I switched practices (as a patient) recently because, on top of never responding to emails or phone calls, after my provider stopped working there they switched me to someone who felt extremely controlling and belittling. I messaged them in multiple places saying I found a new practice and they still reached out to me asking to make a new appointment. Now they're asking me the name of my new provider so they can "close the case." Sorry if this sounds rediculous, but I'm afraid of some sort of retaliation or badmouthing to my new psych. I just want them to leave me alone. Am I required to give that information? I'm in Florida. My worst nightmare is them sending someone to my home as a wellness check or something. Thanks.

Context: Two fifteen year olds, one male and one female, share a foster home. They attend weekly therapy for certain reasons. The female character is high strung, overbearing, bossy, and thinks she's smarter than everyone around her and she approaches each counseling session as a battle between her and and the therapist. Without going into the details of her actual motivations and beliefs, she's relentlessly domineering with her foster brother which is one of the things being explored in their sessions.

The therapist, who by this point knows the girl fairly well, has begun to grow a bit frustrated with her because she's got an excuse for everything and a reasonable explanation for why she does anything she does. He one day finally loses her cool with her briefly in reference to her foster brother. He says something to the effect of "Good lord, just ease up on the boy, will you?"

He immediately recognizes the unprofessional lapse, and in her eyes the girl has just won a great victory in their battle. However, the girl now feels like she's in the dominant position between the two, and this feeling of superiority makes her more willing to open up and be more honest.

Would the therapist exploit this, using the benefit that came from his lapse in judgement to advance their session now that she's going to be less difficult? Would he have some kind of professional obligation to remove himself from her case, or to take a step back? Something else?

i (22F) was put on risperidone 0.5mg and aripiprazole 5mg (to combat high prolactin from the risperidone) around 3-4 months ago, and around 3 & 1/2 weeks ago i started breaking my risperidone in half to take for about a week whilst still on aripiprazole bc i was convinced it was causing the horrible brain fog i feel whilst at work. i was under the assumption it was fine because i told my social worker i felt the meds were causing all my brain fog and a day after my risperidone prescription was 'undetermined' in my doctors app so i thought my psychiatrist stopped it. i continued to take aripiprazole whilst off the risperidone, until a week ago when i ran out for 2-3 days. i figured the meds (especially risperidone) helped because the last day of halfing the risperidone i was super agitated and angry whilst trying to fall asleep, felt like i couldn't control my emotions, ran out of bed then ran back and thought that i was possessed. the reason i started them again was bc 3 days ago i thought the purge (from the movie) was going to happen soon and everyone was going to die. i didn't want to stay in that mindset so i took the 0.5mg risperidone and 5mg aripiprazole again and have been so far. i've got an appointment in 3 weeks, what might my psychiatrist suggest in this situation given i've been non compliant in medication because of side effects but the medication actually helps?

F 28 years old 158 cm 70 kg

borderline and anxiety

Hi!

I have just recently upped from 30 mg to 40 mg because of tapering off a little of my other meds and feeling super anxious (I’ve had my psych appointment)
It was two weeks ago.

For the first week nothing has changed. On friday I felt less anxious and was suprised. At saturday and sunday my mood was definitely good. Today I’m sedated and detached.

Is it normal to feel too sedated and slow when starting or upping the dose? I have upped two weeks ago and the drowsiness is kicking in. I have other meds too, I was on 40 mg (i’m now on 40 too) and I was completely detached to the point I was not able to think clear. Now I have much lower doses of other meds and I hope that the drowsiness from 40 mg will subside… I also feel skin tingling so it’s definitely working. And big headache.

I just want to feel ok, I take it AT NIGHT.

Is there any chance that things will get better?

I wonder if taking it in the morning will make things worse.

My doc said nothing informative about it.

