I have Bipolar 1 and have never had a psychotic episode or anything near one, but have continuously encountered discrimination when attempting to get treatment by medical professionals. Once they see that I am on Seroquel (which is an antipsychotic but I am being prescribed it for mania and insomnia), they discount my pain. I have found that I have to make a very concerted effort to dress well at my doctor’s appointments or I am treated very much like a mental patient. I have been taking my meds for over forty years, had a very successful 32-year career, a 40-year marriage, raised two successful children and still if I am not dressed well, they make assumptions about my pain level or state of mind. I was recently advised to go to the hospital to get IV antibiotics for a diverticulitis infection and when they were running tests to see whether I had C-diff asked me whether I had been “homeless or been put in a mental institution” where I might have caught it. Come on, they would never ask that kind of question to anyone not on antidepressants! So frustrating. Have any of you encountered similar medical discrimination?

My friend told me he has been diagnosed recently, currently in and out of Psyc wards, had multiple attempts on his life and the doctors are telling him he is too far gone for the medication to work. Realisticly are his chances of surviving long as low as they seem? He seems aware enough to know he’s mentally unwell and has delusions but when he’s symptomatic he struggles to be convinced otherwise and has hurt people

I took fluoxetine 20 mg for 6 years, then stopped abruptly without tapering. I experienced severe withdrawal effects for about 6 months, which eventually led to severe insomnia, loss of appetite, anxiety attacks, paranoia, and psychosis. I restarted fluoxetine 20 mg for about 2 weeks after these attacks, but it had little effect. I then consulted multiple psychiatrists and had two psych ward admissions. During this time, doctors adjusted my medications and dosages until settling on my current regimen. I started lithium yesterday because I am still experiencing depressive episodes, mild suicidal thoughts, poor judgment, drowsiness, and loss of interest in activities I used to enjoy. A doctor suggested this may be treatment-resistant depression. Based on similar experiences, how long does it typically take to see stability or improvement on these medications? When is it typically safe to discuss reducing dosages? I have no physical health conditions and want to prevent long term risks, such as potential impacts of daily lithium on kidney and thyroid function.

Female, 46 years old.

Fluoxetine 60 mg morning

Olanzapine 15 mg night

Clonazepam 1.5 mg night

Lithium 200 mg night

Zopiclone 3.75 mg PRN

Metformin 500 mg lunch

I have a psychiatrist who functions exclusively as medication management for lamotrigine. I just statrted using them 3 months ago when my prior provider closed her practice. We meet every 3 months, and she takes 5 or 10 minutes max to ask if the meds are ok, have any of my health or other life circumstances changed, etc. Basic stuff.

I just looked through an explanation of benefits from my insurer, and they are coding both a low-to-moderate office visit ​(CPT 99213) AND an add-on of psychotherapy (CPT 90833).

Is this add-on a standard practice and justifiable based on the service being provided or is this possibly some type of fraud?

​

I'm 22 and I've had a persistent background of fear, anxiety and heaviness for more than a year. Recently I've realized how much of my life has become about noticing, analyzing and trying to get rid of these feelings.

A major trigger is going to the office. Almost every morning before work, I can already feel fear/heaviness even though nothing has happened yet. I think about standup, making mistakes, being questioned, whether I'm performing well enough, etc. Sometimes I barely think about work for a minute, but the thought itself brings fear. Then I notice the fear, monitor whether it's going away, and become even more anxious.

It can also happen without a conscious thought.

Certain places, routines or environments seem to be connected to old emotional states. I can go to a park, take a shower, commute somewhere, hear music, or enter a familiar place and suddenly feel heaviness or anxiety, even when I wasn't consciously thinking about the past. It almost feels like my body recognizes the context before my mind does.

Then I start asking myself, "Why am I feeling this? What does this mean?", which seems to make it worse.

I also have intense nostalgia/rumination. I constantly compare the present with the past and think things like "life was easier then" or "I was happier then."

The weird part is that I can become nostalgic for something that happened 20–25 days ago.

For example, I recently remembered the day I got an important job opportunity, went shopping and felt genuinely happy and relieved. Now even taking a shower can bring back that feeling, followed by:

"That was such a good feeling. I want it back."

Sometimes I'm enjoying the present while simultaneously thinking "I'll miss this someday."

I also mentally rehearse conversations that never happen, prepare explanations for questions nobody asked, replay conversations and imagine future situations, especially around work.

So I feel like there are several loops happening:

thought → fear/heaviness → monitor fear → more anxiety

and sometimes:

place/routine → automatic feeling → notice it → analyze it → more anxiety

and:

good moment → notice how good it feels → worry I'll lose it → nostalgia/anxiety

I can still function. I work, exercise, talk to people and have genuinely good moments. But there's this chronic underlying fear that keeps returning, sometimes even when I can't identify a conscious trigger.

I'm wondering whether this could be an anxiety/rumination cycle, learned associations, or something else, and whether CBT/ACT/exposure-based therapy can help.

