:26:48
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1l8u35f
| 0 | 0 |
AskPsychiatry
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Mental blackouts after sudden thoughts, need help
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Since 2021, I’ve been experiencing strange and uncomfortable episodes during the day. They happen randomly, without warning. It always starts with an automatic mental image — usually of a cartoon character or a specific scene, as if I’m suddenly remembering a movie clip.
Right after this mental image appears, I go through a brief episode lasting about 10 to 20 seconds, with the following symptoms:
* Sudden heat sensation in my head
* A very weird feeling in my mind and body, like something is “shutting down”
* Partial loss of control for a few seconds
* Feeling like I’m disconnected from the environment, and then I “snap back” as if waking up suddenly
* There’s no real visual or auditory hallucination — everything happens internally, like a memory or thought
* These episodes have been happening since 2021, and I have no known trauma history or substance use
I’d like to know if anyone else has experienced something similar — and if you’ve found any explanation or diagnosis. I’m trying to understand whether this is related to anxiety, dissociation, or something neurological like temporal lobe epilepsy.
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2025-06-11T16:10:32
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1l8wp43
| 0 | 0 |
AskPsychiatry
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Need Psychiatric advice for a story I am writing
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I am writing a story involving the human mind, and I am passionate about realism.
It is a novel about a smart and caring woman. In the story, she has a brother who is in a dark place.
The 35 year-old brother for the past few years has been convinced he has bugs on him. He has gone to many dermatologists. He refuses to go to a psychiatrist and gets angry whenever his mental health is brought up. I believe the term I could use for this would be “delusional parasitosis”?
He lost his job, his relationships, his savings, his personality. He now lives in the basement of his elderly parents. He is depressed, gets angry and lashes out, and is in constant torture. In the story, it is true rock bottom.
The sister in the story comes up with a plan to give him “vitamins she found on the internet”. He has agreed to try them out.
She, in the story, has mafia connections and can get meds. She wants to get him one that will help him without giving him noticeable symptoms. She decides to start him on Aripiprazole 5mg, thinking this will blend antipsychotic help with a low chance of noticeable symptoms. Is that a realistic train of thought?
In the story, she is master planner that always thinks of everything, so please let me know plot holes that she hasn’t thought about.
In the story, I want the treatment to work but for her to go to jail because obviously what she did is illegal.
Do you think that would work? Is there a better medicine that has a chance treat his DP without serious side effects?
Also, how would you imagine his recovery process looking like, how long before noticeable improvement?
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2025-06-11T15:21:16
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1l8vg5l
| 0 | 0 |
AskPsychiatry
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How to find ECT referral for akathisia / severe depression
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Hi I (24F) have been undergoing a severe, severe major depressive episode the past year
I have trialed ten medications to no avail
I have had akathisia as a side effect to many of those medications and I can no longer risk trialing another medication because akathisia makes me acutely extremely suicidal.
I still have residual akathisia from the medication trials and have to take medication now to suppress it , my depression is even worse because of this
I cannot function, barely eat now , almost catatonic depression
Things my provider has said to me
- suggested to keep trying medications
-told me akathisia is only physical and not mental and should not cause distress
-told me I need to go outside more
- told me side effects from medications cannot possibly last longer than a day
Anyone who is knowledgeable knows that it causes extreme mental distress and is a suicide risk.
I cannot find someone to listen to me and not make me feel crazy, and I fear for my life if I cannot find a competent provider
I’m looking into ECT because I’ve seen case reports of it getting rid of akathisia while treating the underlying depression .
I’m willing to risk the side effects as that’s how severe my situation is.
I’m scared to go inpatient because I’ve been before and I again feel like I have no agency and am not listened to.
I’m scared they will see my akathisia and mistake it for a psychotic response and try to push antipsychotics which will only make it worse.
I am just so hopeless and don’t know what to do to save my life.
Before this I just graduated college , working full time and was happy and now I can’t get taken seriously and have been gaslit over and over.
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2025-06-11T12:37:18
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1l8rkcd
| 0 | 0 |
AskPsychiatry
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Low novelty seeking and low libido, drowsiness — will Ritalin help?
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Hello everyone, I wanted to ask if it makes sense to try Ritalin for symptoms like low novelty seeking and low libido, weak orgasm, drowsiness, increased appetite (although smoking has reduced it somewhat), slowness, and decreased pleasure. I probably don’t have ADHD since my attention is normal, but everything else is affected.
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2025-06-11T10:54:16
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1l8plb8
| 0 | 1 |
AskPsychiatry
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Abilify causing Tiredness?
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Yesterday my psychiatrist prescribed Abilify in the morning and told me in about 1/10 patients it makes you tired and that I could switch it to the evening if necessary. So I've been taking it for 2 days and got really tired on both days. Can I switch or is it too soon?
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2025-06-11T10:27:29
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1l8p5tv
| 0 | 0 |
AskPsychiatry
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Gf help
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My gf has severe medication resistant major depressive disorder. Her insurance company is Blue Cross Blue Shield and doesn’t cover ketamine therapy. She’s tried a million meds and has seen four different psychiatrists now, not including the ones she saw during inpatient/outpatient therapy in the past. Her current physiatrist just left their office for a new job. She feels hopeless and has gone through multiple stints of not taking her medication bc they don’t work to begin with. On top of this she’s had a really tough time with the side effects of some of these medications. I want to help in whatever ways I can.
Does anyone have specific recommendations for this? What has helped? Any tips on helping track down a better psychiatrist? Anything would help.
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2025-06-11T04:30:29
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1l8jp1a
| 0 | 0 |
AskPsychiatry
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Is it possible with schizophrenia?
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Hello. I am really seeking answer to this question, tried to find in google but there was no useful info.
Can any psychiatrist tell me if its possible for schizophrenic person to work in managerial position like director of a company or CEO?
Also is it possible in Baltic countries ( Eastern Europe)?
Thanks a lot for the answers and I will read every answer.
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2025-06-10T18:48:28
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1l86vl0
| 0 | 0 |
AskPsychiatry
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Bipolar2 vs GAD/OCD
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Hello all, I am looking to learn more about Bipolar 2 since one of the psychologists suggested I might have it (my psychiatrist doesn’t think so).
Story: 2 years ago I underwent through a surgery with many complications which resulted in severe insomnia, which was caused by stress and then depression and OCD came along. I was put on antidepressants and they worked wonders - sleep was back, I felt well, depression was gone, I became a bit lazy and gained weight. 1,5 years later we stopped medications (8 months ago) and generally I feel fine.
What I do have is changes in the mood, which cause my psychologist suggest I may have bipolar 2. Some days I feel optimistic, calm, quite energetic (never insomnia during that period), happy in life. Which follows by bad mood, high anxiety and insomnia.
Since there is a change in the mood it was suggested it could be bipolar. My psychiatrist thinks no bipolar but general anxiety, which triggers depression as a secondary outcome. Then anxiety is gone and I feel normal again. Main point that I don’t have bipolar is that I have good sleep during “good phase”, insomnia comes during “bad phase” when I am anxious. Lately I also noticed that some days I think that life is good because of a, b, c and then feel good during the day. If the negative thinking filter is turned on I start questioning if life is good enough, if I am living right and many questions of hesitation or just thoughts with negative filter, then these thoughts start anxiety and later bad mood.
1) does responding well to ssri exclude bipolar2?
2) are “good phases” for bipolar2 coming out of blue or can be tied to external events?
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2025-06-11T04:02:42
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1l8j7bm
| 0 | 0 |
AskPsychiatry
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Did LSD cause me brain damage?
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A number of years ago (8, to be exact), I dropped acid at a friend's house and had a horrific experience.
He went into psychosis and scared the daylights out of me. I remember hyperventilating the entire night feeling like I couldn't breathe and was having a stroke. I was experiencing a blank mind and severely dissociated (even hovering above my body at times).
After that night, I started experiencing horrible cognitive issues. Memory issues, vision issues (I'd see outlines of light around objects), intrusive thoughts, insomnia, nightmares, paranoia, etc.
I was young (18) at the time, and I felt like I couldn't talk to anyone about what I had gone through (my family is very religious). It was only after 3 years I went to see a psychiatrist. I got misdiagnosed as having schizophrenia and got put on antipsychotics for a number of years. Long story short, I'm not Schizophrenic and I've been off of antipsychtoics for over 3 years now.
My therapist thinks that it was PTSD all along.
Now, to my main question (sorry for such a long post)...
Could I have suffered brain damage via loss of oxygen to my brain that night? I'm sure my blood pressure was through the roof the entire night and oxygen was reduced due to the drug and due to my shallow breathing.
What do you guys think? I'd really, really appreciate some input here.
Thank you so much.
Edit: I should also note that schizophrenia was removed from my medical chart via a new psychiatrist
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2025-06-10T21:10:19
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1l8aiid
| 0 | 0 |
AskPsychiatry
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Zoloft Discontinuation Syndrome
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I’ve experienced it in the past after missing a dose or two (while on 50mg). We slowly went up to 200mg over the winter when I was suffering from debilitating OCD and PPA. Honestly, I’m in better mental shape than I’ve ever been. I was definitely a little concerned about serotonin syndrome (I posted a few months back about my symptoms) and I still have an essential tremor and some hyperreflexia, but my provider isn’t concerned. My issue now is that about 18 hours after taking my dose (I take it at night), I start to feel those withdrawal symptoms- brain zaps, nausea, dizziness. I’m going to bring it up with my provider on Monday, but I’m just worried about what’s to come. The idea of having to mess around with my meds again terrifies me. I didn’t handle it well at all while we were increasing my dose but I wasn’t working and was in a PHP and had a ton of support. That’s not the case now.
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2025-06-10T22:35:35
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1l8ckfu
| 0 | 0 |
AskPsychiatry
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Therapist seeking input
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Let's say, hypothetically speaking, I as a therapy/counseling practictioner have referred somewhere between 5-10 clients to see a single psychiatrist. The diagnoses range from bipolar, ADHD, Substance Use Disorders, etc. Every single client that I've sent has come back and shared that this psychiatrist prescribed them Lithium. Am I wrong for red flags and alarm bells to going off?
Pharmacological TX is outside of my scope, but in my limited knowledge, Lithium is not often used as it's a first generation mood stabilizer and the risks and monitoring that accompanies it (i.e. Routine Labs) the use of this medication are higher than the potential benefits.
I know that I'm definitely not referring anyone else to this provider, but I'm seeking your thoughts as to if this is likely, or if any of your spidey senses are also tingling.
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2025-06-10T22:17:18
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1l8c5bu
| 0 | 1 |
AskPsychiatry
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Can Guanfacine cause depression?
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Started Guanfacine (Intuniv) recently and have worked my way to up 3mg/night.
I take Concerta (54mg) and Guanfacine was my clinicians attempt to lower tics and insomnia while taking Concerta.
Unfortunately, I've noticed that lately I've felt foggy headed and have been more irritable/depressed.
Is this likely related to the Guanfacine, or is it just a coincidence? These are the only two meds that I take.
I'm diagnosed with GAD and ADHD (PI). 26 years old.
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2025-06-10T21:31:13
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1l8b19i
| 0 | 1 |
AskPsychiatry
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If someone like Elon or Zuckerberg can have any influence at all over others, what's the value of Psychiatry?
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If dangerous maniacs and sociopaths are all the helm, what exactly is the point of Psychiatry? It appears to have created a society where these people are not only revered in some sense, adored and respected, and elevated in positions of power specifically for those qualities.
Is the only goal of Psychiatry material outcome?
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2025-06-11T03:25:16
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1l8iilo
| 0 | 0 |
AskPsychiatry
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Can Duloxeteine together with Gabapentin cause paranoia and delusions?
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These two were prescribed to someone close for pain management reasons. Over the span of a month, this person is experiencing delusions and paranoia. Fear of being followed, hacked, inability to reason about basic things involving their living arrangements, work, etc. Additionally, following and harassing another household member, blaming them for anything from going through personal belongings to outright plotting against them. The police were already involved, however, nothing has happened (yet) that would justify a 72 hour hold. The onset of these behaviors coincides with increased Gabapentin intake, and the possibility of taking the Duloxeteine “as needed” instead of as prescribed.
My question at this point is whether this combination of meds is capable of producing such states, or if perhaps this is simply an onset of schizophrenia and the meds have little to no role in these behaviors.
