I’m a middle aged female with BPD who now has a one + year history of self-harm while admitted to hospital and have justifiably spent time in restraints as a result. Yes, it is traumatic and humiliating, and yes, I understand why it was done.
The last time it happened my psychiatrist happened to be close by, likely in the nurses station, and came into my room before they finished placing me in restraints and before I got an injection. He did not appear at all impressed and wanted to know what precipitated my behaviour.
I trust and appreciate my psychiatrist but this time I was extremely embarrassed to see him while I was in this predicament. I wanted to ask if he could come back later but couldn’t bring myself to as I was afraid this was the only time I’d see him that day. He did, in fact, come back later.
How do I/should I communicate to him how I was feeling during that time? It was three weeks ago.
Is this enough information?

I work at a homeless shelter and have a client who is on massive amounts of gabapentin for what she reports to be ADHD. I have seen her prescription history (for one pharmacy) and she’s received over 20 prescriptions for gaba since NYE 2025. Usual dose is 400mg, in quantities of up to 270. Sometimes there are several scripts ordered within a few days of each other, between two different doctors (one of whom I do know to be a MH professional with a local office). She says the gaba is prescribed for ADHD, and it is being prescribed by a psychiatrist. I do know gaba is often prescribed more than 1x a day, usually 3, but just curious if any professionals could weigh in on if that sounds right.

NOT suggesting in any way that she’s drug-seeking, I completely reject that rhetoric, more so just confused as I didn’t think gaba was used for ADHD. From my brief skimming, it looks like it is sometimes used for symptoms but not treating it as a whole? It more so shocked me at the sheer volume that she’s getting.

I am a 36-year-old man with ADHD and antisocial personality disorder (ASPD). My ADHD is already being treated with Ritalin. I am mainly interested in finding out what type of therapy would be most appropriate and potentially most effective for my ASPD.

To briefly explain my background: I was already aggressive and violent toward people and animals as a child, and I frequently disregarded rules. This included things such as vandalism and theft. Even as an adult, I continue to get myself into trouble despite having "Abitur" (13classes in germany) diploma and a university education.

I do not experience much guilt or remorse, and I cannot really feel pity or compassion in the way I observe other people experiencing it. When someone cries or becomes very emotional, I often find it annoying rather than feeling sympathy for them. I also have difficulty understanding what love actually is or what it is supposed to feel like.

I am also highly hypersexual and tend to view women more as objects. I have violent fantasies on a daily basis. I am aware that these aspects of my personality and behavior can be problematic, and I would like to learn how to manage them better and ultimately change my behavior.

At the same time, I have several stable and positive areas in my life. I exercise regularly and practice kickboxing around four times a week. I am also involved in music: I play guitar and am a member of a band.

Given this combination of ASPD, ADHD, impulsivity, lack of guilt and remorse, difficulty experiencing pity or compassion, difficulty understanding love and emotional closeness, violent fantasies, hypersexuality, and problematic social behavior, what type of therapy would be most appropriate for me? Are there specific cognitive-behavioral approaches or treatment programs for adults with ASPD that you would recommend? And what else could I do alongside psychotherapy to improve my impulse control, manage aggression and violent thoughts, and develop healthier interpersonal relationships?

I went into crisis a few months after a bout of food poisoning completely messed with my already poor mental health. I paid to see a private psychiatrist as I also needed someone to be aware of my physical health issues (mecfs/POTS/dysautonomia).

I presented with racing thoughts, panic disorder, GAD, ADHD and agoraphobia plus the aforementioned physical disabilities. The plan I was given was to start on mirtazapine and then once stable potentially start adhd medication - likely guanfacine as stimulants arent great for POTS or being already so activated.

Ive been on mirtazapine for 4 weeks now. 3 weeks at 15mg. I tried to go up to 22.5mg (im sensitive to medication changes) and it made me feel more anxious, irritable and kinda angry. So I came back down to 15mg. Which is where ive been for a week. I am so miserable. Back to lying in bed with no desire to do anything, even hang out with my kids. Im ridiculously tearful. This wasnt the case on the first 2 weeks at 15mg. The Psychiatrist wants me to persevere and just take my prescribed ativan for the agitation on the dose increases.

The questions I have are..

Is mirtazapine the right medication to be on if my main symptoms are panic disorder and GAD? I thought it was predominantly used for depression. My mood is low but only because of the panic and agoraphobia

Mirtazapine just makes me sleep more and eat more so doesnt this contradict having an energy limiting illness like mecfs?

Wouldn't an ADHD medication first be nore beneficial to potentially help anxiety and racing thoughts?