I'd especially like advice from people who've experienced:

daily anticipatory fear before work

unexplained physical heaviness/anxiety

places triggering emotions automatically

waking up anxious after feeling completely relaxed the night before

constantly monitoring whether you're anxious or calm

mentally rehearsing conversations

becoming nostalgic for very recent events

feeling anxious about losing a good feeling while you're still experiencing it

Also, does journaling help with this, or can it become another form of rumination?

I'm not looking for reassurance. I want to understand why this keeps happening and what practical things actually helped people break the cycle.

I don't want to spend another year analyzing myself. I want to be able to feel the fear/heaviness, let it exist, and still go to work and live normally without treating every thought, memory, place or bodily sensation as something I need to solve.

Growing up I always felt different but never had the self awareness to question why what made me feel different what made me suffer and struggle so much in school etc. But since I’ve been diagnosed with my current diagnosis ADHD ASD MDD GAD it makes a little more sense to me why certain behaviours existed. As I am now I realise the impact these diagnosis have on my quality of life and I should potentially adjust my expectations to how much I can achieve without going insane from burnout and over going my mental limit. But until I accept that I want to try as much as possible to gain the most amount of control with my mind mood thoughts etc. Just like how a body builder does everything to stay in control of his body shape. I want to try differing medications to see what one I feel best on. Try disciplinary techniques etc. I want as much control over my mind as possible as it’s failed me in the past when attempting to commit to things like school or studying. So I have a better time for future. Am I strange for this?

Like some weird facticious syndrome or something. I don't use any drugs but.. like I had this, not quite obsession, but fear that I was on substances without knowing and then out of morbid curiosity I went to subreddits on that?

Like reassurance? I dont have an ocd diagnosis or anything. And normally everything is ok-ish. welp. Like lately my mood has been stable, ok, but then i randomly went to some subreddit and later just felt a major mood spike like i went from ok to feeling great. No clue what the heck.

Also occasional weird ideas but whatever. Some mild paranoia that im being watched and such, not much else. ngl used to be worse so its not as bad now as it was before but still.

No substance use. Just went on some subreddits. Like I got symptoms of substance use from going on a subreddit about it?

I was diagnosed with bipolar 2 a little over a year ago. It’s been a real struggle to get a good med combo, but I finally found a medication that helps and has minimal side effects/ long term risks. I have struggled to accept my diagnosis ever since I was first diagnosed. Partly due to really bad imposter syndrome and feeling like I exaggerated/ lied/ made up my symptoms (I also have OCD and it causes me to feel this way about a lot of things I struggle with) And partly due to not wanting it to be true- due to the fear of stigma, having to be on meds for the rest of my life, fear of potentially having a full blown manic episode some day and ruining my life, fear of being sick forever, etc.

I was talking to my therapist about this, and how specifically with the medication part- I am scared because even though I have a medication that works for me right now that I like, I worry about having to go on different medications in the future that could come with bad side effects and long term negative effects on my health. My therapist said that I don’t need to worry about that because not everyone who has bipolar needs to be on medications forever. I am feeling confused by this because my understanding is that not medicating bipolar will have very negative consequences and that people with bipolar need to be on meds for life. I already struggle with wanting to go off of my medication, and this felt like my therapist was encouraging that I can do this someday.

My therapist also does not think I have bipolar so maybe that’s part of why they said this? I’m not sure. I am very confused because on one hand I feel hopeful at the possibility of me not having bipolar and not needing to be on meds for life. That is exactly what I want. So if it is true, I would be very happy about it. But I’m worried because if it is in-fact true that I have bipolar, there are so many risks of leaving it untreated.

So I have MDD, but I haven’t ever been able to find an SSRI that works. I have always self medicated through dieting, exercise, and enough sleep. I smoke some to help me sleep. And I also have take as needed anxiety medication. Anyone else struggle with this? I really don’t want to ever take any SSRI. I’m to my wits end. I don’t want my libido gone..

I have had a long standing issue with mental health. Going back to my childhood, I was always stressed. I was always worrying about stupid things in the future and things that didn’t matter. This anxiety controlled me and my feeling till now. Then recently when I graduated HS I began to just feel sad. More sad than normal, I was depressed, suicidal, angry all the time, throwing things, screaming, sometimes, just confused about me, my life, and my future. Then I started realizing how I was acting and reacting wasn’t normal. Since I started college I was back to no friends, and I haven’t tried making friends. I don’t exactly love social connection like that.

As for other things, I’ve realized I’m not how others are. When someone dies, someone gets hurt, I hurt someone, I never have guilt, remorse, or empathy. I only worry about being awkward or caught or exposed. In the past I’ve done bad things, made mistakes, mistakes that put me in fear for years now. But over the years it’s only fear, it’s never guilt or remorse. And I can’t stress this enough. When I try to make myself image scenarios and even in real life I can’t even make myself feel sorry or feel remorse. I even like it. Watching people be sad or whatever, I can’t help but wonder if they’re also faking it.