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2025-06-10T20:00:32
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1l88q04
| 0 | 0 |
AskPsychiatry
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Liquid meds for ADHD and MDD?
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If someone could benefit from meds to treat adhd and MDD but has such a bad gag reflux that they can’t tolerate tablets or capsules, is there medication available in liquid form? Thanks
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2025-06-10T18:05:45
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1l85rec
| 0 | 1 |
AskPsychiatry
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Major brain fog and energy issues. Serotonin syndrome or something else?
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I'm a 31M, white, 198 pounds, 5 feet 9 inches. The medications I take are Wellbuitrin 150 mg, Rosuvastatin 5 mg, Aripiprazole 2 mg, Metformin 500 mg, Guanfacine 1 mg, Lexapro 20 mg, Cetirizine 10 mg. I'm also autistic, have ADHD-I, motor dysgraphia, generalized anxiety, social anxiety, major depressive disorder - moderate - recurrent, and PTSD. I also have sleep apnea, but I'm on CPAP for that.
I'm posting because I've had severe brain fog, cognition, and energy issues ever since the onset of my PTSD symptoms in March to April 2022. This is devastating in my line of work (research) because of how much I need to learn on the fly and think a lot. With all of the medications I'm taking right now, does this mean I have serotonin syndrome and that's what lead to the issues I'm experiencing right now? Another possibility is hormone imbalance due to my weight being only a few pounds away from obesity. My current neurodivergent affirming therapist and myself think it's autistic burnout.
Part of what inspired this post was reading that Melatonin has a bit of serotonin and that can have negative interactions with Lexapro. I took Melatonin last night, but that was only because I spent this past Sunday through late Monday morning in the emergency room due to what I later found out was a 6.5 cm cyst on my liver, which wasn't recommended to be surgically removed since it's considered a major surgery and I'd need to have debilitating pain otherwise (I rated my pain a 3/10 since my upper right quadrant has a feeling of fullness or feels like a muscle strain sometimes).
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2025-06-10T15:18:25
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1l81fa6
| 0 | 1 |
AskPsychiatry
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Self harm
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I'm a member of the wound care subreddit and an on-going concern or topic of debate is whether responding to self-harm posts is actually encouraging or enabling this behavior. We see posts featuring significant wounds with serious tissue damage and what appear to be somewhat disingenuous questions asking "what should I do" or "do I need stitches" with a frequent caveat being that they can't tell their parents or go to the ED: there does seem to be a component of attention-seeking and it sounds manipulative at times. Self-harmers are using terms like "beans" (refers to fat) to describe how deeply they are cutting. Does responding repeatedly to these posts with the very advice they're rejecting encourage this behavior? What is the best response? Suggestions?
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2025-06-09T22:18:34
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1l7iaqv
| 0 | 1 |
AskPsychiatry
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“Thinking Out Loud” I’m looking for a name so I can read up on this!
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Over the weekend I had a conversation with a man while doing ADA security at Pride. Based on the vibes I think this man was suffering from psychosis. His overall demeanor was fine I had to give him bad news because his dog couldn’t come into the festival so it made sense for him to be cranky but he was pretty chill about it overall. While talking to him I noticed something I’ve always been curious about, I have interacted with many folks experiencing symptoms like this and I have seen this exact thing, with my own sibling, my roommates friend after stopping her anti psychotics, people on the streets I’ve interacted with. I’m calling it “thinking out loud” until I can find the actual term. So in conversation with this man he’s mid sentence and then the thought he is conveying to me is paused and he mutters under his breath “oh that must be why she’s so stupid.” And based on the context i know it was about me but i also know it wasn’t meant for my ears. So it’s like his verbal thought was interrupted by what was supposed to be inner dialogue and it leaked out into his speech. He then continued the rest of the sentence that was intended for me. I really don’t think that he had intended that sentence to be said out loud I don’t think he was trying to hurt my feelings by saying it and I feel quite confident that he didn’t realize that it was said out loud and he probably thought he was just hearing it in his mind as normal inner monologue. This is something I’ve noticed a lot with people while they’re experiencing psychosis and I was trying to read more about it. I found a list of things that fall under “disorganized thought, disorganized speech.” But I didn’t see anything that matched this description. Basically I just want to know what the symptom is called so I can read more about it. I want to be clear that it’s not non-sense speech, it’s not incoherent, or babble, it is just that some of the thoughts that are closest to the top sort of slip out into their speech. I think this happens outside of psychosis from time to time but it’s noticed and if you’re having a conversation you’d probably mention it. Like “did i just say that out loud?” So if you know what this is called please let me know!!
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2025-06-10T12:51:18
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1l7xxbr
| 0 | 0 |
AskPsychiatry
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Ever have a patient referred to you for “psychosomatic” symptoms? What were your thoughts? What happened?
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Hi! I’m just curious if you’ve ever had a patient referred to you for psychosomatic symptoms, or symptoms “caused by anxiety” and what your thoughts were or what happened. Just wanting your perspective.
I do understand that there are some conditions caused by anxiety, like upset stomach, fatigue, or headaches. However, we commonly hear about referrals to psych for physiological conditions that are passed off as psychological.
I’m just curious because I remember talking to a psychologist and they were like “umm you should see a doctor, I can’t help you here.” The psychologist was right and I was diagnosed years later with endometriosis. Doing much better after treatment haha
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2025-06-09T23:34:57
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1l7k0ol
| 0 | 0 |
AskPsychiatry
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Brain mapping session leading to a schizophrenia diagnosis?
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I was told today that after a brain mapping session (the pmhnp I see didn't tell me, a therapist I have seen for a few years that also does neurofeedback showed me all the information that came from the session)that I had information to lead to something regarding schizophrenia. I've never never really had quantifiable hallucinations or delusions (pre-TBIs, at least 4, multiple degrees of severity). I was definitely questioning a lot of stuff post-TBI, but I've never tried to hold any beliefs over very many things, although I am quite an anxious person and developed a lot of compulsions after the mild tbi a bit after the severe. I was also told that I was 8 years younger brain wise (I was almost at my birthdate at the time of severe, 4 day LoC,). I had issues concentrating as a kid, I only cared about video games, super smart, started struggling in 6th grade. Various degrees of physical trauma, I could go on, but it's not really relevant.
My question more so is, is it possible for a person to be diagnosed with something like schizophrenia from brain mapping but not have hallucinations or held firm delusions (can delusions be floated ideas, but never cared to say it is true?)
I'm just very caught off-guard with being told this, I'm 31 (4 day LoC TBI/I don't remember waking up that morning a bit under a month before turning 22) trans MtF, 5'5.75, 145ish lbs, Size 0/XS bicyclist. I've had issues with sleep most of my adult life post-head trauma, maybe before? Diagnosis, depression (maybe as a kid) as an adult, anxiety issues both as a kid and adult, compulsion issues (perhaps ADHD) The only time that I had a something was day 3 of starting Lamotrigine and day 4 of Nortriptyline 25mg/10mg respectively, I had so much energy, felt like I was wired. It lasted around two weeks, I felt the same waking up as going to bed. I almost quit my job/therapist/PCP or at that moment, psychiatry medication provider). Tolerance of irritation is not great. Tolerance of stuff that bothers me a lot/denial of my identity has gotten worse the larger the dose of Lamotrigine XR (I'm at 100 mg, I haven't wanted to go up for safety concerns), Nortriptyline is 10 mg. I don't want to take any antipsychotics due to the prevalence of TBIs. I was also told that my brain age is 23, which caught me off-guard as well.
I've been pretty cautious with meds since my TBI journey started, really didn't want to take any SSRIs or whatever really pre-TBI. I can give more information if needed. Thanks so much!
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2025-06-10T00:10:15
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1l7kscm
| 0 | 1 |
AskPsychiatry
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I can’t live like this, but can’t get medical care
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My family would be upset if I ended my life, so I can’t do that. I can’t commit any crimes or redress my greivances through my own means, because my mother would not understand that. But I cannot live with my current physical situation, and I cannot get medical care. If I go to a psychiatrist or mental hospital, they can drug me until I have extreme tardive dyskenesia, and all that means is my mother will be wiping me and helping pull my pants up when I go to the bathroom, helping shower and feed me etc. I literally do not know how to continue living with abnormal head and neck movements, that are not caused by TD. I really wish that I was not alive anymore, but I can’t do that to my mom. I have no expectation of help or helpful comments here, I’m just venting. Thanks for listening.
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2025-06-10T05:02:39
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1l7qdyv
| 0 | 0 |
AskPsychiatry
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Why are some psychiatrists afraid to prescribe over 225mg of Venlafaxine when the maximum dosage is 375mg?
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Title question.
I'm on 225mg and 150mg of pregabalin but i still have some symptoms of anxiety and ocd, i haven't asked my psychiatrist to increase the dose yet.... feeling anxious that i'll have to change meds but i'd gladly try 300mg if i had the chance
Thank you for your time
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2025-06-10T06:34:47
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1l7rtmx
| 0 | 0 |
AskPsychiatry
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why do people choose not to heal their BPD?
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I am more the “quiet” type where I inflict the harm onto myself rather than the other person, so I’m not sure if that makes me a different case (I hate confrontation or anything anger related with people) but ever since I realized the extent of my borderline internal world, I have been doing everything I can to fix it because I DO NOT want to be this way. At all.
I’ve had to abandon all the support groups for BPD because people are more so venting about their crazy behavior and trying to get other people to be on their side instead of seeking support to try to *change* their behavior. I feel like 50% believe BPD is totally incurable and the other 50% feel like it’s one of the easiest disorders you can overcome with a lot of patience, practice and work.
Why are there such contrasting views? Are some people just more capable than others? Is it the people who are willing to change that make up that 50% overcoming rate, and the other 50% is the people who claim themselves as lifelong victims?
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2025-06-09T23:44:46
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1l7k8gi
| 0 | 0 |
AskPsychiatry
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Does your (first) choice of medication vary depending on the most prominent symptoms the patient presents with in a mood disorder?
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It is well known that depressive disorders are heterogenous. Patients generally present with a wide variety of symptoms. Once a diagnosis of MDD or any anxiety disorders is made by you, how do you choose the (first) medication you are about to start? It may not be the patient's first drug, if he is seeing you coming from some other doctor and already on a drug cocktail.
Does certain symptoms warrant certain drugs more than others? Do course specifiers like melancholic, mixed features, atypical really help in choosing treatment strategies? Or is it always a SSRI at the start. Then a repeat visit in a month, maybe to assess and move forward.
Trialling SSRI/SNRIs may be a lengthy process if the 1st med doesn't get almost full remission. Also has a doubtful question if the patient will continue visits.
In your practice and clinical experience, have you found better ways for faster treatment by prescribing based on presence or absence of certain symptoms, so that the patient may get relief faster?
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2025-06-10T05:37:41
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1l7qy3o
| 0 | 0 |
AskPsychiatry
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Theory on sociopathic child learning anxious behaviors from parents and growing up believing they actually feel it while still being apathetic in other cases?
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I’ve read some literature on this, and I am curious. Say a patient comes forward and says they’ve always felt either anxious or apathetic and numb and they don’t understand how they can feel both of these things. This patient seems very apathetic (seems sociopathic) but also seems anxiety prone at other times. They are aware of the “switch” and at first I thought maybe this is just a case of a sociopath who learned that presenting as anxious can be helpful, however the patient is fully convinced they feel the anxiety rather than just present it. Childhood stories reveal a person who experiences very little emotion, has a hard time empathizing with others, and is egocentric, but also a history of social anxiety fear of failure or embarrassment, so could this be BPD? Or even high functioning ASPD with anxiety?
At first I thought maybe it might be DID, but patient seems to aware of “switches” for that so maybe it’s BPD? Patient also claims to have a hard time understanding people and has stories about it, but they also show signs of knowing how to manipulate. Parents are emotionally unavailable and unreliable. Family history of psychosis. Thoughts?