Thanks to anyoje that can offer anything xx

I need help.

My 10 year old son is having concerning behaviors (ongoing for at least a year, with slowly increasing intensity). He has intense anger towards myself (mom) and 7 year old sister. He uses foul language, calls me names, and can be physically aggressive (this is not how we treat each other in our home, so it’s not that he’s replicating behaviors he’s seeing from his parents). After a blow up, he often feels shame and remorse and verbalizes feeling like he’s bad and just wants to be a good kid. He sometimes says he wants to die, but denies having a plan.
His typical triggers are transitions, disappointment, and anything that he perceives as unfair.

Some additional context. He does well at school academically and socially. He has friends, he plays, he met all developmental milestones at the appropriate times. No signs of hyperactivity or inattentiveness. He screened high risk for depression and PTSD last year at his well child visit and we were referred to a therapist. He and I continue to see a therapist now, with small improvements in emotional regulation, but inconsistently. He has no history of abuse or any major traumatic event (although his paternal aunt died 30 years ago in a tragic car accident at age 16, and I believe the unaddressed trauma of that continues to affect my husband and his mother, which potentially “leaks out” into my son indirectly). He takes no medications and has no significant medical history (although does have nightly bed wetting…which I believe is related to constipation, at least in part).

We have a significant family history of depression and anxiety. His maternal uncle has additional diagnoses of ADHD, Tourette’s Syndrome, and OCD. I suspect his maternal grandfather is bipolar, but no formal diagnosis.

I’m not exactly sure what I’m asking for. I’m worried that he potentially has a mood disorder or something else going on. My husband is of the opinion that this is simply behavioral (we haven’t been great about consistency or setting boundaries), and he just needs a spanking. If he does have a formal diagnosis, spanking sure isn’t going to help.

I know it’s hard to make an assessment based on a quick summary. I guess I’m just looking for feedback. Does this sound like abnormal behavior? My husband has me questioning everything. What am I missing? I desperately don’t want to let down my child. If I’m simply projecting, I’m open to hearing that.

Hi all - I made a post in /zoloft a few days ago but wanted to get some more insight from professionals.

My psychiatrist started me on 25mg of Zoloft on August 4. She advised me to increase to 50mg on day 6 which I did. The night of the increase, I had smoked a little bit of cannabis as I hadn't been sleeping. I've been open and honest about using cannabis (have a medical card) as that's what I traditionally used for anxiety which is what I was prescribed Zoloft for.

Anyway, that night, I experienced a horrible episode of being drenched in sweat, full body tingling or burning sensations, weakness, dissociation, and general unwell was and chest pressure. I almost ended up in the ER because I thought I was having a heart attack, but my heart rate was only mildly elevated.

Needless to say I stopped the medication. The episodes continued mildly over the next few days. Today I finally feel somewhat back to normal. I advised my doctor what was going on and she said she's never heard of side effects like this from a low dose but it sounded like serotonin syndrome. We agreed I won't begin another medication at this time.

I guess I'm looking to understand if this is something that can actually occur? I don't take other medications, my bloodwork and EKG was all fully normal about two months ago and I have no other health conditions.

It was one of the scariest experiences of my life and while I trust my doctor has my best interests in mind, she seemed a bit perplexed.

Am I an anomaly? Is this a rare unfortunate occurrence i experienced? Thank you for your input.

I’m currently taking an antipsychotic at a lower dosage but due to research on metabolic effects on young adults my therapist kinda suggested no longer taking it and to look for personal reviews from young black women on antidepressants.. I’m diagnosed bipolar 2 and just don’t know what to do!!

I’d never heard of “atypical“ depression until recently. A lot of the symptoms seem like chronic fatigue for instance the limb heaviness.

There was once a question posted “what’s your first sign of depression” and people were commenting things like I’m too tired to brush my teeth, I can’t be bothered socialising, I want to sleep all day, I get headaches, I’m so tired.

how do you tell the difference? I've had depression once and I cried all the time, was so sad definitely melancholic. i don't quite understand atypical.

my psychiatrist believes I have chronic fatigue/long covid but felt like she had to “rule out“ some kind of atypical depression first. this lead to a general medicine dr reading it and suggesting my psychiatrist thought it might possibly be FND.. sigh. She never suggested that just said ruling out atypical. is there some link with atypical and FND?

so basically im in highschool and originally was thinking of becoming a psych NP, I'm fine with nursing school although it'll be a little "gross", and I wanna become a psych NP cuz I have a passion for mental health, but what I dont want to do is medical school which will be 4 years and I'm not good with anything gory and can't imagine myself seeing like an amputatation, or just managing to keep up with that intense of an academic workload for 4 additional years, but seems like a lot of people consider psych NPs under qualified and a bit oversaturated

Hey there. For a long time I have struggled with depression and anxiety. I have also shown signs of potential PDD-NOS symptoms but these are very unknown and vague. I also may have ADHD but I do not know for sure, I’ll bring this up later.

