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My psychosis does not fit the stereotype I have of psychosis


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I have had this stereotype of psychosis being something all-encompassing, overwhelming, disabling, that affects one's entire thought process and, in many cases, is associated with auditory hallucinations, especially voices, in particular, and is commonly associated with poor insight. And the thing that gets me about this is that while, objectively speaking, I do get psychosis, after all I get hallucinations (aside from the perfectly normal hypnagogic hallucinations) and I get delusions (of the paranoid sort), my psychosis does not seem to fit the stereotype in my head that I have - I have never heard voices and most of my hallucinations are visual, my delusions are very self-contained, with my thought processes outside them remaining essentially intact, aside from things such as avolition and inappropriate affect, I generally have insight, even though I have not always had it in the past, and in general it has little impact on my functioning. This is such that I often find it hard to acknowledge that I get psychosis in the first place; it does not feel like what I tend to think psychosis is supposed to be like. So I am not sure how to get myself to really intuitively acknowledge that indeed do get psychosis, even though I can rationally tell myself this.

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Psychosis it's a so weird word... and it doesn't always mean schizophrenia

What is the typical psychosis? Voices narrating what you do, insulting you and telling you to do things.

What is the typical delusion? Abduction, FBI, CIA, demons, angels; paranoid ones or religious one.

 

I was told I get bizzarre hallucinations and delusions, wugh, it doesn't seem the norm.

I can relate, I have insight, I know which things are considered delusions or hallucinations even if I consider them to be real, just different, and not psychsosis (I hate the word psychosis). Outside the what it's so called delusions and hallucinations, I look almost normal (maybe a bit schizoid or weird), that's why while IP I tend to be diagnosed with Personality disorders (NOS or mixed), they don't see me as schizophrenic because I don't act on the so called hallucination/delusions and I am coherent when it's about college and my future. Anyway, mi pdoc who knows me better thinks it's schizophrenia, just not the paranoid type, one with more negative symptoms and bizzarre positive ones with partial insight. I would be diagnosed with deorganized schizophrenia if I had deorganized symptoms, but it seems I only have negative ones and bizarre positive ones.

Avolition, lack of affect, emotions, anhedonia... it's part of the psychosis spectrum. Actually schizoid and schizotypal personality disorders are part of the psychosis spectrum.

Any kind of hallucination, delusion, it's too, even if they are not the typical ones.... it's part of the psychosis spectrum.

If you mainly have them, or you have them associated with another disorder, you have a psychotic disorder or an X disorder with psychotic features.

I guess what you mean with "what psychosis is to be like"... it's actually the typical paranoid schizophrenia, weh, it's just the most common type of schizophrenia and presentation, but not the most common case of psychosis (we have psychosis on mood disorders and personality disorders too).

 

So, I think, your psychosis 'fit', it's just not like the typical paranoid schizophrenia.

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I think the typical paranoid schizophrenia it's more notorious because there are little negative symptoms so they share their delusions and hallucinations and act on them.

While, me, I didn't find any reason to share anything when I was deluded about a second civil war, I just did werid things they didn't know why, and was diagnosed wiith psychosis NOS by then, when they found out I get full delusions they changed it to schizophrenia.

My Wonderland, the other world and behind reality are also considered delusions, but it took me long to share them, and when I do I give little details... because of alogia/asociality... well... until some weeks ago I started amisulpride and it seems now my communication it's much better and my psychiatrist see my case clearier, or that's what he said. I don't like they are called delusions, they are just different eyes to see the same physical space, whatever... I also got hallucinations that told me to be cautious and to don't disclose information and act normal, so I looked less psychotic when I was.

Last time I was IP even if my psychiatrist consider me still deluded and by then I was having a lot of voices from the other world, they still considered I didn't have a full psychosis clear state... so theyput mixed personality disorder with borderline and schiztypal traits. I didn't talked enough about voices and Wonderland because I was dealing with negative symptoms, and didn't reply when they said something about my imagination, which clearly it's not my imagination but it's a different reality perception from Wonderland eyes, other world, behind reality, ugh... The only thing I can said it's the voice was paranoid when he told me to don't disclose too much because it was dangerous, they almost indrectly controlled me and made me look schizoid-like.

Anyway my pdoc was skilled enough to know I have a psychotic disorder since March even if I disclosed 0 about it, maybe I did indirectly, while IP pdocs who see less things, who knew me less, who are used to more florid psychosis thought it just was my personality.

 

I forgot the point of all of this, almost. I am sorry for the long message, what I wanted to say it's psychosis somtimes doesn't look like psychosis even for professionals because it can be kinda confusing. It depends on the type of psychosis (if its the typical one or not), it depends on how much you disclose, it depends on how you interact with the psychosis and how much insight you have, and, of course, how skilled and what the doctor is used to see.