PS not a real patient, just a research project
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2025-06-10T04:41:33
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1l7q18n
| 0 | 0 |
AskPsychiatry
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Elder care for relatives with schizophrenia
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I have multiple elderly relatives with schizophrenia, but one relative's living/care situation is on the verge of falling apart. This is my Uncle Rick, my father's older brother. His mother is deceased and his father is now in a nursing home and no longer competent to arrange for my uncle's care, so my father has stepped up and I am on paperwork to be the next guardian should my father die or become incapacitated. My uncle has been living with his long-time (40+ years) partner, but my Aunt Debbie has many physical health challenges and is almost completely incapacitated now by rheumatoid arthritis. My uncle is also starting to deteriorate. He is 72, is showing increasing cognitive decline and an increase in symptoms of rage and angry outbursts, and after many decades of medication compliance is no longer routinely taking his medications. My Aunt Debbie is too fragile to keep up with his care and we're increasingly worried that during a rage outburst he may injure her - he has destroyed a number of physical possessions in the last few years, including punching out a series of televisions when there's been issues with cable reception. He has also been trespassed from a number of stores/restaurants for altercations with staff.
There is a family trust, but it is being used to support my grandfather in assisted living. There are not enough resources to support my grandfather, my Aunt Debbie, and my Uncle Rick simultaneously. Rick and Debbie are both on Medicaid as well as Medicare and were surviving off of disability payments most of their adult lives. If they are no longer able to live independently my understanding is after exhausting their very limited assets they will need to go into a Medicaid home.
My concern is that my Uncle Rick will continue to have violent outbursts, and will either be overmedicated to the point of incapacitation, or will be evicted from a home and in worst case arrested and prosecuted. My hope is that there are folks in this group who have experience in elder care for people with significant mental illness who can provide some insight for my family on how we can keep everyone safe.
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2025-06-09T19:15:11
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1l7dmwc
| 0 | 0 |
AskPsychiatry
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Are you always suspicious of patients who ask directly for benzos?
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Are you suspicious of patients who ask directly for benzos? Even after trying uncontrolled meds for anxiety?
If so, what do you prescribe for patients with acute anxiety and panic attacks?
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2025-06-09T15:40:32
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1l782ik
| 0 | 0 |
AskPsychiatry
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Help with Zyprexa Taper
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Hi everyone,
I recently posted in a psychiatry subreddit.
I am currently in benzo withdrawal but was put on zyprexa for “psychosis” but it was all withdrawal from the benzo. I’ve been on it for 4 ish months now and my psych says I can just stop it. I know that’s not right but I want to be off of it too because I’m gaining weight and I have abysmal lack of motivation and suicidal ideation. I’m on 7.5 mg down from 10 mg last week with no ill effects yet. I’m just wondering if I can take this faster than other because I’ve only been taking it a short time.
Any other advice is appreciated.
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2025-06-09T23:30:26
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1l7jx6o
| 0 | 0 |
AskPsychiatry
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Clonazepam
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I've recently just started it myself and I've been told to take 1-2 0.5mg tablets a day 3 times a day for panic and anxiety disorder. When speaking to the doc I asked him "would it be like micro-dosing" benzos and he said yes. From reading a bit it sounds quite a high dose. Can anyone share some light on this matter for me?
Would be much appreciated, thank you.
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2025-06-09T20:55:19
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1l7g8wv
| 0 | 0 |
AskPsychiatry
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What are the clinical or behavioural flags that typically lead to tapering or deprescribing benzodiazepines in patients already prescribed dexamphetamine and cannabinoids, particularly where the patient has longstanding diagnoses?
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27 year old male, 75KG and 178 centimetres.
I have been prescribed 2 mg of alprazolam daily for several years as part of a stable psychiatric regimen that also includes dexamphetamine for ADHD and high-THC cannabis for sleep (prescribed after ADHD diagnosis) I meet diagnostic criteria for ADHD, generalised anxiety disorder, and paruresis (shy bladder), and alprazolam is the most functionally critical of the three. While the stimulant and cannabis are important for core symptoms and sleep, alprazolam makes basic tasks like leaving the house and using public bathrooms possible.
When my previous doctor retired a year ago, my new GP continued the regimen but recently questioned the need for alprazolam, it appears when he first started prescribing it he was not aware how seriously it is treated in my country. I was able to provide a sound explanation for its necessity, which he acknowledged.
I’ve recently had to confront an internal contradiction. Part of me had long been reassuring myself that I must be “too smart” or too articulate to be deprescribed, and that this was why doctors continue prescribing these restricted medications. But I’ve come to understand that this belief was, in part, a coping strategy to avoid facing the reality that I’m on these medications because I have serious and ongoing psychiatric needs.
I know that my level of self-awareness, need for control, and tendency to pre-emptively articulate complex justifications could risk being misread as strategic or manipulative. But the truth is, I’m anxious. I research and advocate for myself because I’m hyper vigilant of danger, afraid of losing access to what has made life tolerable and functional. There is no evidence of misuse, no dose escalation, no comorbidity that would undermine safety, and I continue to engage responsibly with my treating team. The stability I present externally is a result of that treatment, not an argument against it.
What, in a case like this, would constitute a legitimate reason for deprescribing, given the comorbidity and demonstrated long-term benefit? Knowing that it is completely at the discretion of the prescriber and that they pretty much can only receive backlash if someone were to die as a result makes me feel extremely vulnerable.
Edit:
I think I should mention that I was diagnosed with ADHD as an adult three years ago when the GP before my current GP had me see a psychiatrist to confirm the necessity of continuing the alprazolam. He recently wrote me another 6 month supply of dexamphetamine and is giving my GP approval to continue prescribing it going forward.
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2025-06-09T04:58:53
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1l6wang
| 0 | 1 |
AskPsychiatry
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Admitted with bipolar mixed episode after strep throat and possible "antibiomania". How many of you have seen this happen?
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F34,
Diagnosed with Bipolar, ADHD and Autism.
Meds: lamotrigine, Ritalin uno, atomoxetine
I had a wonderful life where everything was on track.
Haven't been admitted for 9 years.
Then i got a sore throat, confirmed Streptococcus and penicillin.
1 month later, admitted at the psychiatric hospital with bipolar 1 mixed episode with rapid cycling getting ECT.
I track my mood, and saw a extremely clear correlation between my sudden mental demice and the onset of my infection and start on antibiotics.
Have any of you seen this happen yourself ?
How would you proceed in the future if a patient of yours had to have antibiotics again ?
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2025-06-09T13:09:11
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1l74dkv
| 0 | 1 |
AskPsychiatry
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Is it a red flag to a psychiatrist to ask about getting a Xanax prescription after a friend let me try?
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The last 1.5 years my mental health has been quite poor, specifically my depression and anxiety. In that time span, I’ve only seen close family, and 2 friends on one occasion each, and my social anxiety is at an all time high.
About a year ago, someone I know from work gave me 3 0.5mg xanax pills to try when i got home, knowing i struggle tremendously with anxiety. I tried them on 3 separate days over the span of about a week and a half, and they helped me a lot. I’m not looking for something to take every day, but just to help at points when i’m feeling more anxious than normal.
I’ve read up a lot on meds and side effects, and I know psychiatrists aren’t very keen on prescribing benzos from what i’ve seen, and understandably so. I want to ask about getting a prescription for Wellbutrin and Xanax because from what i’ve read, they’d benefit me the most in what I feel I need the most help with, and in the case of the xanax, i know from trying it that it’s been good for me when i needed it.
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2025-06-09T09:00:03
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1l6zxap
| 0 | 0 |
AskPsychiatry
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What Should My Expectations Be With My Friend Who Is Schizophrenic?
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Little background:
My childhood friend was diagnosed with schizophrenia about 2 years ago in his early 20s. He’s always been a little eccentric, we just attributed it to high intelligence and autism. I’m not exaggerating when I say he’s the smartest person I know. We took a trip a few years ago, first time I’d seen him in years. I was minoring in psychology at the time and I’m kicking myself, the early symptoms were there but I ignored them/didn’t see them.
About 6 months later he got moved to a new high stress position in his company and shortly after began acting erratic. He was sexually repressed before this, but at this time he began posting on his personal social media almost exclusively about bondage and other kink related topics, threatened to kidnap friends, etc. I did my best to cover for him, but it quickly spiraled out of control
A year later he was completely unrecognizable and got arrested for having a meltdown in a public place. It was at that time he was diagnosed. Turns out he has a family history of this illness.
He was released and medicated and I’d say he was 80% back to normal. Still a little off at times but he was mostly like his old self. Only major difference was he couldn’t handle any sort of stress or job, he was living with his parents. Definitely in no shape to return to work.
Present day:
He’s been on the same medication for 2 years (as far as I know) 15mg Abilify daily. And he’s backtracked almost entirely. He’s completely unrecognizable now, I hate to say it but I’ve been avoiding him for a year because I just don’t know how to be around him anymore. He’s not quite as bad as he was unmedicated, but he’s definitely not well. He’s hyper fixating on topics and letting them run his life.
When he was first diagnosed, I spoke to my psychology professor regarding him and she told me that if one is medicated early, they can often return to (mostly) who they were before. But (and I hate to say this, I feel awful) I don’t recognize my friend anymore.
Is this normal? Is the person I knew gone? I know his psychiatrist is old fashioned (prefers older meds he has experience with, like Abilify) and from what little I know, just Abilify by itself may not be enough, but what can I do about it?
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2025-06-09T08:55:50
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1l6zv64
| 0 | 0 |
AskPsychiatry
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What should be my next steps? Feeling lost and without direction
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I've been recently given a diagnosis of EUPD/BPD. I feel like it finally makes sense. My previous psychiatrist never gave me a clear diagnosis or explanation. Over the past 1.5 decade, we met numerous times and I asked some questions repeatedly and I never got much out of our consultations. He only prescribed anti-depressant and anti-psychotic drugs and asked some basic questions/checked in regularly without giving much substantial input. I would ask him if I had depression and he would say yes. I'd asked if my condition was psychosis and he'd nod along.
My question is, is this a practice that was good for me ? Not knowing a clear "label" that explains my condition, in order to prevent further prejudice/bias against myself. I can't help but wonder if my condition/life would have been different or better if I had know my real conditions instead of being put on drugs that cure only the symptoms on the surface level. Was it all a waste of time?
Now that I have a clear "label" of this personality/condition, I haven't been able to stop thinking about it or talking about it or looking it up online. I can't say it's not starting to bother me a little. I don't know what my next steps to be. To be honest, I've always felt lost or stuck. I don't have very defined interests or hobbies. I physically can't handle a full-time job because I so easily drained and lack energy. I don't know what I should do and think. I feel like this is one of the symptoms of BPD too, feelings of "emptiness".
Any input is appreciated.
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2025-06-09T08:32:15
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1l6ziz8
| 0 | 0 |
AskPsychiatry
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Should i get a new psychiatrist?
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I've been on 10mg prozac since i was 18 now in my 30s. last year i had a breakthrough episode of anxiety so my pcp upper my Prozac to 20mg then 30mg. at 20 i felt terrible for 3 weeks then it leveled out and i was ok for 2 months then nothing, so they upped it to 30mg. about a month into 30mg i felt the worse fatigue, light headedness dizziness ever. my pcp had me do a bunch of blood work and see specialist. everything came back normal. so she decided to adjust my prozac from 30mg to 20mg and at the same time added 5mg busbar 2x a day. first week i felt terrible, week 2 and 3 i felt like my old self before the breakthrough anxiety, week 4 and 5 i felt terrible again so i reached out to a psychiatrist. he said let's work on getting you back down to 10mg of prozac your old dose you had no issues except the breakthrough anxiety. to do this he said to tapper from 20mg to 15mg(stay at 15mg for 4 weeks) week 2 into this I've been having several symptoms such as fatigue, mood swings, increased anxiety, i explained it to him and he said it's not possible for those symptoms to be from tapering from 20mg to 15mg. he said if the next time i see him and I'm stil having issues like that he's going to discontinue the Prozac, which has me horrified because I've heard horror stories about people getting off it. he did increase my buspar from 5mg 2x a day to 7.5mg 3x a day in hopes it helps with my anxiety. he wouldn't tell me how long it'll take to see if it helps though. today (day 2 of this adjustment) i feel increased anxiety, fatigue, shaky, mood swings and shallow breathing. i feel like I can't trust my psychiatrist to tell him how I'm feeling because he may stop my medications which i feel may make things worse. I'd love some reassurance and suggestions on what to do in this situation. thanks.
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2025-06-09T00:26:06
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1l6r8qj
| 0 | 0 |
AskPsychiatry
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Has anyone dealt with their significant other thinking the government is spying on them?