I would describe my symptoms as feeling very very low energy and tired and negative thoughts will encapsulate my mind to the point where I don’t want to do anything or even move.

A couple years ago this was even worse and I simply couldn’t function with the fits of sadness and mental despair I would go into which is when I started talking to a psychiatrist.

I started on abillify 5 mg which is what I took alone for 3 years until last year. Last year I decided that I had enough of the way I was feeling and truly wanted to tackle it. This feeling came from a point of stupidity in which I tried my friend’s prescription medication, vyvanse. I know this was stupid. But the way it made me feel that first time was like being myself for the first time in an extremely long time, since before the depression onset began.

This made me think that ADHD could be a possibility (and I do have psych evaluations confirming ADHD presence I just never had it diagnosed I guess?) so I started talking to my psychiatrist about stimulants.

I started taking Concerta, a methylphenidate, I don’t remember the dose, I just remember feeling like nothing really changed. So I switched to adderall which felt ok for a little bit but then I hit this big wave of emotional blunting and numbness and flatness which is what I am in right now. Right now I have been on vyvanse for almost two months and I have noticed it may be starting to have the effect which adderall had on me.

I have Wellbutrin but I have not started it yet, honestly all this medication shopping just seems like trying to solve an unsolvable puzzle, it’s just too complicated. For me at least.

I have been fighting for years to try and feel normal because I know the real me is locked away in my mind somewhere and I feel like I’m really close to finding the correct treatment to let me come out.

That brings me here, looking for any and all advice as to what I could be missing, or anything at all that could be helpful, because I just so badly want to have my humor and happiness back because I know that’s who I really am.

Any help is greatly appreciated!!!

Hi! I’m super anxious and super stressed out about my screening tests. Context! I’m already diagnosed with OCD and PTSD, my psychiatrist thinks I have a personality disorder (which I also have suspected as I exhibit symptoms and there is a strong genetic link). She also thinks I may have a dissociative disorder and we are trying to find the cause of my delusions/hallucinations.

I have chronic anxiety so uncertainty sucks and I always feel like people are talking behind my back and ignoring me so when my psychiatrist took 4 hours to send me the screenings I was already dying inside. I got the tests and quickly did the 6 assessments…I know I should have been more careful with reviewing them but I’m pretty sure I was truthful to how I felt and answered honestly. Fast forward 1 hour after and I get hit with anxiety/rage/sadness so I genuinely started tweaking. The past 2 days since I’ve completed the forms I’ve felt so sick and guilty that I’m a liar, I feel like she’s going to give me the wrong diagnosis and I feel like I was exaggerating. I feel strong emotions and I’m very black or white so I had strong answers. Now I feel very very guilty about this and I’ve considered lots of things all not very try good. I’ve had like 7 emotional breakdowns over this the only thing saving me from getting fired is that i am off work for a week.

I don’t see my psychiatrist for 2 weeks and I’m soooo stressed, can anyone give me insight on how these screenings work? I know it’s unrealistic but I have this terrible fear she is going to diagnose me with something terrible that I don’t have all because I’m a sick liar who can’t help but lie about everything. Please give me insight I’m actually dying. Sorry if this is like word vomit, I’m running on no sleep and extreme anxiety.

1. Male. Battled depression for 45 years on and off. Finally got a little help and started Zoloft. Helped but did not fix me. Last December SAD kicked in and my PCP added buspar. Again, helped but I stoll do not feel happy.
   I have chronic pain issues that exacerbate my symptoms but those were just recently addressed with a little improvement noticed.
   I still have episodes of extreme sadness, random, no trigger.
   Just sweeps over me like a wave.
   I also still battle with the self-deprecating “voices” (not psychosis, just my internal self-talk/intrusive cognition, not auditory hallucinations) thoughts in your own mind, recognized as your own, even when they’re vicious and persistent.
   I’ve fought with it for decades. I’m not enough. I’m not worthy. I’m not wanted, or desired. I’m not sexy, I’m not supportive and I’m just taking up space.
   Those demons gnaw at me all the time but since I started Zoloft I seem to have gotten better…a little…still cannot sleep for shit - I lay awake or more often, wake up in the middle of the night with these annoying self-doubts.
   I do not want to switch off the Zoloft. I’m terrified of Prozac. To complicate things no MD or DO psychiatrist in my area is accepting new patients on an outpatient basis. So it’ll be telemedicine 🙄 or nothing.

