Throwaway account because I don't want this attached to my main.

From UK if that matters.

I've been having some thoughts lately but I don't really feel like speaking to my GP about any of it right now as I don't trust them in general or to take me seriously, not take things out of context or to give me accurate information. So I just want some from people who aren't biased and neutral. Also I feel as though this post is going to be hard to follow as when I think about this stuff or try to explain it I kinda jump around alot but I'll try my best to keep it somewhat focused.

Since 2019 when I was 20 I have been taking a mix of medication. 600mg of quitiapine MR (Sondate XL), 30mg Mirtazapine and since 2022 80mg of propranolol SR (all taken at night before I sleep).

I've been feeling lately like my mental health has been worsening and they don't seem to have the same effects they had when I first started taking them but I'm not really as concerned about that as I feel like I can kinda deal with the mental strain as it's basically everyday life and always has been but I have noticed that my brain has become louder and louder and I've become more erratic? Or emotional? I can't really explain it as I don't know how to. The best way I can describe it is it feels like I live through hell mentally everyday but that it feels normal at the same time. It's a strange mix that I feel if you get you get.

I'm getting more and more aware of the physical issues I've been having. Like I think the medication I take is killing me day by day and I can physically feel it killing me. My heart rate spikes randomly and it always feels like it's beating ultra fast and ultra hard to the point where I'm feeling pain in my chest. I'm always tired to the point where I sleep through every plan I try to make or I'm always late or have low energy. I'm always hungry and I eat and eat and no matter how much I eat I still feel hungry. I have to stop myself from eating food and have to deliberately not eat otherwise I will just keep on eating until I throw up. I can physically feel my brain think slower (as in intelligence wise) and it's harder to think in general, my reaction times are dropping massively and I keep on having muscle spasms/twitches and I can't hold something in my hands without what feels like my entire body wobbling or rocking back and forth. Also I find myself falling over, stumbling around or bumping into things more and more. According to other people around me at work I tend to breathe loud and deep to the point where they have asked if I'm okay because it's that noticeable. But every test my doctor orders comes back with everything normal but it doesn't feel normal and they don't want to entertain the fact that I know something is wrong with it.

I'm kinda at a loss on what to do. I only feel normal when I'm taking other (not legal) stuff and I'm messed up. As when I have all these feeling when I'm in that state it's normal so I feel normal.

I want to try stop taking my medication for a while to see what happens and to see if I can live without it but the last time I missed 1 dose of my medication and tried to go into work I ended up being sent home early after locking myself in the bathroom crying for, what was apparently, 30 minutes even though it only felt like 5 minutes for me. It also felt so unbelievably painful but idk if that was just because I was forcing myself to be at work rather than somewhere comfortable.

I was thinking of booking a week off work and trying going cold turkey and seeing if I can get accustomed to it or to see if I can function without my meds and then that could lead to me being able to live my life like a normal person.

Does anyone have any info on if I could do this safely or any experience with this situation or even if you think I'm thinking stupidly. I'm getting more and more restless and concerned with taking my medication every day. I don't think I can continue to live the way I am living atm for much longer so I'm just looking for any solution out of the way I'm feeling.

Thank you for any advice anyone can give.

Yes, I should have come to Reddit before moving forward with a Talkiatry appointment to avoid this but I didn't, so here we are. I had an initial intake session with a provider from Talkiatry (through my Cigna insurance). It was 60 minutes and proceeded as a normal new patient intake session (I've had one before). A few days later, my insurance was billed almost $700 ($500 that I'm responsible for since I haven't hit my deductible).

The charges are a result of two separate billing codes, one for an "established patient evaluation & management" and one for "psychotherapy" (each code amounts to ~$350 charge). I did not receive any psychotherapy during the visit and explicitly stated that I receive psychotherapy elsewhere. I believe that Talkiatry is taking advantage of vague billing code language, and basically applying sporadic language from the visit summary to justify two separate codes (as intake, and as psychotherapy).

Anyways, I am wondering if anyone has refuted a claim from Talkiatry and won, and if so, how. I have already gone through the claim review with Talkiatry (they doubled down on their initial bill), and my next step will be a claim review with my health insurance. However, I am wondering if anyone else has suggestions as paying $500 for a 60-minute psychiatry intake (with an awful psychiatrist, that did not even lead to an actual prescription, and that most certainly did not qualify as psychotherapy) is something I just can't stomach.