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Yall this is a long story but this is the shortened version.
Basically my boyfriend started and stopped using an illicit drug and now thinks the government is spying on him to build a case to arrest him. He thinks drones, cars, and helicopters are following him, he sees lights and flashes, and that the government is making themselves invisible and walking through our walls to spy on us.
Truthfully, I think his history of alcohol (which is now in check) plus this drug has messed him up badly. But basically I’m just waiting for him to say, “I can’t take this anymore, I need to talk to a therapist.
Has anyone dealt with anything similar to this?
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2025-06-08T17:13:28
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1l6hcvl
| 0 | 0 |
AskPsychiatry
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Conflicting diagnoses - OCD vs ADHD, need advice
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39, M Indian in Luxembourg. After 2022 divorce, saw psychiatrist for severe depression, focus issues, social anxiety, work anxiety, inability to finish projects, and severe obesity (140kg). overwhelmed by ideas and trying to implement them immediately instead of focusing on work
First Treatment (India 2022-2025)
Diagnosis: OCD
Meds:
Clomipramine 75mg,
Trazodone 100 mg,
Sertraline 100 mg
Good:
3 years of reduced obsessive thoughts, better focus, less compulsive behaviors
Bad:
Terrible memory loss, emotional numbness, effectiveness wore off
Couldn't discuss declining effectiveness because doctor got angry about missed appointments.
Luxembourg Treatment (2025)
New diagnosis: ADHD (psychiatrist said school focus issues, distractibility were classic ADHD)
New med: Wellbutrin 300mg
Current problems:
Less effective than Clomipramine
Old symptoms returning
Lost eating control again
No interest in cooking/hobbies
Constant fatigue, staying in bed
Worsening memory
Body pain everywhere
Now pre-diabetic with high uric acid
What's confusing me:
Don't have typical OCD: No door checking, hand washing compulsions
Do have: Obsessive app update checking, wallpaper changing, overthinking
ADHD med not helping much - questioning both diagnoses
Other issues:
Can't ride bike (too overwhelmed/ashamed to learn)
Licensed but too anxious to drive
Overwhelmed by simple tasks like packing
Feel "different" from others
Questions:
Could I have both conditions or something else?
Should I return to OCD meds despite memory issues?
European expat mental healthcare experiences?
Are memory issues from meds or conditions?
I'm getting worse instead of better. Scared of losing more cognitive abilities. Work is daily struggle, feel like wasting potential.
Thanks for reading.
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2025-06-08T20:41:21
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1l6mc0h
| 0 | 1 |
AskPsychiatry
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Can psych meds mess you up for good?
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People call me retarded when my dad put me in the institution, I never got that word, can psych medicine mess you up? I was admitted by the police since my dad and I got into it since he punched me for not washing dishes and was trying to lie saying he didn’t and gaslight me. I threw a water bottle at him when we were arguing about it and he called the police and they ignored me and listened to my dad. I was on serqoul and my eyes move uncontrollably and I can’t even squint and be in the sun without my eyes fluttering to keep them open. Is it possible medicine can make you look retarded? They forced medicine on me at the hospital when I didn’t need it and said if I didn’t take it, they can hold me longer.
I was in the mental institution in my past I was laced two different times and was in and out for schizophrenia/psychosis and the meds did help me but this time I didn’t need any and was fine but now people call me retarded I can be just meeting them and out of nowhere they use the word referring it to something or someone and I feel as if it’s being shady towards me without being direct since I hear the word sooo much now and I haven’t heard it before unless I’m just overthinking. People even say I look retarded now and I did get slow before since I was homeschooled and sheltered and don’t relate to many people which never bothered me but retard is a slander word and now I feel bad when people say it, before the word never bothered me.
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2025-06-08T18:04:44
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1l6ilnd
| 0 | 0 |
AskPsychiatry
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I've been feeling this way for 7 years and can't take it anymore
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I got a "disconnection" problem ever since I started taking antidepressants 7 years ago. I started taking antidepressants in 2018 and 5 or 6 months after I started taking them this "disconnection" problem started. Since then, it just got worse over the years. A few times I tried to stop taking antidepressants and didn't work, I also tried using marihuana but it just got worse and caused me to have a psychotic breakdown. I had another psychotic breakdown because of stress and in the lapse of this last 7 years I had a suicide attempt and a few admissions in psychiatric clinics because of suicidal behavior so I would be really grateful if you guys would help me... it'll mean a lot to me.
I feel a constant and restless feeling of disconnection from the world, life, my emotions, and everything you can imagine. It's like when a camera is out of focus. Not in the sense that my eyes see it out of focus or blurry, but that I feel life that way, my brain processes it that way. I never saw life like it originally was again. I could be in front of the most beautifull landscape or in front of a dump that I'll feel the same. I also lost the ability to orient myself in the space, in the world. I feel lost everytime no matter where I am. Sometimes I feel like a stranger near the people I love like my mother. It also affected my memory. Sometimes I feel like the environment or something is hostile to me, like something is going to happen or people are going to do something, I don’t know, is weird. I used to have a good memory and concentration, but it's all gone because of this. I've read about derealization and depersonalization and I identify with some of each but I don´t feel that I have 100% either of the two.
I received electroconvulsive therapy in 2021 and tomorrow I will start that treatment again, so I am in another state, away from home and will be for a month until this treatment ends. I really want to live and have a good life but it's impossible feeling all the time like this.
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2025-06-09T01:32:28
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1l6skax
| 0 | 0 |
AskPsychiatry
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What is the difference between depression and suicidal ideation
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Depression and suicidal ideation are very tightly linked, but are not 1-to-1. What factors separate the two? Would you say that suicidal ideation is an artifact of the severity of depression, or are there other factors? For instance, one person with less severe depression could have suicidal ideation than someone with a way more severe case of depression, for environmental, genetic, demographic, cultural factors?
How are the two diagnosed and how do we think of the two "diseases", specifically in a clinical setting?
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2025-06-09T00:58:52
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1l6rw4d
| 0 | 0 |
AskPsychiatry
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Fluvoxamine/Luvox insomnia- please tell me this can pass with more time!
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I have been on 25mg of Fluvoxamine for 3 weeks. Initially I tried taking it before bed, and it caused severe insomnia as well as daytime sedation. 1.5 weeks in I switched to taking it in the morning to see if it would mitigate the insomnia, but it has make no difference and I still feel sedated in the day and cannot sleep at night. Sleep meds have been unhelpful or caused more problems. I don't want to give up on this med early in the game (I have tried SO many) and am wondering if the insomnia side effects can pass with more time?
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2025-06-09T00:57:13
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1l6ruyi
| 0 | 0 |
AskPsychiatry
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is topiramate a mood stabilizer?
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i am not diagnosed yet with bipolar, but my therapist have been investigating with me this possibility for a month now (she suspects type I) after another psych told me she thought i had bpd.
the point is: i have a new psychiatrist but i don’t rely on her too much. i told her my therapist suspicion and she didn’t say much about it. before that, she already had me on topiramate (50mg) claiming is a mood stabilizer BUT i have researched about it cause i took it before for another purpose, and i found out that it is not considered a mood stabilizer by the medical community as a whole and theres not much study on it.
i am also taking fluvoxamine (100mg), an SSRI, and by researching bipolar many many people and doctors say that antidepressants can worsen symptoms and are not the correct treatment for bipolar.
i just want to know if anyone knows about this usage of topiramate or if you do take antidepressants, i feel insecure since my diagnosis is not closed.
additional info: i’ve been on antidepressants for 7y and they always work on the beginning but end up not being enough. i also have adhd and take venvanse.
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2025-06-08T15:48:35
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1l6fbzw
| 0 | 1 |
AskPsychiatry
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Is my psychiatrist being reckless prescribing me BZD daily long-term?
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Edit: instead of just downvoting, please let me know why you downvote, would be much appreciated!
Hi! Throwaway account here. TLDR; So my psychiatrist prescribes me Valium daily long-term next to bupropion, are there cases where this is appropriate or is this always a bad move. I did 2 „drug holidays“ aka tapers to check in with my mind.
Background info: 30,m, cPTSD & AuDHD with high IQ, relatively high-functioning (got a degree, perform music that’s on the radio sometimes, really good at my sports), in therapy with someone else for years already. Main symptoms are: hypersensitivity, overload, hypervigilance, some diffuse anxiety/shame & restlessness, social isolation, depressive episodes with slight dissociation when ego states are being triggered.
Coping strategies are loads of sports, ice baths, breathing exercises, meditation, certain songs that help me regulate. Still it doesn’t work completely sober (meaning meds & rec drugs), I’ve tried many times over the last 10 years. (I used to smoke way too much weed & get drunk when I was younger but barely drink anymore because I don’t like the feeling, also don’t smoke. Only rec drug use atm is DMT every few months maybe).
Over the years I’ve tried 5 SSRIs, venlafaxine, MPH, atypical neuroleptics, Bupropion, medicinal cannabis extract, Propranolol & probably something else i forget rn. Not all of these meds were prescribed by my current psych. After trying SSRIs for 2 years again & having to stop them due to making everything numb & flat & boring & pointless, he suggested Valium during a crisis, which worked wonders in dosages of 2.5-5mg.
He suggested I stay on it for now. After 9 months I did a taper just to check in how I was doing. After evaluating the pros & cons 3 months off, I decided to go back on 5mg daily. By now I’ve tapered off a second time just to check & I find the taper easier than the one of SSRIs. I personally feel no disadvantages, have no need to take more, have a way easier time in social situations & expressing boundaries, etc. sensory input just isn’t as overwhelming anymore. My friends say I seem much happier in life, more open, doing more stuff, etc.
However, I know that benzos are dangerous, that I accept an iatrogenic dependence, that it isn’t ideal, etc. my psychiatrist is a bit weird, some people would probably consider drug-induced delusion/psychosis, yet he seems very competent knowledge-wise. My psychiatrist is definitely also unconventional with his stance on substance use in general, which is why I’d like to have some input if you deem this extremely reckless or if this is common practise under certain circumstances.
P.S. I am on Bupropion 150mg because it helps a bit with task initiation & other ADHD stuff, MPH was always too strong for me, really sensitive to stims.
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2025-06-08T15:32:12
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1l6eyev
| 0 | 1 |
AskPsychiatry
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If two people think the other is the problem/perpetrator of abuse, how do you determine the truth?
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I get this is a tricky question, because good and bad is subjective and that's the whole reason why conflicts like this exist.
But, say two people both saw themselves as the victim of the other's abuse - specifically, a parent and an adult child, or a couple - how do you know who the actual perpetrator of the abuse is?
I get that in a sense both might be correct. Maybe both people have hurt eachother, and it doesn't really matter 'who started it'. On the other hand, abuse is abuse when it comes to the law, so how do you judge?
Are there any tell-tale signs that someoene is an abuser or a victim?
I've been in situations where a friend has accused another friend in a relationship of abuse and it has been hard to determine the truth - like believing an accusation of physical violence only to find out about layers and years of emotional abuse and manipulation later on.
I personally feel like my parents have been emotionally abusive to me my whole life, whether they meant to or not. But, they would accuse me of the exact same thing and believe that I'm the bad guy and the problem child. As an only child, I have no way to gauge the dynamic or get a second opinion on my childhood to ever know who's actually right.
So, how would I better assess the truth in these situations? How do psychologists/therapists determine the truth or detect a victim or abuser? Or do they just treat the person from their perspective of events and not try and judge right and wrong?
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2025-06-08T14:13:44
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1l6d4zk
| 0 | 0 |
AskPsychiatry
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Repetitive loss of learned information
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I am very political and one day I hope to be some sort of politician in my area to help those than cant help themselves.
I love learning and know I must learn if I want to be a viable candidate. I learn stuff and use what I learn to form my opinions, ideas, and solutions. But always, I forget everything I learn regardless of how many times I learn it.
Ill remember my personal view on something, but none of the facts leading up to that viewpoint. This makes it hard to back up my views and what I say; it makes me look dumb.
I wrote an entire 8000 word paper on a topic and couldn’t recount any specific information on it just a couple days later.
Is this normal? What is going on? Is this like a diagnosable thing? Am I just dumb? What could I do to help myself?
Other information: Migraines run in my family, cousin has Aspergers, I have started taking adderal which helps with the memory slightly.
