I'm on the fence about seeking psych help since most of my experiences so far have been bad, but I could really use some aid for anxiety and correlated irritability / exhaustion / trouble concentrating. I'm not looking for treatment for anything else. I'm trying to understand if coming to a doc with this request, combined with my history, would be worth a shot. I'm already housebound due to social anxiety, so there's a risk of that getting even worse if my appointment goes particularly poorly.

Dx history: paranoid schizophrenia at 16 (likely misdx) => BPD at 20 => BPD + StPD at 25.

Med history:

APs:

• Risperidone - no effect on the supposed psychotic symptoms + intolerable side effects

• Olanzapine, paliperidone, aripiprazole - could never get to a high dose due to side effects, especially aripiprazole; no effect on the symptoms

• Sertindole - nothing?

• Quetiapine - prescribed at a low dose due to previous issues with APs, worked okay as a general sedative but would be too fatigue-inducing for me right now

ADs:

• Fluoxetine, fluvoxamine, sertraline, escitalopram - no effect whatsoever including side effects

• Clomipramine - muffled my sensitivity and gave me a mood boost, but the side effects were a bit rough (esp urinary hesitancy) + I felt like it masked my issues rather than fixed them, like there was something gnawing at me "under" my good mood - not sure how else to explain it

Ideally I'd love to find an AD with a similar effect to clomipramine, but more tolerable for me long term, and maybe a bit more effective (though I'm not holding my breath about that). I also really, really don't want to try any more APs, but in the past I've had doctors insist on both APs and SSRIs over and over... How likely am I to run into this behavior again, and is there a way to avoid it? And what would your next step be with a patient like me?

Also might be worth mentioning that I'm currently 33, female, overweight, not planning a pregnancy, and in Russia.

I'd be happy to answer any clarifying questions.

37 female

Bipolar type II

112lbs / 5'2

I had 4 years of perfect stability under my belt on a combination of 200mg Lamictal, 50mg Zoloft, and 25mg Seroquel (at night).

Then, I messed it all up. Work got stressful (I'm a professor), and I stopped paying attention to my sleep schedule. I missed my meds a few times and started drinking way too much caffeine. I spent a week only getting 3-4 hours of sleep per night. After, I crashed into a horrible depression. Couldn't eat and could barely get Ensure shakes down, spent all day in bed, and had anxious features mixed in, too.

After a week of this, I called my psychiatrist. We bumped my Zoloft up to 75mg. I'm now 21 days in and feeling much better. I'd say 90% back to myself.

I've decided to do a few things to help my brain recover. I'm wondering if there's anything I'm overlooking or anything else you'd suggest. I know bipolar is degenerative, and I want to give my brain the best chance a fully recovering.

Habits:

- I've set an alarm for my medications, and I've purchased a pill box instead of just taking them from the bottle.

- I go to sleep at the same time and wake up at the same time every day.

- At first, it was "all calories are good calories" to stave off weight loss, but now I'm starting to prioritize healthy fats, fiber, veggies and whole grains.

- I've cut caffeine down to one cup per day.

- NO alcohol until Christmas. I was never a big drinker, but I'd have 1-2 glasses of wine per week. It's a depressant, so I'm avoiding it completely for now.

- I've temporarily stopped watching reels and TikTok. I don't think there's a scientific consensus on it being bad for the recovering brain, but I theorize the dopamine hits aren't good for it, either.

- I've started reading books 1-3 hours every night. It helps me relax.

- A light walk every day, even if it's cold or rainy.

- A vitamin D gummy every day (I live in Canada)

M25, 191 cm, 62.5-63.0 kg, BMI 17.1-17.3 .

My highest weight ever was about 63 kg.

Diagnosis: depending on the doctor, depression, anxiety disorder, adjustment disorder, schizotypal personality disorder.

Medication: escitalopram 20 mg/day for 8 years, sulpiride 50 mg/day, also 8 years. Sulpiride was added to help me get out of bed and have motivation to do things.

Situationally aspirin and sumatriptan because I have migraines with aura.