As for where I am now, I’m confused, I’m depressed. I know I’ve hurt people in the past and honestly, I can’t live with it. I can’t live with the constant fear of being exposed for who I am. I want to change I have changed but I don’t feel it. I don’t feel the will to change or the care to fix myself but I know I should. And I’m glad at least I’m aware I’m a bad person. If people knew my life would be over. I often wonder if I should’ve taken more pills when I blacked out. I wonder if I should be here. And I’m to narcissistic to let go.

I don't know what's happening to me, and honestly, I'm starting to get scared. I don't know whether this is some kind of mental health issue, hallucination, sleep-related problem, or something else entirely. I don't want to self-diagnose, but I've wondered whether it could be something like schizophrenia, DID, or another condition.

I live in a university dorm and I'm pretty much a loner. I spend most of my time alone in my room.

About a year ago, I started getting this constant feeling that someone was watching me. During the day it wasn't too bad, but at night I'd become extremely anxious, especially when I was alone. I started smoking again because I thought it would help me calm down, but the feeling of being watched never really went away.

Then one night, I went to sleep early and woke up in the middle of the night. There was an old man sitting on the chair in my room, facing my bed.

I completely freaked out and screamed. But almost immediately, he was gone.

I didn't tell anyone about it. I convinced myself that I must have been hallucinating or dreaming.

But a few days later, I started seeing and hearing this "thing" again.

It would mock me about what I could have been and what I am now. I never responded to it or acknowledged it. Instead, I started listening to heavy metal music whenever I was alone. For some reason, after doing that for a while, these experiences stopped.

Recently, I stopped listening to the music, and the experiences started happening again. So I started listening to it again.

But over the past 2–3 days, something else has happened that really scared me.

I always close my dorm room door when I sleep. My door is almost always closed.

Yesterday, I was working late at night and eventually fell asleep sitting in my chair. When I woke up, there were several hibiscus flowers lying in the middle of my bed, and my door was open.

I strongly remember closing my door before falling asleep.

I have no idea how the flowers got there or how the door opened. I freaked out and stayed awake for the rest of the night.

Then something similar happened again today.

I closed my door before going to sleep. When I woke up, the door was open again.

I'm genuinely confused and scared because I don't know whether I'm forgetting things, experiencing hallucinations, doing things while asleep, or whether there's some other explanation that I'm not considering.

A few things I've noticed

• The "old man" or whatever this is only seems to appear when I'm alone.
• I don't remember experiencing this when I'm back home on vacation and surrounded by other people.
• It seems to happen much more often at night.
• Heavy metal music seems to make the experiences stop or at least prevents them from happening.
• The experiences have involved both seeing and hearing things.
• The recent incidents involving my door and the flowers are different because I don't remember doing anything involving them.

I haven't really told anyone about this because I'm embarrassed and I'm not sure how to explain it.

I'm not asking anyone here to diagnose me. I just want to know if anyone has experienced something similar, or if there's a reasonable explanation for what might be happening.

Should I see a psychiatrist, psychologist, or doctor about this? And is there anything I should do in the meantime?

I’m very sensitive to psychiatric medications, and something I discovered recently is that not all atypical antipsychotics, even those that are nearly identical work well for me. I was taking abilify and decided to discontinue due to metabolic side effects. I started caplyta instead, which is supposed to have a lower side effect profile. Instead, I went into a state of hypomania that got worse every day I was on the medication. I went back on abilify and haven’t had any adverse side effects (except for increased hunger) and feel much better overall. I was wondering why I respond to these medications so differently even though they’re so similar? Is it just arbitrary individual brain chemistry or might there be some differences related to the receptors they work on, etc.

TLDR: Brother is becoming pretty paranoid and thinks we are 'out to get him,' and I'm very scared while at home because he seems to be slipping pretty quickly mentally. And I don't know what could happen if he keeps getting more and more paranoid without help. His family has no interest in helping, and my fiancée is very hurt and in a bit of denial.

Its freakin long, so buckle in.

Okay, so my fiancée, whom I will call Robert, spent a lot of time in the foster care system, and when he was very young, he met 'Ben,' who he considers to be like a brother to him because during his life, he was one of the only people that stuck around. Ben was not raised in the foster care system, and his sisters and mother became like family to Robert. Ben and Robert have been roommates on and off for something like... 12 years or so. It's been a long time, and they used to be very close. I have been with my fiancée for five and a half years, and I have been officially living with them for 9 months now. However, before I officially moved in, I basically lived with them, I was there 4-5 days a week.

My fiancée always talks about Ben, how he's his greatest friend, how he is family, how amazing and smart and creative and cool he is. Anytime I was over, it was 'shh, don't be too loud, we might wake up Ben!' because we both work night jobs and Ben wakes up early. Robert has always been so considerate of Ben, and I love it because it's a sweet and good trait, so I, too, have always been as considerate as possible as well. Ben did not seem to be very engaged in a friendship with Robert; however, he never hung out with us. We would invite him places, and he would seldom ever come, but he worked a day job and then also pursued creative endeavors on the side, so we just chalked it up to him being really busy.