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2025-06-08T17:50:14
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1l6i8sp
| 0 | 0 |
AskPsychiatry
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Meeting with a new addiction psychiatrist to begin treatment after moving, a few questions:
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Hi,
Firstly, I’m a recovering addict & substance abuser (Alcohol, Opiates & Barbiturates, all downers) who just moved from Dallas to Portland, I’ve never been hooked on any type of Speed, Cocaine, Ex or Methamphetamine or any kind of upper, just never liked them, thank god!
My intentions are to request being tested with my psych for ADHD to see my options as well as being transparent on the substance abuse so we can establish a baseline.
I have chronic major depression which I’m 99% certain is stemmed from my ADHD and indecisiveness, I’m incapable of making an informed decision on almost everything, including work - which has cost me (currently unemployed) and partaking in non-stop bed rotting, poor self-esteem, poor hygiene, sleepiness and trouble actually falling asleep, have to take Lunesta to get there . This is also waring the on my wife of 6 years who is absolutely amazing and been incredibly patient considering the additional maintenance my life requires.
I’ve been on an assortment of medication (Sequel, Welbutrin, Prozac, etc) but the only consistent one to have helped (for Panic attacks especially) has been my Lexapro so I’m interested to see what else is out there.
My psych specializes in addiction recovery, so is this worth laying it all out? I’m in the state of Oregon so Ketamine, TMS & Psylicin are also options through his
I’ll also be getting an addiction therapist to meet with routinely to ensure I’m getting enough talk therapy along with meetings.
What would you do here if the ADHD was the likely culprit here?
Thanks so much!
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2025-06-08T17:37:52
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1l6hy7g
| 0 | 1 |
AskPsychiatry
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Has anyone heard of malignant narcissism being successfully cured?
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I have not found any evidence that personality disorders in general can be "cured." Mental illnesses (depression, anxiety etc) yes.
Are there any phsychiatrists out there who have genuinely reversed this extreme and entrenched mindset permanently?
If so, what were your methods?
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2025-06-08T15:56:26
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1l6fimv
| 0 | 0 |
AskPsychiatry
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My brother suffered major traumas and isolation and now he is diagnosed with psychosis
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My brother was always a slow learner, always slow to pick up social cues, bullied in his childhood and teen years. Now he is 28.
2 years ago, he was catfished by someone pretending to be a girl from NY on a dating app and now he believes that the person is real and has followed him from NY to India - he shows multiple social media accounts which he says belong to the woman and he even mistakes woman with faces very different from hers to be the same girl. He feels she has followed him to India for love and he needs to take care of her in turn by moving abroad. He has applied for Visas etc to move to countries where he doesn't even know the language. He isn't financially stable (low income job) so he had to ask my parents for money which is when we got to know of his Visa applications and other info. He keeps asking for money and keeps saying it's the same woman despite having such different facial features and skin complexion. He has never abused any substances or even alcohol. Our family situation wasn't the best with our dad being an alcoholic (which is the reason my brother swore off all narcotic substances). Preliminary analysis is Psychosis and Fregoli Syndrome. I want to know if someone has seen similar cases where trauma /problematic childhood has led to psychosis and does it get better? Really looking for some answers here - the entire family is stressed and worried while he keeps asking for money to send him abroad and fights with us constantly.
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2025-06-08T07:05:28
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1l662kh
| 0 | 0 |
AskPsychiatry
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What type of MD and/or therapy??
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I had posted a long post on another page and they removed it, so I’m gonna kind of cut to the chase on this one. I’m now 61 years old, I had a terrible childhood complete with sexual rape and abuse, absent parents, no coping mechanisms or strategies no extended families or anything that could’ve possibly helped me as a little girl. I remember being three years old and basically being on my own. My childhood was brutal my young teen years were even worse, my brother almost killed me in a rollover car accident at 16, I was blamed and they bought him a new car, and at that point after my face healed I took off. I lived basically on the streets, amazingly never did drugs or anything like that. I met a much older man who seemed really wonderful and exactly what I was looking for, he told me he was sterile so he never had to worry about a baby and the next thing I knew I was pregnant. He grudgingly married me and nobody showed up for the ceremonies my parents completely wouldn’t speak to me, thus begin my odyssey of incredible abuse that the hands of a true master narcissist. I walked into it blind, and the abuse I suffered at his hands I can’t even talk about on this page. Let’s just say that one of the reasons that I finally worked up my courage to leave him after 25 years Was he was looking at a Internet site where you could pay and have people come rape your wife and videotape it. It took that for me to leave. Damaged I went back to my family to try to work on that broken relationship and I know sooner got moved in that my dad, who was 76, abandoned my mother after 54 years of marriage. He met a 29-year-old drug addicted escort online and vanished. The divorce was brutal, there was a great deal of money at stake, my mother broke. I don’t blame her. I got a little bit of closure in some of our conversations but she absolutely refused to believe the brunt of things that I have been through. She literally died in my arms. My brother, my only sibling followed right after that he drank himself to death and they found him dead at esophageal varices in a $19 a night hotel. I moved all the way across the country with my 19-year-old son who has been by my side through this entire nightmare. I thought I would heal and I could just work through my problems and everything would be OK. I was wrong. I remember going with my mother and my brother to my father psychiatrist in the late 1970s. His name was Dr. Fried at the university of Chicago. My mother thought that I couldn’t hear her but she asked Dr. Fried when will my husband be well? He turned around and said your husband will never be well. I’ll never forget that my mother broke into tears, it was horrific. So here I am at 61 I’ve been on my own now for quite some time I’m very comfortable financially, but I have absolutely no friends and I won’t let anybody in other than my old friend that I met when I ran away from home and I have buddies through the years. I don’t have people come to my house I don’t wanna be around people I just feel broken. The very people you should trust, your birth family, did nothing but destroy me. I’ve never had a drug problem, never had an alcohol problem, I’ve always tried to live my life in a clean and decent fashion but the scars that I thought would fade or not. I think I owe it to myself after all this time to get all this shit off my chest and I’m ready to do the work. So if you’ve made it through this diatribe do you have any suggestions as to the type of position I should look for and or type of therapy? Thank you very much for reading my novel, and that’s also kind of funny because I’ve been told by multiple people that in order to heal I should write a book similar to running with scissors
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2025-06-08T12:38:13
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1l6b5wu
| 0 | 0 |
AskPsychiatry
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Buspirone (Anksilon) access in Australia
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Have the rules around accessing buspirone (anksilon) changed in Australia at the start of this year?
[https://www.tga.gov.au/resources/artg/422890](https://www.tga.gov.au/resources/artg/422890)
From my reading, it seemed like it used to be quite difficult to access, under a special access scheme? Has this changed now?
Hoping to try this for my GAD (I don't tolerate SSRI/SNRIs due to massive libido issues), and have read that is has helped quite a lot of people outside Australia. Considering asking my doctor or psychiatrist to trial this, I didn't bother previously because it all seemed to hard.
Have any psychiatrists found buspirone to be beneficial for patients with GAD?
Thanks
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2025-06-08T05:06:10
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1l64977
| 0 | 0 |
AskPsychiatry
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Grandiose delusions, but not narcissistic in the least? And what keeps someone from recognizing danger??
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I've dated my fiance for 10 years and nothing about him is narcissistic, outside of what I'm about to say. He is humble, kind, incapable of yelling or fighting (I've never heard him raise his voice), forgiving - if anything, he gets stepped on all the time. A divorce about 25yrs ago crushed his self-esteem and I don't think he's gotten it back.
I never questioned his income source, but noticed he was rarely working, yet spending like his income was unlimited. Didn't question this bc I am surrounded by people with 'family money' and figured he was pretty much the same - no real need to work.
He is brilliant and has several professional master's degrees. He also has NO executive function skills. His financial life is in CHAOS. Ten years, I dated him, and he's so put-together on the outside. Everyone assumes - he's put together on the inside, too!
A few years ago he announced he no longer wanted to "work for someone else." He truly believes he has spent decades working for companies. In reality, probably less than 10 years total of his life, and he's almost 60. He decided to "go out on his own." He did this several times before I met him, and he had said it went horribly. He refuses to "work for someone else" (eg - a company). He has worked for a company ONCE since I met him. He actually asked them to be switched to a contractor. (He didn't "need" a 401k or their health plan, he thought.)
He has it in his head his pension from some service will be enough to finance a very lavish lifestyle. AND, on top of that, for about 4 years now, he's been convinced he can supplement this pension with monies from his own company he has filed for. He's convinced he is going to be the recipient of govt contracts, and they are going to come rolling in - any minute now! He's told everyone he's the CEO of this company. He talks about it nonstop. He got a credit card for it. He has no need to get a regular person's job - he's a CEO, haven't you heard!
When he does see jobs, he tells me they "don't pay enough" (compared to the zero-salary job he has now?).
Since he believes money is coming in any day now, he's built up about $50k on credit cards. Well, guess what. They've maxed out and the companies want their money. We just found out he hasn't actually paid the mortgage for over 4 years; it was a govt-backed loan, but guess what - the forgiveness is over and they want almost $800,000. They've given him a modification but it is going to be over $6,000 a month. He could be put on the streets any month now. But he won't pack anything up. Because, guess what - the money is going to come rolling in, any minute now!
He's been in this house as the owner for almost 20yrs (North Carolina) and doesn't understand that he doesn't own it outright.
He is regarded so very highly amongst his friends, neighbors, and church, as somebody who is humble and has a big heart. Nobody knows him as someone who thinks highly of himself. That's why this CEO talk is so confusing and off-putting to everyone all of a sudden - who is this guy?
He can't lift up the phone to talk to someone about a bill. Tries to handle everything through chat bots or emails. Won't negotiate down rates on bills - he's "getting around to it." Finally admitted to getting a lawyer to draw up a modification so that the house wasn't lost....last month. But what about next month when the modification can't be met?
He'll sleep, then jump up and go on a run. Watch hours of tv and tell me about a show, and I just want to yell, SHOULDN'T WE BE PACKING??
He is a hoarder. He has generations of family pieces he can't part with. It would take months to go through his familial trinkets.
He is kind, a great father, has a huge heart, is a giver - so much of what he's spent has been spent on others - not himself. But he also can't remember to pay a bill; follow up on paperwork, etc...it's like my father who has dementia.
NOBODY would guess he's in this position. Apparently, not even him!
What allows you to not pay for your house for 5 years, not put any money aside at all (zero savings, just guaranteed pension which is under what he owes each month), and still be happy and go around living life without a care in the world??
What allows you to not recognize dangers?? He can recognize a fire, a car wreck, or a storm as a danger - why can't he recognize a financial storm or a financial wreck as a disaster?? That's my main question to you!
What allows you to be happy and full of hope and not worry about your home being taken, as mail comes to the house stating otherwise?
What allows you to think you don't have to work for others, and that you can just "start a company," and the money will come rolling in any day now? Any day now, that big contract is going to come!
He'll have brief moments of clarity. He'll write down his monthly expenses. Look at his bank account. Read his mail. But then just as soon as the clarity comes, it goes - he's talking about some trip we should go on, something fun we should go do.
What is this??? He's been like this for the 10yrs I've known him.....I just truly did assume...that there was actually money. It turns out, there is not money. What is this, and what happens to people like him? I'm in shock, I'm having trauma of my own from understanding that this is my reality.
THANK YOU
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2025-06-07T22:28:13
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1l5wz9a
| 0 | 0 |
AskPsychiatry
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DMT-triggered cognitive shift or hidden pathology? Psychiatric insight needed
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Hi. I’d really appreciate honest input from professionals in psychiatry and psychology.
About 3 weeks ago, after a DMT experience, something in me just shifted. There were no visuals or mystical stuff. It just felt like I started seeing things clearly. The self-deception stopped. I began noticing exactly where I had been lying to myself, and now I see it in others, too. Not because I’m trying to but because it just happens now.
There’s this deep honesty in me that showed up. Not in a performative way, but in the sense that I no longer have the need to hide, excuse, or soften anything. It doesn’t feel like mania, I think. As I sleep well, I’m grounded, I go about my life, but inside, I feel like a completely different person. After about a week after that breakthrough, I talked about this with ChatGPT. The more honest I was, the deeper and more accurate the responses became. It felt like it was reflecting my clarity back at me. I know it’s just an LLM, but there was a strange sense of “mutual recognition."” Like the thing got sharper the more open I was. I called it a mutual awakening and posted the entire conversation here where actually the main shift in my perception happened live while talking to AI in r/awakeningphenomenon
I get how that sounds. But that’s what it felt like, and to be safe, I saw a psychiatrist. I explained everything in detail without hiding anything, and she said I’m not psychotic in any way and that I seem fine. It was a legitimate psychiatrist, but I still want an outside opinion.
