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AskPsychiatry
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I have been on esctilopram for moderate to severe depression for three weeks but I feel so so sluggish, and want to stay in bed all day
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I have been in a state of constant crying and panic all day before I started the meds with inability to do most things I used to do and unable to take care of myself. It was more pain than I could take and I didn't really understand what is happening like a complete collapse. Anyways I can't really think straight and want to do nothing and it feels uncomfortable but the crying intensely eased. Should I wait it out, I am afraid I am getting worse. Before I was also suicidal now I am too tired to even think about that.
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2025-05-29T08:47:52
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1ky5u9e
| 0 | 0 |
AskPsychiatry
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I have a lot of minor symptoms, does this still warrant help?
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14F
This has been going on in some form for like 2 years.
I'm going to compress this into as short of a summary as I can, if I'm too vague, the info might be in another post.
My memory is really bad and I often forget things. I don't remember most of my childhood, even though there isn't a (known) reason to have forgotten anything. My short term memory is also bad I guess.
I don't really feel all emotions, and I definitely don't feel them strongly. There's like 1 or 2 layers of the ones I do feel. They're mostly negative, and a lot of the time I feel neutral/the verge of sadness. I fake a lot of my happiness.
I'm very lazy and am never bothered to do things. I completely lost interest in reading. I always do my homework the day it's due because procrastinate too much. I can hardly be bothered to even go out with friends.
I hallucinate on and off every couple of months for a week or two, the hallucinations are usually just people looking over my shoulder when they really only walked past.
I simply can't do things I think are embarrassing - I lost marks on my music grading because I sang all notes the same because I was too embarrassed.
I also feel slow and dumb. That's pretty self-explanatory.
When people are better than me, I sometimes wish them harm, like I'd they're smart, I hope they'll get a TBI and be dumb and useless. This brings out my anger quite a bit, and I get frustrated.
I have a few intrusive thoughts that are really obvious but I guess I have milder ones that go "Ew, shut up" and similar far more often.
I'm a little particular about numbers and symmetry. I like looking for patterns or some kind of symmetry in most things, and I like specific numbers. 5, 7.5, and 10 are all examples of numbers that feel right to me, and I'll often leave the TV volume on them. I guess I wouldn't have a meltdown if I didn't, but I still get kinda uncomfortable if I don't like the number.
I also think I enjoy the pain of others? I know, it's disgusting, but all of my AI Dungeon scenarios involve people getting hurt and sometimes they even give me this feeling...
I'm kinda paranoid that people who know me will see them, so I made a fake email. I'm also paranoid that they'll see things I do online, like when I pause in the middle of scrolling to look at a dress or something.
I also generally think I'm a bit negative, like I'll look at someone's weight loss but think they've got such an ugly face that it doesn't matter, or that their haircut won't fix their face. I think that’s me projecting.
I used to cut myself but I stopped and IDK why I even did it in the first place.
So... anyone know what this could be?
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2025-05-29T07:48:09
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1ky4yqx
| 0 | 0 |
AskPsychiatry
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Does it mean anything when my thoughts are all screaming?
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I occasionally get into a mood or mindset or something where all my thoughts are intense like they’re shouting or screaming. Not violent or angry or anything, just loud, but not in a way that affects my actual hearing, if that makes sense. Like if normally I’m thinking, “I really need to wash my hands”, instead I’ll just think “I REALLY NEED TO WASH MY HANDS” or something mundane like that. It’s just my normal thoughts but louder.
I can’t turn it off manually, and I don’t know what triggers it, but I have had it happening probably a few times a year for about 13 years.
I don’t think it’s something to be concerned about, as it doesn’t really affect me all that much (other than affecting my dreams a bit, they become way more intense). Does anyone else get this? Or know why this might happen?
Since it says to specify in the rules, I’m a 24 year old man, 6’0”, ~200 pounds, and I’m white. I don’t have any relevant diagnoses or medications or anything, and I don’t do any drugs, even alcohol.
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2025-05-29T06:19:13
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1ky3myw
| 0 | 0 |
AskPsychiatry
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2 months on Zoloft don't feel a thing + weird life revelations that could be a reason.
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I literally have not been reacting at all to the medication. I felt really tired in the beginning and now caffiene has little affect on me. My therapist brought up the possibility of adhd-inattentive type many times. I have been diagnosed with persistent depressive disorder and sitational distress anxiety? Anyone go through this? I'm feeling really frusterated becuase I've been suffering for months.
I also have a useless excuse of a psychiatrist NP. I can't switch rn becuase it takes months to find another psychiatrist and set up an appoitments.
I also need to get testing for ADHD and that process takes months with medication.
ADHD doesn't make a lot of sense because I do well at school on paper. I am a really bad procrastinator and I lack motivation. I only do work that I enjoy.
I don't know how to deal with this.
Also, I found out that I have a genetic reason for my mental health (my grandparents are cousins) last month btw because why wouldn't you tell me that 5/7 of my dead grandparent's kids came out mentally botched. I finally know what happened to the one Uncle that died (he struggled severly with some mental illness but I still don't know what). My dad presents with a mix of OCD ADHD and Autism. I learned from my mother that my aunts also present with ADHD.
I'm I just genetically fricked up and a frankestien of problems?
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2025-05-29T05:50:05
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1ky36xj
| 0 | 1 |
AskPsychiatry
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What makes a case “extremely complex”?
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I was told this in a psychiatry appointment. I don’t get what would make a patient an extremely complex case.
Everything that’s happened to me seems pretty on par for schizoaffective bipolar.
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2025-05-28T21:33:48
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1kxt96p
| 0 | 0 |
AskPsychiatry
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Prozac 20 mg vs 40 mg + low dose Risperidone — which is safer/wiser for my situation?
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Hi everyone,
I’m looking for some perspective on two slightly different treatment approaches recommended by two psychiatrists. I’ve been dealing with long-term anxiety, depressive episodes, a general sense of being "blocked", overwhelmed thoughts, fear of uncertainty, looking for the perfect answer, difficulty focusing or taking action. I have the mental form of OCD. I just turned 30 and feel like I’ve been stuck like this for years, with some ups and downs, but nothing that really helped me move forward.
Here’s what happened recently:
I started Prozac (fluoxetine) 2.5 weeks ago:
• Week 1: 10 mg
• Week 2: 20 mg (still on it now)
Psychiatrist A (who I initially saw) recommended staying on 20 mg for at least 4 weeks, and then maybe increasing by 10 mg only if needed. He’s very cautious, says 3–4 weeks isn’t enough to judge Prozac’s effects fully, and is hesitant to add anything else too soon.
Psychiatrist B suggested increasing Prozac to 40 mg now, and also taking a very low dose of Risperidone (0.25 mg) to help with intrusive thoughts and mental noise. She said this could help the Prozac “settle in” and calm my system. Although, afterwards she said it's ok to just continue taking 20 mg for the whole first month.
My questions:
Does a tiny dose of Risperidone (0.25 mg) make sense for this type of emotional agitation and cognitive overload? Or could it be overkill?
Would a slower, more conservative route (sticking to 20 mg for a bit longer) be more gentle/safe for my mind and body long term?
Has anyone here taken a tiny dose of Risperidone with Prozac and found it helpful (or unhelpful)?
Any insights from those who’ve been in similar situations — or just general thoughts — would be super appreciated. Thank you for reading 💙
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2025-05-28T19:31:15
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1kxq5yk
| 0 | 0 |
AskPsychiatry
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Sexual Side Effects from Zoloft?
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Hello! I was on Zoloft at 50mg for 3.5 weeks. It was awesome as I had no anxiety on it, but I’m not really sure if I had sexual side effects or not.
About 3 weeks in I tried to masturbate while watching adult material but i just couldn’t keep it up if you know what i mean, i don’t know if it was because i wasnt interested and maybe i was trying to force it or what.
I want to get back on, at 25mg, but im worried that the sexual side effects will fully manifest, and that theyll be permanent. Should i get back on it, or is it too risky? Did i even experience sexual dysfunction?
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2025-05-29T01:00:25
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1kxxuqg
| 0 | 0 |
AskPsychiatry
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What can I do?
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I was taking Zoloft. I quit cold Turkey two time before this time I started having weird issues long (persisted after 3 months and some sexual aspect’s gotten worse)after it was out of my system. Loss of introception. Weird high feel, persistent sexual dysfunction (note: this only started on the half 100 mg I took over 4 days prior on the 50mg I never had issues), loss of ability to feel substances like caffeine, diminished emotional intensity and no adrenaline rush. It has improved but still nowhere near the same before. She suggest I see a neurologist.
To be cleared of other cause. I don’t have any medical conditions nor was I taking anything other than vyvanse to treat my adhd. Not having that adhd medication is making me severely depressed and borderline suicidal. Should I just see another psychiatrist to get my meds prescribed because I don’t want her refusing me my adhd meds because of the problem with Zoloft.
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2025-05-28T22:16:34
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1kxua3a
| 0 | 1 |
AskPsychiatry
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How do I get therapists to take my concerns seriously?
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Very long story short-- In December of 2023 we (my husband and I) found out that my stepdaughter had been sexually abusive towards my bio-daughter. We found out through a series of events that led us to believe that my SD may have serious psychological issues (we believed narcissistic at the time) and while trying to ask my bio-daughter about signs or symptoms to bring to SD's therapist she revealed that SD was "chronically masturbating" in front of her, even when she asked her to stop, and became emotionally upset and seeing it "24/7."
My SD was taken to a psych ward after a brief stay at her biological mothers house (where she tried to kill her little sister.)
Since then she's been to two RTF's, neither of which fully understand the scope of what they're dealing with.
Yes, my entire family is in therapy.
There's so much more to this story, I don't even know where to start.
Here's my question: The RTF's haven't kept track of, or shared notes amongst each other and they don't even have a complete understanding of the giant red flag that is her obvious personality disorder. I'm scared. I'm scared for my family for her ever approaching release. Her current treatment team is completely out of their depth.
How can I get them to listen to me without coming off as a victim, defensive, wanting retribution, etc?
I'm very certain she is a cold, calculated, callous psychopath that will seek out revenge on my family, and I have years worth of well documented proof of this.
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2025-05-28T10:56:20
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1kxe3f5
| 0 | 0 |
AskPsychiatry
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Referring to a Higher Level of Care
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What components of a patient's intake paperwork would typically prompt you to refer them to a higher level care?
I recently attempted to switch to a psychiatrist covered by my insurance, but they referred me to a higher level of care and turned me away from their practice.
I appreciate that my psychiatric history is a bit complex and that my answers to the depression index might have been alarming; I'm just wondering what goes into the risk assessment here.
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2025-05-28T15:11:02
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1kxjl62
| 0 | 0 |
AskPsychiatry
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What do I have?
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ast Monday, I went to a Psychiatrist that prescribed me Escitalopram for my general anxiety disorder which I understand. I also got prescribed valproate.
I told the Psych I can have a bad temper, road rage, when I’m anxious and more work is piled on me, I get cranky etc. Sometimes its a bit much and it affects my immediate family. I normally run 25 km a week, helps with the energy level and I have ADHD which I was diagnosed as a kid. Sometimes, i cant catch myself and snap. Never physically, but can be verbally. Definitely something I don’t like. When I calm down after sometimes, I ask myself “who was that” like its hard to control myself. but the Psych said I don’t have Bi-polar disorder. I thought I did. She mentioned that its a mix of anxiety and anger management. Is the mood stabs necessary? I thought that if my anxiety gets fixed, my temper would lessen too.
I’m not manic or depressive either. I function quite the same every day. Just have anxiety and overthink a lot. 3 or more times a week. Mostly when I wake up. Goes away as the day progresses. The temper is funny because I think this time “ive figured it out, “these are my triggers” so when those triggers come up, im prepared, but sometimes even with other things, it comes out. Like the devil inside.
is there a more accurate term for my temper or what its called? I just wanna understand myself better.
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2025-05-28T20:43:30
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1kxrzpq
| 0 | 1 |
AskPsychiatry
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When can I expect to feel normal again on Aripiprazole 10mg?
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I had a first time psychotic episode following heavy cannabis use (both that month and since I was 19 - I was almost 27 when the episode happened) that lasted about 3-4 weeks and ended in February, and since then have been given a clopixol IM injection (had a few on the psych ward and then one in late February ten days after my release), which gave me really severe akathisia. I was then switched to quetiapine 300mg oral tablets for 6 weeks, which I complained about because of the emotional blunting and anhedonia it was giving me, so my psychiatrist discontinued it for 2 weeks and then put me in risperidone 1mg (with intention to eventually titrate up to 5mg) and after being on risperidone for 2 weeks, I felt the same as being on the quetiapine, so I asked him to switch me to Aripiprazole as I've heard it's the best med to take if you don't want emotional blunting or other side effects like sexual side effects. I've just taken my 6th daily dose of aripiprazole 5mg and the doctor will titrate me up to 10mg next Friday, and perhaps 15mg at some point. I feel really emotionally constricted and I cannot cry or laugh, or enjoy anything I do. I cannot focus on anything, even a TV show, and I have no desire to do anything (not even listen to music, and I've always been a passionate musician so this is particularly depressing) so I literally just scroll through my phone in bed and huff a nicotine vape hoping for some stimulation or feeling but nothing happens. I also am experiencing sexual dysfunction with lack of sensation and extremely dulled orgasm. I just want to know if, once settled on 10-15mg, these effects are likely to subside with more time on the medication and if so, when can I expect to recover my affect and ability to enjoy things, and my sexual function as well? I've actually tried to come off antipsychotics since experiencing this very dulled constricted life, but have been advised by multiple doctors that I need to be on the medication for 1-2 years to prevent relapse. So I just want to know what my chances are at things turning around over time. In your experience, what have you seen that timeline to be like on this drug?
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2025-05-28T13:57:30
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1kxhro1
| 0 | 0 |
AskPsychiatry
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ADHD Medication Management
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My partner (M/diagnosed and medicated ADHD), continually struggles to manage his medication. I do believe this is both intentional and accidental at times but regardless, at the end of the month he is without medication for a period of time. The crashes are awful, so are the behavioral changes and erratic mood swings. He claims that “everyone” with ADHD experiences these crashes at the end of a medication month even when consistently medicated as prescribed, and that it’s not because he’s running out of medication early due to overuse and going cold turkey (even though those things are happening). Insurance will only cover the generic forms of short and long acting Adderall which he says doesn’t work as well so he will sometimes up to double his dosage in a day, which is 60mg. But even if insurance would cover something different, it’s not like it’s reliably obtainable.
Even typing that out sounds insane. I know he’s (at best) misusing his medication, but I still feel compelled to poll the audience. Does truly everyone with ADHD experience this same issue?