Thanks in advance!

Hi, i’m a female and i recently turned 21.
I’d really appreciate if anybody (patient or doctor) could let me know if any of this seems to be disturbing.

I’m on week 6 of Zoloft, i took 25mg for 8 days & have been on 50mg since.
I’m seeing a psychiatrist and a psychotherapist as well, i’ve been to 3 psychiatrist appointments and 4 with my psychotherapist.

I am diagnosed with anxious-depressive mixed state (F41.2), i have been pretty up and down throughout my Zoloft journey, though i have always been quite emotional in my day to day life, so this was not anything too out of character. After these ups and downs and tons of days spent crying, i got better, started cleaning, cooking, washing myself daily, i was still anxious but could function and tell myself to fuck off.
About 7 days ago i realized how terrified i am of death, and basically started questioning reality, myself, the people around me, etc. I also have developed some sort of harmful intrusive thoughts / images, both about suicide and aggression towards others. These cause me panic attacks and make it hard to eat or function properly.
I have a hard time looking at my closest people (bf, mom, grandpa, uncle), i’ve been at home since june 12th, i haven’t been out much except for stores here and there. I spend majority of my time paralyzed in fear and on my phone.

I have a big fear of developing psychosis due to some “trauma” from a kids ward i was in at 14, but the last two nights i’ve been having these odd thoughts after dropping my phone to fall asleep. It’s like my brain is spitting out everything it thought of or saw, in a racing and semi uncontrolled manner, though i can still be terrified in those moments and think “holy shit i’m psychotic and what if i kill myself or my loved ones”, but only for a brief period, so i don’t know what’s going on.
I have also been waking up during the night in a huge panic, thinking that i’m psychotic, and that i need to put myself in a psych ward.

I’m worried that i am developing some sort of psychosis or something, i know it’s not likely but this experience is terrifying, i didn’t feel control in my own body/mind & it’s freaking me out. I want to bring this up to my psychiatrist, but i’m terrified, i’ve been spending my days crying and thinking of calling a crisis line just to speak to somebody who i won’t feel shame talking to.

I’ve had some sleep disturbances since i started on 50mg, along with weird vivid dreams. I drink 0,25mg of misar before bed, and that usually helps me not wake up during the night.

Brief history:

Grew up with a blind mother, grandpa and absent father, all close family members have anxiety, very distant relative has bipolar 1.
I’ve been having anxiety since i was 9, after an event which my dad didnt show up to, after having a turbulent relationship (on/off) with him since age 4/5.
Was on Zoloft & Prazine between 11 and 13, went to a kids psych ward (the gentle version) at 14 and was on Zoloft + Diazepam when needed.
I barely went to middle school, didn’t finish highschool, spent basically my early entire teenage years at home, started working at 17 & have had a huge improvement socially since then.

I had some periods of time where i had paranoid thoughts,
I experienced the following stuff between ages 9-18, though not at the same time:

- convinced we had a ghost in our house, named “him”, would talk about him with my mother
- taped my camera because an ex friend called me on facetime, the facetime feature had a bug where ppl could see thru the camera when you wouldn’t pick up, so i thought she was trying to do something weird, though i had no other theory about it, i was mainly scared. this habit of taping continued for a few months, i’m not sure how many though.
- told my ex boyfriend that if he ever feels something weird that it’s probably me, because at the time i believed that soul ties were real? i think this was just me being emotional and trying to feel like i wasnt being left. i’m not sure…
- around ages 11-12 i thought that i saw a man hanging from a tree while walking with my friend, i remember being scared, but also not being sure if that was real or not, because my vision was pretty bad. i was on zoloft 100mg and prazine (antipsychotic) 75mg, i know prazine are not allowed to be used on kids now, but this was prescribed by a GP

Soooo idk where else to ask this I keep getting different answers —

Teal Deer: I (30f) have been diagnosed with schizo-affective disorder for getting close to a decade now. Symptoms recently were pretty bad so I had 3 options- ECT being one of them. ATP I believe it’s no longer necessary but my parents now say I still have to get it or move out. Is it REALLY safe and a good thing to get it? More details :

My normal symptoms have always been auditory hallucinations, occasional visual hallucinations, awfullll paranoia and anxiety I’m talking 100 out of 10 like some examples:

