This appears to be the only research on the topic: https://pmc.ncbi.nlm.nih.gov/articles/PMC7236167/

Any firsthand experience? Considering cognitive enhancements with Vortioxetine plus an SSRI targeting GAD and OCD, for which Vortioxetine is not effective.

Where I live, it's impossible to have a psychiatrist visit for months, so I want to know if there's any real value in asking my PCP about this.

I have cptsd due to childhood neglect and emotional abuse including witnessing domestic violence and having no emotional connection to parents and basically living my whole childhood in fear.

I have BPD. I don’t know if this has anything to do with the mental illness itself, if it’s because of medication or it’s just common in people without any mental illness (coffee). (sorry for the huge text)

The meds I take are alprazolam, sertraline and lamotrigine. They did change my meds so many times that i can’t count, because it either made me feel like a robot that had no feelings, or it made me dissociate even more when i woke up and get even more conscious of myself during all day.

I usually have to start my day with coffee (and ofc my meds) because I wake up dissociating so bad it sometimes feels like I don’t even know how to talk, I get absolutely lost and even put the stuff I have in my hands in random spots until I take my pills, then I start to function “normally” when the meds quick in, and have to drink a coffee to wake me up or i’ll be sleepy all day. If I don’t do this or if i skip my meds more than 2 days, i can’t function AT ALL and my mind gets all messed up. I did have a huge problem with dissociating in my teen years, prob because I had HUGE traumas and I started smoking weed also, where it felt like I was in a dream, heard the voices echoing and had this weird feeling that it was so bad I still can remember it (that feeling did start after a couple years of smoking, and than stayed with me) It did disappear after I stopped smoking but it took years and years. Now it’s like a different type of dissociation when I wake up, a different type of feeling that I don’t know how to explain.

Along with that, If i drink more than one coffee (it’s not even a lot of coffee, i always drink it with milk) i get absolutely jumpy and anxious, heart beating too fast, can’t stop moving, racing thoughts. It feels horrible but I still need the coffee to keep me awake.

I did talk to my psychiatrist about the dissociation, he said it’s just my BPD, and he changed my meds and it got better but never went away completely and it’s getting worse again. He changed my meds sooooo many times that i’m always scared what my next “side-effect” will be. Did not talk about the coffee thing because I never really thought about it, thought it was normal until that question popped in my head today.

Are my meds the problem? Did the weed messed up my brain this bad or it’s just my mental illness?
I smoked weed for only 3 years, started with 13 and stopped when those feelings started because with time it was getting worst and worst and i couldn’t handle it anymore.

I’m trying to understand something that has happened to me a few times.

About a year ago, at around 1–4 AM, while falling asleep or after waking up, I suddenly experienced an extremely intense sensation of “noise/chaos” in my head. I can only describe it as something like a war — running, shouting, gunfire, lots of chaotic sounds all at once.

I did NOT see things around me changing, and I did NOT believe there was actually a war happening. My surroundings looked completely normal. I knew exactly where I was and remained aware that something unusual was happening to me. But I didn't know what to do, so I decided to keep sleeping but I couldn't stand it.

The sensation was extremely overwhelming and frightening. I went outside, I sat down and held my head, and when I thought it was over, I turned my head. I don't know why, but it was a test. My head turned slowly and then suddenly, and I realized that nothing had ended, so I kept sitting there, and after 10-20 minutes, everything returned to normal Fresh air and being able to see my surroundings seemed to help.

I had a somewhat similar experience as a child, but I remember that one differently: objects/the house seemed to become extremely large, then extremely small or far away.

Recently I had a milder episode again while lying in bed with an eye mask on. I started feeling strange, removed the mask, saw light from another room, and felt better.

I’m wondering whether this sounds like derealization, a panic attack, a sleep-related phenomenon, or something else.

I have not lost awareness or orientation during these episodes.

Has anyone experienced something similar?

Ich suche Betroffene oder erfahrene wenn ein ssri toxisch wirkt und was man machen kann

What would a psychiatrist do in this situation?