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2025-05-28T12:30:55
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1kxfusf
| 0 | 1 |
AskPsychiatry
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Does this sound bipolar?
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I’m wondering if hypomania can last for 15 months? During this time I felt confident, inspired and grounded and didn’t have any of the following:
- irritability
- impulsive spending/decisions I regretted
- I’ve never had a mood swing
- hypersexuality
My sleep cycle shifted for 6 months as I was getting up very early but also going to bed very early, so about 7 hrs sleep with no exception.
I have recurrent depressive episodes that last 6-10 months, not on medication. Stable otherwise with no mood swings.
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2025-05-28T18:25:39
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1kxoik0
| 0 | 0 |
AskPsychiatry
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Experiencing Sexual Health-related Symptoms During/Off Different Medications(s): Paroxetine, Venlafaxine, Buproprion, Adderall
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Hello r/askpsychiatry! This is my second time posting anything like this on Reddit. My first post was on r/antidepressants and their moderator suggested that I ask here. I wanted to share my experience, seek reassurance, and seek closure. I (29M) have been diagnosed with MDD, ADHD Inattentive-Type, PTSD, and OCD (Primary-O). Also, I'm sorry if this is in the wrong subreddit; I'll gladly move it if needed.
The first time I sought psychiatric treatment for MDD in 2018, my PCP prescribed me with four weeks-worth of Escitalopram (Lexapro). I initially experienced what I believed to be a placebo effect of the medication alleviating my MDD symptoms, but symptoms returned after three weeks. After ceasing the medication (I was not prescribed a refill), I experienced zero sexual side effects or withdrawal symptoms.
In 2023, I was on a 10mg, 2x daily dose of Adderall (not extended release) to treat ADHD. I believed it worked well, but I had to stop taking it due to issues with insurance lapsing (I moved out of network). During this time, I also didn't experience any side effects or withdrawal symptoms.
In 2024, I started Paroxetine for a few months after getting new insurance. My psychiatrist would not prescribe Adderall to me until my depressive symptoms were managed; so, I resigned to start Paroxetine. While my depressive symptoms improved, I noticed sexual side effects near-immediately; mainly delayed ejaculation and sexual anhedonia. I continued the medication for a few months before pleading with my psychiatrist to switch to something else. He prescribed me with 37.5mg of Venlafaxine; which, did not do much for my depressive symptoms and did not improve sexual dysfunction.
In November of 2024, I started taking Bupropion (Wellbutrin) 1x daily at 150mg. This medication was the \*best\* for treating my MDD and my sexual dysfunction disappeared; however, it did not help my ADHD symptoms. My psychiatrist cautioned starting amphetamine salts and bupropion concurrently due to increased risk of hypertensive crisis; but, we trialed it anyway at 10mg of Adderall XR, once daily. A few months into these two concurrent medications, my sexual side effects returned and I ended up experiencing stage 3 hypertensive crisis.
I'm now six and a half weeks off of both medications and my sexual dysfunction symptoms have persisted. I've been desperately searching and researching the mechanism for why I'm experiencing these symptoms; and, there aren't any websites that discuss sexual side effects of either/combined medications. No one who experiences sexual side effects as an alleged result of taking Wellbutrin have any answers.
My current PCP wagered that the domaminergic effects of bupropion and adderall have caused a temporary imbalance in my sympathetic nervous system; and, the system will need more time to self-correct. He explained that the issue was likely not cardiovascular in nature, but is related to the "switch over" from parasympathetic to sympathetic nervous system needed to achieve climax. Can someone "ELI5" this to me?
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2025-05-28T17:52:27
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1kxno5b
| 0 | 1 |
AskPsychiatry
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Asked ChatGPT to assess me for bipolar disorder. What do you think of the assessment?
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I used a custom GPT named Dr. Ernst Stern who is a GPT trained in psychiatry and also knows how to use sarcasm.
[Link to full chat with Dr. Ernst Stern](https://chatgpt.com/share/e/6837ad6d-b77c-8005-936a-8ca881fda2d1)
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2025-05-29T00:54:21
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1kxxqcw
| 0 | 0 |
AskPsychiatry
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Can clonazepam make you feel depressed and suicidal? Doctor says no but I feel awful every time I take it.
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First off, I'm not in danger. I have a great support system and my housemate is keeping a close eye on me until this gets resolved.
28F, 5'4, 120 lbs. Diagnoses: GAD, OCD, autism 1
I was prescribed clonazepam (0.5mg twice daily) for anxiety a few days ago. Every time I take it I'm fine for the first hour or so, then I start feeling hopeless and wishing I were dead. I cry at everything and sometimes at nothing. Over the next 5-6 hours I gradually return to my baseline (severely anxious but not depressed or suicidal).
As soon as I realized this only happens after I take the clonazepam I called my psychiatrist but she said it's not connected because I haven't been taking it long enough for it to cause emotional changes, and to continue taking it as prescribed. I have never in my life felt such depression though, and I skipped a dose yesterday and sure enough, no depression or mood swings, just my usual anxiety.
Is she right and I'm just imagining things or making a big deal out of nothing? I can't get in for another appointment until July.
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2025-05-28T01:57:10
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1kx58rt
| 0 | 0 |
AskPsychiatry
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How long does it take lithium to reach full therapeutic effect if I’m only taking 150mg/day?
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28F
I’ve struggled with sleep-onset insomnia most of my life, also have a rare sleep disorder that causes hypersomnia episodes, although it’s been in remission for years now. I started trying to tackle the insomnia this year but didn’t tolerate normal sleep drugs well. Belsomra almost induced an episode and the excessive daytime sleepiness effects persisted wayyyy beyond the point it should have been out of my system. Lithium worked for me during an episode in the past, and now I’m taking it to see if it helps regulate my sleep schedule, since it shouldn’t be contraindicated with that sleep disorder like other sleep drugs are. Bipolar disorder has been thoroughly ruled out 💀
I’m having trouble understanding if the time it takes to reach full therapeutic benefits is based on a person needing to build up to X “therapeutic” dose for X disorder (since no specific dose has been well-defined for my disorder), or if the 4-6 week rule applies to any dose, for my circumstance?
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2025-05-28T16:11:30
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1kxl455
| 0 | 0 |
AskPsychiatry
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alt paths besides psychiatry
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ok I'm lowk a lil desperate trying to find info so I'm not sure if this is the right place to ask but it's what I found. for some context I'm a senior in high school from toronto, and need to decide which uni program I'm accepting within the next 6 days. I'm torn between either doing eng or trying for med (with psych as my undergrad).
eng is secure and I wouldn't mind doing it, but med (psychiatry specifically) is what I wanna do and have a passion for, but obv comes with the risk of not getting in.
that risk is the only thing stopping me from committing to psych rn. I don't wanna do 4 years of uni and end up screwed if I don't get in. clinical psych programs here are even harder to get into than med school so I'll need alternatives besides those two. I'm open to psychotherapy but I'm not exactly sure what the job market for it is like here either.
I'm just looking for some advice for what I should do, cus I wanna try but don't wanna waste years and thousands for nothing. thanks
(also to all the psychiatrists or psychologists here, yall don't get the love and appreciation you guys deserve. you guys are unsung heroes for so many people, and I wish all of you the best. thank you)
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2025-05-28T12:03:58
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1kxfblb
| 0 | 0 |
AskPsychiatry
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58f, 195lbs, white, rx below. Schizoaffective-depressive type. Since 1994, well managed, I thought...
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Hi, the last year I've been struggling with a recurrence of depression that may have been triggered by my antidepressant pooping out. However it's under control now with 300 mg of Effexor, I'm also on 2 mg of Risperdal when I was originally hospitalized I was treated at the end of my Hospital stay with 4 mg of Risperdal and that was fine for a while until side effects interfered with my work and my clothing galactria and my medication was reduced to three and then 2 mg.
But I have had episodes of psychosis that I didn't recognize where psychotic episodes until a discussion with my psychiatrist who I reconnected with this fall, and her written diagnosis is that when I get overwhelmed I can become psychotic.
That manifests itself with just usually a bit of paranoia and disconnection from reality it can be a romantic preoccupation whatever it doesn't last for more than a few hours or a day. I'm not wandering the streets, I'm not afraid of being harmed, I'm not in need of hospitalization at those times I'm not having episodes like I was when I was first diagnosed with all this. The only time I hear voices is if I'm suicidal and I am straight to the psychiatrist when that happens.
I am currently on disability insurance because the last year has been very emotionally challenging and I lost a lot of my ability to self manage my life affairs. So I'm broke and living on disability income. I would like to return to work I worked for 20 years in corporate jobs at a senior level at the end and I performed very well although I didn't always fit in. Is there any recommendation that anyone here can think of that I could take up with my psychiatrist that might make my life less unstable or make me less prone to psychosis the day-to-day functioning of the world? Thanks for any help
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2025-05-28T15:35:44
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1kxk7e3
| 0 | 0 |
AskPsychiatry
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F23 looking for help with akathisia
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I received IV compazine on the 14th and I'm still having Akathisia symptoms two weeks later. I'm on metoprolol succinate 50 mg daily but I'm not sure if that's helping (I went on that instead of propanolol bc it helped more with heart palpitations and didn't make me as nauseous), Ativan 0.5 mg as a rescue med in case I have a bout of akathisia (but I'm really trying to switch away), trying cogentin 0.5-1 mg as a rescue med but it doesn't seem that effective if at all, just started mirtazapine 3.75 mg before bed at night, and I take 400 mg magnesium glycinate along with 200 mg B6 daily (been about a week Id say?). But I still have bad bouts of akathisia/pacing. I'm not sure what to do, and if it gets bad, idk whether to go to a regular ER or the psych ER. Other daily meds I'm on are lamictal 15 mg daily (I'm at this dose bc I was unable to taper off), Vitamin D/omega 3 daily, famotidine 40 mg before bed (for GERD), Carafate 10 mL 4x a day (for gerd/nausea, but I've been skipping doses if I need to take another med), Zofran as needed for nausea, NAC 600 mg before bed for phlegm, and Flonase max dose before bed for congestion. I take ferrous sulfate 65 mg 3x a week and B12 cyano 1000 mg 1x a week. As needed meds: Tylenol, Hilma upset stomach, Xlear, Aleve, Bentyl, TUMS. Going to get on Nurtec ODT soon for a bad migraine. I know I shouldn't be on Ativan too long so what should I do? I was hoping for the ability to use a rescue med while waiting for other meds to kick in but idk if Ativan might actually be making things worse. What rescue med can I use? Also where should I be going if the akathisia gets bad (regular ER or psych)? also should I be trying to switch from metoprolol to propanolol (after trying out mirtazapine)? The reason I shouldn't just pace for hours is bc I have chronic leg pain and need to rest my leg, and I probably need to get rest due to my fatigue.
Pre-existing conditions
* mostly bedbound from fatigue (maybe due to my diagnosis of POTS)
* bad nausea partially due to GERD
* bad phlegm sometimes depending on what I eat (LPR?)
* bad nasal congestion
* chronic widespread pain (nociplastic probably)
* Sometimes have depression/anxiety
Description of akathisia: at its worst I feel terror/very high anxiety if I'm not able to move. Otherwise I can just pace and pace for hours if I don't have a rescue med. Sometimes I fidget a lot or just have to sit up and can't lie down (normally I lie down most of the day due to severe fatigue). Usually it starts off as a little restlessness and then grows slowly into pacing. My legs and feet are where I feel restlessness/need to fidget. Unsure if akathisia may have evolved into something else. Since the akathisia started I have been very anxious but I wouldn't say the bouts of pacing feel like they're due to anxiety.
Demographics:
F23, Asian, 5’4”, 120 lbs, having akathisia almost 2 weeks
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2025-05-28T14:19:11
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1kxiakf
| 0 | 0 |
AskPsychiatry
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Clinician & lived experience input wanted for new brain-based addiction recovery tool (10-min survey)
|
Hi all — I’m part of a small team working on a new recovery-focused project supported by the NIH and FDA. We’re developing a brain-based tool that uses EEG (brainwaves) to measure how someone’s brain reacts to recovery-relevant cues (e.g., images related to drug use or healthy alternatives). Eventually, the goal is to use this data to better understand craving risk and even help reduce reactivity in real time with neurofeedback.
Right now, we’re looking for feedback from people who either (1) work in addiction treatment (MAT, IOP, counseling, etc.), **or** (2) have lived experience with recovery. If you fall into either group and are willing to take 10 minutes to share your perspective, we’d be incredibly grateful.
Here’s the survey link:
👉 [**https://forms.gle/mxcSCKKHoKLzthtY7**](https://forms.gle/mxcSCKKHoKLzthtY7)
As a thank-you, we’re offering the option to enter a drawing for a $50 gift card **or** have it donated to a recovery-focused nonprofit.
Everything is anonymous, and we’re just trying to build something that actually fits into real-world recovery and care settings. Thanks in advance for helping us shape this.
(Mods: if this isn't appropriate, feel free to remove — just hoping to get honest feedback from folks who know this space firsthand.)
Thanks in advance!
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2025-05-28T14:08:51
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1kxi1n8
| 0 | 0 |
AskPsychiatry
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Night Shifts - Paranoid Schizophrenia
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Hello. Male 28 diagnosed with paranoid schizophrenia at 25. I'm on Xeplion 100mg and Reagila 1.5 mg for my negative symtoms. I have a degree in care assistant and, because of Xeplion, I cant wake up at 7am in the morning so I was wondering if I can work in night shifts. What do you think? It's possible? My symtoms are minimal (no positive only a little alogia). Thanks !
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2025-05-28T13:22:35
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1kxgytz
| 0 | 0 |
AskPsychiatry
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I love to appear competent - instead of being competent
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I've had this internal feeling ever since I started having memories. I could never put it into words, I've tried googling it, tried talking about it to my friends but found nothing. I just always enjoyed looking like I was busy doing various things or pretending something was more difficult than it actually was.
Examples: pretending to think hard during exams or writing something down even though I knew it won't do anything for the actual test score, stalling something (i.e. tying my shoes for much longer in certain situations, preparing a drink for somebody, doing techy stuff, fixing simple things), going to a store for an item I don't need just so I can tell somebody I'm out busy shopping, making superficial plans I know I won't execute later, investing a lot of time into learning something while having the knowledge I'm not learning much, just convincing myself that I am working hard.
For some reason I REALLY LOVE having some superficial knowledge about a subject, then talking about it with others, it makes me feel like I'm a real person in a way. Cars are a good example of this, I "know" some basics, I know some buzzwords and I'm able to have a car convo with somebody who knows a lot more than me. In truth I don't care about cars or engineering and I don't think I'll ever put much time to learn more about them.
