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Everything posted by jeva39

  1. post removed, didn't feel comfortable having it discussed
  2. i'm people here can help me figure out what i should do with my meds or what to bring up with my PA dx: depressive psychosis and social anxiety my meds are: venlafaxine ER: 225 mg Lithium 1200 mg mirtazapine 7.5 mg valium: 2.5 mg bid levothyroxine 75 mcg risperidone (oral): .25 mg bid Risperdal consta: 50 mg injection i'm trying to figure out why i feel so sedated/loopy at times, i don't like like feeling so inept and it reinforces my shyness. i usually dont want to talk to anyone til the sense of normality returns. i can't tell if i'm over or undermedicated. with the high dose of risperdal. i might be overmedicated, on the other hand the last time i tried stopping the morning risperdal dose it felt like i was overactivated. today i started the oral risperdal and felt sedated but stable. im wondering why the 50 mg injection wouldn't be enough to keep me stable. could it be that i need less instead of more antipsyhotic? would peak effects with the oral doses factor into all of this? maybe i need to omit the morning AP and up the valium. in any case, any help is much appreciated, thanks
  3. I'm not trying to upset anyone here, I'm genuinely interested after what I've gone through the past several months, which I don't feel comfortable going into detail here.
  4. I suppose it has something to do with the reactions i receive from people - i know that's flimsy but i can't seem to think of anything else., it's just a instinctive feeling i have about how people react to me. I did have a friend once who when i asked him "do you think i make people uncomfortable?" responded, "i think you THINK you make people uncomfortable".. basically he was alluding to a self fulfilling prophecy. but on the other hand this friend i think on many occasions treated me not so much as a friend but as a project (even while he was someone i looked up to), and it took me a while in retrospect to realize that...other than that i can't say much more, it's a good question. perhaps my thoughts are distorted on this matter.
  5. When i'm at my best i know i don't look or sound weird at all, but when i'm anxious and require some kind of medication like valium to be less dysregulated i seem to put others off. i come across as immature - I feel worthless, defective... i don't know.. i wonder if it could be seen as anxiety combined with negative symptoms? i'm grasping at straws. a lot of people struggle with anxiety but it doesn't affect their ability to function, as far as appearance goes. and i certainly can't see this as solely a psychologically based issue. i wonder if years of med treatment along with withdrawals and multiple psychotic episodes has made my nervous system irreversibly hypersensitive, i don't recall ever being as sensitive to med changes in the past as i am now. i'd like to try clozapine as iv heard great things but i'm worried that trying it when i'm not in crisis could backfire in some way. perhaps it'll be more effective when i'm in the middle of an episode. the meds listed below are current
  6. it feels very real. i feel as though something is very wrong with me. i came up with various search results using terms related to what i'm experiencing and came up with "magical thinking" schizotypy" and "attenuated psychosis" - basically pertaining to near-psychotic or "psychotic-like or sub-clinical psychosis" there's a term for being outside one's own body "heautoscopy" distinct from trauma based depersonalization..i dont know why i havent encountered these descriptions before.. i wonder if there's any association between attachment or developmental trauma and these kinds of phenomena https://books.google.com/books?id=biicBQAAQBAJ&printsec=frontcover&dq=assessment+of+psychosis&hl=en&sa=X&ved=2ahUKEwigmMz13LzkAhUHtlkKHWC7BZgQ6AEwAXoECAIQAg#v=onepage&q=depersonalization&f=false
  7. I have brought up valium as an option, in my experience klonopin is way too strong. i will bring up rexulti as an option as an aside i am wondering if anyone can answer: is there a psychiatric term for the belief that one's thoughts can negatively influence others or cause bad things to happen. almost like when i'm around others things easily go wrong unless i exert enough mental energy to cause my mind to go blank thereby preventing negative things from happening. yes i understand that sounds crazy, i dont believe it, but its a persistent thought that makes me feel as though thers something wrong with me beyond psychiatry.. and i havent come across a psychiatry term describing such a phenomenon...