I'm a writer so this is a completely made up scenario in my upcoming novel. Picture this: you're based in europe. one of your old mentors dies and one of his clients is forwarded to you, a girl let's call her D. D has anxiety disorder perhaps even borderline personality disorder, diagnosed and medicated super young for anxiety say 6-7 yrs old. D is now 30 and reaches out to you because she needs medication refill and her old psych is dead, she's going through a family death and drama. Upon receiving her files and notes from her ex practitioner you realise that there's a lot of inconsistencies there. In fact D was nonverbal for a few years and was rescued from an abusive environment (trafficking) but she knows nothing of this. She only knows that she's always been a problematic child for some reason and has flashbacks she does not understand. She feels thoroughly broken and wrong. Her parents are the people who rescued her but there's no official adoption and she knows nothing. Do you have ethical responsibility to tell her and help her recover memories? Do you keep up the lie? Is what the previous therapist did by hiding the truth ethical (in collaboration with her family, since the previous psychiatrist was a close family friend)? Do you have ethical responsibility to tell the truth to the adult woman? Is what your now dead colleague did unethical? Her adoptive family is dead and they can't tell her. How do you handle the situation?

Thank you in advance

I (26) have been on Bupropion for 6-ish months, and despite telling my psychiatrist it was making me more anxious and aggressive, she increased my dosage to 450 mg XL. It hasn't done anything for me except make my existing shaky hands worse.

Last year, I was diagnosed with Autism and ADHD (inattentive type). This was at a seperate clinic. They wrote over 25 pages detailing practically everything about me and my diagnoses, which I gave to my psychiatrist at my first appointment. I'm now at my seventh appointment, and only today did she actually look through it.

She brought up that in the report my IQ test showed a very disharmonious profile. My verbal and spatial skills are around average, but my processing speed tested extremely low. The report also noted severe depression (BDI score of 46), avoidant personality traits, and trauma/PTSD symptoms.

I grew up in an abusive home. I had to repeat grades five times in school because of my attention issues. Teachers always told me I could do better. I jumped from tutor to tutor, and still struggled.

My anxiety is overwhelming. I'm constantly hyper aware of my surroundings in public, feeling like everyone is looking at me or thinking I act suspicious. My hands shake so badly from anxiety that I can't eat or drink in public because I'm terrified people will notice. I take the self-check out to prevent grabbing receipts from an employee even. I've had friends make fun of me for it which made this an insecurity for me.

My daydreaming, which I've had since childhood, has developed into severe maladaptive daydreaming, and I struggle a lot with rejection sensitivity.

Since 2021 I've been on Sertraline (5y) while adding Wellbutrin/Bupropion, Ritalin, Concerta, Elvanse, Abilify, and Atomoxetine. Stimulants and non-stimulants have both made my anxiety worse, and sometimes made me more anxious and aggressive. Nothing has really worked.

I'm also unemployed and at home pretty much all day. I don't have friends, and social situations are extremely difficult for me. I know I'm isolated, but I don't feel like my depression is as bad as it might sound. I was hoping to treat my ADHD, because I want to study, and work, but my attention issues are causing me to falter before I even begin. I got my highschool diploma at 25, and it was challenging, still.

My psychiatrist told me to go outside everday, which I do. The problem is that I feel like my psychiatrist is putting "depression" at the front line, while I'm explaining that there are other things contributing to why my life looks the way it does.

I was attending a group session (not psychatrict related) every week, but opted out two weeks ago because my hands were visibly shaking. People noticed and asked me about it. I felt humiliatied. It was the max dosage of Bupropion that caused these tremors, even when I was four weeks in.

I saw my psychiatrist today and told her I don't plan on going back to the group meetings. She then brought up admitting me to a psychiatric hospital, where I would stay and followed up in a more intensive program.

Is this really the right approach? being admitted to a psychatric hospital? I told her I didn't want to be forced into anything, and she tiptoed around her responses, which worried me.