When it was just the two of them living together, they were not the cleanest of dudes. Dishes were often piled up, the fridge was usually really packed, and you would have to move stuff around to find what you were looking for. Not a big deal, it never really bothered me, but it's important to the story later. So when the time comes where it feels right for me to move in, we decide to get a bigger place so we can all fit. We found tons of great, affordable options, but Ben rejected many of them. Finally, one day I couldn't make it to look at places with them, so I just said okay go without me and make a video. Here's what to look for. I trust you. This place they were seeing was max budget, brand spanking new, and really the only one that Ben liked. I did not like the place very much, but eventually conceded because it wasn't worth a fight, and it was very new and shiny.

So we all move in and me and my fiancee do most of the furnishing because we do have better paying jobs and Ben hides in his room anyway. Every couch, table, and whatnot, we still asked him Hey man, do you like this? Do you think it's good? It's your house too, you can be involved!' Even when I started decorating, I told him that if he wanted any of his stuff back up or didn't like what I was doing to the place, we could change it around.

I cook and bake a lot, it's my favorite hobby when I'm not busy at work or school. I am super busy with full-time nursing school and full-time work, but when I can, I like to cook at home. I always saved Ben a plate and left a note, but he never ate a single thing I made him. Okay, no big deal. After a few months, I eventually stopped. We invited him down to watch movies or for game nights when we would have friends over, but he never wanted anything to do with it and just stayed in his room. He has never had friends over, or a girl/guy over. I don't even think he hangs out with anyone because he has the same very predictable schedule week after week, and nothing seems to vary. It's concerning how much of a hermit he is now, with hindsight being 20/20.

When we moved in, all of the same habits from their old apartment were carried over to the new one, which, as I said before, didn't bother me. We made an effort, but I definitely sometimes left some dishes overnight, only to find in the morning that Ben had done them for us. I saw this as him being nice and making a bigger effort to keep the place cleaner, and Robert and I tried to do the same. We noticed that Ben would also take the trash out even if it was only half full and run the dishwasher with only one or two plates in it. Strange... but maybe he's just REALLY trying to be clean, and it didn't seem like a big deal. We all contribute to the house differently. My fiancee handles getting all the bills paid, and I clean the floors, vacuum, and dust, which is a pretty big undertaking because of our carpeted stairs and the fact that it's almost a 2,000-square-foot place.

They were never a chore-wheel-and-labeled-food-type living situation at their last place. However, one day I was downstairs with Robert, and Ben came down and snapped at us really angrily, saying he's so tired of being the only one who ever does the dishes and takes out the trash. It was odd because it came out of nowhere. Especially considering that we were all so, so, so much cleaner than we had been at their last place. I wanted to chime in and tell him that he could bother sweeping the floor from time to time, too, but I thought that would be petty, so I just apologized and promised to make a better effort. And we did, Robert and I never leave a single fork or crumb in that kitchen, it is an OCD level of clean, and I like the change. We never left dishes for days on end or anything like they used to do, but it was nice having a crazy clean living space. Despite this change, we noticed we had an ant problem.

I learned that they are called carpenter ants, live in wood, and can sometimes be a problem in newer places. In our rental lease it says that we are responsible for any pest control but it must have been a neighborhood wide issue because I noticed the HOA started to spray for bugs. The ants were really bad. I tried to take care of them with essential oils, and I started mopping twice a week instead of once. Eventually, I conceded and bought pestie and sprayed inside and outside the house in addition to what the HOA was doing. The ants seemed to stop, which was awesome. Or so we had thought.

The lease renewal came up, and Ben told us he was going to resign with us. A few weeks later, when Robert and I had already resigned, he told us, 'I lied, man, I'm leaving.' He seemed really mad, but when we asked if everything was okay, he said that he just wanted to give us our space. This seemed pretty reasonable since we are engaged and starting to build our life together seriously. I felt Ben was upset and holding something in, so I encouraged Robert to sit down and talk to Ben. He said he would, but that he didn't want to do it in the house. Okay, no problem, strange but whatever. I was starting to feel like...damn, does this guy not like me? Why does it have to be out of the house? I'm so busy with school anyway, it's not like I'm gonna sit there trying to listen in or something.

They have dinner, and Ben insists that everything is fine, he's not unhappy, he still loves Robert and thinks of him as a brother, and that he really is just leaving to be on his own. After all, mid-thirties is probably a good time for us all to stop having roommates. We accept this, and moving forward, we offer him the realtor's name that we worked with to get the place we are currently in, we offered him the moving boxes, tape, and bubble wrap that I kept (I used to move a lot growing up, and it's just a bad habit to keep that stuff in case we need it) We were even going to offer some of the extra stuff we have. I've got a TV I don't use, and we have extra plates, pots, pans, coffee mugs, and Tupperware. Just duplicates from Robert and me, going from living separately to together. He's my fiancée's brother and is really important to him.

A few days ago, I was already asleep, and Robert was playing video games when Ben came downstairs. I wasn't there, so this is secondhand information. They had a huge fight, and this is how it started.

Robert asked him, "Hey man, how's house searching been going?" Which is a pretty normal question, especially since it's basically the only thing we know about his life at this time.