 

Now I disclose much more for my psychiatrist it's much more clear it is psychosis ahahaha. Also, the fact amisulpride "fixed" the social related negative symptoms also indicates it was not part of my personality, because if it wasn't psychosis, what was it?

Depression but not majoyr depression.

Mood changes but not cycling...

Anxiety but not enough for anxiety disorder...

The only option.... left... it's always a personality disorder... which are not 'fixed' with meds. The change was enormous about my communication with amisulpride (you ccan see it, I am writing a lot... maybe too much, I am sorry).

So to finish with this... mild psychosis after a mood episode... with a lot of insight and with few negative symptoms... I would consider it's a consequence of the mood episode. If the psychosis goes out of control without a mood episode, I would consider it more schizoaffective/schizophrenia like.

Mild psychosis with insight it's schizotypal/schizoid PD normally... or schizotypal disorder according to the ICD (on ICD it's consider a mild type of schizophrenia, on DSM a personality disorder with schizophrenia-like traits and a lot of social anxiety).

 

Then, if you can function, have insight, outside a mood episode, mild psychotic symptoms, everything under control, yeah, it's psychosis, the functioning one. It's a good new, you are not having a psychotic break. But it is still psychosis, maybe residual, but psychosis.

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To me I doubt this is a personality disorder because in the past risperidone "fixed" my positive symptoms altogether... it just did not fix the permanently, but it did for approximately half a decade. Also, I do not get any of the "weird" personality stuff associated with schizoid/schizotypal personality disorder. This also does not seem to be mood-related, as I have still gotten positive symptoms even when my mood has not been symptomatic at all, like for much of last November-December. I will see what my pdoc thinks, because I called her telling her about my gdoc appt today and asked for a dx so I would know what to say to my gdoc (as she has not given me a dx aside from agreeing with a past OCD dx at all so far).

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At the same time, it does seem mild all things considered. Even at its very worst, i.e. having thoughts of unmarked police cars watching and following me and of having police hunting me down for crimes unknown to myself, I did not have anything else going on that affected my thought processes, and aside from my general lack of motivation could function at least at work. But then, is having delusions of being hunted down by the police mild at all? Am I just fooling myself by downplaying the severity of my psychotic symptoms?

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Closure I think a lot of us have an image of mental illness that doesn't fit our experience.

I thought with a diagnosis like mine i would necessarily be extremely symptomatic chronically. There are people who are, but it is more of a spectrum.

Anyways, on medication I have insight and have very few breakthrough symptoms. But, when I am symptomatic I can get lost in delusions.

Yes, I think you are downplaying it right now. If you are dx it must have been interfering with your life at some point.

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I essentially have two pictures of psychosis in my head - psychosis associated with mania, and severe paranoid SZ. And I don't really have either of them (I have gotten psychotic while manic before, but that was ages ago). So that leaves me with something that does not fit any picture I have, which makes it hard for me to acknowledge it, which makes it not feel real, which makes me downplay it. What I do see it as is my hallucinating and my having paranoia, without the psychosis word, because that is what I understand it as. But at the same time, when other people use the words psychosis or psychotic with me, it feels like they are taking me seriously despite my efforts to downplay it, and it makes it feel easier for me to acknowledge it as such myself.

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why do you have to stereotype psychosis in the first place?  everyone's experience of psychosis and the course it runs is unique to them.  for example, i probably fit your notion of 'severe paranoid SZ' before i was medicated, but now, if you met me IRL, you would have no idea i had any sort of mental illness if i hadn't told you.

i accept that i experience psychosis on a daily basis because i am aware of the fact that i hear voices a few times a day.  i also draw on my past experiences where, like you, i had delusions (one among many) of unmarked police cars tracking my every move.  this was when i was severely psychotic.  i don't get delusions anymore.  i also have excellent insight into the nature of my disorder. 

anyway, i don't think psychosis is necessarily 'all-encompassing, disabling, associated with poor insight, etc etc.'   if you're having symptoms like hallucinations, delusions, paranoia, i would definitely classify that as psychosis, just as i classify my daily auditory hallucinations as psychosis.

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When I was younger, I used to get delusions with mania. Now I tend to get mostly hallucinations with depression. Occasionally I get hallucinations outside of a mood episode. Rather than delusions, I typically get command hallucinations now, which can be really terrifying. I used to only get auditory hallucinations, but that has changed. I get visual hallucinations now too, and even tactile ones. My last pure delusion had me taping magnets to the inside of my freezer, and then sticking my head in. This was supposed to prevent "them" from exerting mind control and/or stealing my thoughts. It seemed so sensible at the time, but I was clearly cuckoo. 