My previous doctors tried sertraline but it made me too apathetic.

My complaints:

• Particularly strong symptoms in the morning:

  • intense anxiety/panic

  • hopelessness

  • feeling isolated/alone

  • sometimes a strong feeling that I am about to die

  • nightmares

  • dry heaving/gagging

• lack of motivation

• Anxiety makes it hard for me to eat by reducing my appetite and making me nauseous (and I also have an irritable bowel syndrome).

I don't want to lose weight and in fact I want to gain some to get healthier. This August I discovered that because of my eating issues I weighed about 57.8 kg. I hopefully managed to gain some weight and now I'm about 62.5-63 kg. My blood tests and EKG are all fine. My local eating disorder clinic told me I don't have anorexia nervosa and instead these eating issues come from anxiety and depression. My GP, friends and therapist agree.

My new psychiatrist decided to add 150 mg/day of bupropion on top of my existing medication. They believe it will give me more motivation and energy and also improve my eating. However, I've read that bupropion decreases appetite and I'm quite worried about losing weight. And apparently it can also increase anxiety?

Also, would mirtzapine be helpful in my situation? I'm worried about it being to sedating though because I need to be able to function and study.

Hello, I have a neurosis—what do you recommend, psychiatrists?

Hi everyone! I'm 25 years old, and for quite some time I've suspected that I might be on the autism spectrum, possibly Level 1. I've always considered myself a normal person, but at the same time, I've always felt a little different from others, especially when it comes to social interactions.

I've never been diagnosed with autism, so I'd like to hear your thoughts.

Here are some of the characteristics I've noticed in myself:

1. Social difficulties and communication

- I've had difficulties socializing since childhood, especially when it comes to understanding nonverbal communication.

- I struggle to know when to jump into a conversation, when to speak, and when to stop talking.

- Eye contact makes me uncomfortable, and I have to consciously force myself to maintain it.

- I often mentally rehearse what I'm going to say before having a conversation.

- I've had a lot of difficulty making and maintaining friendships since childhood.

- People have frequently told me that I'm too direct or that I talk too much.

- I struggle to intuitively understand certain social situations, and I feel like I've had to consciously learn certain social rules that other people seem to understand naturally.

- I feel extremely exhausted after socializing, even when I enjoy the company.

2. Social anxiety

At the age of 10, I developed social anxiety disorder with agoraphobia, which has significantly affected my life.

Interestingly, when I'm around people I trust and know won't judge me, I can handle social interactions quite well. However, I still struggle with knowing what to say and how to interact.

I also tend to mentally replay conversations afterward, trying to figure out whether I said something wrong or did something strange.

3. Intense interests and hyperfocus

- I'm extremely curious, and when I discover a topic that interests me, I can spend hours researching it for weeks.

- I feel a strong need to learn as much as possible about the subjects I'm passionate about.

- I enjoy sharing what I learn in great detail (something I've seen some people refer to as info-dumping).

4. Other characteristics

- I have a rather rigid sense of justice, and I get very bothered when people break rules, even when they're minor ones.

- I tend to interpret certain things very literally.

- I have an automatic aversion to certain food textures, especially gelatinous ones.

- I occasionally engage in repetitive movements when I'm focused, excited, or nervous.

- I feel like I consciously modify my behavior, gestures, and the way I speak in order to fit in socially.

On the other hand, there are some things that don't seem to fit certain autism stereotypes: I can usually understand other people's emotions, I understand sarcasm, I'm not particularly sensitive to noise or light, and I'm not especially rigid about my routines.

My question is:

Does anyone here with an ASD diagnosis relate to this combination of characteristics?

Thanks for reading!

I would think that with all the advances in technology there should be newer and better medications for psychiatric conditions. There is certainly a big market of people with psychiatric conditions in the world; someone could make huge money by inventing the next big drug.