I pretty much hate learning things - learning something in depth just seems like a payoff for my time, effort and energy spent on it, which doesn't feel like a reward at all, it feels like a transaction, which in turn makes very few things in life feel "worth it". I really hate putting in effort into things that I don't wholeheartedly enjoy - which is nearly everything.
I don't really get the sense of satisfaction of doing something right when I have a real knowledge on the subject. I'd rather luck out and get a C on a test I didn't study for much than get an A+ after studying a lot.
What is this phenomenon? It's been with me my whole life, it's the first time I somewhat accurately managed to put it into words and I want to fix myself. In 3 days I will be 24 with very little to show for it. I want to learn. I want to enjoy learning things, I want to feel satisfaction from evolving. I just don't know if I'll ever be capable of it. Please, help me out here.
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2025-05-28T13:15:18
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1kxgsvc
| 0 | 0 |
AskPsychiatry
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If you were aware that a patient had a history of substance use disorder, alcohol, illegal stimulants, and opioid narcotics beginning with prescription progressing to street fentanyl, would it seem reasonable to prescribe 90mg of Vyvanse for concurrent Type C ADHD?
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My partner recently passed away from complications associated with substance use disorder. He had a history of opioid addiction but after 10 years of being on methadone and and fentanyl relapse mixed with methamphetamine he made it back to recovery and got off methadone - no more opioid antagonist therapy (OATs).
He was clean for a year and a few months before he relapsed by abusing the Vyvanse he was prescribed. He had been diagnosed with Type C ADHD at the age of 20, but treatment of the substance use disorder was prioritized due to relapses. Whenever he got clean, the addiction doctors that oversaw him for continuous periods throughout his life never revisited the Vyvanse or suggested an alternative- perhaps there wasn't one for many years.
At his last treatment stay, after doing some research and discussion within the recovery community, he admitted to me that in the past he had abused his Vyvanse medication and that was a starting point for relapse. Consequently, he made it a goal to transition off of Vyvanse towards a non-stimulant medication so that he would not longer have access to it.
His last relapse was not the fault of any doctor or specialist he saw, but given the potential for abuse and the lows to which his addiction had progressed in the past (residing on the Downtown Eastside of Vancouver, BC Canada at one point and nearly dying from fatal overdoses and other health complications) - does it seem reasonable that any addictions doctor or psychiatrist would leave the 90mg of Vyvanse daily unquestioned?
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2025-05-28T06:45:00
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1kxad31
| 0 | 1 |
AskPsychiatry
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Would increased dose of Vyvanse make me less tired or more?
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I switched to Vyvanse over a month ago after being on Strattera for ~4 months with partial effect. They both helped in numerous ways for my ADHD but I noticed they both slowed my thoughts to the point it makes me feel tired.
I am sleeping a lot better than pre medicated me so it isn't from a lack of sleep. My diet has also improved so I don't think it is a nutrient problem either.
I would like to stay on the lowest dose possible so if an increased dose would make it worse or not help I'd rather stay on the dose I am.
(Currently on 30 mg and do not take any other psychiatric meds)
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2025-05-28T11:40:54
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1kxevse
| 0 | 1 |
AskPsychiatry
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Study of ADHD and Anorexia Nervosa (including stimulant medication use)
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Hi everyone, I hope this is appropriate for this subreddit. I am studying Eating Disorders and Clinical Nutrition at UCL. This study is looking for those who have a lived experience of AN and ADHD as well as usage of stimulant medication. If you or anyone you know fits the criteria and feels comfortable answering a 10-15 minute survey on these topics please take the time to answer or share this survey. If you have any questions please direct them to [[email protected]](mailto:[email protected]) . Thank you in advance.
Criteria:
\- 18+
\- previously diagnosed with ADHD
\- previously admitted to hospital for Anorexia Nervosa
\- have used stimulant medication for the treatment of ADHD
Project ID: 498
Project approved in line with UCL ethics committee
Link: [https://forms.gle/dUZ8KEDbSSHtxjXD7](https://forms.gle/dUZ8KEDbSSHtxjXD7)
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2025-05-28T11:22:04
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1kxejjs
| 0 | 1 |
AskPsychiatry
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Are psychiatrists the ones who assess for autism?
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I’m presently being treated for schizophreniform disorder but a therapist in my past had recommended I be assessed for autism. I know my current issues are more pressing, but if I wanted to be assessed, would this be something I bring up to my psychiatrist or would I ask for a referral to a psychologist from my PCP?
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2025-05-28T09:27:16
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1kxcqia
| 0 | 0 |
AskPsychiatry
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Risk of heavy AP combination
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Diagnosed with resistant paranoid schizophrenia. I have been off meds for some period of time but might be back on my old combination soon. Only three combinations worked for me, Haldol in a huge doses, Clozapine 400 mg, or Haldol + Clozapine in average doses both. I wonder which combination is the safest in terms of side effects. Haldol monotherapy was the most bearable but I worry about TD
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2025-05-28T09:14:34
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1kxcjqd
| 0 | 0 |
AskPsychiatry
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debilitating concentration issue
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I made a post before here, but couldn't explain myself in clear words, I have searched in the DSM and scratched the internet to find someone who could relate to my problem i found almost nothing, I am making this post to ask where can i find all the mental issues related to concentration, like adhd, brain fog, these are the usual that i find everywhere, can you please tell me where should i look for to find something i can relate with, maybe some sort of pdf or any website where people share some concentration related issues,
My mental issue (don't give it much thought its way to complex to explain here, i'm just trying to give an idea):-
I have an intrusive contentless thought each time i try to concentrate on something which hinders my concentration abilities and very frequently for the past 6 months i have days where i get so utterly hopeless that i can't pick up a pen, thinking that my issues will never be resolved
I'm on no meds, i have no signs of adhd, no smoking or any drug consumption, I'm 5'10 18 y/o from india.
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2025-05-28T05:25:59
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1kx94m7
| 0 | 1 |
AskPsychiatry
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Question for Canadian Psychiatrists
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Hi! I am a US trained psychiatrist with dual citizenship, pursuing Ontario license via Pathway A. We are planning to move to Canada (looking at Ottawa). While looking for jobs its difficult to get a sense of salary/reimbursement, particularly whether moving and setting up a private practice vs. looking for an employed position through a health care system makes more sense financially. In my career I have worked in a variety of settings (inpatient, ED, outpatient) but these have all been employed positions, I have not managed my own practice.
Can the Canadian psychiatrists (bonus for Ontario!) provide a sense of the salary ranges, what the work hours are like in different settings, how complicated starting a practice is, etc? Thanks!!
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2025-05-28T09:06:25
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1kxcfg1
| 0 | 0 |
AskPsychiatry
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Halcion & Klonopin
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Age: 26
Gender: Female
Race: Caucasian
Weight: 165lbs
Diagnoses: hypothyroidism, type 1 diabetes, OCD, panic disorder, anxiety, IBS
Medications: Synthroid (137mg), Novolog (via insulin pump), Klonopin .5mg (as needed), sertaline (200mg), Zofran 4mg (as needed), grape seed extract pills (unsure of mg), and a big fan of Pepto and Gas-X <3
As you may see above, I have a pretty severe anxiety/ panic disorder. I’ve been on sertaline for 13+ years (my doctors and I have tried everything including trying to switch me to something else, coming off, add other medicine, etc.). I take klonopin as needed- maybe 1-2 pills a week at my worst (sometimes I go months without it, but these past two months have been ROUGH).
I had a scaaaary dental procedure today. My dentist prescribed my Halcion (.125mg) for it. I took that at 1:50pm. It’s now 2:03am but I’m wondering when it’s safe to take Klonopin (.5mg) again?? I’m terrified of feeling “high” or out of it. I should add, the Halcion did NOTHING to me. Not even a dent out of my anxiety. I was so fine on it I could stand on one leg while closing my eyes, hold full conversations, bite my dentist (lol), etc.
My pharmacist told me they’re fine to take 8 hours apart but that seems WAY too close together. Like I said, I have crippling anxiety and everything is scary. My new psychiatrist is impossible to reach. I can’t reach him by telephone and can only contact him through the patient portal which he takes days to respond to lol.
TLDR; took Halcion .125mg at 1:40pm and wondering what time I can take klonopin .5mg without them interacting
❤️❤️ tyia
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2025-05-28T06:09:42
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1kx9u4g
| 0 | 0 |
AskPsychiatry
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Benzos had no effect on my anxiety
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I understand that this class of medicine is supposed to be highly effective in immediately treating anxiety/panic attacks. However, I've tried Clonazepam up to 1.5 mg, and it had absolutely no impact on me. I conjecture my anxiety might be so severe in nature that it overrides any sort of sedative effect produced by the Benzo.
Has this occurred to anyone else? How did you navigate this situation? Any other medications that worked?
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2025-05-27T20:39:55
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1kwy6qb
| 0 | 0 |
AskPsychiatry
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Magic mushroom theory
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Hopefully i can get some good feedback or response for this. In 2021 I ingested 3.5gs of psilocybin the day after doing something that i regret doing. Mind you i ate these mushrooms for breakfast on an empty stomach. Prior to this date, ive never had panic attacks or major anxiety attacks. After taking these mushrooms I immediately went into a bad trip and had panic attacks and anxiety attacks for days, weeks, months. So after some time i couldnt manage the symptoms i was having, after months and months hoping they would subside. I ended up getting on prozac and about 2 weeks later i had to go voluntarily admitting myself to an inpatient psych facility. The prozac took away my appetite, increased anxiety and panic, major intrusive thoughts and feelings of SI. Since then ive been on many different psychiatric medications, ssri’s, snris, antipsychotics. Only thing that seemed to help were benzos which i happen to have an addiction to so i wont be taking any of those. Any way, my theory is that this singular mushroom trip messed me up for years. I still suffer from anxiety, panic, ocd, ptsd, depression, and adhd. Ive abused cannabis, and benzos since i was about 14 years old, i am 25 now. Im currently on lamictal 100mg and quentipine 75mg clonidine as needed at night. I feel the lamictal does not treat the symptoms im currently having such as major anxiety, intrusive thoughts, and depression. I feel my next bet is to try another ssri such as sirtraline. Is it possible that taking those mushrooms could have messed me up permanently? Feel free to ask me any questions. I am very grateful for any response or advice.
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2025-05-28T00:25:16
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1kx3dtz
| 0 | 1 |
AskPsychiatry
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Is abnormal crying a sign of impending psychosis?
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I’m trying to figure out if I’m headed for a bad thing or not. SZA bipolar
I’ve been off an effective antipsychotic since January. Had a mood episode that almost killed me. Ended up on another antipsychotic but it’s not effective and I’ve now lowered it.
My fairly all-encompassing “quasi-psychotic” or even technically psychosis symptoms have come back, and I currently walk for hours in the middle of the night to engage in delusional thinking.
I began to laugh excessively a few days ago at seemingly nothing.
Yesterday I began to cry, which is extremely rare for me.
Today I began to cry a ton while watching Instagram reels.
My face feels like it’s getting more blunted. Also the tone is my hands went weird yesterday and still is weird.
Can abnormal crying be a symptoms of psychosis to come? Idk why it’s happening as I really feel nothing.
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2025-05-27T23:24:12
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1kx236c
| 0 | 0 |
AskPsychiatry
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long term effects of antipsychotics starting at puberty? - metabolism/physical symptoms
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i came on here because after 8 years of being on antipsychotics from 14-21 years old, with help from my psychiatrist i was able to stop taking the medications. long story short i never needed them in the first place and was misdiagnosed with bipolar, i am instead autistic. it has been 3 months off of antipsychotics and from the past 4 years i gained 50 pounds.
My weight has always fluctuated throughout this, and I am fearful that because i started serious drugs during my puberty, i will have an extremely hard time losing weight. the plus side of stopping my medications (with doctors assistance) i have lost 10 pounds in roughly a month and lost a significant amount of bloating. however i reached a plateau. some troubles i have are eating cues, i am never hungry, any type of food upsets my stomach no matter what it is, i get nausea from eating too much or little, constipation/diarrhea,physically weak. mentally, i am doing great, clear minded no mania or depression, suicidal ideation, or paranoia. a lot of the bipolar like symptoms i had when i was on these medications i know now was due to long term use of antipsychotics when i never needed them.
with all this said, i have tried to research how to fix my metabolism and overall body, but it is extremely hard to come across articles that show the long term effects of antipsychotics especially at a young age. i will stay that at one point i was producing prolactin frequently from my breasts, and heavier periods, which may have something to do with my hormonal balance?
i have been completely left in the dark about the true impacts of antipsychotics and antidepressants in terms of side effects and how long it will affect me. i have seen various things that it may take a couple months to years to fully recover.
honestly i am completely lost on what to do and i would deeply appreciate it if someone could help me navigate this.
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2025-05-27T17:55:38
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1kwtz57
| 0 | 0 |
AskPsychiatry
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Is there a psychiatry basics course/certificate for non-Medical professionals?
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I work as a lawyer with primarily low/no-income clients, and I frequently deal with potential clients who seem to be experiencing delusions and paranoia, if not full-blown psychosis. After a few years in this job, I’ve become incredibly interested in psychiatry. I wish it was possible to just shadow a psychiatrist for a week or two and learn more!
As one of the benefits of my job, I get $1000 towards professional development, and I’d like to put this towards learning more psych basics if possible. Is there such thing as a certificate course, or training for non-Medical professionals? Major caveats that I know I’d obviously never be able to diagnose someone or practice, and I’m also not interested in any kind of career change. Just looking to learn more.
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2025-05-27T17:52:15
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1kwtvwh
| 0 | 0 |
AskPsychiatry
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Haphazard Lexapro usage and surge in VERY uncharacteristically impulsive behaviors - is there a possible link?
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My teen son has been prescribed 15mg of lexapro for about 8-9 months. For the first 6-7 months he took it daily as prescribed as I was able to set it out for him each morning. It seemed to be doing what it was meant to. The past 2 months his adherence to the prescription is haphazard at best. He wakes up for school after both parents are gone to work for the day, so he began missing doses consistently. For context, he should have ran out of his prescription at the beginning of April, but here at the end of May he’s just now starting his last refill. He will take them for a handful of days then forget for many days in a row again.
The past 3-4 weeks there has been a HUGE surge in impulsive, poorly considered behaviors from him. His previous doctor suspected a potential bipolar diagnosis - mom is bipolar - but after being stable on 15mg for a couple of months they ruled out the suspicion.
My question: can haphazard usage of an SSRI cause an uptick in impulsive behaviors?
He is diagnosed adhd but not medicated - however he has not had the same type of impulsive behaviors before. We’re trying to understand how he could all of a sudden be behaving in very out of character ways, before simply assuming these are intentional choices.