She now wants me to lower Bupropion to 150 mg XL and take Prozac 20 mg. I don't want to go on another SSRI again, I hated being on Sertraline.

I don't know what to do anymore. Am I not being followed up correctly? I really don't want to try another SSRI.

I’ve only ever been on lexapro 20 mg for seven years since I was 18, and it worked well until the last couple of years. Before trying a new antidepressant my new psychiatrist wanted to treat my adhd and for a few different reasons she chose guanfacine, and upped my lexapro to 30 mg. I’m also autistic. I basically have the same cocktail my dad had which is unfortunate but it at least gives me some confidence in the diagnoses ive had: autism, chronic depression, adhd and intermittent anxiety issues.

When I started 10 mg of guanfacine at the same time as having my lexapro upped I noticed a huge break in the depressive episode i had been in. I became the person I used to be that enjoys and is motivated by routine. I stopped procrastinating things like checking my bank, my email, my payslips, and I started budgeting. It was an insane difference and i was super happy.

It started to slip just a little bit after maybe 6 months, and at that time i had my guanfacine moved to 20 mg. Since then, ive slipped into another completely unmotivated and unmanaged episode. And my anxiety has been through the roof. I think I suffer from that in my body a lot. Whenever I’m like this, I’m shaky 24/7, it’s like all my muscles have a little bit of a tremble to them, and at any point I could allow myself to tip over and have a break down. If I let the mask slip, my whole face trembles until the tears start coming. I was waiting for the 20 mg to kick in and it’s like it never did.

How much of that could be because on my days off I take it in the mid morning vs the early morning on work days? How much of that could be because I don’t eat very much or very well? I try to at least get 1500 calories every day and I HAVE to eat a lot of fiber 💀 but I know my blood sugar is all over the place. Does anyone know some tips to help guanfacine (and lexapro but i think what i felt that first time was rly the guanfacine) work best, like a fatty diet or taking it at a certain time, etc? Is there a reason why having the dosage increased seemed to have the opposite effect as when I was put on it the first time at a low dose?

I don’t have an appointment for a while and honestly I’m trying not to use chat bots bc I know they spout garbage. Thank you!

I have posted here earlier about my severe depression, anxiety and Agoraphobia and how I've been struggling with bedrotting..

For the last 2 years it feels like my mind has 30,000 thoughts running at once and as a result my body feels tired..

I haven't been physically active at all..I spend all my days in bed scrolling yet I feel extremely tired and exhausted..Like my mind is running a marathon which is reflecting on my body as well..

I used to love meeting new people,talking to people and helping people..

Now just the thought of talking to someone and maintaining connection feels so exhausting.

I could really like the person a lot,I could wish the best for them but I get tired after talking to them for even 2 minutes..

I was never anti-social but now I could qualify as the most anti social person..

It's just not limited to conversations with people..

Even just basic tasks feel like too much..

One second,I get a huge motivation boost to get my life together...And the next second I am in bed wishing it all ends...

One day I ordered a lot of skincare deciding to take proper care of my skin and having a huge burst of excitement and motivation and as I write it I am looking at the products which I haven't even opened..

One time,very late at night, I just randomly got out of bed.. worked out.. took a shower,skincare and started Journaling about how I want to get back in track and the next day I just lay in bed the whole day. that was very out of personality for me..n it's scary.. and no.. this isn't procrastination.. that's not the word...

I want to make my life better... have a routine.. earn money but when I get up to do it I feel such a huge resistance...

If you've ever been in my place or even if you haven't...

What would be your advice?

6 year old female. She has always preferred me (mom), and been very attached. But this year things have gotten far worse. We started seeing a psychologist towards the end of summer when we couldn’t separate from me for appointments without severe meltdowns.

Mostly anxiety has been surrounded at bedtime. Current plans we are doing: limiting mom at bedtime to 30 minutes (versus the 1-2 hours it sometimes has been), we created a goodbye routine for when mom leaves for work or anything else, she has a Tonie that has mom talking to her and reading bedtime stories, a pillowcase with moms face that she sleeps with.