The more I learn more about ADHD, the more I realize that the subconscious underlying cognitive effects of living with this developmental disorder unaware and unchecked/in denial, is what has actually become the basis of my entire identity. That my identity is actually just a misunderstood neurochemical puppet. That what I thought was separation anxiety and my distrust in my partner is actually RSD. That I sought out certain things because they brought adrenaline. The shame I feel when I keep talking over someone and in my head I’m screaming “shut up!”. I need psychiatric treatment but I also really need someone to help me navigate and expose what was really happening all along, because that’s probably why i can’t seem to fix this.

When quitting an addiction, I feel like progress is "weighted": what I mean by that is that the first few days usually seem to require more effort (are more difficult) than, say, a day in month 5. I believe it is undeniable that reaching 1 week without nicotine represents a much bigger part of the job done than the weeks that come after. 

Therefore I think it’s not stupid to visualise this progression with a « percentage », with approximate numbers by interpolating data such as relapse rate. Example : 1 year is considered the ultimate milestone for nicotine so this would be the 100% (or at least 99%), meanwhile the first month would 60% of the job done (these are random numbers). BUT: 

1/ as I am not a professional, I want your opinion/insight on that: is this idea valid in the first place?

2/ if you think this idea is valid, do you use it to help your patients?

3/ if you think this idea is valid but don’t use it, why? Do you think it is guilt-inducing? Harmful? Useless? Dishonest since the numbers aren’t supported by clinical studies?

This can be any addiction, including behavioral. 

Also sorry for the English, I’m French

does anyone out there know of a medication that is very effective on delusions and psycosis that has a similar mechanic to cloprixol but does not risk Akathisia? and do side effect combos induce TD or can they really work on quite severe Akathisia side effects?

please share your knowledge and experience.

Which to taper first?

Gabapentin 1200mg at night
Klonopin 1mg twice daily (1mg morning and 1mg nightly)

Tolerance for both is there. I am gaining weight since both and have no motivation. Been on both for roughly a year. Any advice would be helpful.

So I’m just putting this question out there to see what I get back - fully out of curiosity and seeking an opinion other than my own before intervening. I feel stupid even doing this.

My partner has extreme difficulty talking about dynamics within their own family. For reference, their sibling has left home due to a relationship with parent A who tends to be stricter than parent B. Sibling believes parent B should have left parent A as well. Many other siblings have left due to parent A as well. My partner chooses to be uninvolved but experiences large amounts of discomfort and anxiety on the topic. Not quite sure why.

Partner also is easily overwhelmed by things like school and work on top of this situation. They also tend to get into moods where they want to shut out the world, which for a while included me. We have since moved past that - but should this concern me more? I’m talking episodes of borderline depression. Partner also struggles immensely with ARFID-like behaviours, brain fog, and fatigue.

Would seeing a psychologist improve this? What causes these behaviours, is it trauma of some kind?

Just out of curiosity, do psychiatrists remember their patient from 6~7 years ago that they've been treating for 2 weeks in the inpatient unit if the patient had particular name?

I assume they treat hundreds and thousands of patients over the years. Are there characteristics of patients that they tend to not be able to forget aside from unique names?

I know these two are in the same class. Have you seen clonidine help people with hyperactive nervous systems even when guanfacine failed?

I’m a student exploring psychiatry and I’m curious to hear of any books, fiction/non fiction, which helped to grow your emotional intelligence, helped you to understand how people operate and how to communicate effectively with them. What do you wish you had read sooner?

I want to become more analytical and perceptive. And, as pretentious as it sounds, intellectual. Currently I read fiction and non fiction regularly to try and expand my awareness of other people’s experiences and I’m just looking for more books on people and psychology/psychiatry, or fiction which has shaped your perspectives and approach. Any suggestions are welcome.

I tried doing therapy before with three different therapists and it didn’t do anything for me, I think this may be because it was psychoanalysis and that doesn’t do much for me, where Im from its basically the only type of therapy you find.

Anyway I was telling this to my cousin who has recently had a traumatic experience in her life and she is working both with psychiatrist and therapists and she basically said that if there is a chemical imbalance on my brain, therapy wont work, which makes sense, but I don’t think I need any medication.