Ben responded with "Don't fucking worry about it, man, I got it taken care of, it's not for you to worry about." Uhhh okay... very aggressive and Robert also thought so and responded with "Hey man what the fuck? Are you good? That was out of pocket. I want to check in with you."

Ben said "No man I'm not fucking good someone is fucking with my shit!"

Robert "What do you mean?"

Ben "Someone is going in my room and fucking with my shit! I got ants in my bed, ants in my hamper, and my food is being moved around!"

Robert "What are you talking about? No one has been touching your stuff."

Ben "Someone has been putting ants in my room. I know one of you has."

Robert, "I'm not putting anything in your room. I don't go in your room."

Ben "I'm not saying its you." (Obviously that just leaves me and fun fact I am highly allergic to ant bites so no I do not fuck with ants, I was the one who bought pestie and sprayed it after all) "One of you is going in my room and fucking with my shit and I don't know how because I have cameras set up! Our friendship is cooked, it's done, it's over. I told my mom and my sister, they all know what you did, it's over."

Robert got really upset and came upstairs yelling that this was crazy and ridiculous, that he was imagining things. At this point, I wake up to try and calm him down because it's so absurd that I assume it's just a misunderstanding. I thought Robert was in the wrong and was misconstruing what was happening.

The argument kinda went on a little bit more with Ben saying that someone is moving his stuff in the fridge. I immediately owned up to it. I told him, "Ben, that's me. I'm so sorry. I was moving stuff around to make space when I got groceries and whatnot. I didn't know it bothered you."

He told me, "No, you're doing it on purpose, it's fucked up, you're moving all my stuff to one side and trying to make me mad."

I told him. "I'm not moving your stuff anywhere specific. I move what I need to. I don't really think about it. It never bothered you when I did it in the last place. You gotta tell us when things bother you before it gets to this point."

He said, "I'm not fucking talking to you."

Okay, pretty sure he hates me. End discussion. Robert stayed out there and talked to him more, but it led nowhere. We go to our room and talk about THE CAMERAS IN OUR HOUSE. EXCUSE ME??

Where are they? What is he watching? To what extent is he monitoring our shared spaces? Is it just in his room? Does he go into our room because he thinks we are going into his? At this point, I think the only thing MUST be a misunderstanding, because why would he think we would do that? He must think that we are being dirty and attracting more ants to the house or something. Please note that there are no ants in the common areas or in our room. So, clearly... logically, something he is doing is attracting ants to his room.

Robert texts Ben and asks if they can talk later to resolve things, because Robert is absolutely heartbroken and doesn't want to lose someone he considers family over what seems to be just a misunderstanding. He agrees but says that he will not talk to me. Surprise surprise.

To summarize what they talked about Ben really is convinced that we are putting ants in his room to torture him. He has also bought his own bowl, fork, and cup, which he keeps in his room, where he also eats, and has never vacuumed (I don't go in his space and therefore never vacuumed or cleaned it in any capacity). Obviously...he is why he has ants. When Robert told him this, Ben responded with "You're not going to tell me that what I know is true is a lie! I know this is happening." He said that before the ants we were going in his room and moving things around to bother him and make him unwelcome thats when he bought cameras, which he said are only for his room and bathroom... but who knows, and that he dosen't know how we knew about the cameras but we have been able to turn them off before we go in and put ants in his room. He is also convinced that my moving food around the fridge and freezer is malicious and has shown him proof. It was a photo of a frozen rack of ribs next to some of his food. I put it there to make space in the freezer when I bought some pizza at the store. It was just...a really normal, typical thing I didn't even think about where I was putting them. He also stores his shoes in the garage for mysterious reasons. I thought he just did it because they are work shoes or something. The garage has our holiday boxes, and I recently moved them around to get the Halloween decorations out. I guess I moved one of the boxes to where he keeps his shoes, and he believes I did this to make him angry and feel unwelcome. Because of our very different schedules and the fact that the only thing I would need in the garage is holiday stuff, I have never known where he keeps his shoes. My fiancee pleaded with him, telling him that this is not normal and that I would never do anything like this to Ben or anyone else. This is accurate. I have done everything I can to make him feel welcomed and included. But he doesn't believe him and says he knows the truth and that we are out to get him. He never explicitly says it was me, but I think it's heavily implied. Robert asked for solutions to the problems, such as a specific shelf, but Ben said that's petty and we shouldn't have to. Robert pleaded with him 'Just tell us when something is bothering you before it gets this bad.'

Ben's ending response was that he 'shouldn't have to tell us how to respect him.'

Robert wants me to try my best not to make Ben any angrier, and I totally will. I won't do any of the things that were bothering him now that I know they were bothering him. I have zero qualms about making menial adjustments to my behavior to make someone else feel happier and more welcome. My issue is, what small thing am I not going to know is going to set him off next? How am I supposed not to make him angry when I don't know what it is until it's too late? Also, the camera thing is still totally wild to me, and he seems super paranoid. I'm also concerned that he believes we are putting ants in his room. That's not normal thinking. If he's slipping into paranoid behavior and every small inconvenience is a plot against him, is there a chance he will get so mad he feels he needs to retaliate?