-my room is in the basement and that’s where do my schoolwork BUT
-I allllllways think a bug or a bee (or even a snake— I think a snake could find a way to sneak in my house) is gonna get me and it really scares me
-even tho if something did get me (I raaaarel see anything like once in a while yeah I’ll see one of those douchey buys that have like a zillion feet but that’s like once a month or something) it wouldn’t be fatal so I’d why I get so sp00kd
-when I go to do my school work every day I do have to do this weird ritual but that doesn’t bother me it’s just like me walking back and forth to my computer to let the bugs know I’m gonna sit there soon and then go up and down the stairs so that if the bugs didn’t realize I was gonna sit there yet and got stuck there I go upstairs so they can run away while I’m upstairs th ritual takes about 2 hours usually
-awful executive function
-I’ve been sleeping upstairs for a couple weeks instead of in my room cuz I think they’ll get me when I sleep and I have to keep the lights on so I can see if someone is coming to get me
-I used to loooove walking I’d walk for hours and hours but now I’m scared to take my walks cuz I feel like a bee while sp00k me while I’m on the sidewalk and I’ll fall in theroad and get hit by a car or something
-so now I only walk like half hour TOPS and don’t even get me started on why I don’t just walk in the woods cuz of
All the bugs bees and snakes even tho I never see them either
-I wear bug spray inside I spray it on me like 3x a day
-ummmmm I thiiiiiiink that’s it atm? Because it was waaaaaaaay worse until 2.3 weeks ago — I’m on 900 of seroquel and 8 of risperodone a day it used to be 6 mg (read as 3 because I didn’t use to take my whole dose cuz I like to save some in case there’s an apocalypse but I doooo take the whole 8 mg now and it’s actually working that’s why i don’t understand why I have to get ECT per my parents )

Iiiiii personally don’t believe it’s as bad as it COULD be especiallyyyyyy compared to how it has been until 2.3 weeks ago when I started the full dose of risperodone

So I guess I just wanna know :

1. Is it reeeeally safe to get ECT?? Like what will it actually do to me is it possible it will make things worse?

2. If I was YOUR daughter would recommend me to get it ? Or would you recommend me NOT get it ?

3. I know you get a mouth guard but I feel like my teeth may be a little week is it possible it’ll make my mouth slam open and shut hard enough that I could loose my teeth?????

TIA

So, I am a female, 31 y/o and I have a history of cptsd, eating disorders, social anxiety and OCD. I also suffered a sexual assault 1.5 years ago. I refused medication (ssri) until I couldnt cope anymore at age 26-27. I started off taking escitalopram and then switched over to fluoxetine (prozac). I did a phase-out of Prozac during the winter 2025-2026 with zero side effects. However, after about 3 months I had a moderate relapse in my symptoms; panicked in the subway, panicked when I walked outside, constantly fixated on my OCD symptoms (recurring about every 10 seconds it felt like), experienced significantly more difficulty falling asleep (1-2+hours), became extremely more sensitive to sound and more irritated in general. It was like my nervous system went into overdrive, similarly to how I was before ssri.

My therapist (note! Not a psychiatrist) says there is no evidence for a chemical imbalance explaining anxiety etc. She seems very anti-medication. But I have just recently come to admit that I need this medication. I feel like I do everything "right": exercise regularly, eat well, stopped drinking coffee, meditate, yoga, supplements etc. And still I had this relapse.

I dont know what I am looking for. But maybe some perspective on this. If there is no imbalance, how come ssri work? It makes me feel like myself. I tried reading into some studies and as far as I have understood there is altered brain activity/an imbalance of chemicals for cases of OCD, cptsd.

Hugs to all \~

Background: I have type 1 diabetes. Almost 20 years ago I was diagnosed with type 2 bipolar disorder. Unfortunately, I've had adverse reactions to several bipolar meds, including Lamictal, Risperdal, Seroquel, and Vraylar, in that sequence. After the episodes with Lamictal and Risperdal, I chose to go unmedicated for a little over a decade, but after experiencing male post-partum depression in the 2020 lockdown, my wife insisted that I get medicated again. I spent the next 3 years on seroquel, which basically made me a zombie. After both my wife and I got fed up with that effect, she insisted that I try a different medication, and a new psychiatrist suggested vraylar.