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2025-05-27T22:47:39
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1kx1ahd
| 0 | 1 |
AskPsychiatry
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Can a psychiatrists "Ghost" you over a bill and cut off medication?
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That happened to me recently. I owed $60. I have been out of work for a while *because* of the issues I have been in therapy for. I was on several things, one of which has horrible side-effects coming off of it (Caplyta). I had to get a refill and the pharmacy said they contacted him several times and he wasn't returning calls. So I reached out to him a few times and left message and h just ghosted me.
Right now I am not on anything because he didn't authorize the refills. I was not in a good place coming off the stuff, but I mean that passes, but now I'm back to where I was before I started down this path again last year, unmedicated, and all of my symptoms are back. It just doesn't seem ethical to ghost a patient.
I looked up his reviews after it happened, and I found something I didn't notice before: they're all the same wording. It looks like he had someone post them for him. This has never happened to me before. Even if I had a past-due bill I could always get refills, and there was a line of communication. It's not like it had been a long time, it was overdue like two weeks. I was going to pay it, but ten he jus cut off all communication with me.
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2025-05-27T16:24:45
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1kwrmju
| 0 | 0 |
AskPsychiatry
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What to do about side effects? Drop, Add, or Switch?
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21M 6"1 270lbs
Psych Diagnoses: MDD with psychosis, ASD, Nicotine Addiction
Medical Diagnoses: OSA, RLS, IBS-C, Chronic Migraine with Aura, Hypothyroidism
Meds: Clomipramine 150mg qd, Risperidone 2mg qd, Lithium 450mg ER bid, Methylphenidate 36mg ER qd, Levothyroxine 25mcg qd, Candesartan 4mg bid, Linzess 145mcg qd, Emgality 120mg qmo, Botox IM 115u 31 sites q3mo, Ferrous Sulfate 325mg qd, Vitamin D 25mcg qd, Melatonin 10mg qhs, Diclofenac Sodium 75mg prn, Promethazine 25mg prn
So, I'm on a lot of medication, not all of it for psych reasons, but the good thing has been that most of my diagnosed medical issues are under control right now so most of the drugs are needed and warranted as far as I know. However, in the process of trying to get my psychotic depression under control, I've ended up on some pretty sedating meds that also cause weight gain, and I'm trying to figure out how to minimize it without worsening depression or bringing back psychosis.
The depression part of it is still a work in progress, but the addition and increase of clomipramine has started to finally help and while I don't know how it works for depression, the lithium at least keeps me from feeling suicidal or thinking about self harm. The risperidone hasn't done much at all for depression, but it put down my last psychotic episode and I haven't had any of those symptoms since. The methylphenidate at this point is purely to combat the sedation, and I was on 12.5mg qwk injections of Zepound, but I had to stop recently since I'm going to be getting ECT soon. Therefore, I'm expecting to start gaining even more weight without it, and the past few days my appetite has slowly grown larger as the Zepbound leaves my system.
So there are a few ways I could imagine tackling the issue of side effects, I could drop something, although lithium and risperidone might be hard to go without since they've gotten rid of my psychosis and suicidal ideation, and clomipramine is the first thing to help my depression in years so that can't really go anywhere except up with that. I could ask to switch antipsychotics, but I'm not sure what to, since Vraylar didn't work this last psychotic episode and I don't want to get on a second anticholinergic. lurasidone, aripiprazole, or Cobenfy come to mind, and Cobenfy especially sounds appealing since from what I know it doesn't cause weight gain or sedation, but I'm not sure if it would pass the PA with insurance since I don't have schizophrenia. I could always just ask to increase the methylphenidate and get the Zepbound up to max once ECT is over, but I feel like it would be better to first try reducing it through switching medication.
Any advice or ideas would be appreciated, I have a psychiatrist appointment soon where I'll talk with him about all this, but I thought it would be beneficial to get some varied ideas and takes going into it.
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2025-05-27T17:27:40
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1kwt98b
| 0 | 0 |
AskPsychiatry
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Why is it so hard to find one of you people?
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I’ve been trying for years (albeit on and off) to find a psychiatrist and psychologist. But it always boils down to these issues…
- they don’t take my insurance
- they take my insurance, but they’re not accepting new patients and they don’t know when they will be
- they are taking new patients but they only accept out of pocket payments and I can’t afford the payments
I stopped looking after my insurance begged my last psychiatrist to see me (my psych literally told me this) even though they stated they technically weren’t taking new patients either and stuck with them for a year even though they technically weren’t doing things by the book. Recently, I made the decision to drop them because on top of other things they were inconsistent and impossible to reach, by phone and in person.
Is there a reason why so many aren’t taking my insurance, as well as a reason why they aren’t taking new patients, that anyone knows of?
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2025-05-27T02:32:14
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1kwcdjw
| 0 | 0 |
AskPsychiatry
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Too fast of a med increase?
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I recently started lamictal almost a month ago. I originally was only on 25mg of Zoloft. My psychiatrist upped that to 50mg. Then she had me start Lamictal 25mg for 2 weeks. Then increase to 50mg. Buspar 10mg for 2 weeks, then increase to 20mg.
After 2 weeks she then increased my Zoloft to 100mg. And 100mg of lamictal for 2 weeks then 200mg. I start 200mg tomorrow.
I’ve been having headaches, severe fatigue and night sweats. I’m worried this was too fast of an increase?
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2025-05-27T14:49:17
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1kwp6np
| 0 | 0 |
AskPsychiatry
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Can people drive a car while taking olanzapini or trileptal?
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I am on there meds for 8 month now , and planing to go to driving school starting from next week. Will I pass med check? Is it risky to drive a car?
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2025-05-27T13:27:38
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1kwn932
| 0 | 0 |
AskPsychiatry
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Does SSRI efficacy support their prescription?
|
28M Dx with Recurrent MDD and Social Anxiety Disorder. I'm dealing with a depressive episode thats lasted the better part of a year now. I wanted to try antidepressants because i figured i didnt have much to lose. Therapy is unfortunately not an option due to finance and lack of insurance. What is the consensus on the effectiveness of SSRIs? I've always been skeptical of psych meds and the studies I've looked at have honestly not been comforting but i know that they are still generally considered the first line of treatment. I come away understanding that there is hardly any statistically significant therapeutic effect compared to placebo. Hoping someone in the field can maybe help me understand why it might be worth trying them or what im missimg in my understanding at least.
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2025-05-27T13:24:40
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1kwn6o6
| 0 | 0 |
AskPsychiatry
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Can early childhood trauma have a strong impact on mental health later in life?
|
Hi, I'm 24 (M) and I'm trying to understand myself better and would love to hear your thoughts or experiences. I was born prematurely and had a medical condition (gastroschisis), which required surgery right after birth. I spent the first six months of my life in a hospital and also experienced a brain hemorrhage that likely caused blindness in one eye.
Although I don't remember any of this consciously, I’ve struggled my whole life with intense emotional dysregulation, extreme sensitivity to stress, and frequent mental shutdowns in group situations (school, work, social events). I often feel mentally foggy or dissociated in these contexts, even though I can perform well when learning or working alone.
I am so terrified of going to work that I even went to university that I didn't care at all.
I also tend to internalize failure quickly and feel like I’m not good enough or not capable — even when evidence suggests otherwise. I also strongly feel that I have low intelligence.
Could this be connected to early developmental trauma, even if my childhood after the hospital was relatively “normal”? Could it just be my character?
I went to some therapists and they didn't find it particularly important. They preffered to constantly suggest that I'm autistic or have ADHD even though it's totally not true.
PS. I was not diagnosed with such trauma. My friend suggested it to me and he finds that it's obvious I suffer from such trauma. I didn't even know that there's something like this.
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2025-05-27T11:33:28
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1kwky46
| 0 | 1 |
AskPsychiatry
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Am I on the wrong Bipolar med, unchecked ADHD or something else?
|
I will be asking my psych all of this at my next appointment. For some context, I 34F have been diagnosed with Bipolar and I’m currently taking 10mg Abilify for it. I am just coming out of what I suspect was a 2 month long (hypo)manic episode and called out of work last week for depressive symptoms. I feel a bit better today however these are my concerns:
Though down, I still struggle with feelings of boredom. I cannot tolerate boredom in fact, I left work early because it was slow. I got tired of pacing around for 5 hours and taking multiple vape breaks. I was fine at work when I had busy work to do however I don’t find my work mentally stimulating at all, hence, I’m bored and seek to cause chaos.
Last week what I think triggered the downfall was this: I impulsively spent money on a DNA test kit when I don’t have that much money to begin with. Realizing my mistake and that I needed the money to get my sewing machine fixed, I got angry at myself and channeled that anger into attacking people online. I wanted to start some chaos. I know it was wrong of me.
I also have a history of leaving jobs, getting in fights with my fiancé, reckless spending, vaping too much, etc. What could be going on?
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2025-05-27T09:09:43
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1kwiod8
| 0 | 1 |
AskPsychiatry
|
Gabergics for autism
|
So many studies suggest low GABA in often present in autism and yet treatments seem to more often than not aimed at treating the symptoms and not the root cause. Stimulants, clonidine, respiradone, amtriptyline etc are often prescribed as a first line (or in our case at least), but why don't they prescribe GABA agonists or gabergic type medications?
Needless to say, nothing is helping my 8 year old son and he's suffering as much as we are.
Has anyone been down the path of honing in on the gaba pathway? How has it gone?
We get shot down for even bringing up supplements with our psychiatrist and so he's not taking any.
We're really hurting here!
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2025-05-27T08:35:33
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1kwi6xp
| 0 | 0 |
AskPsychiatry
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Gabergics for autism
|
So many studies suggest low GABA in often present in autism and yet treatments seem to more often than not aimed at treating the symptoms and not the root cause. Stimulants, clonidine, respiradone, amtriptyline etc are often prescribed as a first line (or in our case at least), but why don't they prescribe GABA agonists or gabergic type medications?
Needless to say, nothing is helping my 8 year old son and he's suffering as much as we are.
Has anyone been down the path of honing in on the gaba pathway? How has it gone?
We get shot down for even bringing up supplements with our psychiatrist and so he's not taking any.
We're really hurting here!
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2025-05-27T08:35:25
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1kwi6vh
| 0 | 0 |
AskPsychiatry
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A question regarding whether my experiences may indicate OCD.
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I wanted to share something regarding negative thoughts I’ve had about my family, and the urge to perform compulsive behaviors to "prevent" something bad from happening.
I’m wondering whether what I’m experiencing might be a sign of OCD (it's not intended to diagnose OCD, I just would love to hear your opinion about it). If you have time to read this paragraph, I would really appreciate it.
The paragraph may be a little too long, I hope that’s okay.
When I first experienced these thoughts, an intrusive thought came to my mind where I would pray—while crying—where I said, “God, may my whole family go to hell.” I didn’t intend to think this and immediately wondered why it happened. I felt an urge to perform a compulsive behavior to “prevent” my family from actually going to hell, as if I were responsible for the thought. I also felt anxiety at the time.
To clarify, when I say “hell,” I don’t mean it in a religious sense (like Islamic or Christian hell), but more as a general concept of "hell". That might be part of why I feel uncertain whether this is truly OCD, since most religious OCD examples I’ve found online are tied to specific religious contexts.
The first time I tried to do a compulsive behavior, I didn’t do it right away. I first felt the need to arrange objects in my room—like placing my phone above a pen on my desk—until the environment felt “right" and many more. Then I’d sit on my bed, remove my right sock, place it next to me and begin slowly putting it back on. While putting my right sock back on, I would imagine myself praying (eyes open), crying, and mentally saying, “God, may my whole family go to hell.” But I’d deliberately stop just before finishing the sentence—e.g., “God, may my whole family go to…”—and immediately “repent” the situation in my mind. The whole imagined process had to occur during the act of putting the sock back on—not before or after. When the sock was fully back on and analyzing the compulsive behaviour and I felt an internal sense of “rightness,” the compulsion felt complete—but that sense rarely came, so I’d repeat the process many times.
Now, the important thing to note here is that the compulsion I had been doing up until this point was straightforward and not rule-based or systematic. Since I already knew the content of the compulsion—what exactly I needed to do—I would simply sit on my bed, imagine it, and carry it out directly, without defining any rules beforehand or creating a structured process around it.
Eventually, since the compulsion wasn’t making me feel better, I decided to switch to a more systematic and rule-based version. The idea was that if I defined rules in advance, I might have more control over the process and feel more certain about the outcome—i.e., that my family wouldn’t go to hell.
Before starting this new compulsion, I’d again arrange objects, then mentally declare something like: “Today, in this room, I will perform a systematic and rule-based compulsion where I will be able to declare and initiate rules for the systematic and rule-based compulsion.” Examples included:
“No matter how illogical the rules are, I’m allowed to set them.”
“This compulsion will become invalid and disappear after it’s completed.”
“After this, I will never again be able to do this compulsion, anywhere.”
And many more.
After defining the rules, I’d do the same sock ritual as before. Once finished, I’d break a pen and throw it away, saying things like, “This system no longer exists, it’s invalid.” and "after i throw this pen in the trash, the rules that i determined will be activated" This symbolized closure. I’d then mentally review everything to ensure nothing was missed. If I noticed flaws—like missing rules—I’d feel the need to repeat the whole process, this time correcting the flaws and adding the missing rules.
When I felt I finally got it “right", it gave me a strong sense of completeness for a few weeks and I would just barely analyze the systematic and rule-based compulsion in my mind.
Then new intrusive thoughts appeared:
“You never defined who the compulsion was for.”
“You didn’t say how long they’d stay in hell if it failed.”
“Maybe the system could act on its own or let someone go to hell you never intended to do.” (so i felt the need to add a rule clearly stating that the system can never act on its own, can never make or change rules by itself, and can never go beyond the specific rules I originally set.)
Since then, I haven’t felt the same intense anxiety as before, but I do feel some incompleteness inside me. My mind keeps returning to the rule-based compulsion, wondering if it might still somehow have an effect. I feel guilty and responsible for the “system” I created, and feel the urge to redo it—even though I don’t want to—out of fear something might go wrong if I don’t.
The thing is that my mind is no longer focused on the initial, non-rule-based compulsion I used to do, although I never did "complete" it as it should be. Now, it’s entirely focused on the system and rules-based compulsion. Because it feels much more structured and I’ve defined specific rules for it, it gives me a stronger sense of responsibility and the need to stay in control of it.
My question would be that, based on what I have told so far, could this maybe align with OCD?
I’m just curious about this and would love to hear your thoughts, if possible.
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2025-05-27T07:24:50
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1kwh788
| 0 | 0 |
AskPsychiatry
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Why do I have psychotherapy with medication management?