  8. I have treied latuda in the past and it was effective but the only bothersome side effect that caused me to stop taking it eventually was facial swelling. other than that it worked pretty well. i am going to in the meantime try to drop the concerta i have some 18 mg pills left over.. i may try rexulti to replace the quetiapine cause at the moment i feel very unlike myself, i'm stutering, slurring my words a bit, having difficulty speaking coherently, feeling tense, agitated.. even though i was fine week ago when i first started the mirtazapine. also like i said the fact that my benzo dose is gradually escalating since my PA has been away is very very cocerning to me as i dont wish to experience benzo withdrawal again last time i went through withrawal was followed by several hospitalizations involving delirium and self harm (still have the scars from that time). again this signals to me that my symptoms are more than anxiety related, but then again what the hell do i know
  9. i don't think so.. my PA put forward the suggestions that i try a 3rd generation dopamine balancer like rexulti vraylar or abilify, however i probably wouldnt do something like that unless i were taken off the stimulant and effexor lowered.. cause right now i feel overactivated the only thing about raising mood stabilizer/aap dose means that id probably become sluggish, flattened affect, slow word recall etc. at which point im essentially non functional.. how can i strike the right balance??? is such a thing possible? ----going to take a break, any replies are welcome, and il get back to them sometime later on today.
  10. i dont know if thats the current official dx.. but its along those lines regarding the meds, should be accurate aside from the Vyvanse, i dont take that anymore, just concerta 27 mg I would really like to see a specialist of some kind, not just any psychiatrist. I'm in the US. I dont feel that checking into a psych unit is necessary right now, but availability and scheduling issues with my THERAPIST means that i havent talked to anyone for weeks now, plus my PA is on vacation this week. its been really difficult to deal with. im thinking of seeing a new therapist as well. one that specailizes in codependency issues with narcissistic/mentally ill mother along with severe/chronic mental illness (i'm not sure if i struggle with one or the other or both tbh)
  11. I have been trying to determine the most likely dx based on my past hospitalizations, episodes, symptoms, etc. in light of recent adverse symptoms following mirtazapine 7.5 mg as well as the the fact that whenever any new med is introduced i become liable to fly off the handles, less stable overall such that i wonder whether i should be hospitalized. during these mood swings i feel a need for relief due to the ovewheliming distress and ultimately usually wind up being told to take an extra ativan. yesterday however, i wound up taking 3 mg of ativan total throughout the day just to function. the fact that the dose of ativan seems to be escalating over time and my symptoms involve not just worry or jitteriness but also rage and extreme discomfort suggests to me that in my treatment the wheels are beginning to fall off. I wonder if the introduction of mirtazapine a few weeks ago is triggering manic like symptoms in me. and if so, what would that mean with regard to dx and future treatment plans? I understand the doctor should have most of the say on this matter, but my current doctor is actually a PA not an MD. i am currently looking through the book Manic Depressive Illness Bipolar drisorders and Recurrent Depression by Goodwin and Jamison that i picked up at the library recently in effort to discern the most likely dx based on what iv experienced in the past (which included blackouts, delusions, psychomotor retardation, flat afffect, depression, derealization/depersonalization, social anxiety/phobia, isolation, difficulty communicating) and then issue my ideas to a competent professional right now i'm trying to remain stable but i am nontehelss feeling very wired even though im getting 3 mg of ativan total throughout the day and was told not to take any more than that during a 24 hr period. I would simply ask my PA what to do next but i have doubts about any suggestions he might make and id like to be sure that i'm going the best possible route. if i could see a specialist of some kind for a second opinion that might be best, but id like suggestions from anyone here. it seems the really good doctors/therapists are not accepting new patients or are completly booked for months. in any case, any suggestions at all would be really helpful. thanks
  12. i havent tried provigil/nuvigil, insurance wouldn't cover the cost because i wasn't diagnosed with a sleep condition (i think they said narcolepsy).. so at the time we gave up on that possibility
  13. for a while, years in fact, i did feel this way. until summer of 17' the breakdown was unexpected and nearly life-threatening - my blood pressure was extremely high and i experienced blackouts and violent rage... my internal experience was very bizzarre- a phantasmagoria of horror mystery and revelation... anyway, being that i'm more or less stable currently, i'm trying to treat that experience as an opportunity for personal and spiritual growth rather than a persistent trauma... there's no longer any question in my mind that what i experienced was real and valid. whether it was "mental illness" is a whole other question that imo is not at all clear. the question on my mind now is why did this happen to begin with, and what is madness really?