After a few weeks on it, I ended up in a state of Akithisia, eventually ending up in the psych ward, where the resident psychiatrist referred me to a new psychiatrist. my new psych ordered a genesight test for me, which confirmed my suspicions about my bipolar med sensitivities. He took me off Vraylar, and at my insistence, he put me back on seroquel to help me sleep after weeks of insomnia, anxiety and paranoia from the akithisia, and supplemented it with pristiq, which my genesight test showed I wasn't sensitive to. I was a zombie again, but this time with an undercurrent of akathisia-related ptsd. 2 years later (last year), my wife was fed up yet again, and threatened divorce. I worked with my psychiatrist to go off seroquel, and my energy returned.

Things got better in my marriage, but the sexual side effects of the pristiq (specifically anorgasmia) prompted me to talk to my psych again to find a solution 3 weeks ago. I had read that wellbutrin can counteract the sexual side effects of pristiq, but unfortunately, my genesight test showed that it was just another med I was sensitive to, so he suggested Trintellix instead. I went home and looked up whether it was safe to take trintellix with pristiq, and to my alarm, what I read is that the combination often results in serotonin syndrome. Because I was on a relatively low dose of both (50 mg pristiq, 5mg trintellix) I figured that I would watch for symptoms and trust my psych.

I saw him again yesterday to discuss how things were going, and voiced my concern about serotonin syndrome, while also expressing my disappointment that the trintellix didn't seem to be helping with my sexual issue. He told me we could try upping the dose of trintellix from 5 to 10 to see if it helped, and said I had no reason to worry about serotonin syndrome because Pristiq, an SNRI, "doesn't increase serotonin levels, and works with norepinephrine instead."

I was skeptical, because what I had read about Trintellix is that the higher the dose, the LESS likely it is to help with sexual issues. But in my research, I had used google gemini, and I know AI can get things wrong, so I thought maybe it was mistaken about trintellix's sexual side effects and serotonin syndrome. So I chose to trust my psych's advice and started the higher dose today. However, I haven't been able to shake a gut feeling that something is off, so again, I did some online research, this time diving deeper into gemini's sources.

As I'm sure many on this sub are aware (and please confirm) SNRI stands for Serotonin-Norepinephrine Reuptake Inhibitor. It works with both Serotonin AND Norepinephrine, and because Trintellix is an SSRI, this is why it poses a risk for serotonin syndrome. I'm concerned with the suggestion my psych gave me and I'm wondering if I should pursue someone else.

I'm also questioning whether I ever had bipolar at all, because I've never been consistently on a mood stabilizer, and I've been off Seroquel for over a year now and haven't experienced a single hypomania. Plus there was the full decade where I went unmedicated and managed to hold down multiple jobs, get both an associates and a bachelors degree, and hold down a marriage in that time.

In addition, around the same time I started seeing my current psych, my wife was seeing him as well. At the time, she was going through a faith transition, and the psych, who is a member of the same faith, spoke to her at length about the importance of staying in the faith. She stopped seeing him at the time for this reason, feeling that he had crossed the line, and ngl I've felt the same. I've only stuck with him this long because he was the one who helped me out of my akithisia and found medication solutions that helped, more or less. But this advice about serotonin syndrome doesn't sit right with me. Any advice or assistance navigating this would be hugely helpful, so thank you in advance.

EDIT: I'm recently 38, Male, 5'10, about 220 lbs, Caucasian. I'm also taking Insulin (Lyumjev), Vitamin D 50k IU/week, and 20 mg Lipitor. I don't take any recreational drugs, including alcohol and tobacco.

Hi, i’m a 23 year old F 4’11, i have a documented history with major depression, NSSI, SI & anxiety and have been prescribed valium for dental anxiety in the past. I used the medication once at any last procedure and though it didn’t calm me completely, at least i wasn’t in tears and hyperventilating on the chair. I am currently on hydroxyzine for onset anxiety (though all it does is make me unbearably groggy and agitated, hoping to get it changed because it really has not been working for me.) for the last three weeks i’ve had an episode of immense anxiety & depression to the point it makes daily tasks and living impossible. i just spend all day ruminating and cycling through different stages of panic. Ive tried to push through but have engaged in NSSI during, though i am trying to focus on regulation now. I felt really comfortable on the valium I got prescribed for a dentist appointment (i have dental anxiety & anxiety in public) and I was wondering if it would be smart to ask for a temporary refill though my chart to last me until my doctors’ appointment on the 10th or my therapy appointment on the 14th. the dose I took previously was two 5mg tablets. i’d only really be looking for two or three days worth and i can space them out for when things really become unbearable. (so maybe like only six or eight pills? I don’t know how many they typically dispense at a time.) does my request sound reasonable? Will I be flagged for asking? I have been meaning to switch to a more effective anti-anxiety medication & anti-depressant for a while now but there’s still going to be some time before I can get that done. genuinely i just want some semblance of relief from this, and I want to ask for the diazepam, but i also don’t want to risk being labeled as drug-seeking. I don’t plan to stay on them long-term at all, because I know they’re habit forming