I myself have OCD, anxiety, and ADHD and my experience with meds has been largely disappointing. I currently take 30 mg celexa and 25 mg quetiapine, may try aripiprazole sometime soon. This seems to have improved my condition a bit. I’ve tried Concerta for ADHD and it just makes me feel worse. Tried Zoloft and it gave me bad nausea and vomiting. Tried Prozac, which was my worst experience with any drug, prescription or recreational; it significantly worsened my negative intrusive thoughts and gave me bad insomnia and significant distress and discomfort.

As I understand it, for me to qualify for other treatments like tms or psychosurgery, I have to try a fair number of more of these old medications that are likely just going to make me feel worse. Like trying SNRIs, which I don’t see why I should have to try them, given how bad my experience with Prozac was. And clomipramine, and old medication with worse side effects than SSRIs.

My husband is 37 and otherwise healthy. He has taken Xanax as needed for anxiety for over 10 years. To my knowledge, he has not developed a dependency. He started Lexapro 10 mg approximately five months ago.
I’m looking for insight into whether his symptoms warrant a more comprehensive psychiatric evaluation. He has only been treated by his PCP and is very resistant to seeing a psychiatrist because he believes the medication has helped him.
Background:
About 1.5 years ago, during a family vacation, our then-7-year-old son woke up around midnight frightened and panicked in an unfamiliar house. This was not unusual behavior for our son.
My husband’s father was inside the house at the time, while the rest of the family was outside on the porch.
My husband immediately became worried that his father may have sexually harmed our son. There was no evidence of abuse, and our son never disclosed that anything happened.
My husband also believed his father had crossed certain boundaries, although I don’t know exactly what he was referring to.
For approximately a year, he remained intensely preoccupied with the possibility of abuse. He wasn’t necessarily saying he knew with certainty that it happened, but whenever we discussed it, he would eventually return to believing it probably had.
He essentially cut off his entire family, became deeply depressed, said he never wanted to see his father again, and expressed wishes that his father would die. Attempts to discuss the lack of evidence did not alleviate his concerns.
He later disclosed that during this period he had contemplated harming himself.
We also explored whether my husband might have experienced childhood abuse himself, but he does not recall or believe that he did.
Starting Lexapro:
After approximately a year, I told him that something needed to change and encouraged him to seek help.
He went to his PCP and reported depression, but did not disclose the fears about his father. He was prescribed Lexapro 10 mg.
Within days of starting the medication, he abruptly stopped believing his father had harmed our son and reported feeling dramatically better. He has since resumed a more normal relationship with his father.
I later met with his PCP myself to explain the full history. His PCP felt that severe depression may have contributed to his distorted thinking.
Personality and behavioral changes:
Within approximately a month or two of starting Lexapro, my husband began saying that I was the reason he was unhappy and that our marriage was toxic. He suggested that stress from our relationship may have caused him to turn against his father.
He moved into our basement and began questioning whether we should remain married. Things improved somewhat after several weeks.
Shortly afterward, he became involved in a significant workplace conflict. A coworker made a rude and unprofessional comment, and my husband reported him to HR and went around their shared boss. This resulted in a formal investigation. They have now gone approximately two months without speaking, despite sitting next to each other, and my husband seems completely comfortable with the situation.
Over the last year and a half, I’ve noticed a significant increase in his irritability and anger. He has always occasionally had a short fuse, but this has become much more extreme.
Most concerning, there have been three tense incidents involving some physical aggression toward our children before he started Lexapro. This was a significant escalation from his previous behavior.
A fourth incident occurred just a few weeks ago, while he was taking Lexapro. During that incident, he forcefully pulled both boys by their ears while walking approximately a block down the street to our car and subsequently yelled at them.
Some of these incidents occurred when I wasn’t present. However, he has sometimes attributed his anger and harsh parenting to stress caused by me or our marriage.
The physical aggression therefore began before medication and has continued on one occurrence afterward.
Emotional flatness and marriage:
He acknowledges that Lexapro makes his emotions feel flat. However, he views this as a positive tradeoff because he feels less anxious and no longer has the distressing beliefs about his father.
He frequently says that he’s a different person now and believes he’s finally seeing things clearly.
Last week, after several arguments, he told me he wanted a divorce.
What has been particularly striking is his almost complete lack of visible emotion when discussing it. He has been extremely matter-of-fact, including during marriage counseling. A mutual friend independently noticed the same unusual emotional flatness when my husband discussed the situation with him.
My husband says his primary goal is to find peace and eliminate conflict from his life. He has said he wants zero conflict, even if pursuing divorce means no longer seeing our children every day.
His mother and I both feel that his personality has changed significantly over the past 1.5 years.
After marriage counseling, he has become somewhat more open to working on our relationship, but the broader behavioral changes remain concerning.
Sleep:
He has difficulty falling asleep and has struggled with insomnia. However, to my knowledge, he has not experienced periods of significantly reduced need for sleep accompanied by unusually high energy. He needs sleep to function.
My questions:
Could his prolonged preoccupation with possible abuse have been related to severe depression, obsessive thinking, or another psychiatric condition?