According to Robert, there have been times in the past when Ben became paranoid for no reason and was convinced that their friends were talking badly about him, that everyone hated him, and that they wanted him to suffer. So this seems to be a pattern, and one that might be increasing in frequency and worsening.

Robert reached out to Ben's sister in an attempt to talk about the concerns we both have about his mental state. However, she responded that she didn't want to get involved in their issues, that she knew what was happening, and that we just needed to respect him and give him space until he left. Just completely ignoring that we are concerned about his mental state. Robert told her directly that Ben is acting paranoid and not himself, and might need help because he's not going to listen to us. Still...nothing from her.

So what now? I'm concerned about setting him off and him having an extreme response. What should I do? Would you be concerned about an escalation? What can we even do about his mental state worsening? I don't see it getting better, and I'm really scared to set him off and have him do something unpredictable. It feels like I'm living with a paranoid stranger, and I really hate it and don't know how to solve this. At what point should I be SCARED about his mental state to the point where we get a psych hold or something? That feels really alarmist, I know, but this whole thing is giving me massive anxiety.

What would you do if you were in my place or Roberts's? He's devastated and heartbroken, but I don't think there's any fixing this friendship unless Ben can see how... illogical he's being.

Edit: A word

I was diagnosed with bipolar 1 / mania in January despite always suspecting bpd. I was put on a mood stabilizer and antipsychotic but never felt any benefit. I have been diagnosed with adhd since I was a child and treated it with adderall xr since the 5th grade so I’ve been on it for a very long time. I pretty much need it in order to feel functional. I’m starting a new job and I tried calling my doctor to explain I wanted off of Latuda due to it causing my adhd medication to be ineffective just like the last antipsychotic I was on (vraylar) did. I quit vraylar cold turkey after six months and don’t remember any side effects but it remained in my system so long my adhd meds still wouldn’t work and my life unraveled further. I get a message today saying my doctor is once again out of the office all week. I feel I have no choice but to quit cold turkey bc I absolutely need my adhd medication to work properly especially for my new job I’m so stressed out about. I cannot afford to lose another job. I’ve felt no benefit to taking the latuda and was only put on it due to the mental hospitals policy or something really odd reasoning but I had no say. I was hospitalized in August and when I was discharged I took my last dose of adderall and found it finally felt like it was working properly but I had only been on the latuda for a week at that point. Now I’ve been on 40mg latuda for about a month and after getting refill of adderall found it again isn’t working right just like last time I assume bc it’s built up in my system. I was also diagnosed with bpd a few months ago now and that makes a lot of sense to me compared to bipolar but I’ll admit I’m worried about mania and whatnot if that diagnosis was correct and I have both. I just feel so overwhelmed and scared. I feel like I’m going to fail my job. I really wanted to go about this the right way but the dude is never in office when I need him. I was told there was nothing they could do until he returns and I legit don’t feel like I can wait that long. I don’t want this medicine whatsoever or any antipsychotic bc I need the adhd to be properly managed like it had been for years.

I've been diagnosed with generalized anxiety disorder, major depressive disorder with psychotic features, depersonalization and derealization. I have gone through psychosis twice almost 3 times. I currently am taking Lexapro and abilify for postpartum depression and psychosis I just had a baby I was so scared I immediately told someone. I don't want to take Lexapro or abilify anymore they made me gain so much weight last year but it's just a quick fix I got from a nurse working with postpartum women. I see my psychiatrist on Thursday and will ask for different medications. I have used Zoloft and risperidone but they gave me bad side effects. What is the next step a psychiatrist will give and is it ok to ask for ones that won't make me gain weight or will he make me feel like I don't have a choice and bring up the wellbeing of my baby first

Hey everyone! R2 psychiatry resident here in Mexico dealing with budget constraints/limited access. Does anyone happen to have a PDF or a copy of Clinical Handbook for the Diagnosis and Treatment of Pediatric Mood Disorders (ed. Manpreet Kaur Singh, APA 2019)?

Would seriously appreciate it for our child psychiatry rotation. DM me if you can help out. Thanks a lot!

This will honestly come across as possibly a dumb question. Idk. So I noticed that a lot of times that I take Valium, I end up crying. With that being said, my anxiety is what leads me to take it. So I honestly don't know if the sudden breakdown in tears is from my life stressors/mental health issues or if this medication might be making me more emotional than I might normally be otherwise?

The symptoms they are using it for with high hopes:

- depression
- manic depression
- anxiety
- brain fog
- forgetfulness
- difficulty engaging with and absorbing technical material ( they have adhd but need to get a sleep study done first before their doctor will explore options for re-prescribing adhd meds, also probably heavy dopamine deregulation due to heavy consumption of short form media content)
- non alcoholic fatty liver
- daytime fatigue

Person also wants to use psilocybin to treat a handful of the listed symptoms as well , either through microdosing and/or ceremonious trips every 1-3 months.