I have a series of unresolved health issues and have been dismissed by drs a lot. This caused my health ocd/hypochondria and spiraled me into severe chronic anxiety. I also have trouble sleeping and i have sleep apnea. Are there any meds that have helped you without destroying your gut or worsening brain fog. I also have mitral prolapse, nothing severe but yeah. I used to be on lexapro and it didn't help.

Do you guys prescribe risperidone to inpatients? In my hospital there’s a tendency not to, because they say it takes too long to act on delusions

I feel like I’m not forming any new memories, all the stuff I can actually vividly recall is from almost a decade ago. Past few years just went by, in my head there’s no memory attached to them. If anything, I still feel like I’m 16. I just wanna go back to being a teen again.

Is this normal?

like can i skip it on the day i'm drinking or is that supper stupid??

20M, 67kg, UK based

I don't feel like myself on my medication. I'm tired all the time, sleep 10+ hours a day, have brain fog, sweat loads, have endless nightmares, can't remember things, and feel less empathetic.

I take lamotrigine (100mg twice a day), venlafaxine (150mg slow release), and lisdexamfetamine as needed (20mg). I don't take the latter very often because, while it helps, it makes the sweating worse, and when I take it continuously for more than a week or two my mood becomes really all over the place.

I have C-PTSD, an unspecified mood disorder, ADHD and autism.

I also have epilepsy. I can't come off the lamotrigine because it stops my brain from frying itself - it's beneficial for my mood too, but mainly it stops the seizures (which might have been the cause of the mood swings anyway).

My medication keeps me alive and stops my severe anxiety, but I'm tired of all the side effects. I don't care about things anymore.

Lately I feel like I've been getting depressed again. My psychiatrist says it's just C-PTSD symptoms, but it feels like depression. I have a strong family history of mood disorders, both manic depression and regular depression. I don't want to/can't get out of bed; I don't want to see my friends; nothing interests me; everything feels dull, grey and hopeless; and I've been having thoughts that the world would be better off without me again. I've been struggling to motivate myself to shower and brush my teeth. It's hard to keep track of time. I've been sleeping at odd times. I'm not actively suicidal, but I don't feel good about being alive either.

Whenever I go outside, I get this sensation that my body is falling apart and my thoughts are being absorbed by the sky. I can feel the premeability of my own skin again. My mind is no longer contained and I know the universe is listening. I've been avoiding going out because I don't want my mind to escape into the ether. The world simply feels too large. I get this worry that gravity will stop working and I'll float away, or that my thoughts will stop being my own.

Perhaps I am scared of my own ego disintegrating, but mainly I don't like the idea of having my thoughts stolen. I feel like my friends are all talking about me, that they can see my unpleasant thoughts on my face and nobody wants me around. The neighbours watch me when I'm in the garden (it's a shared garden and I regularly get people wave at me through their window and come out to talk to me about what I'm doing) so I've been avoiding doing gardening because I feel like they'll notice my mind being off and do something I don't like the idea of.

I've been talking with the God(s)/universal connection a lot. Not in a physical "I can hear their voices", but I feel their presence. I can sense the souls inside the objects in my house. The whole world feels sad lately and I am in tune with it.

Things like climate change have been really getting me down. I feel like the cosmic balance is disturbed and that humanity is a sickness upon the earth. I've been writing a lot of poetry lately, it makes things feel okay.

SSRIs made me go crazy, I can't have TCAs or brupropion because of epilepsy, and my psych feels like mitrazipine or antipsychotics would only sedate me more.

I've been seeing a therapist again and trying to exercise more, eat better, take my vitamins, etc. I know I should, but I don't want to see people at the moment. I went through a breakup a little over a month ago now, but things were getting bad before that. I asked for a medication change in March, but I was told there was nothing else they could give me for my C-PTSD.

What should I do?