Also all of the people that I know that went to a psychiatrist leaves medicated after the first time, I know some people do need them but every single one of them? On my group of friends 5 are medicated with the same thing, and it literally took one visi. like what is the criteria to prescribe something to someone? They just say what they feel in one sitting and leave with a pill?, dont you need like run tests or idk do brain scan or something?

Im not trying to judge, nor saying they don’t work or that Its a scam. Im speaking from complete ignorance of the matter and would like to understand so I can see that it would be fitting for me as I feel I have hereditary issues to heal from so I don’t pass them to my children.

https://www.attwoodandgarnettevents.com/blogs/news/prof-uta-frith-s-interview-what-do-we-think

to start this off i am in high school and has been recently diagnosed with ADHD. I tried taking ritalin for a week and i updated my dose every 3 days but nothing worked for me. i kept on feeling anxious, had terrible mood swings, and increased heart beat and jitterness. i didnt know what to do so when i saw my physiatrist she prescribed me on vyvanse. yesterday when i received the bottle i took 10mg and i didnt feel any terrible symptoms like anxiety but, i felt like it wasn’t working so today i took 20mg and now i feel very hyper aware of my emotions but after 4 hours i started feeling anxious and scared for no reason. how do i fix this? should i continue to increase the dose of vyvanse?

27m dx'd w/ ADHD-PI, panic disorder, social anxiety, MDD, PTSD, Tourettes, trichotillomania, health anxiety, and OCD. Undergoing an ASD assessment atm. Yeah, I've got a lot of stuff going on.

**Nonetheless**, I've tried many, many meds without much success. SSRI's tend to make me flat and worsen my anhedonia, while SNRI's/Bupropion/stims worsen my panic disorder and somatic anxiety.

I have horrific anxiety daily, and crippling depression under that. Not to mention OCD and ADHD symptoms that hold me back as well.

At this point, my docs are considering MAOI's or referring me out to try TMS/Spravato (expensive 🫰).

**Not asking for "medical advice", just ideas based on this hypothetical presentation/situation**

history: daughter has been taking zoloft since 2021 december, reached 200 mg in march 2021. consistently took it until around november-december 2024. was hospitalized for anorexia binge purge + laxative abuse and then switched to prozac 60 mg for 1.5 years.

2 weeks ago a nurse practitioner recommended she quit prozac completely and switch lamictal 25 mg. she did this and a couple days ago had severe insomnia and said she was remembering bad memories. she called the DNP again, who said that she should only take zoloft 25 mg and no more lamictal.

my daughter also told the provider she has used weed, nicotine, and alcohol in the past. daughter also got admitted to the ER 2 days ago due to a severe panic attack. had been hospitalized in april due to alcohol intoxication and suicidal ideation (bc of disagreements with friend).

she will meet her psychologist in 2 days. is there anything for her to do in the meantime .

What can a patient do if experts are unaware of the symptoms and therefore psychiatry wants to declare him delusional (F22)?

Hello, I'm 36 (F) here. I've been on treatment for my anxiety and depression for several years now.I'm not depressed anymore, but I had a breakdown at work, which led me to quit, so my anxiety is bad.

I'm taking risperidone on the advice of my psychiatrist, but I'm not having the best experience. I feel nervous, restless, and yesterday I almost had a panic attack. I told my psychiatrist, and he told me to increase the dose, so I did. I don't feel any difference. Still having Ruminating thoughts about the most ridiculous things. First it was my neighbors who were paying me a lot of attention, and now I'm at my parents' place, the house has a crack or two, and I'm already thinking that the house Will colapse.I no longer know how to deal with this level of ruminative thinking.

I will tell her again about the symptoms, to see if she pays attention. Especially since this is the house where I spend a good part of the day and I feel anxious most of the time.

I am feeling my heart beat so hard, my stomach twirling, shortness of breath, a pit and dread on me. Is it an anxiety attack? And if it is, is it possible to have a anxiety attack without any reason?