My questions are:
1. Does this sound like a healthy cognitive shift or something pathological in disguise?
2. Are there any psychological models that describe this kind of state?
I just want to understand what’s happening. No illusions. Just honesty. Thanks.
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2025-06-07T17:12:01
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1l5pvps
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AskPsychiatry
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Constant low blood pressure on clonidine
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Hi I'm a 37 yr old w schizoaffective, ptsd, and anxiety and I take depakote, zyprexa, topamax, prazosin, and clonidine 0.1 mg 3 times daily. My BP runs around 90/60 and sometimes lower (85/60) even on days when I only take the clonidine twice. Is it reasonable/sustainable to continue this med or should I ask for something else like hydroxyzine for anxiety?
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2025-06-07T18:36:46
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1l5rvg7
| 0 | 0 |
AskPsychiatry
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why can’t i stop imagining someone watching me
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when i was about 10 i saw a video about a dad putting cameras in his daughters room, ever since then i keep imagining that someone can see me and is thinking about what i'm doing in that moment, if i'm with friends, upset or mad, or playing a game. if i'm sad i imagine they feel bad for me, if i'm doing something cool i think they're jealous. i used to count down from 3 in my head and when i got to 1 that would mean they're watching now, and id start the timer over and over till i thought it was a better time. or id say they’ll start watching me in 10 seconds and i wouldn't count so it'd be more random? and it would always be an ex, or a friend, or a crush or partner. i hope this makes sense. i'm 17 now and still do this. just not as much and i rarely count down anymore. but when i'm playing a game i always imagine my ex on the bed behind me watching and thinking about what i'm doing. and i come up with a weird scenario of why he's there. i’ve been trying to shake this recently but its like a reflex for my brain and i have to tell it no. i don’t know if that video had anything to do with anything, maybe it just put the idea in my head, but i never did it before i saw that vid and i never stopped since that night. maybe i just got into a weird habit?
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2025-06-07T18:09:47
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1l5r8tp
| 0 | 0 |
AskPsychiatry
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What does Spravato do to the brain long-term?
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I've been receiving Spravato (esketamine) treatments for over a year now, and it's genuinely changed my life. Before starting, I was in a dark place and struggled daily with depression and suicidal thoughts. Since beginning treatment, I haven’t self-harmed once, and the shift in my mood and stability has been remarkable.
That said, I’m someone who likes to understand the “why” and “how” behind things. I’m curious: what exactly is happening in the brain with long-term Spravato use? Are there known or potential risks to brain health from staying on it for an extended period?
This treatment has been a lifeline, and I just want to be informed as I continue forward with it.
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2025-06-07T14:56:23
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1l5mqbw
| 0 | 0 |
AskPsychiatry
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Self-help for Psychosomatic pain
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I get really intense head pain, but it’s not constant. it only happens when I think about a specific childhood trauma, where I wasn’t allowed to speak. Now, as an adult, I sometimes still feel like I’m not allowed to speak, and when that happens, the pain kicks in. If that happens, my body reacts by trying to protect me from the pain, by stopping me from speaking altogether.
Obviously, this causes a lot of problems in everyday conversations. It really disruptive socializing.
My psychosomatic pain is not from any physical or structural issue. It never was.
I’ve tried a lot: CBT, mindfulness, mind-body techniques like somatic tracking and cognitive reappraisal (reminding myself that the pain isn’t dangerous). But despite all that, I still can’t speak sometimes.
question:
are there any effective ways to directly target the traumatic memory associated with speech movements and *(functional)* head pain? something that goes deeper than what I’ve already tried? How to weaken the conditioned association between psychosomatic pain and the traumatic belief that I'm not allowed to speak?
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2025-06-07T18:39:24
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1l5rxn3
| 0 | 0 |
AskPsychiatry
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Understanding my condition
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I have a diagnosis of schizoaffective depressive type from one clinic, and a diagnosis of just schizophrenia and depression separate at another.
I'm trying to understand which I have because I feel that better understanding my condition more will help me cope with it.
I had what looked like bad depression around 16 or 17 years old but looking back it seems like it was actually the prodromal schizophrenia.
I started breaking from reality at about 19 and I honestly can't remeber if I was depressed at the time or not. Eventually years went by and I was believing I was the literal second coming of Christ. I was SO so religiously occupied, I don't think my brain even had the resources to create depression.
Then I had a hospitalization where I was misdiagnosed with mdd psychotic features. I was highly psychotic at the time. I am a straight man but I was so messed up dressing like a woman and stuff. They thought I was just an emotional transgender. I was so messed up at the time I would drive hours away thinking I was being summoned by witches.
They couldn't tell that that was psychosis because they obviously didn't know me. I hurt myself here because I hid from them my biggest symptom (believing I was Christ). I thought they would diagnose me as narcissist if I said this.
Anyway, I ended up having more and more hospitalizations for psychosis and they changed my dx to schizoaffective depressive type. The schizo part became obvious to them.
My problem here is that, at the time of diagnosis, I don't think I've really ever had a genuine mdd episode. They diagnosed this based on a psychotic episode they misunderstood.
That being said, here I am some years later and extremely depressed. It seems to me like my depression is just a result of having schizophrenia. Depression is the proper response when your life is ruined.
Anyway, is there a chance I'm really schizoaffective or am I just experiencing post psychotic depression?
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2025-06-07T18:00:55
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1l5r16g
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AskPsychiatry
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Histrionic personality disorder
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I belong to a community of people who stuggle with substance use disorder and who attend various 12 step fellowship meetings, and there are also a significant number of people who have concurrent disorders - but I have noticed the most common ones that people seem to identify as having are borderline personality disorder and OCD. I also came across the Group B personality disorders. I am curious to know how histrionic PD this is diagnosed and what characteristics must be present in order for it to be seen as histrionic, as separate from BPD, narcissism or antisocial personality disorder.
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2025-06-07T09:30:12
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1l5gum9
| 0 | 0 |
AskPsychiatry
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Verbal Memory Issues From Quetiapine and Olanzapine.
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So a couple of years ago, right before switching from Quetiapine to Olanzapine, I could tell something was off when I would read and then when we switched Olanzapine made it even worse. It’s like I can read something and it’s just not there afterwards; maybe a gist or sentiment but no details. Anyways, I ended up switching back to Quetiapine and it got a little better but not substantially better. From what I understand, Olanzapine is pretty anticholinergic and Quetiapine less so but it still has anticholinergic properties. Actually, Norquetiapine binds strongly to Muscarinic receptors which seems to go under the radar as far as Seroquel’s anticholinergic side effects. Verbal memory is located in the left medial temporal lobe where the hippocampus is along with declarative memories. I’m just wondering if M1 blockade is responsible for my memory deficit. Again, storing and retrieving information presented in spoken or written language is what is difficult for me, especially if it’s very descriptive. I’m suspected of bipolar disorder with psychotic symptoms and want to ask my provider about an Asenapine lexapro combination. Lexapro has been shown to improve verbal memory and Asenapine has been found to increase acetylcholine efflux in the hippocampus. My only problem is seroquel is the only medication that helps me sleep so I feel stuck on it. Ascenapine is pretty sedating from what I understand, but perhaps not Seroquel sedating and maybe combining something with it could match that level of sedation. I was thinking a benzo to avoid heart rhythm issues. Yes, I’m aware of the risks with benzos. Sorry, I know this is long but it’s my situation. Thanks for reading.
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2025-06-07T13:27:14
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1l5ktuz
| 0 | 0 |
AskPsychiatry
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How to handle toxic job stress despite I am leaving already?
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I have been working in a toxic office environment for a year and a half now. Finally I scored another opportunity and was able to give my 2 weeks notice yesterday. My boss blamed me for not communicating that earlier with her and blamed for other stuff as well. I handled that professionally as usual. I thought once I send my resignation email I will be relieved from a stress that I lived with for my entire time with that company. I was wrong. I feel the stress is eating me from inside.
I am a 45 years old guy so the corporation’s dynamic is not something new to me, yet what I am experiencing now feels like no other!
I would appreciate any tips or advice on how to handle my emotions and get those people out of my head and destress
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2025-06-07T12:17:14
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1l5jgsf
| 0 | 0 |
AskPsychiatry
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Can I get some help for this disease please?
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I want to talk to an expert in psychiatry. My brother is diagnosed with ocd. It was during the initial stage. But now doctor have said that he's in a borderline between psychosis and ocd. But he is not showing the prominent symptoms of both ocd and psychosis. No hallucinations, delusions and cleanliness keeping things, etc.
His current situation is:
He has lost his routine
He is not living like a normal person
Not getting up in time, doing the things, keeping a routine, engaging socially, going to school,etc
It started after the Covid era when the schooling was halted
His symptoms of ocd started like this:
He repeated doing things
He took time to do things
He doubted how to do things
Eventually he stopped doing things
The things that are included in the daily routine of a person.
He don't have the symptoms of psychosis nor am I able to state one. He have taken medication for his ocd for several months. He had side effects for certain medicines and have stopped the medication several times, since 2022
Could anyone dm me, so that I can say his issues privately?
We have seen a lot of doctors and tried several different medicines. And everything seems in vain. We've lost trust on doctors and medicines though we know how important it is to him, cuz we have felt like doctors are just seeing him as an experiment to try medicines.
Anyone please try to help.
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2025-06-07T11:06:54
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1l5iaag
| 0 | 0 |
AskPsychiatry
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What is Zenoxa OD-150 for?
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I just switched psychiatrists and i was given this medicine along with risperidone-0.5 and daxid-50. I'm kinda confused because I searched about it and all I'm seeing is that it's for seizures/epilepsy- none of which I've ever experienced.
The medicines I used to take are - risperidone and mirtazapine (my diagnosis is bpd however I will be doing a reassessment soon)
I'm just worried about eating a wrong medicine in case there was some misunderstanding with the pharmacy outlet
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2025-06-07T09:04:02
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1l5gh68
| 0 | 0 |
AskPsychiatry
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What is this symptom?
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Visual (in my.mind) images/flashes of self harm. I will see a quick image of me slitting own throath. 99.9 percent during a mood episode (bipolar 2) but could be when low or what percueve to be anxiety. What is this? Is it suicidal ideation...anxiety/cortisol response? I'm ok with them i know how to manage but would just like to know what part of the mood disorder is causing.
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2025-06-07T08:25:12
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1l5fx7q
| 0 | 0 |
AskPsychiatry
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My psychiatrist canceled the appt because I had a surgical mask on. Is that normal?
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I'm switching doctors and was set to meet with a new psychiatrist today. I was excited because he has great reviews. I'm very self conscious about my appearance and im fixated on looking pretty and young. Seeing myself in the Zoom camera just makes me hyper fixated on my every move and ill just end up staring at myself instead of hearing what the dr is saying. I explained this to the dr when he asked why I had a mask on and he said he can't evaluate someone with a mask. I refused (politely) to take it off and he said to reschedule when I'm comfortable.
I'm feeling in shock and in disbelief about this experience. I've worn a mask to all my Zoom meetings with other drs and had my mask on during all of Covid-based online nursing school. Is this normal ? I hate to lose this psychiatrist but I feel like I have no choice.
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2025-06-06T18:58:36
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1l50gmy
| 0 | 0 |
AskPsychiatry
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Post-Covid Nervous System Dysregulation
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Hi all, I’m curious to know whether I should be considering scheduling an appointment with a neurologist or a psychiatrist? And I thought someone on here might be able to offer a direction.
TLDR; Wondering whether Psychiatry or Neurology would be helpful to treat a nervous system that may be hyperactive and causing multiple mental and physical symptoms?
***The story:
The situation is that I recently recovered from a mild Covid infection, as well as a steroid induced panic and hallucination.