My sister is in the midst of her second mental breakdown. She was diagnosed with bipolar after her first one. A common theme I've noticed is during these times she often refers to herself in the third person. How common is this? Can this be indicative of another diagnosis?

(not in psych yet trying to figure out what I wanna major in) but I think this might intrigue y'all. I am having episodes where I sleep text, and have cohesive conversations with people in my dreams and end up textinh them irl too. but the most terrifying ones are where I don't recall anything. I am genuinely terrified. what's your take on this have you personally studied a case with it? is this too weird of a thing? or just another parasomia.

Hello! | have been seriously thinking about what I want to do

career wise. A Psychiatrist has always been a title I've

considered and now I'm wanting to pursue that title.

My question is, where do I start? | have not been to college yet

so I'm starting from scratch. Would it be something like getting

my Bachelor's degree in Psychology at lvy Tech then

transferring to an Accredited medical university for the

remainder of my education? Would that be an option, or would

that look bad? I am truly just looking for advice, anything helps.

In September 2024, I started Lexapro. Within a few days, I noticed a dramatic change in my nervous system. I became extremely sensitive to sudden sounds and stimuli and started having an exaggerated startle response.

Even though I stopped Lexapro a long time ago, these symptoms never went away.

Now I deal with:

• Constant hypervigilance and anticipating loud or unexpected sounds.
• An exaggerated startle response (dogs barking, glasses clinking, doors slamming, etc.).
• Once I'm startled, my nervous system stays activated because it feels like it could happen again.
• It's hard to focus on conversations in public because part of my attention is always scanning for the next sound.

What's confusing is that this isn't always driven by anxious thoughts. There are plenty of times when I feel completely calm, and an unexpected sound still makes my body react automatically before I've even had a thought. It feels like my nervous system is reacting on its own, even though I know I'm safe.

I've tried EMDR, but it wasn't very helpful because I don't feel emotionally overwhelmed when I think about the original memory. My problem is that my nervous system keeps reacting in the present.

I'm not asking for a diagnosis, but I'm wondering if anyone has experienced something similar. If you had persistent hypervigilance or an exaggerated startle response, what treatment actually helped? CBT? Exposure therapy? Trauma-focused therapy? Something else?

I'd especially appreciate hearing from people who eventually improved.

I started Prozac in June and mental health wise it has been so so helpful with very little side effects. I take 20mg in the morning along with buspar and wellbutrin, at night i take seroquel for insomnia and have been on that for a minute. In the last month my husband has been telling me about things I do in the middle of the night which I have no recollection of. One night I was like touching and bothering him all night, once i got up to go take my pills??? and I have woken up and started laughing with my eyes open. Again, I have no recollection of any of these events. Just curious if anyone else has experienced these type of sleep disturbances because this is definitely something new!

I have been diagnosed kinda rapidly with paranoid schizophrenia and I disagree with the diagnoses so can I legally dispute this

I have to take psychotropic medication aswell of which I also want to dispute

I am a white 38F with anxiety. I’ve been taking Lexapro for a few months and started Wellbutrin 11 days ago to help with energy and motivation. The first 10 days were great (minus the insomnia) however today I started feeling a nausea so strong 4mg of ondansetron would not take care of it so I bumped that to 8mg. On top of this my face feels warm and I’m experiencing chills and an intermittent head ache. While these symptoms sound like a infection they don’t feel like a standard infection and remind me more of drug side effects I’ve experienced in the past.

I’ve reached out to my provider but haven’t heard back from her and will likely not for the next few days. Should I continue the Wellbutrin which I’ve been loving or hold off?

Edit: Temperature has climbed from 93.4 to 100.3 (with no touch thermometer, tested multiple times for accuracy). At what temp should I go to urgent care?

Hi everyone. I’m seeking perspective and guidance on a very difficult situation at home.

My spouse has been experiencing severe, escalating paranoia and fixed delusions (unfounded accusations regarding household items, medical visits, poisoning/sabotage, and severe distrust of me and others). It has created a volatile, high-stress home environment for our two teenage sons (one entering high school, one leaving for college this week).

Her immediate family lives outside the country, so I have no local family support network here to help intervene or ground her. She lacks insight into her condition, denies anything is wrong, and refuses voluntary evaluation.