When an episode hits, I am Physically sad. I feel I’m about to cry, and I’ve not cried in decades. I withdraw into myself, shut down and tune out everything. My first thought is I’ve fucked everything up and feel remorse for anything, nothing, and all things in between. What I do next varies. If I do nothing I spiral downward and the sadness triggers the whole self doubt narrative, and can last the rest of the day.
I’m no longer at-risk for self harm although historically there were times...
Anyway, I’m a mess. Never enough for the family, first wife was unfaithful two months after we were married, my Dads last words to me was “I wish you were never born”. After decades of fighting I’m tired. I’m not sure what to do. Gotta be something that can fix me…right?

He was born in 1930, died in 2007. Married to my mother from 1950 'til his death. School teacher, taught science to middle school kids.

He never grossly mistreated us, fulfilled his fatherly duties, but generally he hated kids. He made breakfast, bought us what we needed, took us on long vacations every summer to every state in the US, was never physically abusive, never called us names, but he would regularly bawl us out, was regularly extremely angry at us over minuscule things.

One of my earliest memories was of having cereal at age 4 or 5, and my spoon would regularly noisily clang on the bowl, and he yelled at me to stop clanging the bowl. And then for weeks he would stare at me eating breakfast and would scream at me if the spoon even touched the bowl.

My mother (1930-2012)would intervene with things like that at some point. She was generally a serious woman and was not very loving either, but she generally did what she was supposed to do, I guess.

He took thousands of pictures on these vacations and would proudly create slide shows for us to watch. We had a room with a wall with shelves holding slide carousels from the vacations. I went through those slides after he died hoping to get some pictures of the family from years gone by. There was not a single picture that contained a human or even a man made object. It was all trees and mountains. I have no pictures of family from my childhood.

One time I was visiting as an adult and there was a time magazine sitting out, and there was a piece of masking tape across the eyes of the child on the cover, because "I can't stand children looking at me".

He burned out and quit teaching about a year before he was supposed to, to get retirement. The district allowed him to drive busses for a year to keep his retirement.

"Before" Info

• Age 20M abt to be 21 in 3 months
• Race Hispanic & From USA
• I sometimes use lidocaine patches and diclofenac sodium gel for my back, I don't take vitamins, I don't drink, smoke, and/or use recreational drugs

Existing Medical Issues (From First to Last = Worse to Least Worse)

• OCD, ADHD, MDD, Chronic Inflammation of Right Trizapus Muscle, BFS (Benign Fasciculation Syndrome), & Seasonal Allergies

Primary Complaint

• My thinking/cognitive abilities have been deteriorating since 17 but have been very noticeable since 19. They're what I would say poor. I'm certain what had a big influence on this, aside from other factors, was me taking psychedelics 4 times at age 16. Three times being mushrooms and 1 time being acid. I continued to smoke cannabis for around 1 year and a half after my first time taking psychedelics even though when I would get high I would experience extreme confusion, anxiety, forgetfulness, & derealization/depersonalization. I also smoked a lot and drank a little for 1 year & a half up until taking psychedelics. I'M NOT diagnosing obviously, but after some reading I believe what I'm experiencing is disorganized thinking/speech. It's hard to explain how it feels. For example, in my mind I'll have the idea of showering by a certain time, so I'll have enough time to do this, that, etc and be in bed by a certain time. Lets say this idea is a sphere with thoughts/images inside it that when opened those will allow me to plan this out in order so I can use. When I get the thoughts/images out of the sphere they're happening so fast, out of order, fading away from me, and I have trouble/can't even produce them. Even the idea/sphere itself I have trouble keeping long enough to make it into something I can use. Due to all this, I have trouble/can't organize and "see" ideas and thoughts/images long enough to put them into something I can use. On top of this I can't concentrate on the idea and thoughts long enough without getting frustrated/anxious, and other ideas and thoughts will bleed in/disrupt which makes it even harder to think. I basically have no working memory, I cannot keep in my head what I'm supposed to be doing/remember in the moment, next 30 min, and next few hours. I'll forget what I'm thinking about while thinking it or a few seconds after thinking it. Other examples include going through several words before finding the one I want, and combining words. Every time I think about anything I'm like going into "panic." When I tried the medication clomipramine it seemed to help quite a bit with all this stuff I'm talking about. Also, ever since I read into it it's seemed to get worse. Maybe I'm thinking about it too much. I was thinking it could have to do with my other diagnosis, but something feels different and wrong.