Most people probably associate psychosis with hearing voices telling you to do terrible things. That's a command hallucination, and I don't think they're as common as people think. From reading the boards here, a lot of people experiencing hallucinations get an interior running commentary, often telling them that they're worthless pieces of shit, that whatever they're doing is wrong, and the like. I don't tend to get that type. Mine are typically outside the head, not inside the head. They're loud and clear. But I've had the other type too. 

I guess my point is that there are multiple types of psychosis. You might get hallucinations. They might be inside the head or outside the head. You might get delusions. Or you might get command hallucinations. It's all basically the same thing: you perceive or believe something that isn't actually there. But it can make so much sense to you at the time, despite being absolutely ridiculous. I thought I had to start life over as a prostitute once. Crazy. The other day, I was being attacked by bobcats jumping out of shopping carts, along with all kinds of other weird.

Dreams and psychosis are sort of brother and sister, but the psychosis can often be weirder and more terrifying. And you might test it, to see if it's real, but it doesn't matter, because it's still real as far as you're concerned. I once had a hallucination of meowing cats. So I would go see why they were crying. But they were both sound asleep. This went on for at least an hour or two, and everytime my cats were asleep. Until I disturbed them so many times that they woke up and actually did meow. But even when you realize you're hallucinating, you often can't shake it. I have even gotten under the covers and pulled them over my head, and still had the hallucinations.  

It's a really ghastly thing, and people often tend to distance themselves from you when you describe what happened. They can maybe deal with depression or bipolar, but when you describe psychosis, they often say, "OK, you are seriously loony tunes, and I need to run away. Sites like this are especially important because you can connect with people who actually understand. 

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3 hours ago, Flash said:

When I was younger, I used to get delusions with mania. Now I tend to get mostly hallucinations with depression. Occasionally I get hallucinations outside of a mood episode. Rather than delusions, I typically get command hallucinations now, which can be really terrifying. I used to only get auditory hallucinations, but that has changed. I get visual hallucinations now too, and even tactile ones. My last pure delusion had me taping magnets to the inside of my freezer, and then sticking my head in. This was supposed to prevent "them" from exerting mind control and/or stealing my thoughts. It seemed so sensible at the time, but I was clearly cuckoo. 

I started out with essentially a garden variety mood disorder, with depressed mood, (hypo)mania, and very occasionally mixed mood, with paranoid delusions only appearing while manic. I had some trouble with motivation, but I did not really take note of it. Then over time I started hallucinating, having paranoid delusions outside mania, and started having a harder time functioning in general. Then I was put on risperidone, and it quashed the hallucinations and delusions but I still had trouble functioning. And now then the paranoia and hallucinations have come back despite being put on quetiapine, even though the paranoia has been less severe on quetiapine, and indeed the quetiapine likely exacerbated the hallucinations. So hence I have been taken off the quetiapine and will be put on aripiprazole.

3 hours ago, Flash said:

Most people probably associate psychosis with hearing voices telling you to do terrible things. That's a command hallucination, and I don't think they're as common as people think. From reading the boards here, a lot of people experiencing hallucinations get an interior running commentary, often telling them that they're worthless pieces of shit, that whatever they're doing is wrong, and the like. I don't tend to get that type. Mine are typically outside the head, not inside the head. They're loud and clear. But I've had the other type too. 

In my case I have never heard a voice, ever, even though I have gotten auditory hallucinations.

3 hours ago, Flash said:

I guess my point is that there are multiple types of psychosis. You might get hallucinations. They might be inside the head or outside the head. You might get delusions. Or you might get command hallucinations. It's all basically the same thing: you perceive or believe something that isn't actually there. But it can make so much sense to you at the time, despite being absolutely ridiculous. I thought I had to start life over as a prostitute once. Crazy. The other day, I was being attacked by bobcats jumping out of shopping carts, along with all kinds of other weird.

This is true. In my case my delusions are essentially solely paranoid in nature, sometimes quite mildly, sometimes very intensely, terrifyingly so.

3 hours ago, Flash said:

Dreams and psychosis are sort of brother and sister, but the psychosis can often be weirder and more terrifying. And you might test it, to see if it's real, but it doesn't matter, because it's still real as far as you're concerned. I once had a hallucination of meowing cats. So I would go see why they were crying. But they were both sound asleep. This went on for at least an hour or two, and everytime my cats were asleep. Until I disturbed them so many times that they woke up and actually did meow. But even when you realize you're hallucinating, you often can't shake it. I have even gotten under the covers and pulled them over my head, and still had the hallucinations.

These days, I typically just know that my hallucinations and delusions are not real, without needing to reality test. But I still react to them as if they were real. I still keep my eyes on cars or people I feel are watching or following me. I still reflexively feel anxious about the very idea of Facebook due to feeling threatened by it. In the past, I would still feel terrified by police I felt were coming to arrest me for crimes unknown to myself.