  14. residual depression, slowed thoughts and sedation. i don't know what a psychiatrist would ordinarily do but i haven't any adverse effects aside from some irritability
  15. for the past several weeks i have been taking Concerta, first starting with 18 mg and very gradually working up to 36 mg (current dose). at the lower doses i seemed to be able to think and focus better than on previous stimulants. eg my ability to recall words without straining to remember them in conversations was much improved, my concentration was much improved and accomplishing tasks became easier which made me more productive in daily tasks as well as creative work (prose writing, noting inspiration for future creative projects, music composition, immersion in peripheral reading material... etc the downside of being at this dose range is that there seemed to be issues related to my affect - while i initially, over the first couple days, appeared brighter and more engaged i.e. less prone to emotional withdrawal/shutting down and appearing blunted or constricted in my affect - that would seem to wane after about a week at 18 mg or 27.. and i would return to looking somewhat like i was overmedicated on neuroleptics additionally i also had sleep related issues - i was easily fatigued and worn down by the middle of the day. however, with higher dose -i.e. my current dose of 36 mg- the issues with blunted affect seems to be much less of an issue, in fact basically completely ameliorated, as well as having more normal sleep patterns and higher energy levels. but now i'm much slower in my thinking, word recall and completion of tasks isn't as fluid/effortless and i'm less productive... i feel dulled in my thought process.. which for me cancels out the benefits of improved affect display, higher energy levels etc.... what can be done to address this? i did at first have issues with Concerta in generic form but for the past month or so iv been working with the brand version of Concerta so its unlikely to be that this issue can be attributed to drug formulation(s). Is it possible my PA and I overshot the dose at 36 mg of Concerta, is it worth trying the next highest ose?? or Would something like Adderall XR be more beneficial? i did have issues with Vyvanse, which seemed to be too potent for me.
  16. I should also say that my stimulant (Concerta) seems to eliminate the flattened/blunted/constricted affect upon starting a certain dose. many people say i look "brighter" and "more engaged". however after several weeks on it and givin enough time for my body to adjust to the effects of the medication, the flat affect seems to reappear and i think people notice, consciously or not.. the fact that stimulant medication can help me to appear "normal" tells me that my constricted affect is due mainly to my condition(s) and/or any possible medication side effects, e.g. antipsychotics. any neuroleptic/AAP including Seroquel XR can as far as i know contribute to the flat affect, but i'm not sure to what degree at my current dose (100 mg). as far as the Asperger's I've been told that i have traits of asperger's but dont have the condition per se... id think having traits of something doesnt necessarily equate to being on its spectrum but i'm not really sure. perhaps in my case the flat affect is also a form of withdrawal due to severe social anxiety when psychological stress is heightened in social situations.
  17. it seems to me that my emotions become blunted (i.e. that i appear "off") when i'm experiencing a great deal of psychological stress, and others pick up on it . for instance, just before i take my scheduled ativan my anxiety is heightened and i seem more susceptible to such stress which in turn seems to cause me to become emotionally disconnected. whether others are simply unconsciously reacting to my appearance in these states or instead consciously recognize that i seem "off"or not i can't say.. but i can't help think that they do recognize somethin "off" in my presentation, consciously or not.. so why might high anxiety lead to blunted or constricted affect? could there in this case be a connection or am i just imagining things? i understand that flattned affect is normally associated with psychosis and depresion, but givn that my therapist and doctors both noted in the past few weeks that i appear to be on the right track I think its safe to assume that i am not currently experiencing psychosis or depression
  18. So perhaps in my case it's more of an issue of adverse reactions associated with sensitivity to dopamine.. not NE.
  19. one more question, if you wouldn't mind, browri.. if lower doses of Vyvanse have more of an effect of NE, could this conceivably translate into a clinical picture involving agitation, rage, flying off the handle over minor things, seeming on the verge of relapse etc. I ask because I have been having this issue lately at 20 mg of Vyvanse, whereas higher doses (30 and 40 mg) where (presumably) dopamine RI was involved, there seemed to be more of a calming effect, for the most part, not to say there wasn't any anxiety/agitation but it was mild in comparison.
  20. does anyone know if lower doses of stimulants have more of an effect on NE as opposed to DA at higher doses? also if i may ask, what is the difference (put in layman's terms) d-methylphenidate vs d-l methylphenidate and why would one be more beneficial than the other?
  21. thanks mikl, going to run by everything you just wrote with my PA if things ultimately dont work out with the vyvanse
  22. I can't really say for sur whether iv had the same response with other stimulants, my memory taking those other meds (ritalin and conceta) are a little hazy. but i have often been very sensitive to meds generally. im not sure but maybe thats a result of treatment resistant depression? when you say Vyvanse doesn't become fully active until its metabolized by liver, how long does that generally take, if i may ask? I am trying to exercise and sleep regularly in addition to taking the vyvanse. i intend on starting fish oil tommorow in hopes that it might clear up some of these issues eventually. fyi: i dont have an ADD diagnosis so my response to meds may be different from yours, but i'm not sure... thanks for responding :))
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