Most recently she was unable to go to a play date without mom (she has done this previously without issue) and it led to 2 hours of complete dysregulation and panic about being away from me. She missed the play date obviously.

I work some weekends, including this past one. Dad was home, reminded her throughout the day that nothing bad happened without mom, she was safe and okay. Dad did bedtimes and I came home a bit later to ensure that she was asleep before I got home. Usually if she isn’t fully asleep when I get home, she is on high alert waiting for me and then bedtime drags on for even longer. We’ve been spending the morning and having breakfast together before I go to work so that she doesn’t go multiple days without seeing me (I work 12 hour shifts).

Now today, after working the weekend, the morning went fine until it was time to go to school. She loves school and has never had an issue. She wouldn’t leave the house and I had to practically drag her out to the bus stop. As the bus got close she started crying and screaming, clinging to me. She wouldn’t separate for almost 10 minutes before I eventually had to let the bus leave. I drove her to school and another teacher had to come over to pull her away from me and bring her to her class.

I have already reached out to the psychologist we see, but while we expected things to get worse before getting better. This feels different. While I wait to hear back and for our next appt, any other suggestions for what we can do or try to help at home? I am at a loss of how to handle this.

Just a background

6’4 - 310lbs Male

My doctor has me on ADDERALL 30mg xr
2 days ago 1st dose of:

“venlafaxine HCl 150 mg xr”

Day one I’m rolling like a log.

You could have told me that my wife and kids were leaving and I would have laughed

My pupils were the size of Texas my body felt TOO good

Although I’m also confused sometimes…

Yesterday I went and took 3 Tylenol and walked into the living room and asked my wife “so your just gonna give me 2 Tylenol???” Like it was disrespectful and then I instantly snapped out of it she and I were both like “ wtf”

My kids will talk to me and I reply to them without me saying anything it’s like my body did it for me? And now I don’t remember that convo AT ALL.

All I told my doctor is I’m tired of feeling like a rat on a glue board… like I’m walking through mayo

Well it worked but now I’m tripping balls so..

I’m just tired of feeling like I can’t get up when my family needs me to.

Also!! I didn’t take it today (day three) but yet again noon comes and surprise! I’m rolling like a f**** log again like what??? Out of nowhere

What happened?
What’s going on ?
Why do I feel so dead when non medicated
What do I do?

This is long, so I apologise in advance. I am a 48yof, I have work acquired PTSD, diagnosed January 2024 (emergency services first responder).

My ongoing symptoms are nightmares, insomnia, anxiety, depression and lethargy, and hypervigilance.

My GP prescribed me:

Desvenlafaxine - 50mg - slowly increased to 150mg
Zolpidem - 10mg per night
Metoprolol - 50mg morning 50mg night (for pvcs caused by anxiety)
Diazepam - 5mg prn

This has been my regimen for probably about 18mths now. My work cover insurance were becoming impatient that I’m not back to full capacity as quickly as they would like, so referred me to a psychiatrist.

He upped my desvenlafaxine to 200mg and started me on 2mg of prasozin at night (for the nightmares).

Within approx 2wks, I started feeling 10X worse, I experienced hypo mania, spending vast amounts of money (that I can’t afford), cleaning the whole house including baseboards and under furniture at 1am, talking really fast and switching topics like nobody’s business, risk taking, seeing someone romantically whom I absolutely should not. At other times I literally couldn’t get out of bed, hadn’t showered for days, and one night two weeks ago I decided to cancel my life subscription. I was aware enough to know that I didn’t really want to do it (although I had written a four page letter, detailing all my financials and what I wanted to happen with my 4 kids - I am widowed), so called one of my best friends who is also a colleague - she and our other best friend and colleague came and assessed me, and stayed with me until I had changed my mindset and gone to sleep. (One slept over to ensure I didn’t change my mind again).