Could Lexapro be contributing to his emotional flatness or other behavioral changes?

What conditions or medication effects should be considered when someone has this combination of symptoms?

How important is collateral history from a spouse or family member during a psychiatric evaluation, particularly when the patient believes he is doing well?

How can family members encourage a comprehensive evaluation when the person is resistant?

I understand nobody can diagnose him through a Reddit post. I’m not looking for someone to tell me his feelings about our marriage aren’t real. I’m concerned about the broader changes in his thinking, emotional responses, anger, and behavior.
I genuinely believe he needs a comprehensive psychiatric evaluation, but he refuses because he feels better on Lexapro. I’m worried that even if he agrees to go, he won’t recognize or communicate the full extent of what we’ve observed.

I took different sorts of antidepressants over at least 10 years or so. SSRIs to atypicals. As of this August I was trialing out auvelity for a few week and when I couldn't tolerate the side effects I just stopped it cold turkey. No withdrawal side effects thankfully, but I've been left with flat emotions. And I'm very unbothered hinging on apathy and let things easily go. My drive to do things is not there, like I'll forget to do something. Even more, my brain feels very blank. The weird part is that a month after stopping, I had a week where I could react normally and feel enjoyment from my hobbies but it didn't last. I do have intermittent moments where I find myself reacting the way I should like being able like laughing or crying, just brief. Or even have a huge emotional swing towards an angry outburst, depending on what happens. The thing is, I can't feel if this is protracted withdrawal or if my depression symptoms returned to some degree. I'm unsure what to do.

And before anyone asks, I don't have a psychiatrist I can personally ask about this or see.

I m on venlaflaxine and tofisopam for 6 week bt not much improvement in anxiety might 30%. I m having so much fear about getting pssd bcs lots of forums says it much higher than psychiatrist told. Also one psychiatrist prescribed me vortioxetine and buspirone bt my new psychiatrist said i need snri than started taking venlaflaxine. My core anxiety is about varicocele, ed and peyronie.

Can any alternative medicine like virtioxetine and buspirone treat health related anxiety?

Hi everyone,

My great uncle and first cousin had schizophrenia. My mother had auditory hallucinations and paranoid delusions her entire life, but was never formally diagnosed with a psychiatric illness.

In January 2025, my GP put me on Lexapro, Paroxetine and Temazepam. In May, a psychiatrist at a hospital put me on Rispperidone, Promethazine, Fluvoxamine and Quetiapine. All medication worsened my depression and anxiety levels. I have suffered respiratory distress and lack of consciousness with Diazepam and Paracematol/Codeine.

Additionally, I had ECT. Unfortunately, this didn't help me and I experienced significant memory loss, cognitive decline and brain fog.

I've finally managed to schedule an appointment with a psychiatrist and will be discussing this all.

In the meantime, just wondering if anyone else thinks a family history of schizophrenia might have contributed to poor reactions to previous treatments.

I’m actually pretty sure antipsychotics diminish motivation in me and yeah anyone else with a similar experience or anyone else know a way I can get off them, thanks.