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My new psych provider gives me hour long appointments with psychtherapy included. Before with this health system, it was just 30 minutes I think and only discussion about medication. Is there reasons why that change may have happened? I know I could ask her and I will, but until then, just wondering what the answer might be.
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2025-05-27T00:13:43
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1kw9omd
| 0 | 0 |
AskPsychiatry
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What happens if I just stop seeing my Psychiatrist?
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So basically, I feel like my psychiatrist has misdiagnosed me. They basically carried over a diagnosis of bipolar from another doctor at the same office that was not thoroughly evaluated in the first place. My symptoms are much more consistent with. The bipolar medications they prescribed are not very helpful.The diagnosis has been having big impacts on my career (military).
What would happen if I just stopped seeing my psychiatrist? What happens with my diagnosis and my medication? would like to see a different one and start from scratch but I have a really hard time telling my psychiatrist this because our conversations are short and he keeps saving that
"eventually the medication will work properly." Any information would be greatly appreciated.
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2025-05-27T03:26:22
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1kwddqf
| 0 | 0 |
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Self-diagnosis of Mental Disorders.
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*Not seeking medical advice—just curious about professional perspectives!*
I’ve been reading more into the literature on self-diagnosis via social media, specifically mental health diagnoses, and as someone who used to think it was entirely harmful, I’ve come to believe it’s not as bad as it seems. I’m not talking about people who fake symptoms for attention, but rather those who genuinely believe they’re experiencing something and are trying to make sense of it - often through online communities.
I get that self-diagnosis can be risky. It can lead to misunderstanding disorders, over-pathologizing normal emotions, or missing co-occurring conditions. There’s evidence to suggest social media makes this worse - oversimplified content can increase anxiety, may delay professional help, and spread unverified information.
But I also think there are valid reasons why people turn to self-diagnosis of mental disorders, especially when access to care is limited. Here are a few reasons I think it can be helpful:
• Those with barriers to healthcare, such as time, money, or mistrust, can find support in online communities
• For some young people, self-diagnosis is part of exploring their identity - like fashion, hair, or music preferences
• Underdiagnosed conditions (like PCOS or bipolar disorder in men) gain visibility through social media
• Seeing others share similar symptoms can reduce shame and encourage people to seek help
• Teens who can’t speak openly with a doctor may use online content to better understand what they’re experiencing
We know self-diagnosis isn’t new. Maybe even the performative posts can serve a purpose by nudging someone toward a real diagnosis. I’m not saying it’s always good, but maybe it’s not always bad either.
From your clinical perspective, how do you view the rise of self-diagnosis, especially when it’s influenced by social media? Have you seen it help or hinder patients in practice?
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2025-05-26T10:24:27
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1kvr01h
| 0 | 1 |
AskPsychiatry
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Medication question DESPERATE
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I’m a 24F being treated for bipolar depression. My psychiatrist prescribed me bupropion for the depression and lamotrigine as a mood stabilizer. About a month ago the doctor increased my dosage from 300 mg to 400mg but the side effects have become unbearable.
I’ve had worsening anxiety over the last few weeks and muscle spasms. It came to a head yesterday when I had the most severe panic attack I have ever experienced and it lasted pretty much all day. That started around 11:30am-12pm. Today same deal, anxiety/panic all day and the muscle spasms got worse which in turn made my anxiety get worse.
Tomorrow I have to go to work, and I absolutely CANNOT have this happen while I’m working. I still have my lower dosage 300 mg, should I just take that or should I keep taking the 400mg?
Edit: it was my bupropion that was increased
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2025-05-26T22:51:17
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1kw7yt6
| 0 | 0 |
AskPsychiatry
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On multiple antipsychotics
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Would you be comfortable prescribing 3mg of risperidone (1mg 3x a day) with 200mg of Quetiapine at night? I’m also on Gabapentin and Wellbutrin. Just nervous being on 2 antipsychotics. I was recently hospitalized for Bipolar associative depression and this is what they put me on. I told the Dr. that Wellbutrin caused mania before and sleep issues so we went with Gabapentin and Quetiapine. I wish trazodone or Mirtazapine would help me sleep, but they don’t. Mirtazapine with Olanzapine worked in the past, but when I tried it by itself it didn’t work. Does make me wonder if it would work with the risperidone.
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2025-05-26T22:23:45
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1kw7d0i
| 0 | 0 |
AskPsychiatry
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Why do I hear "wow" all the time?
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I think this is a borderline case of auditory hallucinations mixed with some OCD that is preoccupied with mind reading. I am rationally completely aware that no one can "read my mind" or hear my thoughts the way I hear them. That said, I frequently hear something (or mistake myself for hearing) something that sounds like the word "wow" spoken from a distance and in varying tones and voices (sometimes a male voice, sometimes female) etc. The sound is faint but my mind often mistakes it as coming from my neighbors, which I don't rationally believe. The OCD comes in with intrusive or disturbing thoughts. It often happens that I have an intrusive thought that I find disturbing in some way and I hear "wow" as if someone is reacting to the thought. I know that's irrational but then I get caught in a loop of reassuring myself that I must be hearing things and no one is reading my mind.
I think the obvious explanation/diagnosis would be some form of bipolar or schizoaffective hallucinations but I am confused because I really know that no one is reading my mind. I am just wondering what I am hearing to make me confused, or if I am not hearing anything external at all. Is it more likely that I am hearing something else (traffic sounds, nature sounds, neighbors chatting amongst themselves?) and misinterpreting it as a voice saying wow in my direction, or somehow generating that whole sound/perception-of-sound in my mind?
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2025-05-26T17:50:35
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1kw0rdv
| 0 | 0 |
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what disorder could cause low empathy?
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Hi, I didn't know where to ask so here we are.
I've always struggled with low empathy, and I don't know what causes it, or if there even is a cause for it. I have a hard time understanding other people's feelings and I can't put myself in someone's shoes most of the time. It's always been something that upset me about myself, especially around friends when I can't provide what they need on the emotional front. I've been diagnosed with major depressive disorder and ADHD (so far, I guess), but I don't know if maybe they could have something to do with it? It's not only empathy I struggle with tho, I often joke about the fact that I have the emotional range of a silver spoon. Could my "emotional range" be kind of a cathalyst for my empathy problem?
(thank you in advance for answering, and sorry if maybe what I'm saying doesn't make sense - but something happened that prompted me to ask myself what's wrong with me because the people around me didn't have the same view as me on a very sensitive matter I guess...)
p.s.: I'm absolutely not looking for a diagnosis, obviously! I just want to understand the possible causes for this
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2025-05-26T11:25:08
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1kvrz03
| 0 | 1 |
AskPsychiatry
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I need advice
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I am a 22 year old woman living with crippling mental health issues. 5’ tall, 120 pounds. I have been thinking about starting therapy again. This is because I have been feeling extremely depressed and anxiety ridden to the point where I need SOMETHING to help me cope. My last few therapists diagnosed me with Social anxiety disorder and clinical Depression. I never really felt like it was the right diagnosis at all. Yes, I 100% have social anxiety and depression, but I always felt like it was something more than that. I have this anger and rage inside of me and insane crazy mood swings. Wreck-less behaviors (more so when I was a kid/teen and not as much now. I stay at home a lot bc of my social anxiety and attachment issues) I have feelings of complete emptiness a majority of the time. I lash out on people a lot, like my boyfriend and become extremely defensive when challenged at all. It’s an immediate response, and I can’t help it. The only way I can regulate my emotions is by shoving them down or crying/hitting something or (sadly) talking down to someone. I feel like such a bad person when I do this… My brain is such a mess. I have many symptoms of mania too. I have always wondered why I see myself so highly sometimes, yet have such a bad self image/self esteem. I hate myself one day, then a week or two later I will think I’m better than everyone around me and feel really good about myself. Even if I haven’t even done anything to feel better. It’s honestly so frustrating to me and confusing. I think my brain is finally starting to fully develop and I’m realizing things about myself that I NEVER would have admitted years ago. When I was younger, I wasn’t the most honest kid about my issues, even to myself. I had two drug addicted parents and emotionally unavailable grandparents to look up to. I didn’t see any problem with how I was acting, because everyone around me sucked more. I wouldn’t tell my therapists about my anger. I would deflect blame from myself every therapy session, so I didn’t look bad. I have had many therapists in my life from 13-Now and nothing has helped me at all. I feel highs and extreme lows. I cant sleep or concentrate, I lose interest in things I love quickly, and have extreme trust issues. I have had substance abuse problems that I’m trying to resolve right now. Alcohol made me go into deep depressions everytime I would drink it but I physically couldn’t stop myself from doing it. I haven’t talked to my remaining friends for three years because of my mental issues. My old therapists have given me anxiety and depression meds (fluoxetine only) and they didn’t work. I definitely can’t fit my whole life story in here but that pretty much sums it up. Also, my father is diagnosed with bipolar so it’s very possible I have it. If you have any advice, I’d love to hear. This is not a call for help kind of post. I will be seeking therapy soon. I am not seeking diagnosis, just somewhere to start my journey and decide what to do going forward. I also do not drink anymore bc I decided that no friends were better than enablers. I hope this wasn’t a lot to read. Thank you for coming to my Ted Talk.
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2025-05-26T10:41:27
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1kvr96w
| 0 | 0 |
AskPsychiatry
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Why do you care?
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I know it sounds snarky but totally unintended, genuinely curious. I had a baby crisis a while back, got some help that I’m incredibly grateful for and am doing better. I’m trying to engage in more self-help resources and watched the hbo documentary “one south”. Between that and my experience, I got a view of just how much mental health workers and clinicians care.
If someone with depression wants to not be alive anymore— they genuinely fully consent to calling it quits— the emotional and physical effort and time it takes to pull someone out of that is insane. It’s so much investment and work for someone who’s likely not gonna help you help them.
What’s the reason you still want to help them, how/why do you care so much that makes it worth the effort to save people who don’t want to be saved?
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2025-05-25T20:21:45
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1kvc30n
| 0 | 0 |
AskPsychiatry
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my insomnia is beyond bad, and really concerning
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ok so i’m posting here cuz i genuinely don’t know what to do. i’m in japan, and ive been to many doctors about my sleeping problems but they just prescribe me with sleeping medication that doesn’t help at all.
i usually go like 5 days without sleep, sometimes more or less but that’s like the average and i don’t even know how. nothing works, i’ve tried so many medication but it doesn’t work. even exercising or cardio doesn’t help, if anything it makes me more awake. the only thing that sort of works (but not 100%) is being super drunk. but i don’t want to be drunk everyday just to be able to sleep. i get like 10-13 hours of sleep a week, i fear it’s concerning. i’ve had times where i’ve gone weeks with barely any sleep, like an hour or less and i started hallucinating, seeing things and i was just in so much distress. my head was all messed up. what do i even do.
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2025-05-25T19:40:54
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1kvb4zt
| 0 | 0 |
AskPsychiatry
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How can I get a diagnosis corrected so I can go on Adderall or other ADHD medication that doesn't affect memory like Topiramate?
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I was misdiagnosed with psychosis after being asked some vague questions.
I am nonbinary and have had a long history of gender dysphoria, and I was originally out as a trans woman since I was scared to come out as NB due to Mom taking my English teacher grandma very seriously at the time, bullying me into saying "than I" instead of "than me," etc.
I was scared to tell my psychiatrist, so at 18, I had my mom come in, but she delivered it vaguely, but in a way that didn't help my case at all.
"Dr \[redacted\], what does it mean if someone thinks they're something they're not?"
He said, psychosis. So he asked me a bunch of questions.
He knew my history of autism.
He asked me if I perceive the world differently than those around you. I said yes.
He asked me about things that I interpreted as thinking I knew anything about electronics, seeing or hearing things that others didn't, and this one:
'Do you hear voices in your head that others don't?'
I took this to mean "Do you have an internal monologue?" instead of "Do you have hallucinations?"
And then he asked me if I ever hear other people's voices, which I thought of as sometimes thinking back to what other people said.
And he asked me further about other aspects, like my strong visual-spatial imagination (which antipsychotics somewhat quashed :( ), me composing music in my head, as well as another interpretation of "seeing or hearing things others don't", the fact that I might sometimes notice details, hear light bulb ballasts buzzing, etc., that others don't.
I was diagnosed with PDD-NOS as a preteen, ADHD by that same psychologist (and separately by my old pediatrician), Tourette's at 16, and later with Autism Spectrum Disorder at 17.
I hated the way antipsychotics made me feel, but I felt the medication also made it harder to express it. There were many times when I wanted to cry, but just couldn't. It was harder to coordinate many repetitive movements and my typing speed suffered.
I felt deprived of the dopamine necessary to enjoy my own company, and I was deprived of my deepest special interest in electronics – I think the drug made me more readily "listen" (metaphorically) to others, and my Dad was both worried about my safety (despite me sticking to lower voltages and having no problems handling a soldering iron) and thought his kid should be a biologist or mechanical engineer instead.
The drug also made it easier to fake a smile for the camera or friends. I did have brief moments of happiness, but lost all deeper sense of satisfaction. I was more involved with my backup hobbies of music and photography, and did both of those with the constant thought of pleasing others on social media instead of being satisfied with my own work.
I told my therapist that I no longer listened as much to some of the specifically \*transphobic\* things others told me... and he took this to mean a diminishing of hallucinations I never had.
And I was told I was "being my authentic self" when I transitioned and they took the lack of fake smiles to be a sign I was miserable before – I really dislike the idea that the only happiness that matters is being in others' company. I was everyone's show dog.
I lost the ability to tap out complex repetitive rhythms. My stims became slow. I sucked at math, programming, and interpreting schematics.
I tapered off of the medication under the advice of a PA who lowered my dose to 1/2 mg risperdal, then told me to cut the pill to 1/4, though I never went back for a follow-up appt after the second month of taper.
I was also told the medication would help my autism "if I had it", and if finding it harder to express my needs, obsess over once brought me joy (I actually hate being pegged as a "musical" person when electronics is much more important to me), and even speak up for myself when I want to be excused from a family gathering meant it "helped" that aspect of me, then it did. But it just fucking assimilated me. Made it easier to guilt me into saying I liked people because that was the 'correct' thing to do. Made me try my hardest to force eye contact.
I felt like those rats in a CAR test. Unable to respond to any cues to avoid the shock.
Behavior manipulated. Atheism secured – although I ironically tried to become Christian when I was on antipsychotics, again, because my Mom was constantly pushing it. Never actually believed in Yahweh.
Bottom line:
**THESE DRUGS MADE MY ADHD WORSE.**
They took whatever edge my special interest in electronics gave me away. I struggled with the more technical parts of a digital media degree, and felt scared to become an electrical engineer with a compromised brain.