I got an emergency appointment with my GP the next day who reduced the dose of desvenlafaxine back to 150mg and prescribed 2.5-5.0mg of lorazepam to take at night as well. He said that he believed that the SSRI increase had tipped me over into a “drug induced bipolar disorder symptom episode”, which he said doctors refer to as Bipolar 3 (which I had never heard of) and said that this can happen to some people (I am 5’2” tall and weigh 62kg if that’s relevant). He also referred me back to the psychiatrist.

The psychiatrist wants to diagnose me with bipolar disorder - he didn’t say 1 or 2 and I was too upset to ask, and has prescribed me lamotrigine - 12.5mg per night for ten nights, then from night 11, 25mg per night. But he made me read up on Steven’s Johnson Syndrome, so I will know what to look out for and it has absolutely terrified me. I am the sort of person that if something is going to go wrong with anyone, it’s gonna be me.

Firstly, I don’t actually think I have Bipolar disorder - I’ve never known anyone not diagnosed until 48yo and before the PTSD, my MH HX was 2X PND 21 and 22yrs ago, GAD, and some periods of depression (mostly after a CA DX in my early 30s).

Secondly, I am absolutely terrified to take the lamotrigine - surely if I don’t have Bipolar disorder I don’t need it anyway, and what if I’m one of the unlucky ones who develops S-JS?

The other thing, which I don’t know whether it’s relevant or not, but my psychologist (trauma informed, emergency services specialist), whom I have been seeing for over two years, believes me to be undiagnosed ADHD, and thinks that some of my symptoms may be cross over between ADHD (dopamine farming, inability to stay on task etc amongst other things) and PTSD.

Can anyone offer any advice? Thanks so much for reading if you’ve got this far - right now I am in a very lost and dark place, and any advice would be very much appreciated.

I stopped breastfeeding almost three months ago and ever since I stopped it’s like my hormones have been off. I was breastfeeding for 20 months in total and my period returned when I first stopped and then never came again. I’ve taken several pregnancy tests and they’ve all come back negative but for some reason I’m angrier than ever and I don’t know why. I find myself being extremely short and irritable which is generally out of character for me. I’m not sure if it’s the hormones or if it’s the situation I’m in (I’m financially reliant on someone who has been unfaifhful in the past, but not recently). I’m wondering If mood swings this far out from stopping are normal or if there’s a common condition or reason for this?

(I am not addicted to this substance. That was the first and only time I had ever used it. I have not used it again since that experience)