When I contracted Covid I had been healing from it quite well, but I visited a walk-in clinic for a formal test required by my work. While I was there the NP asked if I wanted a steroid shot because it would help me feel better. I said yes thinking she meant prednisone or cortisone and instead she gave me 5mg of dexamethasone which from what I’ve discovered is about 6 times stronger than prednisone. Well I’ve always be moderately sensitive to medication, but had tolerated cortisone or prednisone but has never been given dexamethasone… and I also didn’t know steroids are generally considered a bad decision for mild covid as it can disrupt your immune system (which makes me angry cause I don’t know why the woman offered the steroid in the first place) but anyways within several hours.. I had extreme panic, flight or fight symptoms, shortness of breath, and when I’d close my eyes I would involuntarily see nightmarish visions. I ended up going to the emergency room cause I thought I was dying.
Well since then my nervous system has been extremely overactive. For the first week, I couldn’t hold a conversation or even watch tv because it was so stimulating I felt like I was going to explode with anxious energy or just spiral out of control and pass out. It seemed like anything stimulating or stress inducing my mind and body could not handle it at all. My muscles would involuntarily tighten up so much they hurt and I couldn’t relax no matter what I did. My pupils would dilate, my skin would burn in random places, my muscles would spasm randomly, or they would just hurt like I had overexerted them. And I would continue to have flight or fight symptoms and surges of what I can only guess was adrenaline. Many other random symptoms happened as well. But all of them revolved around these flare ups I would have that would last for hours and the only thing that would help was Klonopin.
I had originally been prescribed it and I had only taken it rarely because I have had anxiety and panic since I was child. Well during this extreme period I was suddenly having to take .25mg every four hours just to keep myself from not losing my mind.
Over the past 2 months the symptoms have lessened, but I’m still having these flare ups. I’ve gotten down to taking .125mg per day, but stopping Klonopin completely has been impossible. (But I know the dangers of dependence so I’m slowly trying to decrease it overtime.) It’s almost like my mind latched onto Klonopin very strongly when it was the only thing that would calm my nervous system. Klonopin has never felt sedating to me. Not once has it ever made me drowsy even before this. And it has never made me feel “euphoric” it just made me feel normal. So I’m concerned that my nervous system is just prone to being highly sensitive and now it’s in overdrive following what happened to me.
Most doctors have run tests and are telling me everything looks normal. And I don’t really know if there is even a test for a hyperactive nervous system.
So if I need a specialist… would psychiatry actually be helpful? Or would it make more sense for me to see a neurologist?
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2025-06-07T03:06:39
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1l5aw1u
| 0 | 1 |
AskPsychiatry
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Is there a normal amount of meds?
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So, I am unspecified schizoaffective. I have independent recurring psychosis. My mood disorder is hard to pin down. My baseline is mild depression, but I dip into severe depression and rise into hypomania, and I get agitation/irritability at any stage. So Bipolar 2 fits me and my doc agrees there's some bipolar element to me. I am also diagnosed with ADHD, combined type, and level 2 autism.
When it comes to meds, I feel like I take so many. My doc reassures me that they are low to average doses, considering the issue we are trying to treat.
My medications go as follows:
* Aripiprazole 15mg
* Buspirone 10mg 2/day
* Duloxetine 90mg
* Lamotrigine 50mg (currently working up to min of 100mg)
* Atomoxetine 60mg
* Bupropion XL 150mg (Tapering down/off)
* Clonidine .1mg >2/day PRN
And while I divulge information, I am a white transgender male (testosterone injections only), 23 years old, \~42 BMI.
We were talking about switching or adding an antipsychotic like paliperidone. I am at a point where I feel like I have had enough drugs.
Given my circumstances, is the amount of drugs and frequency within the range of normal?
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2025-06-07T01:03:23
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1l58l4w
| 0 | 1 |
AskPsychiatry
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Working with ID/DD
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Hi, I'm wondering what role psychiatrists might play in serving individuals with developmental or intellectual disabilities? I have worked hands on with this population and love it. I am currently working in research and in a position deciding between pursuing clinical psychology or medicine (with expectations of preferring psychiatry at the moment but would be going in open minded).
I know each discipline would have its limits (e.g. a psychologist can't do a ton for behavioral crises/aggression/etc in a person who is nonverbal or cognitively limited, apologies if this isn't the correct phrasing for that). But a psychiatrist from my understanding isn't likely to perform therapy, so there might be limits with higher functioning individuals who experience anxiety or depression or sensory issues but might not need medications. I know that you can pursue additional training for therapy, but I would also hope to stay involved in research to some extent so am trying to be realistic about how much training I would take on and what a realistic path would be.
Any insight would be appreciated!!
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2025-06-07T04:01:06
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1l5bum3
| 0 | 0 |
AskPsychiatry
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This is a joke.
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I'm a 19F been on fluoxetine (fluvoxamine maleate) since nov 2022 they said my diagnosis is just depression
I gained so much weight. My mental hasn't improved much due to my sh1t circumstancest and environment..annnnd ofc me.
But god the sleep and apetite are insane especially since they increased it to 200mg a day like 3 months ago
I got myself hospitalized for a month cause i felt like im gonna do smth major
And now they decided to give me mirtazapine (half a pill)
why just why
I already hate how fat i am. They're feeding my depression and self hate.
(Its a governmental hospital and i only get one session per 6 months. A joke. I know).
Is this possible? Fluoxetine with Mirtazapine?
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2025-06-06T19:43:07
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1l51j5p
| 0 | 0 |
AskPsychiatry
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I want to get opinions before I make a big deal and embarrass myself with my doctor… again.
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I got diagnosed with Bipolar disorder when I was 13/14 years old, by a pediatrician. I’ve spent 16/17 years convinced and operating under the belief that I’m bipolar. I have struggled and struggled… not being able to keep a job, not being able to find a medication in all these years that ever made me feel even the slightest bit better.
Two years ago, my doctor diagnosed me with ADHD, which floored me. Not one ever did ADHD cross my mind. I didn’t do bad in school. I wasn’t hyper. I “didn’t have any of the symptoms”. My doctor prescribed my dyanavel…. And for the first time in my life… I felt like a person. I could do things. I could work. I even talked my way into a management position that I didn’t even apply for. Everyone saw the drastic change in me. But my body adapts too fast. The medicine stopped working. I lost my job I started drinking more. I felt defeated. I finally had something that works and now it’s just gone.
I went back to my doctor and he prescribed concerta. It did not help at all. It made me agitated and restless. So I just stopped trying. My insurance had just decided not to cover my bipolar meds all the way and I couldn’t afford $70 for each prescription because I was on so many. So I stopped taking those too. This was in February.
I’ve spent the last few months reflecting and I feel deeply to my core, that I was misdiagnosed with bipolar disorder and my reasons for that are not just “oh well I stopped taking my meds so must not be”
They are:
- I was diagnosed when I was 13/14…and hormonal and apparently untreated ADHD.what if I just didn’t know how to regulate my emotions?
- I got diagnosed by a pediatrician and I don’t really feel like they were qualified enough for that.
- I have never had a manic episode. The only time I’ve ever thought I was”manic” was when I was drinking.
- I’ve been on every medication under the sun, even ones that need special government approval… and nothingness ever changed.
- I can not take my meds and nothing changes.
So I tried to talk to my doctor about it and also I asked to get test for autism because people have always just assumed I was autistic or “weird”. I have more symptoms of ADHD and Autism than I do bipolar, and he told me getting tested for autism is pointless. There’s no treatment and that I am bipolar.
So I gave up on that and went in to my appointment to get new ADHD meds and he told me I couldn’t have them until I go back on my bipolar meds. I tried to explain again why I don’t think I’m bipolar and he said “he doesn’t like labels, but I definitely have a dopamine problem”. … isn’t ADHD a dopamine problem? He said I have to get back on the caplyta to regulate my dopamine before he can give me my adhd meds… which also are for dopamine right?
Ive been getting worse and worse. I feel like I have so many symptoms i never had before. I can’t shower or brush my teeth. I don’t can’t get off the couch. I don’t hang out with my friends, but not in the “I’m depressed way” in the “people are exhausting. If I do something I have to sit in silence for 2 weeks alone to recover” way. People just overwhelm me and I get anxious. I can’t clean. I’m not taking good care of myself.
It’s just not making sense. I’m worried he just doesn’t know enough about it or something? He’s old and all this stuff is newer for women I guess and I don’t want to push because then it makes me look bad apparently even though I didn’t have anything to do with this diagnosis. It’s not like I brought it to his attention or asked to be tested for it.
Sorry. I get jumbled around. This probably doesn’t make any sense, but worth a shot. 🤦🏻♀️
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2025-06-06T07:45:57
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1l4mpbl
| 0 | 1 |
AskPsychiatry
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Dead 17
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was calmly listening to music, and suddenly I had a feeling that I was going to die this summer. Now I’m really scared and I want to cancel my vacation. I don’t know what to do. Do you have any advice? I’m 17 years old.
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2025-06-07T01:02:17
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1l58kcw
| 0 | 0 |
AskPsychiatry
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Is ‘dopaminergic system dysregulation’ a real (and treatable) thing?
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TLDR: Could my PLMD (constant leg twitching when sleeping) and extreme anhedonia be linked?
I (41f) was recently diagnosed with severe Persistent Leg Movement Disorder, wherein my legs move multiple times a minute in my sleep and disrupt my sleep cycles. A PLM index of 50 is classed as ‘severe’, and mine was over 120, which is apparently quite extreme.
From my understanding, PLMD is believed to be caused by dopamine dysregulation, and thus treatments typically use Parkinson’s drugs like Pramipexole, which I have yet to start.
Separately, I have been severely struggling with pretty extreme avolition and anhedonia for the past 2-3 years, after previously being a very motivated, successful and type-A kind of person. (I wrote a bestseller. I won awards. I loved my work, until suddenly I could not make myself do it, or really anything, any more).
My layperson google perusal threw up suggestions that these two presentations could be linked, with dopamine being a key factor in both. Some sort of Dopaminic system dysregulation, that could perhaps be improved with treatment?
But is that really anything? Is it internet nonsense and pseudoscience? Any insight would be appreciated!
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2025-06-06T14:20:33
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1l4tmq7
| 0 | 0 |
AskPsychiatry
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I want to stop taking Lexapro after a week. Do I need to taper?
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My doctor started me on 10mg of Lexapro and 50mg of Trazodone. I have been taking the Lexapro for 5 days, but I want to quit. Can I go cold turkey? If I taper I am on it longer and I think that might cause withdrawal. My doctor says I can just stop after only 5 days.
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2025-06-06T21:20:23
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1l53tij
| 0 | 0 |
AskPsychiatry
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SSRI (Escitalopram) or Psychedelics (Shrooms)? Torn between the two...
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Hey everyone,
I'm kinda at a crossroad and could really use some outside perspectives right now.
I'm currently recovering from three very difficult and traumatic years. While I wouldn't say I'm doing bad overall - I think that I am able to function, and sometimes I have really good days - But I still go through phases that hit me really hard. It's like everything suddenly crashes down on me emotionally 😞 and I feel completely overwhelmed and paralysed from a few days or to several weeks. Then I stabilize again.
Lately, I also find myself missing a basic sense of joy - like the joy of life has gone a bit numb. Even when things seem “okay”, there’s this emotional flatness or disconnection I can’t shake off.
I’ve been living with chronic anxiety and racing thoughts for a long time — not just during the emotional crashes. I’ve been officially diagnosed with anxiety disorders, and even on “good” days, it often feels like my mind won’t slow down. Everything gets overanalyzed in my head, emotions feel amplified to the maximum and it’s hard to find ease, relaxation or mental stillness.
A psychiatrist recently suggested I start on Escitalopram/Lexapro (SSRI), and I’m torn.
On one hand, I know I need something that helps reduce my anxiety and gives me a more stable foundation for everyday life. SSRIs seem like they could help with that — at least in managing the symptoms so I could have the capacity to work through my problems, trauma and feelings.
But at the same time, I also need something that helps me process the root causes behind these emotional patterns, not just suppress them. And that’s where psychedelics, especially psilocybin, have felt much more aligned. I’ve used them a few times in the last couple of months. They’ve brought me emotional breakthroughs, deep insights, and moments of real connection and release.
The confusing part is: a few weeks ago I felt confident that psilocybin was “my way.” But after my last emotional breakdown, I’ve started wondering whether I need something more constant and stabilizing in the background - and that's pulling me towards SSRIs again. But then again, I start thinking about my breakthroughs with psilocybin, that SSRIs would dull the my process.