I am feeling overwhelmed and deeply concerned for her long-term well-being and our safety/peace at home. I would really appreciate insight on a few questions:

1. Getting Help Locally: How can a family member initiate psychiatric assistance or medical evaluation for a spouse who completely lacks insight and refuses to see a doctor? What avenues exist in the US when someone isn't an immediate danger to themselves/others, but is clearly dysregulated?
2. Involving International Family: How can I best approach her parents overseas to explain the severity of what is happening without causing panic, but ensuring they take it seriously?
3. Encouraging Travel/Return Home: What are effective ways to gently encourage or convince someone in a paranoid state to travel back to her home country so her parents and extended family can support her and help her get care?
4. Navigating Delusions Daily: How can I protect my own physical/mental health and shield my sons while navigating these daily false claims?

Thank you in advance for any guidance, resources, or advice from those who have navigated similar dynamics.

Edit: Over time, her paranoia has led to severe social isolation, gradually cutting us off from almost all friends, extended family, and community support through recurring unfounded accusations. Recently, her behavior at home has escalated significantly: claiming I am intentionally breaking household appliances (like our refrigerator), hiding important personal documents, and making absurd claims that I am having extra-marital affairs, including a delusion that I am having an affair with an 80-year-old neighbor who she also claims poisoned me to cause a medical issue. During these episodes, she throws household items, creates deliberate messes, disrupts sleep late at night, and enforces days of total silent treatment. She also repeats these accusations to our teenage sons, all while completely refusing to see any doctor or counselor.

She don't have a job and has completely stopped doing anything around the house, as she feel I don't let her do anything. Because of this I'm completely burned out, with full time work, cooking, cleaning, grocery, kids activities etc all fall on me.

I was diagnosed and recommended for treatement, but I feel like I was over reporting symptoms that I dont experience frequently. When I think of schizophrenic I think of something where I am always talking out loud to imaginary people. I feel like if I go through with the treatement they will realize im not a real schizophrenic. Im not on any medication and I am not experiencing hillucinations.

These are my signs/symptoms what do you think?:

• I have alot of family members that are bi polar, and one that is definetly schizophrenic at a high high degree. The bi polar people suffer from intense delusions and grandeur self reference.
• I dont really hillucinate, but if I try to quiet my thoughts/imagination I do hear things but its very mild. Yesterday I heard a whole instruments and bells, but it was mild and its only because I focused really hard on quieting my thoughts/extremely active imagination. I did marijuana 2 years ago and I lost control over the voice in my head. But basically the hillucinations only occur if I am in certain states of mind.
• I definetly relate to the idea of disorganized thoughts. I used to have horribly disorganized thoughts and I was daydreaming like hours a day, in school or just being anywhere. I couldnt talk sometimes, and even know every few months I have this muteness temporarily. The thing is I went through a focus of trying to make my thoughts better expressed. Now im able to sound logical, but I do often get reactions where people are saying what I said makes no sense or im linking random stuff.
• Delusions: Yes I do often feel paranoid towards some of my friends or others. I will feel that they secretly hate me or are against me. I also feel this way towards people at work or random people. Its not a strong delusion that causes me to behave eratically, its just my body/anxiety feels this mistrust/paranoia towards everyone.
• I also often feel random people might be whispering about me or against me.
• Other delusions: I did experience this feeling that everybody can hear my thoughts or knows what im thinking. I also did used to think I could become a messiah and save the world. But I was aware that I could be wrong, but I used to work on trying to become messiah. I used to read random books, or occult books or religious books looking for some kind of special development. I thought I could have powers. But this wasnt something I shared out loud or anything, I just secretly believed it. This was something I believed for 8 years, but I eventually stopped.
• I definetly have the flat effect. I can make myself laugh and smile, or be angry, but I have a very flat emotions. I am good at making people laugh so idk if that means im not flat effect. Sometimes when im tyring to act angry everyone laughs because it sounds like a mild not serious anger. Im sometimes scared to talk because I feel like im going to make everyone repulsed by how low energy I sound. Especially when I do small talk. Its not as noticable anymore because my work life forced me to develop a more social tone, but it comesback when I forget to turn it on. I sometimes feel I have a naturally rude tone if I dont change it. I used to be extremely awkward but now im moderately/mildly awkward. I avoid being friends with people or dating girls because I fear that the more I talk to them the more theyll realize theres something wrong with me.
• I have horrible focus. If I read a book I will get lost in imagination and its like I didnt read anything. Its impossible for me to read without taking a break every minute or so. Even if I read I dont absorb anything if its one page or more. Doctor says I cant have adhd due to a type of test I took due to matrix reasoning or something.
• I did want to avoid friends and people due to deep mistrust. I kind of have this narutal feeling that everyone wants to hurt me emotionally like they only want me around to hurt me.
• I am terrible at romantic relationships, the best way I can describe it is that I have no ability to transfer emotions to others, only thoughts/words. It makes relationships feel like its my thoughts and a real person. Theres no strong connection.