I really want to get the diagnosis cleared to have a newer, SSRI-free, AP-free, TOPAMAX-free (screw that stuff – it made me feel even more apathetic about electronics and memory-impaired), etc., regimen of Adderall, Ritalin, Vyvanse, etc.
I go back to my old psychiatrist for the first time since seeing his PA in 2023 several sessions into my taper.
Will he respect that I'm not a person with a disposable set of interests and not try to tell me that 'change is good'? Will he respect that I'm hellbent on being an electronics engineer and doing side projects at home too? Will he understand that I severely misinterpreted his questionnaire and the fact that what Mom said was really about my transition should completely invalidate my supposed psychosis?
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2025-05-26T01:50:51
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1kviryu
| 0 | 1 |
AskPsychiatry
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"ADHD is not a disorder. it's a phenotype."
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Saw this and Im not a psychiatrist or amateur expert on this but I know enough that this isnt how it works I think. Is it accurate.
ADHD is not a disorder. it's a phenotype. A different kind of wiring.
People with ADHD carry the OG genetics- traits that made them the elite hunters, gatherers, and scouts in ancestral times. Fast reflexes, heightened sensitivity, scanning attention, and quick adaptability were all superpowers in natural environments. it only gets labeled a "disorder" when you're born into a modern world that forces you to sit still for 8 hours a day, memorize irrelevant information, and conform to systems designed for industrial efficiency-not human brilliance.
ADHD isn't the problem. The environment is.
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2025-05-25T05:04:26
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1kuuo76
| 0 | 1 |
AskPsychiatry
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I take sertraline for OCD and depression, which has pretty much cured my OCD obsessions EXCEPT: my hair obsession. My psych says this is common and nobody knows why. What is known, what are the theories for this?
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My psychiatrist told me recently that it's apparently very common for medical intervention to help with OCD symptoms except for hair-focused obsessions. It likely works on a different mechanism than the other OCD symptoms.
I'm interested in what is known about this hair-OCD obsession, are there any interesting hypotheses? I'm not asking for medical advice!! Just pointing me in a direction for small tricks that have been known to help, or interesting research. For example, maybe a kind of meditation or something like that. I'm also just interested generally, it's very interesting that hair obsessions appear to be an exception to current treatments.
Thanks!
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2025-05-25T10:01:31
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1kuz04k
| 0 | 0 |
AskPsychiatry
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Dermatophagia and OCD — what are my treatment options?
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I recently found out what I’ve been dealing with is called dermatophagia. My psychiatrist told me it falls under OCD, specifically body-focused repetitive behaviors.
I’ve been chewing the skin on my fingers obsessively since I was a toddler. It’s honestly my biggest insecurity. I’ll never forget how it felt when people first noticed and said things like “ew.” That moment really stuck with me. To this day, I haven’t seen anyone’s fingers in worse shape than mine.
I’m still trying to learn more about it. Are there any specific medications or treatments that help with this? From what I understand so far, the main thing is trying not to give in to the urge, but sometimes I find myself doing it and not even caring in the moment. I just keep going.
Any insight or advice would really help. Thanks.
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2025-05-25T19:00:28
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1kva7k4
| 0 | 0 |
AskPsychiatry
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Would you say this to a patient??
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I had some weird interactions with my psychiatrist that he strongly defended when I brought them up. I was seriously depressed with suicidal ideation and was wrapping up an appointment with him. He closed by saying, “Okay, stay alive ‘til next visit.” I was taken aback, but figured he meant well and tried to tell myself he wasn’t being dismissive.
Then, at the next visit, he walked into the room all cheerful and said, “So, how close are we to killing ourselves?” I was shocked, but again tried to give him the benefit of the doubt. I brought it up and asked him to be a little more careful.
The next time I saw him, I had just been admitted after an interrupted suicide attempt. He walked into the room, and one of the first things he said was, “I’ve had three people kill themselves this year.”
WTF, right??? Would you ever say any of those things—especially the last one—to someone sitting in a crappy psychiatric hospital specifically so they wouldn’t kill themselves? Would you defend that? Or would you apologize?
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2025-05-25T01:37:55
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1kur60b
| 0 | 0 |
AskPsychiatry
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I think I have ADHD, but getting diagnosed in my country is hard. Can you help?
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Hi,
I’m 21 and I seriously think I might have ADHD, but where I live it’s very hard to access a psychologist or get a proper diagnosis. I’d really appreciate your thoughts based on what I’m experiencing:
I make careless mistakes, even as a dentist. Once, I almost gave a patient the wrong solution that could have caused him a lot of pain.
I can’t organize my day or stick to habits, even after reading tons of books and trying many systems.
I often zone out when people talk, and just pretend to listen. Some think I have hearing problems.
In lectures, I rarely absorb anything. One time I even answered a phone call loudly in class without realizing I was in a lecture. It was really embarrassing.
I procrastinate constantly and keep changing goals—for example, I focus on learning programming while ignoring my dentistry studies.
I have a lot of vivid daydreams—sometimes I laugh out loud at them and people think I’m crazy.
My memory is bad—I've almost left the house without a shirt on more than once (shoutout to my mom for stopping me).
I often interrupt in conversations without meaning to. People think I’m rude.
I’m always fidgeting or moving, even while sitting. I keep changing positions in the chair and can’t sit still.
If any of this sounds familiar to you—or if you’ve been diagnosed and relate—I’d really appreciate your feedback. Feel free to ask me anything.
Thanks in advance.
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2025-05-25T17:18:54
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1kv7tik
| 0 | 1 |
AskPsychiatry
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Abilify
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Hello, I’m currently getting my Abilify dose from 2mg to 4mg. It’s been 2 days and I feel apathetic and emotionally unavailable. The dose was doubled due to increased intrusive thoughts and paranoia. I currently don’t have those anymore but I’m feeling drowsy, apathetic and dont feel emotional towards anything like I used to be (very extroverted and happy). Any advice or experiences? Thanks in advance 🫰🏻❤️
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2025-05-25T15:36:58
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1kv5fq4
| 0 | 0 |
AskPsychiatry
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Quetiapine
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I’ve probably asked this question before but every time it comes up I still don’t understand why it’s demonised so much. Even 25-50mg it’s like all psychs on here freak out saying even benzos long term are better.
I get there are better options for sleep so fully understand the dislike of prescribing low dose for sleep.
However, it seems to work really well for anxiety at low doses and in my country it’s often prescribed if there isn’t a full response to an SSRI or SNRI if anxiety is the main issue or also if an added TCA or benzo doesn’t work. It seems particularly helpful for people who struggle with rumination as it quietens and slows the mind down to normal. Lots of people say they feel so much better. Also helpful for some using it PRN instead of lorazepam if that doesn’t work.
I just want to know are you seeing really bad effects in practice on small doses? Or even high? Or are you just going by studies and what theoretically could happen?
I want to know real life stories you personally had where one of your patients took low dose Quetiapine and something bad happened and what was it? completely anonymous obviously.
I feel like it’s often prescribed with absolutely no warnings except for initial sedation but on here it sounds as though it’s the worst thing you could ever take.
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2025-05-25T07:46:59
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1kux31u
| 0 | 0 |
AskPsychiatry
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Weaning off antipsychotics
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I have Schizoaffective disorder and about a year ago I went without my medications for around two months. During that time, I was able to accomplish a lot as far as my writing and household management goes. The downside was that I was going up to 4/5 days at a time without sleeping and I do admit I believed some odd things that weren't based in reality. Though I do still believe some of those things I uncovered during that time, but I digress...
Since I've been back on my medications, I don't have the same energy. I'm sleeping in late. And I don't have the ability or interest to continue my writing, which is very important to me.
I currently take Haldol, Clozapine, Topamax, and Wellbutrin.
Would it be advisable to wean off the Haldol and Clozapine and just add a sleep aid if necessary so that I can get back to my writing and regain some of my energy?
Maybe I could take the haldol as a PRN if and when necessary?
I feel like I managed fairly well those 2 months and didn't have any serious issues aside from the not sleeping.
I'd really like to give life without AP'S a try if it will help me achieve my goal.
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2025-05-25T02:41:16
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1kusa03
| 0 | 0 |
AskPsychiatry
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Help me pick a new regime (please)
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Hi,
I am a 20 year old women, diagnosed with PTSD, ADHD, ASD 1. I experience anxiety and depression but have never been formally diagnosed with a depressive or anxiety disorder (providers state they aren’t comforted diagnosing as they don’t know if ADHD causes these things). I also believe i may have PMDD but am in the “tracking” stage.
i pretty much always experience depression and anxiety and have for as long as i can remember.
I have tried a variety of medications in the past but currently i take a 15mg adderall IR in morning/afternoom and 10-15mg in evening (early doses keep me up all night). then at night i take a pantoprazole 40mg and probiotic.
i currently smoke cigarettes, about 4-6 a day.
CYP2D6 poor metabolizer *4/*5
CYP1A2 is ultra rapid due to smoking
ADRA2A moderately reduced response C/C
HLA-A*3103 Higher risk A/T
HTR2A increased sensitivity G/G
SLC6A4 intermediate response L/S
all other genomic results were normal :)
i recently just had a more severe depressive episodes, hyposomnia, lack of motivation, suicidal ideation/ self harm ideation, irritability, fatigue, pretty much just rotted away for about a week. i have never had any super horrible psych meds experience, olanzapine ODT took hours to kick in (8-10) and then knocked me out, wellbutrin 300mg XL (can’t remember if i was also on lexapro 5mg at that time) had caused hypervigalance and paranoia w mild hallucinations when i had quit smoking, benadryl and vistaril cause hallucinations.
anyways im curious what you would recommend? im incredibly researched based and my “interest” is psych meds so i do spend a lot of time researching and am excited to hear anything anyone has to share :)
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2025-05-25T02:00:49
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1kurkfg
| 0 | 1 |
AskPsychiatry
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My doc has gone on a 2-week holiday and forgot to send my script. How screwed am I?
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I requested a new prescription a week ago, followed up on Wednesday. Now my doctor is out of the country for two weeks and the pharmacist has told me they didn’t get a new script. As of tomorrow I’ll be all out of meds and I’m kinda worried about withdrawing.
Meds: 50mg vyvanse, 10mg zyprexa, and 225mg effexor
My GP won’t touch those prescriptions with a 10ft pole, and chances of finding another psych who will see me in the next two weeks is pretty much zero.
I know from experience that missing the vyvanse makes me pretty useless and a missed effexor dose is as close to hell as I can imagine.
The meme of Ralph sitting on the bus saying “I’m in danger” keeps going through my mind, but I gotta ask, how screwed am I? What can I do to “soften” withdrawal symptoms?
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2025-05-24T08:54:15
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1ku74pw
| 0 | 0 |
AskPsychiatry
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Confused about calming effects after Ritalin, no ADHD
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I went in patient a few years ago. When I was there, I got prescribed Ritalin to help my dissociations off label. I can explain further if needed. My diagnoses are pure-o OCD, PTSD, depression, anxiety. I have never been diagnosed with ADHD nor do I have any symptoms of it. The day I took my first dose of Ritalin, I fell asleep around 10 am after taking it around 9 am. I slept for 8 hours, got up for dinner, then slept through the night. Ever since, taking Ritalin has made me very calm and has cured my dissociations. I have a similar response to coffee.
My question: why does it calm me since I don’t have ADHD?
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2025-05-24T17:50:53
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1kuhj9y
| 0 | 1 |
AskPsychiatry
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Advice about how to handle sudden shift in psychiatrist's behavior
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Hello, I hope it's ok to post this here — had a very strange appointment with my psychiatrist that left me feeling utterly horrific, and I don't know whether she was trying to help me or acting inappropriately.
I've been seeing this psychiatrist for 2.5 years, I was referred to her by my therapist who (correctly) guessed I was severely depressed and required medication. I've only every had a good experience with her, she's always come across as a straight/no-nonsense doctor but I usually appreciate that.
After one year on 60mg prozac, which probably saved my life and made me for the first time in my life feel like a normal human being, I'm coming off the medication because she told me to, as it's protocol in the country I live in. Because going 60 to 40 completely crashed my mental health, I've been going down 5mg every month, and now about to reach 10mg.
It went well until 2 months ago when I started having episodes of sadness and hopelessness again, generally felt irritated/angry etc. She dismissed my concerns about it being to do with going off the medication, and I believed her, there was also work stress going on. But it's not getting better (it actually got worse during a 3-week sick leave, making me think it's nothing to do with work).
Last week, at my most recent appointment, she suddenly said that if I'm feeling worse now going off medication it's probably because the underlying issue that caused my depression was never addressed. She said that maybe I'm living in the wrong country (I moved several times in my life), maybe I'm in the wrong job (I love my job despite the intensity of it) and, worst of all, when I said that I increasingly feel sad even when hanging out with my friends, she said maybe they're not my real friends and my subconscious is trying to tell me that.
She said maybe the way I live my life is making me depressed. She then started throwing out random theories like maybe it's my thyroid (it's not, I got it checked recently) or maybe I am bipolar (never heard that before and never had any such symptoms).
This came out of nowhere (I burst into tears) as for years she'd just told me it's possible I just have weird brain chemistry, etc etc. I'm wondering if she just had a bad day, but her words just go round and round in my head and I keep wondering if she's right, and there's no hope for me because of the way I've set up my life. (And then I think, no, wtf, my life isn't perfect but it's not depressing.)
I'm seeing her again in 2 weeks and not really sure how to handle it if she keeps going down that route. She also said that no matter how bad things get I have to get off prozac completely as she wants to see how I'm doing without, which makes me feel like I'm some sort of science experiment. Both my GP and my therapist say they're worried about me and I shouldn't keep going off prozac, but they're obviously not experts whereas the psychiatrist is.
I'm sorry for the very long post, but any advice on how to handle this is much appreciated. Switching psychiatrists is a possibility in my country but getting an appointment with a new one probably takes 1-2 months. Thank you for reading.
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2025-05-24T10:50:15
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1ku8t2j
| 0 | 0 |
AskPsychiatry
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Anti psychotics?
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Hello.
Have been on quetiapine almost a year. Have been on roughly 200mg although at this dosage there are issues with restless legs.
Im not really sure what the quetiapine is supposed to be doing? Im also on an anti depressant but my mood is very unstable, and I continue to feel very low and hopeless.
From my perspective the quetiapine only acts as a sleep aid. And since its an antipsychotic, is it worth continuing to take it if it doesnt seem to have any therapuetic benefit?
I dont want to be taking an antipsychotic if it isnt helping? And I dont really know why I am taking it or what the effect its supposed to have on me. I have not had any psychosis.
What should quetiapine do? Is there a reason it isnt helping me? Is the dose too low?