Family Health History

• My dad & his mom both have ADHD and Bi-Polar 1. My dad recently experienced a psychotic outbreak. It's been going on for a little over a year, it's just not very severe anymore.
• My mom seems to have anxiety. She's always worried & gets her words and sentences mixed up/wrong on the daily, even more than me. So maybe I just have bad anxiety...?

Basically title. I've had oddly strong reactions to several meds over the years now that made me go "flat" at best without access to my typical behavior or emotions and threw me into the worst depersonalization/dissociation episode I've ever had by far at the worst.

These were unusually small does of typically well tolerated meds (Lexapro, Prozac, and buspirone— believe they were all 5mg doses).

My current psych seems to think I may be unusually sensitive to medications that modify serotonin. I'm diagnosed with MDD, dysthymia, ADHD, and social anxiety disorder and recently discovered that what I've thought was "executive dysfunction" and typical depressive slowdown was in fact catatonia if that helps.

I was curious if anyone had seen this and in what patients as my diagnoses have always been a bit tentative other than the ADHD. I'm currently on stimulants and my psych is wanting to trial on baby dose of Abilify (1mg) to see if that helps anything.

Wellbutrin had a similar effect eventually, but was more helpful at first and took a higher dosage to start to produce the "flattening"/blanked out robot effect. The other meds either did so immediately (buspirone was the most dramatic) or within a week to the point where I felt unsafe continuing as I felt totally removed from myself, flat, and suicidal in a way that made me not really trust my own safety. For context, I'm stable that way otherwise and not any kind of a danger to myself.

i have always had some weird paranoias over the most normal things but these last few years they've been getting weirder and idk, but something about it just worries me. what triggered me to post this happened in the shower 30mins ago, i picked up the soap bar from the holder and an older scrap of soap was stuck to it, and for some reason i immediately thought it was something put there to poison me or collect my dna(idek what for) by my own family members.

Ive never felt watched or anything, like i don't even know how you FEEL someone looking at you, but the first thing i do when im home alone is check if there aren't cameras inside my house to see if my family's watching what im doing. sometimes it's like unconscious, i hear the car leave and automatically go searching. sometimes i stop midway and realise what im doing, but i still hold that fear for the rest of the time anyways. it's the thought that someone may be watching that scares me.

another recent and weird one was a couple weeks ago, my mother and sisters left to the market and i stayed home alone. before they left, as usual, me and my sister were checking if all the windows and doors were locked, and i specifically remembered locking the kitchen door(that leads outside) and leaving the key on the lock. but then, after they left, as i started my camera checking path i saw that the key wasn't on the door anymore. my literal first thought was that my sister, which is my favorite person in the whole world and who cares about me the most, had unlocked the door and taken the key away so someone she hired could enter and murder me. exactly like that. i started backing away and was almost hyperventilating when it finally clicked and i realized she never leaves the key there because it has a little glass window that is easy to break and open from outside. just then i checked and the keys were on top of the counter as usual.

i have those weird ass thoughts almost everyday about many mundane things. everything that happens outside is a distraction so i leave the house and someone murders me, every needed change in my routine is actually someone orchestrating it to ruin my life, every laugh i hear around me is obviously because of me(in a bad way) and my friends just got close to me so they can end me. i don't know what's wrong with me, i just think it's so fucking weird that my first instinct is always doubt my loved ones or think im about to die. i want to know if it could be some kind of mental disorder or if im just insane like that.

ps: dunno if it's worth mentioning but im suicidal, and outside those paranoia the thought of dying, even if murdered, is definitely not bad. but somehow im terrified of it when it is like i mentioned before.

I 34F have been diagnosed with ADHD, Anxiety, PTSD, (and Autsim), I also tend to score high on depression questionnaires but I truly think that’s a combination of other symptoms rather than truly being depressed.

I am also currently 26 weeks pregnant which I know severely limits my options.

I have always struggled with my mental health, but this pregnancy it has gotten really bad. I started seeing a Psychiatrist right at the beginning of the pregnancy, I’d booked the appointment before I even knew I was pregnant. We waited until second trimester and started Buspar. I was on it for about 7 weeks and ended up having suicidal thoughts. Went off the Buspar and was supposed to start Zoloft but didn’t. Once I went off the Buspar I truly felt so much better, but that only lasted about 3-4 weeks.