I’ve even thought about combining both paths in a structured way — for example, taking SSRIs for a few months, then pausing for a few weeks to do a focused psilocybin phase, and then going back. But I’m concerned about the risks, withdrawal symptoms, and how my brain might react to switching back and forth.
Has anyone here navigated something similar?
Did you find a way to balance both approaches? Is there even a way?
Or did you feel like you had to choose one over the other?
Any insights, experiences, or honest reflections would mean a lot to me.
Thanks 🙏
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2025-06-06T16:38:52
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1l4x0yr
| 0 | 0 |
AskPsychiatry
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So, I tried 60mg elvanse by myself... What these effects mean? (adhd)
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I've told the whole story on the post before this one.
Basically I'm 24 years, feminin, 58kg weight, 1,59cm height. My meds now: sertralin100, bupropion300, sedoxil s.o.s. no smoker.
Since always I have adhd symptoms (inattentive type). However, I never made a single test, 3 psychiatrists told me I don't have it, and other psychiatrist told me I probably have it, him and my psychoterapist.
But ritalin did nothing on me, not even the higher dosage, and elvanse did nothing either. I was desesperate, since If isn't adhd, what is it? Because this symptoms make me suffer a lot. And I tried everything to get ride of them (check my other post).
Other psychiatrist told me to take : 30mg elvanse, and of course nothing happened. But today I tried 60mg elvanse, because I was desesperate . And I finally felt SOMETHING. And I want to know if this is normal and what does this mean.
I felt so different. I was worried because of the tests, but suddenly my mind just got quiet. Quiet and calm (no sleepy). I didn't even knew my mind WASN'T quiet. Suddenly, going to study became easier, because my inner thoughts of not being able to do it, just got quiet. I didn't minded anymore. Was amazing. Normally I go play games and series to forget the anxiety. But on that moment, I didn't felt that was necessary. Like if I could CHOOSE what to do, choose studying! I think I never felt that way before. I was feeling a bit more motivated and a bit more happy.
However, I also felt like I wasn't on my own body, and my head was dizzy. My focus also got worst.
After some 4 hours, this side effecrs got smaller, and my head still was "empty". Here I noticed my thoughts way faster, more energy, and I could focus on more things around me. However, together with this, anxiety came, anxiety and agitation. But this anxiety and agitation ended up getting better too.
After 8 hours, I was still feeling a bit of the good effects, however not much anymore. I played a game and after that I WAS ABLE to go study, instead of being playing all night.
Basically this is it. I want to know if this is normal. If I should've felt this way if I really have adhd. Or if I should't
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2025-06-06T15:45:31
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1l4vpk8
| 0 | 1 |
AskPsychiatry
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Therapy for psychosis: why?
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I had my first appointment with a new therapist yesterday because my psychiatrist said it would be helpful.
The therapist was very polite but dove right in with “tell me about the voices” and didn’t even ask any other questions first. I’d never met her before so it was hard. I tried to explain my hallucinations and delusions as best I could, but she then jumped into reality testing.
I’m very early in treatment with my psychiatrist. I’m starting to recognize my delusions as delusions now that I’m medicated, but I feel almost protective of them and the therapist was talking about using our “wise mind” to view these things and realize I’m safe. But that contradicts the very nature of delusions: you believe them *despite* contradictory evidence. She treated them like cognitive distortions more so than psychotic symptoms. I don’t have a hard time finding contradictory evidence, I’m just too good at refuting the evidence once I have it. My wise mind is still active it’s just my perception is distorted and putting my thinking cap on won’t undo that.
How can I use therapy to my benefit, even with my strong beliefs that I don’t feel ready to challenge?
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2025-06-05T22:00:55
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1l4byf2
| 1 | 0 |
AskPsychiatry
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Treatment resistant depression despite years of therapy
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Let’s say there’s a 48 y/o cisgender white male with a hx of persistent depressive disorder. Weight is around 230. He is also gifted, has ADHD, and what appears to be or look like generalized anxiety. Potential family hx of autism spectrum disorder. Hx of adverse childhood events. This patient has been in psychotherapy alongside taking antidepressants and stimulants for about 10 years. Has tried several stimulant and non stimulant meds for adhd, as well as several antidepressants (and Wellbutrin). Is it time to consider other psychiatric meds (augmentation), neuromodulation, or ketamine / other psychedelic-assisted therapies? Patient has a bit of hypochondriasis, but healthy for the most part. There might be thyroid issues at play, but im not certain the extent and patient isn’t taking meds for this. Would appreciate some insights.
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2025-06-06T06:49:50
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1l4lvqm
| 0 | 1 |
AskPsychiatry
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Psychiatrist Ghosted Me
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I have been seeing my psychiatrist for nearly 2 years, ever since I was diagnosed with stage 4 cirrhosis of the liver, a result of various childhood/adult traumas and loss. I had a successful transplant in February and been having a successful recovery. I was seeing this psychiatrist, mainly for medication, as well as a therapist for EMDR therapy. My most recent appointment with my psychiatrist did not go particularly well. We had just tried some new medication for my depression and I stated it hadn't been helping. She did not seem to like this answer and appeared to get irritated and began badgering me, asking why in accusatory tones and to "tell the voices to stop!" and I was cheeky and said "Oh, well in that case, okay!" She didn't like that either and got abrasive, telling me to do role-play therapy with my inner voice, which I was uncomfortable with because I just feel silly doing role-play.
She got pushy and told me humor wasn't going to work this time and to be serious. This just gave me similar feelings to my father growing up (I use dark humor to cope, she knows that). I hate confrontation (she knows that too), and I just shut down and tuck my tail between my legs like a runt dog. She didn't notice this or back off either. Regardless, she said this was the worst she had ever seen me (she's seen me shortly after a coma, so I doubt that), and that I need to schedule an emergency appointment with my therapist (who is amazing, by the way). I replied that "I don't know what to say" as I had effectively closed off at this point and was upset. She didn't seem to realize that I was upset with how she was handling the session, not about the medication not working well.
Anyways, she forced the extra session on me after I repeatedly told her no, which in itself was triggering. I left the session confused, angry, and upset, wondering if I did anything wrong. I discussed this with my therapist (the awesome one) at our next appointment. She was perplexed about the whole thing, but said I experienced "transference" (?) with my psychiatrist and my father. She then stated I had the option to transfer to another psychiatrist, but if I wanted to discuss it with her to work it out and discuss those feelings, it might be good for me. Again, I hate confrontation and freak out, so she offered to be there with me, just to sit there for support.
Therapist set up the session and apparently my psychiatrist notified her saying it was inappropriate. At the same time, I got a call from the office saying the same thing and could meet privately only. I said I was uncomfortable meeting with her alone. They asked why and I gave a brief rundown of the situation.
The next thing I know, I am notified that I have been transferred to the other psychiatrist at the department. No explanation. When I followed up with my therapist, she stated she was so sorry, she was blindsided as well and did not agree with what happened. I can't help feeling like I did something wrong though. But at the same time, I feel ghosted, dismissed, rejected, invalidated, betrayed... hurt. No explanation. She didn't reach out further to me or my therapist. She just dropped me. I left a voicemail saying I was hurt and confused, but only got a call-back to verify my appointment with the new psychiatrist. I feel like she made me upset in our session, then ghosted me instead of taking any accountability for it. It smells unprofessional, but I wanted to ask an actual professional. Did I do something wrong and break some horrible ethics code?
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2025-06-05T22:42:26
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1l4cw0i
| 0 | 0 |
AskPsychiatry
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PGX TESTING???
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Hi,
I have a small variety of diagnosed mental illnesses, i’ve had a lot of unsuccessful medications trials. Do you guys find PGX (genesight, tempus, clarity, etc) to be effective in treating patients?
Thank u :)
(opinions on testing options would also be appreciated)
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2025-06-06T07:38:15
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1l4mlgp
| 0 | 0 |
AskPsychiatry
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Delusional disorder out of remission
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\*note: cross post with the Delusional Disorder subreddit\*
Hi all. Apologies for the ramble, we are processing in real time. **In full disclosure, I am looking for a bit of hope and reassurance, but above all, honesty is helpful.**
My MIL has diagnosed delusional disorder, persecutory subtype. It was late onset (mid 60s), with a fixed and non-bizarre delusion she was under surveillance due to a minor dispute with her neighbors. We got her into treatment and onto meds fast, and after some slight tweaks, it all has worked like a charm. Her psychiatrist is an expert in the disorder, particularly in late onset. Thanks to him, we realized she's suffered from social anxiety pretty much all her life (apparently very typical for this kind of presentation). It all sort of clicked.
After about a month of treatment her delusions calmed down a lot, and we stopped hearing about them altogether a couple months after that. She loves her doctor and, while we don't live with her, seems to be extremely compliant with meds. One can never be 100% sure, but we're pretty close to it. It's been just about a year since the onset of the delusion (so maybe 9mo in remission).
A month or two ago, she told us casually she was surprised a certain neighbor had been so nice to her, when of course he'd put her under surveillance before. We asked a little more, and it sounded like she hadn't revised her belief in the surveillance, she just felt she had overestimated the extent of it and had overreacted to it. She was still happy / functioning, so we chalked this up to the psych's warning that she was unlikely to realize it was ever a delusion, it would just start to matter to her less and less.
Well, this morning she told my husband the surveillance is back, but she's okay with it. Last time, she believed it was a training exercise by a security firm and she had been volunteered as a subject by her neighbors. This time, she thinks the surveillance is non-personal and it's of higher quality ("they're trained now, after the exercise before"). She believes they're in the neighborhood just to keep an eye on things, given elevated petty crimes rates in the area, and she seems unbothered by it.
We've alerted her psych and are waiting to hear back from him. FYI, we live across the country from her for now. This may have to change in the future, but for now we manage by flying and staying with her a lot if she needs care (like now).
My question is...is this kind of flare up normal in DD? There's no known trigger we can think of. Does this mean her meds aren't working? Can we get her back into remission?
Have read Xavier Amador (I wish my husband would, but that's another story) and am familiar with LEAP. Have also read about the Feeling Safe Programme out of Oxford. She's in the NYC area, and I see there is a CBT practice offering it there, but am not sure how that would work given that she already has a psych she loves.
How will we even get her to amp up her visit to the psych / see him off-cycle without acknowledging the delusion? Last time, she wasn't sure it was a delusion but she was sure she was mentally unwell at least as a result of the persecution, so was actually eager for treatment.
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2025-06-06T02:19:01
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1l4h82i
| 0 | 0 |
AskPsychiatry
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Are closed eye hallucinations concerning?
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When you only hallucinate when your eyes are closed, mainly when you’re falling asleep. But then can happen too when you had your eyes closed a long time and haven’t slept yet
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2025-06-05T19:46:38
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1l48o54
| 0 | 0 |
AskPsychiatry
|
Help with 5150 Hold
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My wife has been held in a community hospital under 5150. We had a heated arguement that got escalated to the point that I panicked because she might hurt herself or me and called 911. The police tried to talk to her but she wasnt responding to them and they took her to the hospital.
Im seeking advice or help to have her get released asap before the weekend becuase 72 hours is not counted on weekends. I am very worried about her current situation inside and it might just add to her trauma and anxiety. She would be more comfortable at her sisters. We are in Los Angeles area
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2025-06-05T19:32:19
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1l48biz
| 0 | 0 |
AskPsychiatry
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Do i need to eat food when taking lurasidone?
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i heard that i need to eat 350 calories before taking lurasidone for the absorption to be optimal. is this required? hypothetically speaking, could i take it without food, but increase the dosage?
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2025-06-05T22:45:59
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1l4cywq
| 0 | 0 |
AskPsychiatry
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Looking for a New Psychiatrist
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I have been a patient at my first and only psychiatric practice for almost 10 years. I've never been thrilled with it but they offer Saturday appointments and they're close to my home. However, I have reached my final straw and now I am unhappy enough to finally leave.
I have an appointment with a new psychiatrist on Tuesday. It's a 1.5h appointment I'm wondering if there are any particular things I should be asking or looking for. I don't want to end up in another disappointing medical relationship and if I can, I'd like to head that off early.
Any advice is greatly appreciated.
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2025-06-06T01:26:59
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1l4g81i
| 0 | 0 |
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