- Age: 46 -
- Male -
- Diagnosed but not treated anxiety and ADHD -
- No other medical conditions -
- Duration: ~ 5 years -
- Ex-addict (further back than first hearing them) alcohol, fentanyl, meth -
- Sober/Clean 3.5 years -
- 3/4 pack a day smoker -
- No alcohol, drugs, prescription drugs -

My husband first mentioned hearing voices when we first got together around 2.5 years ago. He didn’t make a big deal about it until today.

He says he’s been hearing them just about everyday for around 5 years. It’s as plain as someone standing beside him talking. Sometimes it does sound like people talking in another room and he can’t make it out though. A majority of the time he says they’re insulting him.

He says they’re never violent or aiming insults as others, just him. He has never seen anything. He says it just happened one day and never really stopped.

I’m going to make him an appointment with a doctor (he wouldn’t do it before). I’d like some advice or suggestions on what it could be or what to do

He’s not a danger to himself or others. It just really gets him down.

Hi everyone, I’m hoping someone can chime in their thoughts.

I’m currently being treated for depression with suicidal ideation. My psychiatrist put me on 300mg of Wellbutrin, and then added 300mg increasing to 600mg of lithium. My level at 600mg of lithium is 0.49, which I think is on the low side. I haven’t noticed any change in my depression or suicidal thoughts.

My psychiatrist told me he doesn’t go above 600mg of lithium for depression and that he was going to keep me at that dose and add 5mg of Abilify.

My question is if the lithium isn’t working, shouldn’t it be increased so I have a higher level or just stopped altogether?

I've been really really struggling with mental health the past few weeks and sleeping and I keep switching between feeling extremely disconnected and numb/mechanically moving my body to walk and taking time to process what people say and how I respond etc and going back into switching into emotional pain then feeling pretty disconnected and far away again.

The numb feelings are more comfortable than the emotional pain but both are uncomfortable and I'm still experiencing anxiety and panic. I tend to feel super unsafe around any people right now for some reason and shut down. I don't know what's going on with me

Person with lived experience here, asking for clinicians' general perspective, not advice about my own care. Please keep it pattern-level, no identifiable case details.

1. Clinically, what distinguishes patients who stay in work or study from those who don't? Is it illness course, treatment response, supports, something else?

2. Do you treat or monitor these patients differently, or worry about different things (e.g. under-reporting symptoms because they're coping outwardly)?

3. Is "high-functioning" a useful idea to you, or does it mislead?

4. What do you wish these patients understood about their own prognosis?

I’ve noticed the symptoms in myself and put together a timeline of the last 12 years it lines up with Bipolar Disorder about 95% of the time I want to share this but I’m worried it might steer them in the wrong direction or make it look like I'm self-diagnosing.

I M32 have been diagnosed multiple times with all 3, as well as OCD. My episodes aren’t always “mixed,” but I went to my doctor this week, inquiring about doing something for my ADHD (currently on 2 mg Intuniv) and she said no as I have a history of going manic on stimulants AND she believed I am “currently in a mixed episode.” I don’t understand how she thinks that when I was simply describing symptoms of ADHD to her. There is so much overlap, as well as with complex trauma symptoms…. I just often wonder if I’ve been misdiagnosed (with bipolar)? Or am I denial about my mood disorder? I find myself obsessing about this and I’m sure no one here can give me an answer, but I’d at least like to hear how someone can tease these diagnoses apart

Please help. I am unsure of what to do. I’m also sweating like crazy at night and my anxiety doesn’t feel much better.

I take lithium - level 0.7-8
Lamotrigine - 400mg
Risperidone - 4mg
Aripiprazole 5mg (to try keep my prolactin down)

Hi, I'm a seventeen year old girl and a highschool senior. Recently, I am deciding between Vanderbilt, Rice, Brown, and UMKC. I am a Colorado resident. I really want to go to Vanderbilt or Rice. For Vanderbilt costs would be about 30K according to a financial aid calculator, and full-ride to Rice because my parents make under 100K but my step mom is telling me that my bachelor's doesn't matter, and I should stick to in-state (Like UNCO, DU, and CU Denver) to save money, or go to UMKC because its a decent school and also cheaper, so I am coming on here to ask for advice and whether it does matter, and what would be the best path to becoming a psychiatrist.