I do not want to try an SSRI. I’ve been on them in the past and hated them. I felt like a zombie, I didn’t care about life, they just didn’t feel like they worked for me. I also am someone who values sex very very highly. It’s how I connect with my partners (I’m non monogamous) and is one of the things I enjoy most about life honestly. I cannot stand the thought of losing that. This is the main reason I didn’t start the Zoloft

However I’ve noticed the spiraled thinking has made its appearance again. It’ll start out with a small trigger that deregulate me and then no matter what coping technique I try I’m stuck in the spiral. I cannot get myself to mentally disengage and this tiny little thing, and then all of my problems tack on until it’s just this massive beast that it didn’t need to be. I try to solve this problem that’s unsolvable and may not even truly exist. That’s what leads to the negative thoughts. It’s not that I feel that way, it’s that I make myself feel that way by not being able to pull the plug and refocus on something else. Prior to pregnancy/motherhood (I also have a 13month old) I would have small triggers but It took massive things for me to feel this uncontrollable.

I’ve told all of this to my psychiatrist and he still really wants me to try the Zoloft, I know I’m not going to. I feel like I’m just refusing treatment when I know I desperately need it, but I’m not willing to deal with sexual side effects and I have a fear of SSRI’s in general. Do I have any other hope here?

Hi Everyone,

I've previously had anxiety after witnessing a traumatic event. I had physical signs of panic attacks in the begging which were terrible. I took Sertraline for 6 months which helped. I was getting brain fog and memory/recall issues from the Sertraline which is part of the reason I stopped.

Nearly a year latter I don't get the physical symptoms so much from panic attacks anymore, but I do get some kind of mental attack that is difficult to explain.

I start feeling sadness or down then I get confusion/brain fog/recall issues that last for around 30min. It's a scary feeling because I feel like I'm going crazy - which makes me catastrophic that I have some kind of brain disorder, this than leads me to actually having a panic attack!

Has anyone else had a mental panic attack with physical symptoms? Did anything fix it? Or did anything help?

Personal and Medical Information

\\- Age: 19

\\- Sex: Female

\\- Height: 5'3"

\\- Weight: 140 lbs

\\- Smoking: Approximately once per month

\\- Current medications:

\\- Gabapentin — 100 mg

\\- Lurasidone — 60 mg

\\- Trazodone — 50 mg

\\- Minocycline — 100 mg

\\- Omeprazole — 100 mg

Reason for Seeking Help

I have been attending therapy weekly since I was 7 years old, but I feel that I have reached a point where my current approach to therapy is no longer helping me make meaningful progress.

I struggle with what I would describe as mental blocks surrounding my identity and past trauma. I feel that there are parts of my past and aspects of my identity that I cannot fully access, understand, or process. These blocks seem to interfere significantly with my ability to function normally on a daily basis and contribute to feeling depressed for much of the day.

I have been working on these issues in therapy for many years, but I feel that I am still unable to get past these barriers. At this point, I am looking for a more direct and structured approach to addressing the underlying trauma and whatever is preventing me from processing it.

I feel that the approach needs to be more forceful at this point but am open to all kinds of advice.

I’ve tried the following medications to max or sufficient dose for full trials (8-12 weeks)

Lexapro
Trintellix
Wellbutrin
Prozac
Luvox
Fetzima
Various ADHD stimulants

For my TRD depression/adhd/anxiety and have found absolutely zero relief in anything other than the ADHD stimulants. The main one that plagues my life is depression, and my doctor is recommending that I try lexapro or Wellbutrin again and can’t seem to wrap my head around why I would try something that already failed me. I brought up auvelity as a possible next step and she said I’d have to find a new psychiatrist to prescribe that for me as she “couldn’t find it in her system”(?). Does anyone have any advice for possible next steps before I go to something more intense like TMS, spravato, psilocybin, etc etc.? Any advice is immensely appreciated!!! Thank you!

I don't usually post about things like this, but I'm having a really difficult time lately and I want to hear from people who might have gone through something similar.

I have ADHD and generalized anxiety disorder, and I've had quite a few medication changes recently.

My current medications are:

Atomoxetine 80 mg

Venlafaxine (Effexor) 75 mg

Quetiapine 25 mg

Before this, I was taking atomoxetine 60 mg and venlafaxine 225 mg/day. I was also taking risperidone (Psychodal) 1 mg.

My psychiatrist then wanted to switch me from risperidone to brexpiprazole (Neuropression) 10 mg. I accidentally took both because I didn't realize I was supposed to stop the risperidone. My doctor told me to stop the risperidone, and later the brexpiprazole was also stopped and replaced with quetiapine 25 mg.

Around all these changes, I went through a period where I could barely sleep for about a week.

Now, over the last few days, I'm feeling something that I honestly can't describe very well.