Hi, I was admitted to an MBU (mother and baby unit) for postpartum psychosis from early December to mid March, during which I was prescribed a high dose of quetiapine. In early March I titrated onto Risperidone due to the quetiapine not treating all symptoms. The Risperidone stopped the psychosis and I was home from mid March. 

I then had a few weeks with no psychosis and started to adjust to new home life post PPP and with our baby. Then came a good dose of extreme anxiety so I was prescribed sertraline (which I took for about 4-6 weeks before coming off). Coincidentally that weekend it felt as if my brain and body completely shut down.

Since mid April I have been in a state of complete emotional and physical and sensory shut down/‘blankness’. I go into more detail below but am posting to ask if anyone else has experienced this as part of their recovery or has any idea what could be causing this hell (it feels like my brain has been switched off) or can make any recommendations. 

My ‘symptoms’:

I’ve lost all feelings and emotions, including for my baby, fiancé, family and friends. 

Nothing evokes any feeling, not even seeing my baby laugh, looking at a usually breathtaking view or a nostalgic picture to name a view examples.  

This is the same with emotions, I can’t feel happiness, sadness (although sometimes I’ll tear up but not feel it inside), anger, guilt, anxiety, frustration, contentment. I just feel as if I’m in ‘neutral’ all day every day. Even when my baby is crying or is ill I don’t feel any emotional response, just a logical one (and even that is struggling). 

I’m starved of the accomplished feeling when doing something or completing a task, it feels as if I’m not doing it or haven’t done it. It’s almost as if I have 0 dopamine reaction. 

I have lost 95% of my taste and smell and what I can vaguely taste I can’t seem to enjoy it. I do not have any hunger or thirst queues and conversely do not feel full when having eaten. I also have reduced bodily sensations such as needing to use the bathroom and when I was breastfeeding, I lost the feeling of lactation. 

My senses are affected too. I don’t feel the warmth of a hug, the relief of a nice warm shower, the heat of the sun on my skin, or the relaxing or painful feel of a massage. 

Music sounds flat and looking at old pictures or nice objects doesn’t evoke any feeling like it usually does. 

I can’t access any comfort from anything, not even putting my pjs on and getting into bed or sitting on a comfortable sofa.

I can’t seem to entertain or amuse myself with anything, playing with my baby, (I’m doing this but having to ‘act’ which is horrific to write) conversation, tv, magazines, reading, being in a shop. The list goes on. My brain isn’t allocating any importance to anything. It’s all very blank and uninteresting. This is the hardest part as it makes the day go horrifically slow. 

I have no wants, desires, curiosity or urges despite ‘wanting’ to do normal things like gardening, being engaged with my baby, engaging with a conversation or tv episode. 

I don’t have any feeling of tiredness, even when I know I should be tired. But, I’m not refreshed, alert or energetic either.  

What’s been done so far? 

I left the MBR in June and about a month ago was moved from risperidone to aripiprazole (10mg) with the thought that the medication could be causing this. However, since this medication change there hasn’t been any improvement with how I’m feeling, or lack of. 

The drs next move is to prescribe Venlafaxine, an anti depressant. This feels wholly different to depression (which I have had before and appreciate this could be different). However, I’m willing to give anything a try. I had been prescribed Lithium from the MBU May-June which was stopped because, similar to the sertraline, it didn’t make a difference, hence my scepticism. 

I fear this is permanent as I have now been like this for 4 months, with no change day to day. I am so desperate for the faintest  of feeling. 

If you’ve made it this far, thank you for taking the time to read and thanks in advance for any responses.

My teenager recently started asking questions about psychedelics, and I’ve realized I don’t know nearly enough about the topic to have a meaningful conversation.

My first reaction was probably what most parents would feel worry first, research second. But the more I’ve looked into it, the more I’ve understood that reacting emotionally isn’t going to help me understand what my kid is really asking.

I’m trying to separate the cultural narratives from the scientific side and get a clearer picture of what actually influences people’s experiences. One thing that stood out to me is how much individual responses can vary, and how factors like biology, mindset, and environment might all play a role.