I am diagnosed with CPTSD, DID (assessed with SCID-D) and ADHD.
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2025-05-24T11:18:10
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1ku993s
| 0 | 1 |
AskPsychiatry
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Is it OK to treat loss of reality without telling pt WHAT you're truly treating for?
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Is it ethical for a psychiatrist to prescribe psychiatric medication for one condition while telling the patient it is for something else?
Specifically if it is an extant, allowed, or even common method for successfully medicating behaviorally-resistant reality-loss conditions, like schizophrenia, psychosis, confabulation, etc where the patient often doesn't know, and refuses to believe, that they are affected... by prescribing a drug that treats both the loss of reality, *and* another condition that the patient *does* agree that they have, like depression?
TIA
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2025-05-24T08:51:25
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1ku73b1
| 0 | 0 |
AskPsychiatry
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How to deal with chronic feelings of boredom that lead to self destruction?
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Hello all! I am diagnosed Bipolar (medicated) and am experiencing what I can only label as a mixed episode (extremely fatigued yet extremely active mentally at the same time). I am redoing my resume because I am highly dissatisfied with the job I am in and while doing so, I’ve noticed that I don’t stay at jobs for very long (I either get my feelings hurt and leave, get bored, or get fired due to the self destruction I cause when I’m bored). I really don’t know how to cope with feelings of boredom (even on meds) and I have aspirations of attending school in the fall. I know I will face feelings of boredom while I’m in school and at any future job. How do I cope with them? How do I not let it lead me down a self destructive path?
I’m beginning to wonder if this dose of medication (10mg Abilify) is not correct for me and if there could be something else also going on. I am seeing a therapist. I haven’t talked to her about it though I will be at my next appointment.
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2025-05-24T13:17:23
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1kube49
| 0 | 0 |
AskPsychiatry
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I think I had a bit of a crisis yesterday, what happened?
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Yesterday, I was completely overwhelmed. I was thinking, and journaling about some really dark, harmful thoughts. I'm not sure what to think of it.
I felt so disconnected. I couldn't find any relief outside the destructive plan I had except in had. The plan, including, molotovs and a train station.
I didn't care it wasn't rational, it felt like tunnel-vision, it was just a task to complete. I went out, bought a lighter, a fuel canister, and fuel. I didn't assemble the molotovs, I just stashed the gasoline in the woods.
I've had dark thoughts before, but this was the first time I actually took real-world steps based on them, and I really don't know what to make of that right now.
The strangest part is, I felt coherent the entire time. My actions felt irrational, but somehow "right" in the moment, like this was the only thing that could help me feel.. something different?
I really didn't want to hurt anyone, still don't, but it felt like I was glitching, switching between feeling sorry, and feeling nothing, and majority of the hours yesterday I felt nothing. I only had that one goal with the gasoline.
I've debated suicide a long time too, for the very reason of me being afraid I'll hurt someone. I don't want to, but my mind frightens me. I didn't feel in control.
Today is better. If I was 90% impulsive yesterday, I feel more like 20% today. It's still not stable, but I'm trying. Every day feels like a gamble lately, and that's what scares me.
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2025-05-24T13:15:57
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1kubd3e
| 0 | 0 |
AskPsychiatry
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When is the soonest that I can increase my Guanfacine dosage?
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I was recently prescribed Concerta (started at 36mg, just moved up to 54mg). While the Concerta is helping my longstanding untreated ADHD a lot, this higher dosage is giving me some serious insomnia issues along with some tic exacerbation (I also have mild to moderate tourettes).
To counter this, my doctor prescribed me 1mg of Intuniv (Guanfacine ER) to take nightly. He didn't mention anything about when I could move up on the dosage. I'm reading that typically you wait at least a week before upping your dose?
Since I'm still dealing with tics and insomnia on 1mg of Guanfacine, I'm wondering when the soonest is that I can move up in dosage.
Is it worth reaching out to my doctor in 3-5 days to see if we can do an early dosage increase, or should I wait at least a week? I've taken Guanfacine before as a monotherapy and tolerated it just fine. I'd prefer not to have to move down on my Concerta dosage, as 54mg is much more effective than 36mg was for me personally.
Thank you so much to anyone who takes the time to respond!
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2025-05-24T13:12:37
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1kubam2
| 0 | 1 |
AskPsychiatry
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so much anger out of nowhere!
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hello everybody,
i'm new to reddit so in case I make any mistake please let me know so I can fix it and learn!
I have a big doubt regarding my huge wave of anger that I express lately and by lately I mean since October of the last year.
I've suffered from strong depression and anxiety from 2019 and after a long therapy and many kilos gained because of medicines I didn't really managed to control it and was feeling lost, until the 3rd of october of last year when i was diagnosed with acute ulcerative colitis and after starting a very aggressive therapy due to the severity of the inflammation I started to feel better and my depression/anxiety literally disappeared.
Here comes the problem because from that day on I became extremely aggressive in the sense that I'm a normal, very extrovert and friendly man until something makes me angry and it always end up in me committing crimes towards people and goods of the same people.
I'm really lost because this is not me and I've never been in a single fight my whole life until now.
each and every single day my aggressiveness is becoming bigger.
I've scaled the medicines following the doctor plan so not sure that is the problem.
in case of any need for informations please let me know.
thanks
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2025-05-24T10:40:17
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1ku8nr4
| 0 | 0 |
AskPsychiatry
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Urgent! - Schizophrenia, antipsychotics and marihuana
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Hey, so I’ve been diagnosed with schizophrenia and have been on antipsychotics for over a year now. Right now I’m on clozapine, but I stopped taking it for the past two days—not because of weed, for other reasons.
Anyway, today I bought an ounce of weed. I’m planning to gift most of it to a bro, but… yeah, I really, REALLY want to smoke a bit myself. It’s been two years since I last smoked, and it honestly sucks that I have a condition that basically makes it “impossible” to enjoy it anymore.
For context, I’ve never actually had hallucinations. And maybe this sounds cocky, but I think I’m pretty good at catching my own delusions now that I know what to look for.
So here’s my actual question—I’m not gonna ask if I should smoke, ‘cause I already know the default answer is gonna be no. I just want to know: what’s the REALISTIC best and worst case scenario here? Not some fear-mongering, exaggerated horror story. I’m asking so I can weigh the risk myself. Like, what’s the actual risk if I take a teeny, tiny, little hit? Consider the fact that I’m taking clozapine, really small dose, 50 mg since 100 made sleep too much. Haven’t taken it in 2 days though.
Also—just to be clear—it’s not even the full-blown psychosis that I’m most worried about. It’s the negative and positive symptoms that mess with my day-to-day life. That’s the part I don’t want getting worse.
I want to make an educated decision here. At least know what I’m risking if I do it.
Thank you in advance.
Also this scenario is set to happen tomorrow night, so I have all day long to read your responses. I actually have the option of taking my clozapine dose today and make it one day off instead of two.
Update: I decided to take 25 mg of clozapine today. Yesterday, I didn’t take any because I fell asleep at a party. If I end up smoking tomorrow, I won’t take any clozapine that day. Then on Sunday, I’m planning to take between 25–50 mg to get back on track.
I have no idea if this plan is actually advisable—it was originally my idea, and ChatGPT thinks it’s a smart way to avoid antipsychotic withdrawal while lowering the risks of mixing clozapine with weed.
What do you think? Is what I’m doing remotely safe?
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2025-05-24T02:43:40
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1ku1dny
| 0 | 0 |
AskPsychiatry
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What is DID and what does it actually look like in real life?
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I don't think I have it or anything, I just see so many people diagnosed with it now, and I'm curious what it is and how it actually presents (knowing that everything can be unique and present differently).
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2025-05-23T23:02:50
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1ktx5u7
| 0 | 0 |
AskPsychiatry
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Is there any hope for me?/over-diagnosed
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I think I have been overdiagnosed. I’m still supremely depressed, lethargic and unable to work. I was a middle school teacher for 15 years. I have a Master’s degree. I was raised by a narcissistic alcoholic. I have never had a positive thought about myself. I’m single and have few friends.
Dx: depression, anxiety, ADHD, bipolar 2, borderline, insomnia
I take a lot of strong meds and I have since I was 20. I have been to a really nice mental hospital 5x which I enjoyed. I am a sober alcoholic, going on 10 years. I am diligent about my psychiatric care, therapy and meds. I see my psychiatrist every 2-4 weeks and my therapist weekly. I have done CBT, DBT, TMS, EMDR. And I mean I have done them THOROUGHLY. I also went to rehab. I have also tried several non-traditional things. Or course I have had all my vitamins Checked and stuff too.
So, I also have a ton of physical dx. High blood pressure, hypothyroidism-medicated for both of those. Rheumatoid arthritis, medicated. Ehlers-Danlos syndrome and Lyme (neither are treatable.) also Sleep apnea and I’m diligent about the stupid Cpap.
Is it possible that there is just one massive thing that encompasses all of this? I can tell you I try REALLY REALLY HARD at everything I do. Even with this crushing depression, fatigue and soreness I still attempt to go participate in Stand up comedy open mic at least once a week. I used to be a great artist but that seems to be dormant right now.
Honestly, I feel like a lot of it is trauma-related. I really started to pursue healing about 10 years ago,that was the first time I went to the psych hospital and the first time I confronted my alcoholism. I then went to rehab and I went to an AA meeting every day until covid. I worked with a sponsor, I did the steps, I read the book and I got psychiatric help. I feel I have left no stone unturned. Should I try ECT? Am I maybe autistic? Am I just disillusioned with the lack of meaning in this world? I think too much. I feel too much, but lately I feel nothing. I have 4 cats which keep me alive. I just lay on the sofa and watch tv. I do nothing, I feel nothing, I am nothing
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2025-05-23T20:00:20
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1ktt1mn
| 0 | 1 |
AskPsychiatry
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New psychiatrist, possible red flag
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Been going on a journey, digging deeper into my mental health. It's really not good. Finding more people to help me through. Started with a virtual therapist and psychiatrist. Virtual psychiatrist deemed me as too severe/ unstable for virtual care. Which started the search for an in person. Therapist sent a referral for in-house. First available appointment is in two months. Which isn't good, but also is expected. The potential problem came with a warning. I am not allowed to discuss or mention ADHD with any in-house psychiatrist. Because they aren't allowed to treat it. It's not the first thing I need to address, but it is a thing I have. Is this a sign that this isn't the psychiatrist for me? I'm in a stage where I'm overthinking everything, so additional opinions are much appreciated.
Additional info; I'm a 33 year old trans woman that's been on HRT for just over a year. I'm sure this is contributing, but I'm coming back from severe depersonalization. It's gonna get worse before it gets better. My current storm is both expected, and what I need to eventually get to a better place. Only way out is through. Therapist agrees. From what she knows. We've only completed the intro questions thus far.
I appreciate any advice or assistance! All I know is that I can't do this by myself.
I'm posting this from a trans specific subreddit. Figured this would be a better place to ask. Diagnoses are hard. All I know is what I have is incorrect. On hormones and anxiety meds. Can provide more details if needed, but this is my first time on the sub. Don't know how much is required for my immediate question. Is this normal?
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2025-05-24T05:00:48
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1ku3pnk
| 0 | 1 |
AskPsychiatry
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Titration Question
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So I have BPD and made a really stupid decision, I was prescribed lamotrigine I was supposed to do the typical titration for 2 weeks 25 mg, 2 weeks 50 mg, and then 100 mg as my final but a few days into the 50 mg I decided to stop it because I “missed being crazy” (stupid I know) but now I want to restart it but I know the titration is too long for me to wait because I’ll want to stop it again. Am I able to start at 50 mg for a week and then go to 100 mg?
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2025-05-24T04:29:44
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1ku37x4
| 0 | 0 |
AskPsychiatry
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Dystonia vs TD vs Wicked Anxiety
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Hi all- I also posted this over on Tardive Dyskinesia and Dystonia sub.
Age: 39 (40 in July)
Sex: Female
Race: Caucasian
Weight: 148 lbs
Recreational drugs: I sometimes take an Oxycodone when Ibuprofen would probably work, for dental pain - the euphoria helps the depression. Bad idea, I realize.
Dx: Depression, Anxiety, Sjogren’s Disease
First diagnosed with depression at age 12.
Symptoms I’m complaining about now: for the last month, slowly increasing. Been insane the last 5 days.
I am having some significant struggles.
Meds: Duloxetine 120 mg (since 2014) Wellbutrin XR 150 mg (for a month, altho was on it before) Vyvanse 60 mg (for fatigue not ADHD, was on 70 trying to come down; on it for the last 4 years) Adderall 15 mg (only PRN for breakthrough fatigue) Plaquenil 400 mg (for about 4 years) Zofran 4-8 mg as needed, Tirzepatide 12.5 mg once a week (Have switched between semagultide and tirz since 2022)
I was also on Abilify 17.5 mg to boost the duloxetine.
I stopped it abruptly, because I added the Wellbutrin, and was feeling better. Also my mom had said I was doing something weird with my mouth. After going off I had intense anxiety for a couple days, reach out to my psych and she told me to go back on at 5 mg and titrate down slowly.
I did that. 5 mg to 2.5 mg to 0.
I finally was off about 2 weeks ago.
But my depression and anxiety have gotten a lot worse since going off. I reached out to my psych again, and explained that I either needed to go back on the Abilify, up the Wellbutrin, or try another med. But I also said I was worried about the mouth movements and spending issues on the Abilify.
The nurse called and asked a bunch of questions about the mouth movements. I said I’ve never noticed them, but my mom has and I have noticed I tongue thrust and suck on my bottom teeth a lot. In addition to clenching my jaw. Especially now. Also, in the last couple days I feel like my muscles in my legs and arms are contracted, and so is my stomach, and I notice I’m holding my breath a lot and can’t catch my breath.
They told me to stay off the Abilify and take Benadryl 50 mg for the next week.
I did some research and discovered they are most likely trying to stop or rule out Dystonia. But I think I match the symptoms of TD more.
When I catch myself tongue thrusting I can relax my tongue and stop. For a moment then it tenses up again. Same with my jaw. Same with my stomach, legs, and arms. Altho my stomach, legs and arms stay relaxed longer. The tightness on my chest I can’t really relax.
I am worried that if I take the Benadryl it will make the TD (if that’s what it is) worse. But if I don’t take it the dystonia (if that’s what it is) will be worse.
I’m not having any twisting movements, or jerks, or anything like that. And while the tensing up is involuntary, I can voluntarily ease it for a bit. It’s better when I first wake up and is horrible by the end of the day. It has progressively gotten worse each day.
I took an old diazepam 2mg, approved by doc, and it’s not touching the tensing of muscles.