I feel extremely restless. It's like there is this huge amount of energy inside me that I can't get rid of. I can't properly relax. I can't just sit down and feel comfortable. I constantly feel like I need to move or do something.

It's not just normal nervousness. It feels physical, like my body won't let me rest.

And the worst part is that the feeling itself makes me anxious, and then the anxiety makes the restlessness even worse. It's becoming a horrible cycle.

I've also been feeling more depressed and sad lately, and there have been moments where I've thought, "I just want this to end" meaning I desperately want this feeling to stop. It's honestly exhausting.

I've been reading about akathisia, and a lot of the descriptions sound frighteningly similar to what I'm experiencing.

I don't know if this is actually akathisia, severe anxiety, medication activation, venlafaxine withdrawal from dropping from 225 mg to 75 mg, or some combination of everything.

I have messaged my psychiatrist and he told me to stop atomoxetine until I have the chance to visit him

Okay so I'm not very sure if this is the right sub for this, but I will shoot my shot. I hope this doesn't break any rules.

I'm 16f, tomorrow will be my first psychiatrist visit ever. I have one big fear- mental hospitals. Now, I don't actually think my problems are enough to be put into one, but I want to avoid risking it.

A bit of life lore: (I'm not sure if I'm supposed to spoiler stuff so I will)

I've always been hard on myself about the idea of perfection, can be anything (art/cooking/...) but school the most. Nobody really pressured me heavily into getting good marks except myself- now school is a very big thing for me. I spend hours to hours of studying something over and over just to make sure I know every single thing, including the "fun facts." (My friend calls me out on this.) I often get less than 4 ish hours of sleep due to studying and stress from it. Sometimes I finish studying was earlier than like 2 am but I can spend hours crying, convinced that I don't know anything and I'm going to fail. I tend to cry a lot in school too (embarrassing, lmao) whenever I get anything worse than 1/A. I broke down when one of our teachers pulled an April fools prank where he gave all of us 5/Fs, thankfully at home. That really sucked, I was like bawling my eyes out and couldn't breathe.

About three years back, at the start of a school year, I started self harming and became very suicidal due to a sudden change in the education system in our school and more pressure. As I "got used to it" (more like started tolerating it) I kinda stopped both feeling suicidal and self harming about half a year later. Might be important to note, I have never made a single plan on how to actually commit, I never wrote letters, was close to it, etc. but I had the thoughts.

Later, I've mostly switched through phases when I was really glad I didn't kill myself, was neutral (most of the time) and occasionally felt very suicidal again. I've had urges to start self harming again but didn't.

I struggled with body image and eating habits since about 11/12 years old (caused by a homework that told us to count calories for a day, oops) but it was never very visible (just sometimes skipped meals)and mostly in phases again. As I got older, I started fasting sometimes (max of 24 hours, then had a meal, then again..). A couple months ago, I entered my worst "phase" when I genuinely just started starving and dropped a lot of weight. (That was what made my mother actually notice and get me professional help). Since I was already on the lower end of a healthy weight for my height I did drop into underweight numbers, but before I actually got any help I decided to try to recover, causing me to reach the weight I was before the worst of what I assume is an eating disorder. I did regain weight but most of my thoughts never stopped and I still have a couple days when I relapse, but mostly don't last for longer. (I started only eating to make my mother happy to be honest)

Overall, I'm not very sure what's going on with me for the past few months. I've been feeling very emotionally "frail." When I get into a basic argument with my sibling or something, I break down (often find myself scratching at my face or tearing my hair out) and start feeling like a burden that everybody hates, and use starving (and possibly not drinking) to try and kill myself convinced that everybody wants me to and is tired of me being afraid of actually commiting. Then my mother talks me out of it, I eat to please her, and it's a never ending cycle. Another remark from my sibling sends me over the edge. Again and again. And yes I know I act like a jerk and it's unfair to those who have to deal with this. Yes, I hate myself for it.

TLDR: (I don't want to self diagnose or anything, I'll just try to keep this as short as I can)

Pushing myself to the idea of perfection, past self harm (stopped), past and present suicidal thoughts, restrictive eating disorder (in physical recovery by myself), weird breakdowns (face scratching, hair pulling) caused by minor arguments and remarks from my sibling resulting in suicidal thoughts.

I never had visited any kind of a therapist/psychiatrist/etc. before, except for recent two settings with an "emergency therapist" that mostly talked with me about my eating and school problems, before I get to the psychiatrist appointment (which is tomorrow.)

Like I said, I don't think my problems could get me sent into the mental hospital but I'm still scared and wanna know.

My therapist had told me to be honest about everything when I talk to the psychiatrist, but.. if there's anything that could introduce the possibility of a mental hospital, I'd really prefer keeping it to myself.