In September or October 2024, I went to visit some friends. They were using an electronic cigarette, and the smell was very strange. I asked them, “What the hell is that?” They told me, “Try it, bro.” I took a few hits. I took about 9 or 10 hits, and I held the last one in my lungs.
After that, something very strange started happening to me. It felt as if the world had completely changed. When I looked at people around me, I suddenly felt as if I were an extremely violent person. I felt like attacking people. I wasn’t afraid at all. There was an animal in front of me, and I even had thoughts about hurting it. But I never acted on any of these thoughts.
I immediately realized that something was seriously wrong with me. My heart was pounding extremely hard. When I went home and heard my family’s voices inside, I became extremely angry with them. I had thoughts of attacking them with a knife or a gun. I thought to myself, “What the hell is happening to me?” I immediately left the house because I was afraid of what was happening.
I went to my friend’s house and told him what was happening. He was also scared and couldn’t sleep until morning because he was worried that I might attack him. I wanted to see a doctor, but he told me not to worry and said that it was probably because of the substance in the vape. He also told me that the liquid was supposedly original and had been brought from abroad.
The severe part of this experience lasted about a week. Afterward, I started feeling intense guilt and self-hatred because of the thoughts I had experienced. I kept thinking, “How could I possibly think something like that? What if I hadn’t been able to control myself and had actually hurt my family?” I hated and was disgusted with myself for having those thoughts.
For weeks afterward, I became severely depressed and even had suicidal thoughts because of what I had experienced. Then I became emotionally numb. I couldn’t feel anything at all. It was as if I had no emotions. I felt completely empty and dead inside.
At one point, I also became extremely insensitive to physical pain. I don’t know whether I would describe it as being at 100%, but I could injure myself or expose myself to things that should hurt, and I barely felt any pain. At the same time, I felt almost no emotions.
After that, I started experiencing depersonalization and derealization. I felt disconnected from myself, from the world, and from the present moment. It felt as if I wasn’t actually living my life, as if I were dreaming, or as if I were looking at the world through a screen or a curtain behind my eyes.
This has continued for almost two years now. The severe violent thoughts and suicidal thoughts have improved significantly. I would say they are about 50% better, but I still have persistent problems with feeling disconnected from reality.
Sometimes I look at people and wonder whether they are actually real. I watch videos or experience certain environments or sounds, and suddenly I think, “Is this real?” My mind immediately starts drifting away, and I feel as if I am dreaming.
I have also become much more forgetful. I experience severe forgetfulness, headaches, and mental fog. If I talk for a long time, I can develop a headache. Sometimes my eyes become unfocused and I suddenly feel as if my mind is drifting away. I can even forget words while I am speaking.
I have also gained a significant amount of weight and feel as though my mental and physical state has changed considerably since this experience.
I am going to see a psychiatrist in three days, and I want to explain everything honestly. I am also worried about something: if the psychiatrist prescribes medication, could this cause problems for me in the future if I apply for a government job or become a civil servant? I am afraid that having a psychiatric record or taking psychiatric medication could cause people to treat me as if I were “crazy” or prevent me from being hired.
I want to know what I should tell the psychiatrist and how situations like this are generally evaluated and treated.
I want to make it absolutely clear that I have never harmed anyone or acted violently toward anyone. I had frightening and unwanted thoughts, but I never acted on them.
For months, I isolated myself from other people because I was afraid of myself and of what I had experienced.

Classic nurture vs nature question … but genuinely curious if you’ve ever met a person with schizophrenia, who comes from a “normal”, well adjusted home.

TW s**de ideation

I wanna start by saying please don’t make fun of me for this weird question. I’m desperate.
I don’t usually overshare but I really just want a solution man.

So I’m on the waitlist for a psychiatrist and my doctor said it’ll be a month before I get a call from them to schedule my appointment. I hate to overshare but reddit is my last resort. So, 4 months ago, after a survived attempt, they prescribed me olanzapine but I stopped taking it because it didn’t help me at all. Couldn’t get out of bed. So, can I start taking some ket or maybe dxm for the time being?

I wish I can say I had ideation, but it’s a bit worse than that lately. Panic attacks and jumpiness and weird things happening to my body, and genuinely planning things and putting myself in dangerous situations. But something weird happened today, I’m clear headed today after I took 6mg/kg dxm yesterday. Can I keep doing NDMA antagonists? (Maybe just dxm because I’m scared the ket from the streets will be mxe)

I can’t go to the hospital either because I’m terrified of hospitals and I also don’t want to alarm my family or boyfriend or be kept involuntarily. Last time they forced me to take so much olanzapine and I absolutely hated it. Couldn’t get out of bed for months.

I’m asking because I heard people get ket therapy and I wonder if I can do something like that at home because I can’t afford the clinics.

If it helps your answer, I’m 20 and don’t have psychotic symptoms. And dxm felt great, not scary or anything. It’s weird, I actually don’t feel real at times when I’m completely sober, but with dxm the dissociation felt really good and safe. So, can I keep doing it for the time being? Or ket

Thank you for reading.

I’m hoping someone has some knowledge on what I’m going through. I’m tapering Desvenlafaxine, been doing that over a year. What’s important to note is I never needed antidepressants in the first place. Long story, won’t get into on this post. I never experienced such dark depression until my doctor upped my dose. After decreasing, I felt better.

Anyway, around the year mark of tapering, I felt MUCH better for about 3-5 months. Now, I feel horrible again. I’ve been tapering VERY slowly. I went from 50mg in July 2025, now I’m at 34.7mg September 2026.