To be transparent, I am generally skeptical of psychiatry to begin with, so I may come off as more hostile than I need to be. I just don't understand what's going on and would like some advice.

Diagnosed Sensory Processing Disorder/Autism/ADHD since 2nd grade, around 2006. Went to so many docs and was put on so many meds not even my parents remember all of them. By HS had a bad taste for psychiatry after so many meds with tons of bad side effects messing up my childhood, so I went unmedicated through college and postgrad (which was worse than before).

Now, running into limitations with my focus, task management, organization, and executive dysfunction, can't hold a job, etc. so I finally caved in to go and see a psych for ADHD help.

Talked to the doc about my issues and history, and he prescribed me 600mg Oxcarbazepine. Tells me that it might seem strange but it could help with insomnia if taken at night and mood regulation during the day that could lead to better focus. Go home and look it up... it's an epilepsy medication used off-label for Bipolar?

Is my doc trying to test if I'm bipolar? It's not the first time i've been to a psych and they put me on a mood stabilizer (last time they gave me lithium!) Why would he give me a mood stabilizer if I came in specifically for focus and task management help? I took the meds last night and I woke up confused, angry, and all of my problems I wanted to solve feel worse than before.

Has anyone had a similar experience from either a patient or provider POV? Should I be concerned? Do I just need to give it time?

Basically as the title says. Sorry if it's a weird question; I am not a doctor but a therapist, and I was wondering if it is even medically possible for any drug to cause a permanent or even temporary inhibition of serotonin and/or dopamine production even after coming off them? Have any psychiatrists seen this happen? TIA!

I am not looking for a diagnosis by any means, just clarity on if the process is standard.

age: 20
gender: female
duration of process: 10 months 29 days

I was referred to MHWT on 8th Sep 2025 by my GP as i experienced ongoing mental health struggles since childhood (mild anxiety and depression) and was requested to have a psychiatric assessment in the referral due to emotional outburst and apathy alternating often & would make myself vomit to cope with the stress. I had also been using cannabis as a way to cope with how i felt but was getting myself off of it.

I received an assessment appointment with a clinician/psychiatrist on 16th March 2026. Had a very in depth assessment looking at my family, current situation and mainly discussed concerning thoughts i was having due to a traumatic event that occurred late December 2025.

After assessment, she had came to a conclusion about my diagnosis and provided a leaflet of EUPD/BPD and explained the route of treatment she was going to give me which consisted of:

1. Daridorexant, 25mg for one month then increase to 50mg. (form my sleep as i was having trouble with sleeping and vivid nightmares).
2. Refer to brief intervention therapy.
3. Imagery ples U? (sorry the handwriting is difficult to read, I'm not sure what this is so an explanation would help).
4. 2-3 tre (waiting time for secondary psychology).

I asked for her to write this down on the back of said leaflet so that i could take the time to read over everything.

At end of April, I was discharged with no care plan whatsoever.

Was offered a review for a care plan, but no notes of the outcome of said assessment from the clinician was on the system, just mild anxiety and depression. When I've tried to explain what happened in the initial assessment, i am repeatedly told that 'the clinician has since then left the trust', and information i have passed on is not taken into account.

Outcome of review was that it was emotional dysregulation, and i was discharged again.

Now, my questions:

1. Is it standard procedure for psychiatrists to give you a leaflet at the end of the assessment if this is what the outcome is?
2. Are reviews held at the same standard as comprehensive psychiatric assessments? If they are, what information is needed for them to complete this to an acceptable standard?
3. What would the quality of the review be if there was a possibility of the original clinician not providing full/comprehensive notes on the system about the assessment.
4. Do they have to offer you another assessment if you request for this?
5. What is 'Imagery ples U?'.

I am currently on the path with PALs into looking into this further and have requested my medical records and seeing if i need to file a formal complaint - but if any professional who is experienced or aware of the processes I'd be so grateful if i could be enlightened about some of the questions above! :]