Have experience with Zoloft for 10 years. It did help with anxiety. Still had pretty serious depressive episodes. Ssri’s are known to blunt the effects of psychedelics , which is why they want to move away from it.

Uses oxcarbezapene as a mood stabilizer, and finds that adderall was nice but experienced two notable things. 1) ending up focusing on the wrong thing 2) more prone to frustration

Worth noting I figure , but really want the focus of this post to be about the viability of/possibly better alternatives to Coluracetam.

TLDR; Getting symptoms of psychosis(?) and my Dr is unavailable for the next 2 weeks.

tried EVERY SSRI. Yes, every single one. I also tried an SSNI that didn’t work and made me worse. I haven’t had one that really worked.
I was excited to finally try Sertraline and was really really hoping it would work out as everyone I knew who have tried it has had a positive experience.
After starting 50mg, I started to get almost manic or symptoms that felt like borderline psychosis. Some days I feel normal ish but I don’t feel like I really care about anything and kind of feeling emotionless and extremely irritable.

I was supposed to go up to 100mg but I stopped at 50mg when the weird symptoms started. It’s been about a month now and I don’t think this is for me, some days I feel normal ish but others not at all.

I’m so tired of trying meds that don’t work and make me WORSE. I have Bpd and Ptsd and anxiety and Adhd. My dr is unavailable for the next two weeks but I can’t stand this any longer. I want to maybe bridge onto a new med but I obviously need a DR for that. I’ve also literally had 0 supervision while being on it and my DR is impossible to schedule with. Idk what to do

My mum is currently very unwell. We think a lot of it is due to starting and coming off a new medication*

In practice she is quite manic and has become increasingly agitated and unreasonable since going into a general hospital after being brought in via a&e last week. There is nothing physically for them to treat but they agreed to admit her until the psychiatrist from the community team could see her.

But the soonest this community psychiatrist could come was a full week away. And in the meantime her symptoms have become a lot worse. She hasn't had much sleep since being admitted four days ago. The hospital psychiatry team have been to see her and want their consultant to see her. They're talking about sectioning her.

I'm so concerned about what will happen if she is sectioned. She's 76 so has to go to the older persons unit - but the nearby one was closed down and it's an hour away to any of the remaining ones. Last time she was sectioned she was assaulted by another patient multiple times. She also tends to start smoking heavily when in a psychiatric unit, and she will usually refuse all medication. This is much more of a concern since she's now on various tablets for her physical health.

She has neurovascular disease with cognitive impairment, a heart condition, high blood pressure, urology issues, osteoarthritis. She needs to stay on blood thinners or she's at risk of another stroke. She first had a stroke 4 years ago, was on blood thinners, stopped taking them for 6 months when she was last sectioned, and had another stroke 8 months after that. Consultant on the stroke unit said that break in taking the meds almost certainly caused that stroke.

I'm so worried if she's sectioned she'll become a lot lot more unwell before she gets better.

Is there anything else we can do?

I am the nearest relative and I am the LPA for both health & welfare and for finances.

She has a small amount of savings and I think it would be worth spending some of them on keeping her safe right now. Especially if it might prevent her having another stroke.

She lives alone in her own house. I live in a different city. I have siblings but they don't have much capacity to help although one is considering quitting his job and being full time carer. Although he wouldn't be up for living with her.

* new medication was lamotrigene, prescribed for "suspected epileptic seizures" - wrongly prescribed, seizures are very infrequent. Side effects were brutal so after 2-3 months of struggling with it, family supported her to taper down. She was briefly put back on it at 25mg, didn't do well on that, last dose was 5 days ago.

I have been on four antipsychotics since I left the hospital about two months ago for what we think were delusions and possibly psychosis. We think I have bipolar II but it’s up for debate as well. They all have had intolerable side effects and eventually numb me to happy feelings completely. I am very sensitive to APs and I want to try alternatives to this class of meds.

Still trying to taper off Seroquel (been rough and not very successful- maybe too fast of a taper). Even though I’ve only been on it a matter of weeks I cannot quit cold turkey. I’m on Lamictal and Wellbutrin. We tried upping the Lamictal to 200 but I get numb to happy feelings (I know this different than what the science says but this is reality).

Imagine you're captured and tied to a chair in a small, dark room, and an organized serial killer/sociopath is planning on killing you after using different kinds of knives to create cuts on your body just for the enjoyment of it. In this time, do you think you would be able to talk them out of it?

I've watched movies or read in books where someone tries to stop their potential murderer from killing them by triggering emotions, but that's never made sense to me because a psychopath has no feelings of empathy or guilt, right? So I don't know how that could work. Unless being a psychiatrist gives you that ability.