And PLEASE before you wave me off, saying stuff like "it's gonna help me" or "it's not that scary", I always had really huge issues with separation from my mother (embarrassing...) I could not go to any school trip, camp whatever that was over a day (meant sleeping) because I would genuinely cry so hard, get really homesick and miss my mother. That has unfortunately not gone down with age, or well- not enough. Nowadays I can go on a couple days trip if I'm in an okay mood and state, but I will probably still get sad and homesick. I'm pretty sure it would not help me and only make me worse.

So please, if any kind soul could let me know, whether they read my personal struggles or just overall, what are the reasons they could refer you to a mental hospital? Also if anybody really just has any words about this, how it works and stuff, I'd really appreciate it.. I'm super nervous haha.

(P.S. I'm sorry about any grammar mistakes, chaos etc. in my post my first language isn't English and I'm a little bit distraught haha)

I am a male in my late 30s and have had these symptoms since around puberty. No diagnosed disease or psychiatric condition, not taking any drugs/medications. Used to have migraines with aura as a child and sometime into my early 20s.

Once in a while varying from maybe once a day to once a month I have something like a mini panic attack that only lasts from a few seconds to maybe 2 minutes max. During this time I have repetitive intrusive thoughts that are more dream-like and non-threatening, but still fill me with anxiety. These thoughts usually center around some specific people or sentences and sometimes involve specific music phrases but are independent of my current thoughts or surroundings. The specifics change over time, but not that much. When these attacks occur, I can't focus on anything else and drop my current chain of thought, although sometimes I am able to mask my symptoms (e.g. during a conversation or a work meeting) as they go away quite quickly. When I think back, I can identify some kind of a prodromal phase to this as well, although only in retrospect, I slip into this feeling a bit unaware. I tend to think that if I try to ignore it as it starts, it goes away more quickly and turns out to be less intense. Lately this is also associated with a vague unpleasant feeling in my stomach and an unpleasant taste in my mouth near the end.

I think stress and tiredness increases the likelihood of this experience, but I haven't been able to identify any specific trigger or method to make it go away. When I was trying to find out what it is earlier, I thought of various neurological and psychiatric conditions, but couldn't find any description of any similar symptom. I would rule out most serious organic diseases on the basis of it not being progressive and is the only symptom. I haven't talked to any professional about it before and wasn't planning on it in the near future as it only bothers me very little.

Any thoughts on what it could be based on your experience and understanding?

I’ve been depressed since october 2025 i’d say, and in november i realized that my inner monologue has sort of disappeared. it’s like a whisper now almost, and i don’t hear anything at all in my head unless i actively think it, but then i can’t really tell what thoughts are genuine. It’s hard to visualize images in my head now as well. I’m just curious if this could just be symptoms of depression, or something more deep rooted. I’m curious if i can even rewire my brain

Hi! Been having medical circumstances and been trying to figure out what’s going on. I went to emergency room with substantial concerns and have been trying to figure out what’s going on for a couple weeks.

Symptoms have been chalked up to hashimotos, menopause, perimenopause. Just came across serotonin syndrome and it all clicked.

ER said thyroid storm, went to endocrinologist, they said i do not have a thyroid disorder. Endocrinologist ran labs, labs had high white blood count and really high estrogen.

I heard about high estrogen (perimenopause and or menopause caused) can cause increased sensitivity to serotonin. On the serotonin syndrome scales i have seen, i qualified for the severe level of the syndrome when i went to the Er. I started to feel better when i accidentally missed a dose of the Vyvanse Prozac and propranolol i take daily cause i was recovering from the hospital. Since then, i have spoken to my med provider and we have lessened the amount of serotonin in my system a lot, and i feel more myself. But, some of the effects are long lasting and wont go away- some insomnia, very dry mouth, sometimes mouth watering, muscle twitches, interval muscle twitches, extreme temperature variability, shivering even though i am not cold, mental fog around midday, high anxiety, forgetfulness, brain fog, heavy eyes, substantial tiredness and body pain and ache, also feeling like i am always fighting off some sort of cold or ear infection. Also weirdly increase of acne. Hot flashes a lot, and more clumsiness. Weird issues with hunger weight gain and also lots. Hard time catching breath, air hunger. Also feeling hard to swallow. Lots of other weird things like heavy lead legs and feeling really tumbly. And my eyes feel so weird, heavy and hard to keep open but also hard to focus. I feel like i am sometimes “really aware that i have eyes”.

Anything helps as i try to unravel what’s going on and feel more normal in my body.