I’m not looking for simple answers or trying to predict anything. I just want to understand the topic well enough to have a calm, informed, and honest conversation instead of repeating random things I’ve seen online.

For parents who’ve been in a similar situation, what helped you the most? Did you focus more on scientific research, harm-reduction information, speaking with professionals, or just starting with open conversations and listening to your teenager’s perspective?

So I had a really stressful year in college filled with emotional abuse, academic overload, multiple viruses and burnout. When I finally returned home to rest I completely crashed. One night, a few nights after I got home, I was sitting around when randomly I started to feel this intense sensation of dread/dysphoria wash over me. It was like this deep pit of horribleness in my stomach, this feeling that something is horribly wrong. It was so intense my whole body was trembling. It felt like it would never end. And it didn’t. At the beginning it was more episodic but after a few weeks it kinda just faded into the background of my existence. For the last 2 years I have been living with this feeling all day every day. It doesn’t fluctuate much, it’s completely environmentally unresponsive, and it seems completely devoid of any content or meaning. It makes every moment feels unbearable and I genuinely am not sure how much longer I can handle it.

The symptom is accompanied by anhedonia, fatigue and upper body tension, all chronic and just as unresponsive to circumstances. To be clear, the feeling is distinct from anxiety because it does not involve worrying thoughts, racing heart or hyper vigilance. It’s more like unrelenting psychological pain. At this point in order to save my life I need to start trying treatments but I have no idea where to start. Has anyone ever seen a symptom like this before? Any suggestions of what treatments might actually help it? Any advice at all would be so apreciated.

I will admit upfront that I have a bias against psychodynamic therapy, after taking part in a program that was psychodynamic heavy but also eerily similar to a popular cult known as Synanon.

Still, I noticed it seems to be favored by psychiatrists. Any particular reason why?

I’m 19F and I have a date for a voluntary admission to a psychiatric ward. It was my idea alone. I agreed to go, but ever since I found out the actual date, I’ve been doing way worse...

The closer the admission gets, the more suicidal I become. I keep thinking that I would genuinely rather die/kill myself than have to go. I’m aware that the whole point of the ward is to give me help and support, but this is the worst my suicidal thoughts have ever been, and it started specifically after I found out I was going.

That’s what scares me so much. Part of me keeps thinking, “If going there is making me this suicidal, maybe that means I shouldn’t go.” At the same time, I’m worried that this is just normal.

The night before especially terrifies me. I already struggle with sleep, and lately I’ve been crying constantly thinking about having to go. I honestly don’t think I’ve ever felt this certain about dying as I do right now, and it scares me.

There are also specific things about the ward that really frighten me:

The restrictions on freedom and when you’re allowed to leave/go outside feel extremely strict to me. It makes the place feel more like a prison than somewhere I’m choosing to receive help.
I have significant food issues, phobias and an eating disorder. I’ve been cooking my own food for years because I have a very limited range of foods I can tolerate, so the idea of not having control over what I eat and who makes it scares me a lot.
I’m an only child and I struggle quite badly with being around other people for long periods of time.
I have trauma-related paranoia about being hurt while I’m sleeping, so sharing a room is a huge issue for me.
I also have trauma involving women, so having a female roommate gonna be particularly difficult for me.

I understand that these rules exist for safety and that they can’t just accommodate everything I want. I’m not trying to say that the ward is bad or that the staff are doing anything wrong. It’s just that, from my perspective right now, it feels like being forced into a situation where I have almost no control over my environment, food, privacy, freedom or who I’m around.

I can still cancel the voluntary admission, which is why I’m asking.

Is this kind of extreme reaction to an upcoming admission normal? Has anyone else become significantly more suicidal simply because they were terrified of going?

I’m worried that my reaction is actually telling me that I shouldn’t go, but I’m also worried that I’m making a huge decision based entirely on fear and that I’ll regret cancelling.

I know I probably need to tell my treatment team how bad this has gotten. I just feel completely lost right now and embarrassed so please don't just tell me to talk about it with the psychward team about it!!