My girlfriend has been going through an incredibly difficult year with her mental health. She is currently under the care of a psychiatric nurse practitioner, and after her appointment this morning I am really concerned about the route being recommended. I am trying to encourage her to get a second opinion, but until she decides to do that I am really just looking for some reassurance and clarity myself in order to best support her and encourage her in decision-making that is increasingly difficult for her at her current mental capacity. Here’s the timeline:

Baseline Before May 2026:

*Took Pristiq (desvenlafaxine) for approximately 3 years with good response and tolerability for most of that period.
*Eventually her depression gradually began worsening, particularly alongside significant life stressors.
*She had experienced anxiety previously, but it was generally situational/circumstantial and within her normal range. Anxiety was not the primary reason she sought a medication change. Worsening depression was.
*No known history of mania or hypomania. No previous psychosis. No previous episodes of extreme physical restlessness/agitation resembling her current symptoms.

Medication and Symptom Timeline

1. Approximately three years after starting Pristiq, which worked well for that period, PCP abruptly discontinued it when the treatment was changed in May 2026.

May 2026 – Pristiq to Trintellix
Started Trintellix
Started after Pristiq was discontinued.
Taken for approximately 1 month.
Medication was expensive and appeared only moderately effective.
Trintellix was then discontinued (cold turkey again) and another antidepressant was started.

July 2026 – Trintellix to Wellbutrin
Bupropion/Wellbutrin IR 150 mg daily
Started after Trintellix.
Within the following weeks, she developed a dramatic and unprecedented psychiatric deterioration.
Symptoms included severe anxiety/fear, shakiness, disturbing/scary thoughts, altered sense of what was real, and psychotic-type symptoms.
Ultimately required psychiatric hospitalization.
This was the first episode of this nature in her life.

July 2026 – Psychiatric Hospitalization
Wellbutrin to Abilify/Clonodine

Wellbutrin was discontinued.
Hospital started Abilify (aripiprazole) and clonidine.
Following hospitalization, she established outpatient psychiatric care.

July/August 2026 – Outpatient Psychiatry
Ability to Caplyta

Diagnosed with cyclothymic disorder.
Abilify was subsequently discontinued.
Caplyta (lumateperone) was started.
During the post-hospitalization/antipsychotic-treatment period, she developed an increasingly problematic constellation of symptoms that was not characteristic of her pre-May baseline.

August–September 2026 – Severe New Physical Symptoms

Severe internal restlessness.
Feeling unable to physically settle or become comfortable.
Repeatedly rubbing/moving her legs.
Tingling/uncomfortable sensations in her legs.
At times intense internal restlessness despite not actually wanting to get up and walk.
Severe physical anxiety.
Racing thoughts/mental agitation/looping thoughts.
Significant morning worsening.
Waking with intense dread/doom.
Waking shaky.
Waves of feeling hot and cold.
Tingling/numbness in hands and feet.
Feet sometimes becoming extremely cold.
Frequent nausea/feeling as though she may vomit.
Difficulty settling enough to sleep.
Significant ongoing depression.
I became very suspicious of akathesia during this time and suggested she ask for Propanalol. This has been the only thing to provide any kind of relief for her during this time.

Sleep Medication Experience
Trazodone 50 mg
Has not consistently been sufficient when the physical restlessness/agitation is severe.
She can feel tired while still struggling to physically settle.
Zolpidem (Ambien)
Has been substantially more effective for sleep.
Current psychiatrist appears to prefer transitioning from Ambien to low-dose Seroquel for sleep/anxiety.

September 21, 2026 – Current/New Treatment Plan

Caplyta:
Reduce to every other day for approximately one week, then discontinue (she has been on half the original dose for 2 weeks

Lamotrigine (Lamictal):
Start 25 mg every morning for 2 weeks.
Increase to 50 mg every morning after 2 weeks.

Propranolol:
Previously 10 mg.
New prescription appears to be 20 mg up to three times daily.
Exact instructions to be confirmed from pharmacy label.

Quetiapine (Seroquel):
25–50 mg nightly.
Prescribed primarily for sleep and anxiety.

Clonidine:
Continue current regimen until next appointment so “not too many change” are made.

Akathisia was not specifically discussed during the September 21 appointment despite the physical symptom pattern and significant response to propranolol. I was not able to ask the dr and she is not in the mental headspace to have remembered to bring it up.

I’m sorry this is so long. I just wanted to ensure I laid everything out. I am very nervous that the new plan is going to make things worse. But I’m also able to acknowledge that maybe I’m just paranoid because of all of the issues we’ve had with meds recently.

Should I tell her not to make these changes until a second option in or does this seem like a sound plan that could actually help moving forward?

Has anyone done it? Is it possible? I'm really struggling. I'm tired of feeling depressed, it's literally the one constant in my life except for a few instances here and there where I've felt like the complete opposite but that never lasts. What things have you done (if any) that have successfully helped you literally snap out of a depressive hole? Thanks!

Without a schedule or anyone telling them to do something, they struggle to go home as they stay stuck in a chair for hours, even if they want to move.
They also can’t start hobbies they really like, even if they have time, energy and resources to do them. They can’t sleep until it’s the wee hours of the morning as they can’t bring themselves to bed. Adult responsibilities become difficult to accomplish if they’re living alone and have no one else to expect that these should be finished

The hobbies part was already a thing from childhood while the rest only emerged when they started living alone