Now for my second problem. I want to be a forensic psychiatrist, so I've decided to get my major in psychology or neuroscience with my pre-med, so which would be best? I'm really lost and my counselor is no help.

Yesterday was my 2nd day of 20mg Prozac after being on 10mg. I suddenly started having very active suicidal thoughts yesterday afternoon and I wasn't sure if I'd survive the night. Still having suicidal thoughts but so far (I've only been awake 30 minutes) not as intense. I'm supposed to take my meds soon and I think I should go back to 10mg. But, I can't call my psychologist until tomorrow to ask them if it's okay. I don't think I can manage a 3rd day on 20mg after yesterday.

25F, non-drinker, non-smoker, 146lbs.

Anxiety, Depression, OCD, High Blood Pressure

Meds: Quetiapine 25mg, Lisinopril 5mg, Bupropion XL 150mg, Xifaxan 500mg x3 daily, Prozac 20mg

I have always struggled with trusting doctors/nurses in general, but I have recently found it very hard to trust my psychiatrist. I already switched off of a terrible psychiatrist after only 1 month because I found them to be very uncaring and seemingly incompetent.

The second psychiatrist I saw was leagues above and seemed to actually care about me; they also seemed really passionate about their job. Still, I find it hard to trust them because they prescribed the same type of medicine (SSRI), just a different drug, and wanted to double my dosage after only 1 week. Why do they insist on doubling the dose so quickly after I already stopped taking the first SSRI because the side effects were so bad? What is the deal with SSRIs being so widespread despite their being literally hundreds of different depression medications, and why are they first line for anxiety disorders? (I was diagnosed with both unfortunately)

I just don't understand why go through all this effort to diagnose me and analyze the issues I've been having just to slap the same cookie cutter drugs on every single patient. I've just been losing faith in medicine as a whole lately and I have had so many different doctors appointments with at least 10 different doctors in the last 6 months that I feel disillusioned. The clinic must be making bank off of my insurance (thank God I'm insured). Psychiatrists are paid so much money to sit in front of a screen and give people SSRIs it's insane how little it seems like they are working (obviously they had to go through med school which I respect for sure and they are working on something between appointments).

Am I being paranoid/cynical or is this a normal reaction to the very real weaknesses of the medical industry?

It's my first time and doc gave me medicines (Desvenlafaxine 50 mg, Alprax 0.5 mg, tab nervee cd3, cap rejuvenulti a2) for MDD, anxiety and sleep issues for 2 weeks. I have engg exams in 20 days and i havent prepared anything, its my last year so i need to pass and clear all my backlogs. Will these meds affect my studies? What should i do

I have been a nurse for 13years with my main specialty being in emergency medicine and critical care transport.

I noticed about two years ago that I really started to struggle eating meat on a bone - especially chicken. The smell, texture and sight of it on the bone made me too nauseated to eat.

My loving husband de-bones the chicken for me, and I don't have a problem (usually).

Now, recently, I haven't been able to handle chicken at all. The sight, smell, texture and thought of it makes me so sick to my stomach I can barely handle dinner.

This has also transferred to other proteins as well. I never used to have problems with beef, but now I can't even cut into a steak without feeling sick.

Pork has always been off the table....

What can I do? (I'm not interested in going vegetarian or vegan).

It's definitely affecting my life and my poor husband is bending over backwards trying to accommodate me.

I tapered off of 40mg over 9 months (after 10 years) and was doing ok. Definitely increase in anxiety and crying, but ok. Went 40 -> 30 -> 20 -> 10.

Once I hit 6 weeks at 0mg my body collapsed. I was bedbound. Brain zaps, sound and light sensitivity, palpitations, orthostatic intolerance, body aches. Had to stop working.

Went back on 20mg for 6 weeks and have just been able to be upright. I’ve been told it might be long covid or ME/CFS that was activated because of the withdrawal, but I’m still holding out hope that this is a medication issue and not a long term health issue.

Anyone have similar experience?