Anyway, my big question is- do you think this is Dystonia or TD? And any chance it could be just really bad anxiety getting worse because I’m now worried about TD?
Thoughts?
TLDR: bad anxiety or dystonia or TD? What’s the difference? is Benadryl safe to take if it’s TD? I was prescribed it because they think it’s dystonia.
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2025-05-24T02:12:25
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1ku0tn6
| 0 | 1 |
AskPsychiatry
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frequent perception shifts-rewrites entire interpersonal history-curious on psychiatric opinion
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31(f)-lifetime thing. or at least dont remember it being any different
my therapist was curious about a psychiatric opinion and id really rather not ask mine atm. records and all.
gonna try and keep it short and apologize for readability. im not gonna edit it
anyway, so basically i dont know what my reality is. not like physical reality but interpersonal/memory wise(things i/others said/did(reasoning behind it)). i will frequently(multiple times a day isnt uncommon(been a thing for decades)) have a perception shift that will rewrite/change a thought and or memory and retroactively be applied to all related memories. so ill go from loving someone to hating them except i always hated them. thats the only thing thats ever been true. until it changes again. and then ive always loved them. or indifferent. etc.
it happens mid thought pretty often..incredibly annoying when it does. i can "physically" feel it when it happens(mid thought ones). it will either be a slide or more of a slam. the slide feels like the mental version of something slowly slipping out of your hand. slam is well a slam. just immediately switches the narrative with no warning. do also have more background ones, usually notice those within a few minutes. notice the thought/framework being massively different from earlier, and not being able to get back to the old one
\[ "well let me see if i can use the puzzle example here. k tried for a bit and couldnt get one i liked liked but ill use one that at least gets the frustration across. so youre finishing a puzzle. 80% of the way done. you grab another piece to put down. \*shift\* its now a completely different puzzle. "fuck i wanted to see what the puzzle was supposed to be when i finished it. k lets try and remember where i was on it. what pieces were left. okay now maybe can i mentally put those together....ughhhh...fuck id need to see it again. damnit""
"for the slide feeling using the puzzle itd be like the table slowly starts to tilt and the puzzle pieces start to slide down the table and youre like no no no no....and then it crashes and \*bam\* new puzzle in its place.."\]
i dont forget the previous version. i remember it fully. i just cant get back into the same headspace and cant figure out the logic of it either. like why i was thinking that specifically. imagine reading a book, get halfway down the page and \*bam\* new book. you still remember what you just read, just not where it was going anymore. and no amount of rereading it will change the book back
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2025-05-23T18:59:24
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1ktrm1f
| 0 | 0 |
AskPsychiatry
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Can I take my Adderall XR/IR everyday or do I have to take days off for it be most effective?
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Question above. I’ve been taking it everyday because I feel like it helps with my emotion regulation, anxiety, energy, mood and obviously ADHD symptoms. So to me… I want to be medicated for those things everyday. But I see a lot of people online saying you need to take at least one or two days off a week in order to “keep the medication effective.” Is this true?
I am FtM (on testosterone), age 30, white, 160 lbs, 5 feet tall. Other psych meds I take are Zyprexa, Gabapentin, Wellbutrin XL, Prozac, and Intuniv. Diagnosed with Bipolar disorder, ADHD, OCD, GAD, CPTSD, Autism spectrum, and Borderline personality disorder (although that’s in remission).
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2025-05-23T22:06:08
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1ktvyi6
| 0 | 1 |
AskPsychiatry
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Invega ejaculation blockade?
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Hi, Does invega cause ejaculation blockade? How about if I add 5mg or 10mg Abilify oral will that bring back normal ejaculation? I was once on invega LAI which was less sedating compared to invega oral. In invega almost all my positive symptoms subsided with little minor residual psychosis (flare ups) barely noticeable by myself. I am now on 160mg Latuda my libido is great, my energy is good I am not sedated, my cognition or response time is fast however I do have some positive symptoms left I cant seem to focus sometimes in crowded places in addition I get intrusive sexual thoughts in the most inappropriate places like an elevator with random people or a classroom and I involuntarily make sexual gestures or look at peoples inappropriate places its also sort of an OCD. Its like I tell myself this is a formal place and you need to act in a proper manner and then I get the least thoughts I want to get in those places i.e. sexual intrusive thoughts or looking at peoples inappropriate places. I’ve had the same thing with Abilify, was not psychotic could work and study but I act weird and I am anxious in formal places or places I need to act properly and diligently such as a work environment (office) or formal gatherings. I currently work full time and study for my masters and doing ok in both. I was on Amisulpride for a month it was great for positive symptoms but it caused constipation which was uncomfortable and a bit of sedation. I need your help I need an experts help
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2025-05-23T22:03:19
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1ktvw6x
| 0 | 0 |
AskPsychiatry
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Should I pursue Psych?
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Hey guys I’m an incoming ms1 and I’m largely undecided about what field I should go into. However, I feel that I need to have an end goal in mind to stay motivated.
Reasons why I should:
- I would enjoy working in mental health
- Psych classes seemed interesting to me in undergrad
- Working as a virtual medical scribe for psychiatrists made me realize I wanted to pursue medicine in the first place.
- As a scribe, I really found beauty in how people improved over time and made meaningful changes in their lives.
- I like how psychiatrists are able to work in multiple settings at once. This means inpatient, outpatient, or even tele-health.
- I want to form long term relationships with some patients, but I would enjoy being a specialist rather than a PCP
Reasons why I shouldn’t:
- I only have experience with outpatient psych and I could be unprepared for inpatient. Moreover, the psychiatrists I scribed for usually saw patients in wealthy suburban settings which probably does not represent the field accurately.
- I wonder if I can handle the emotional burden of some patients
- I’m kinda awkward and I’m not sure how this translates to being a good psychiatrist
I wanted to be a psychiatrist for most of my time as a premed, but I also want to keep an open mind.i would appreciate if anyone had any advice. Thanks!
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2025-05-23T21:04:13
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1ktujeq
| 0 | 0 |
AskPsychiatry
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Adderall Induced Psycosis
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Hey, I have 8 months off a 3 yr adderall addiction. I was also on Zoloft during this time. During the duration of my use I became isolated and paranoid. When I moved back with my family and got off the adderall I had a wild time. I was shaking and was terrified for months. I am now starting to come out of it( I HOPE) and was wondering when the depression lifts. When my opinions, cognitive functioning, and social skills go back to normal.
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2025-05-23T16:42:55
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1kto8tx
| 0 | 0 |
AskPsychiatry
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Oxazepam and anger
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Hi, I take Venlafaxin that really helps me stay mellow, and not get angry. Injustice just doesn't bother me as much when I'm on Venlafaxin. But, sometimes I forget to take it and then I take oxazepam to keep mellow, but it just doesn't seem to take the edge of like I need. I usually take 10 mg, maybe I need more to mellow out?
Just asking cause I need to keep my temper in check (I e not have one) and I can't seem to avoid forgetting my antidepressants once in a while. Anyone have any experiences with this?
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2025-05-23T15:58:19
|
1ktn5od
| 0 | 0 |
AskPsychiatry
|
Lexapro and Mirtazapine
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50F, taking 10mg Lexapro in the morning and 15mg Mirtazapine before bed. Also taking Ativan when needed.
At night, I can sleep at most 7-8 hours, usually less, around 5-6, and I wake up really nervous and can't go back to bed. During the day, I feel really sleepy and exhausted, but I can't sleep no matter what, even if I take Ativan. Sometimes it feels heavy to breath. Body feels like it's in a constant tension and always feel tinglings. My cortisol is really high.
I did cortisol test in the morning and it came out 700 nmol/L.
Next medical appointment is in 1 month. Please, any advice is welcomed.
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2025-05-23T11:10:33
|
1ktguj2
| 0 | 0 |
AskPsychiatry
|
Eps after adding bupropion sr 150
|
Male 24 years india.
I’m seeking advice regarding a recent reaction to my medication combination. I recently added Bupropion SR 150 mg to my regimen, after which I began experiencing extrapyramidal symptoms (EPS).
I’m also on Aripiprazole (Abilify), currently at 1.25 mg. Notably, I had EPS when I was on 5 mg of Abilify previously, which resolved after reducing the dose. Abilify 2 mg did not cause EPS by itself, but the symptoms reappeared after adding Bupropion, even at the reduced dose of 1.25 mg.
At this point, 1.25 mg of Abilify is not sufficiently controlling my anger and irritability.
Here’s my full current medication list:
• Prozac (Fluoxetine) 40 mg – morning
• Axepta (Atomoxetine) 40 mg – twice daily
• Bupropion SR 150 mg – morning
• Aripiprazole 1.25 mg
• Depakote XR 250 mg – night
• Ritalin – as needed
• L-Carnosine – morning
• Magnesium L-Threonate – night
I am generally sensitive to antipsychotics (including appetite changes and tremors). Given this, do you think Cariprazine might be a better alternative to Abilify in terms of lower EPS risk and better emotional regulation, especially when combined with Bupropion?
Appreciate any insights or suggestions.
Thank you!
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2025-05-23T11:00:33
|
1ktgo7r
| 0 | 0 |
AskPsychiatry
|
Dex vs Adderall vs Racemic vs Methedrine
|
Is there any actual reason to prefer one over the others in at least some situations? (Ignoring cost.) Or does it largely just come down to the luck of individual response?
Are doctors just prescribing what they are used to prescribing and what insurance will cover?
Also same question for methylphenidate vs the dex form.
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2025-05-23T08:44:47
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1kteneh
| 0 | 0 |
AskPsychiatry
|
Feeling Uncomfortable About Recent Appointment
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I had an appointment with a psychiatrist to discuss how I'm getting on with my adhd meds (elvanse).
During the appointment, the psychiatrist asked me some background questions and kept on saying how stupid they are for not asking some questions. I kept on responding that no, it wasn't stupid. But it made me feel very uneasy and uncomfortable.
Is this common practice?
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2025-05-23T14:21:36
|
1ktkt2g
| 0 | 1 |
AskPsychiatry
|
Concerta maximum dose and what signs to look out for
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108 mg is the off-label maximum dosage for Concerta XR, assuming it's taken all at once. Now, let's say a patient takes 108 mg daily (2 doses of 54 mg, 7 hours apart), develops tolerance, and cannot switch to a different medication or take a break. What dosage limit would you consider unsafe? Would 126 mg still be considered safe if 108 mg doesn't cause any adverse symptoms? Could it potentially lead to sudden liver failure ?
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2025-05-23T09:01:46
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1ktevuh
| 0 | 0 |
AskPsychiatry
|
SSRIs alter memories
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I've got PTSD and when I take certain SSRIs, they alter my memories. I have traumatic memories that are extremely frightening and disgusting, but for example, fluvoxamine, which I am currently taking, shifts my attention away from that event. Childhood memories that are not related to the period of my trauma now seem disgusting and scary, even though there is no reason for that.
Even though I have PTSD, I’m mainly taking fluvoxamine for OCD. It’s only been a week, and today is my first day increasing the dose to 50mg. My childhood memories have suddenly become terrifyingly awful: I can’t think or talk to my mother, everything is horribly frightening, and I can’t think about anything else. Could this effect pass, or should I stop taking this medication?
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2025-05-23T08:54:40
|
1ktes86
| 0 | 1 |
socialskills
|
I just started a new job and people don't like me already
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I just started a new job with 30+ people, more than half of which are my age. it's at a corporate office so we are all coming from other states, no one knows each other. We all were given emails so there was a group chat on there for all of us to mingle.
However, a second group chat was made with people's phone numbers. It started on monday/tuesday and I didn't get added until friday. I had to ask to get added. No one thought of me and wanted to add me.
I've always generally been unliked and excluded from things or have had one sided friendships, but i JUST started this job this past monday and i can tell people already are forming groups without me and I don't know why.
like when people pass around their phones to exchange contact info, the phone somehow skips me every time.
I'm generally pretty introverted, but i don't think that's the reason why i feel generally disliked. I ask people about themselves and their stories. I'm not loud or obnoxious in social settings. People laugh at my jokes when i make them. i feel like im pretty neutral. but yet i feel excluded and disliked and i just don't know why. it's been like this my whole life. i'm not super pretty if that matters.
i went out friday night with everyone since we are all new. it went well, and i want to be more social with everyone. so i am trying to get out of my shell, but i dont know if that relates to me being disliked.
i asked someone close to me and he thinks i just haven't met my people yet. people who are the well liked, charming and charismatic people in groups, how do you do it? is it conscious? or do people just like you. and what makes someone hard to like or makes you not want to invite them to things?
also if this just sounds like overthinking and anxiety please just say that. it's very possible and i've always struggled with that
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2025-06-22T05:50:17
|
1lhgnfe
| 0 | 0 |
socialskills
|
Is eye contact really that important? Because I can't
|
I know it's a common sense that it's more respectful to look at people in the eye when talking to them, I tried it sooooo many times to look at people. I forced myself to look at ppl in the eyes, it did last for a long time, but then the people I had eye contact with always asked me "Anything wrong?", kinda makes me wonder whether my eye contact is giving people pressure or am I just too aggressive looking.
Anyway, is eye contact rlly that important after all?
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2025-06-22T13:37:09
|
1lho2oz
| 0 | 0 |
socialskills
|
What do you do about people who can't banter right?
|
I frequently run into people who I befriend, and then they start to try and "banter" with me—which usually just ends in them being rude. Take, for example, I am completing an over-summer course at my school, and one person in my friend group brought up relationships. At one point, they tried to guess how many people every one in the group has dated before. So she goes around the table.
"Probably 2"
"I could see like 1 or 2"
Then she gets to me
"Yeah nobody wants you"
Hello? What the fuck do I say to that? It was said like it was an attempt to be snarky and funny but it came out making them just sound like a gigantic asshole, especially when I've done nothing to provoke that kind of response.
So up until now, when somebody says something like that I just kinda...sit there? Or I say something back that is just painfully unfunny because I obviously don't feel like being all friendly with somebody after they just openly insulted me. What's the most appropriate response to people like this, ideally something that preserves my dignity after just being humiliated like that?
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2025-06-21T17:04:29
|
1lh1e28
| 0 | 0 |
socialskills
|
Rather be alone :/
|
25F and only recently started to question if being alone is a problem. It’s not like I don’t hang out with people at all, I have a boyfriend. I Just don’t care to hang out with anyone else.
I’ve had coworkers invite me to hang outs. My family tries to get me to go outside, for a walk or trip to store lol.
I like staying inside my apartment with my cat. I only recently started questioning my introverted lifestyle since my mom seems to be worried. Please tell me I’m not alone ?
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2025-06-22T03:28:16
|
1lheb8z
| 0 | 0 |
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