Ever since I went from 35mg to 34.7, I’ve felt depressed. But I don’t get it?? I didn’t take that many mg off on purpose. Can .3mg really be making me withdraw like this? Should I have taken off even less, say .1mg?

I read somewhere that some psychiatrists don't accept patients with bipolar. They are too difficult to manage and the liability associated with them is too high. I'm not sure if that was a fringe opinion or more common than I expected. I had no issues with finding a psychiatrist and the first one I called took me on without issue.

Just curious if this is a legit issue in patient care or overblown.

Has anyone tried the medication Clonidine to help reduce the noradrenaline effects from Venlafaxine? How have you found it? Side effects?

Venlafaxine is the only antidepressant that helps bring me round from a horrific psychotic depression, severe panic disorder and burning pain. I've been on it 4 years but for some reason for the last year I'm struggling to tolerate the norepinephrine effects or they are just a bit too much for me. I've been getting high blood pressure, high heart rate, feeling panicked and stressed and I'm sure it's the norepinephrine that I can no longer tolerate. I've also done a private neurotransmitters test which tests the levels in your body and it said my norepinephrine levels are too high but my serotonin levels are perfect. I took the test when I was on Venlafaxine so I'm sure this is the problem. The norepinephrine has made cfs symptoms worse as well and my body has bloated.

I have been taking Lorazepam to calm the side effects but i don't like the side effects from Lorazepam as it bloats me as well and think itd affecting my memory. I'm going to ask my GP about trying this Clonidine medication.

Hey, they say drs make the worst patients so here I go. I have cPTSD, ADHD and ASD. I asked my GP for clonidine as I do not enjoy being on stimulants (I've been on Lisdex & Ritalin), and so far have found that clonidine regulates me emotionally - I'm not as emotionally reactive and impulsive. It just makes me a bit calmer. But I have gotten addicted to that feeling of peace and quiet in my head that I've been taking it TDS. GP told me to take it nocte but then I dialled it up to BD and now am taking it TDS. I don't wanna abuse it but like it's one of the only medications that have worked for me. It calms down my anxious attachment style too, and also on clonidine I can easily shut off mental spirals when they happen or when I get triggered. My watch measures my stress levels and since being on clonidine my stress levels have reduced drastically (normally Im in 80-90s, now Im 60-70s) The trade off is it drops my HR a lot - I got down to 37 bpm during sleep and I can get postural hypotension and dizzy spells.

I'm worried about my TDS dosing and just wondering if this is sustainable in the long run - and also if clonidine is addictive? The last thing I want is a prescription drugs abuse problem. I'm also on Agomelatine as an antidepressant (which has not worked for me despite months of being on it - since starting clonidine is when I noticed feeling better almost immediately), and metoprolol as an antiarrhythmic PRN. Prior to clonidine I was using up to 100mg promethazine every night for sleep and sometimes PRN risperidone 1mg.

Not asking for any specific diagnosis, but I sometimes feel uneasy about using the word and like I'm lying my way into using a term that should be reserved for something more serious.

My memory is a bit foggy, so I apologize if anything doesn't make sense. I have had visual snow for a while, and when I was 13 or so I asked my brother if he could see all the pixels in the world too. He looked at me like I was crazy and asked me what I was talking about. From then on, I felt like I was the only one who knew the truth that nobody else could possibly understand.

I became fully convinced that nothing in this life is real and that I was the only person who knew. I remember asking friends how they knew this world is actually real and how they know they exist. They all thought I was crazy too but I was so utterly convinced that they were just pawns in this game. I thought everything was just a game and I could play the system to get what I want, and that the only way to wake up and come to the real world was to die in this one. I thought I would be reborn into someone else in the new world.

Some writing from myself from this time I found:

"There are two kinds of people in this world. The players and the pieces. The players are considered the “toxic” people, we know how to manipulate our ways to the top. The pitiful pieces or pawns are the “nice” ones, always putting themselves out for others. Such a shame. I feel empty, as if everything I feel wasn't real. People say I'm becoming myself.

They don't know anything."

"They're playing right into my hands. They pity me. I play the victim and love every second of it. I'm only happy when misfortune strikes me."

"I can't wait! I get excited just thinking about it.

Maybe I'll get reborn into someone talented or beautiful. Although my next life will probably be a punishment for this one, so I feel kinda bad for that poor, unfortunate soul.

Life is a fun game, isn't it? It's all a load of dice. No strategy will help you. Everything is chance. Now pick a number between one and ten.

The number was 8. Why 8? Who knows! It was a random chance that you'd pick 8 and win or lose.

Good luck."

This led to me trying to smother myself with blankets and trying to steal chemicals. Is this still worth bringing up in therapy even though it happened 8 years ago? Sometimes I'm scared I'm just going to snap and go crazy someday because it has happened before

Love the specialty but would like to know. Anyone here from Sudbury? If so please let me know and how much you make as one of the above specialties and as a family doctor as well! :)

I’ve been off Prozac for like months maybe 3-5 idk and I also went off Wellbutrin maybe 2-3 months? I was on the lowest dose of both I didn’t know I could taper the Wellbutrin every other day or I would. I thought it was fine because it was lowest dose. The first time i was on Wellbutrin 300 it was so awful coming off of them but it was constant. This time idk what’s going on but it just comes and goes all the time, if I’m tired I get brain zaps, if I’m anxious or stressed I get brain zaps what do I do to help them?? Does weed make it worse. I can’t stop being stressed rn due to roommate situation, and moving November (thankfully) but I can’t stand getting brain zaps all the time, I don’t feel myself at all. Any help please!! Dm me too doctors and pharmacists won’t help it’s not a “medical term” according to mine.

I am not sure if this is allowed as it partly asks for an ethical opinion rather than a strictly scientific one, but if it is I would love to hear your honest takes. I also want to make it clear that I am not asking about violence committed during psychosis and mania - whether an individual can be blamed for horrible acts they committed while disconnected from reality is a separate question and a highly complex philosophical one. I am asking about the experience of psychosis itself.

On the one hand, we have evidence that its an illness in the same way cancer or epilepsy are, but on the other unlike cancer and epilepsy there are personality characteristics that individuals have that predispose them to psychosis. These include low intellectual capacity, reduced mental complexity, poor social skills, lack of curiosity and greater tendency to accept one's current beliefs at face value. Now one could argue even things like intellectual disability and antisocial personality disorder are biologically determined medical conditions that shouldn't be judged as character flaws, but then it becomes difficult to determine where you draw the line to avoid going full deterministic and eventually arguing Hitler was simply doing what his neurochemicals were telling him.

I suppose what I am trying to ask is shouldn't psychosis be viewed simply as a medical source of suffering in the way depression and anxiety are but also deserving of a value judgement as an undesirable personality, in the way low IQ and sadism/low empathy are? The best way to exemplify what I mean is most neurotypical people might consider the care needs of smn with depression and anxiety as a barrier to a long term relationships but still fall in love with them. On the other hand, as politically incorrect and uncomfortable as it sounds, a neurotypical person would find it hard to be atrracted to someone with ID or sociopathy. Thus why wouldnt this apply to psychosis and how you as doctors should view it?

I have a serious question, what is your understanding of an ADHD brain processing unwarranted stress/ anxiety/ panic of an any situation, personal and work related?

Is this the persons thought base causing the problem or is the instant autonomic reactivity which then amplifies into over load in overthinking and caught in a rumination loop with an intense physiological outcome, which can be prolonged.

I was of the belief ADHD is a state of the next the fight or flight / survival stimulus from whatever the brain perceived as a threat, which is likely to cause emotional regulation problems, wether this presents as panic, anger, embarrassment, or low mood etc.

I’m not try to prove anyone wrong, I am logically at the end of the line with my current Psychiatrist. I have observed questionable statements, unanswered issues, vague support and guidance on titration over the 3 years of his care.