4 hours ago, Flash said:

It's a really ghastly thing, and people often tend to distance themselves from you when you describe what happened. They can maybe deal with depression or bipolar, but when you describe psychosis, they often say, "OK, you are seriously loony tunes, and I need to run away. Sites like this are especially important because you can connect with people who actually understand. 

I have always reflexively felt a need to hide my hallucinations and paranoia from people, even my pdoc or tdoc. My pdoc and tdoc want me to bring my parents in so they can talk to them about my MI, but I feel very anxious about the idea because while I am okay with them knowing I have a mood disorder, I feel the need to hide my psychotic symptoms from them.

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1 hour ago, Closure said:

I started out with essentially a garden variety mood disorder, with depressed mood, (hypo)mania, and very occasionally mixed mood, with paranoid delusions only appearing while manic. I had some trouble with motivation, but I did not really take note of it. Then over time I started hallucinating, having paranoid delusions outside mania, and started having a harder time functioning in general. Then I was put on risperidone, and it quashed the hallucinations and delusions but I still had trouble functioning. And now then the paranoia and hallucinations have come back despite being put on quetiapine, even though the paranoia has been less severe on quetiapine, and indeed the quetiapine likely exacerbated the hallucinations. So hence I have been taken off the quetiapine and will be put on aripiprazole.

In my case I have never heard a voice, ever, even though I have gotten auditory hallucinations.

This is true. In my case my delusions are essentially solely paranoid in nature, sometimes quite mildly, sometimes very intensely, terrifyingly so.

These days, I typically just know that my hallucinations and delusions are not real, without needing to reality test. But I still react to them as if they were real. I still keep my eyes on cars or people I feel are watching or following me. I still reflexively feel anxious about the very idea of Facebook due to feeling threatened by it. In the past, I would still feel terrified by police I felt were coming to arrest me for crimes unknown to myself.

I have always reflexively felt a need to hide my hallucinations and paranoia from people, even my pdoc or tdoc. My pdoc and tdoc want me to bring my parents in so they can talk to them about my MI, but I feel very anxious about the idea because while I am okay with them knowing I have a mood disorder, I feel the need to hide my psychotic symptoms from them.

My first auditory hallucination was a smoke detector that went off. I removed the battery and it still went off. I smashed it to bits with a hammer, and it still went off. I finally put it in the trash can on the street (it was trash day). It still went off. I honestly did not think I was having a hallucination. I thought the damn thing was simply indestructible. Later, I heard dead people talking to me. Then came music and all manner of noises.

The music usually comes from speakers, but they'll be turned off. I've unplugged the cord, turned off the circuit breaker. Nothing helps. One time I had music coming from behind me in the air. I went all over downtown trying to escape it, to no avail. And the other day, my clock radio went off. I spent quite a bit of time trying to turn it off before I realized I was hallucinating. Then it immediately went off every time looked away from it. It immediately stopped when I looked at it, but it would immediately start up again when I looked away.

And the program kept on changing. Sometimes it was announcers for a sports event, sometimes talk radio, and at other times all manner of different kinds of music. Well, everything except classical, which is what I listen to 99% of the time. And sometimes the station wouldn't be in tune, so it would be partially garbled or have a bunch of static.

Another time when I was having music hallucinations, it was song, and I decided to write down the lyrics as best I could. I then asked a friend if she knew what it was, because I had no idea whether these were real songs, or just something my mind invented. She said it was really close to a song she knew, but the style was completely different. The music is sometimes in foreign languages that I don't speak. 

Noises are the worst, though. I hear jackhammers, explosions, wrecking balls, footsteps, bangs of unknown origin, crying, screaming, laughing, sirens, fire alarms, garbage disposals, trash chutes, breaking glass, car collisions, barking dogs, doorbells (we don't even have them here), phone calls, water running, etc. The list is endless. And I never know if it's real or not. So I might here someone drop something something down the trash chute on the other side of the building. I shouldn't be able to hear that.

But when I'm symptomatic, especially mixed, my senses get ridiculously heightened. I hear EVERYTHING. One time, at my old house, I heard the beeping of a smoke detector or something. So I went down the hill to a neighbor, which was the origin of the sound. And I knocked on their door. I told the woman if she could please shut it off, because it was driving me insane. She looked at me like I was a complete froot loop. But it turned out her carbon monoxide detector in her basement was going off, because the battery was low. But she couldn't even hear it inside her own house, while I was up the hill and it was frying my nerves. 

So anyway, I often have no idea when I hear noises. Only when I hear dead people talking to me, do I know for sure without testing it. And it even takes me a little while to realize that sometimes. I have had homicidal and suicidal command hallucinations, but these are not things you really want to disclose. People will think you're a serial killer or the next unabomber. I've been incarcerated a handful of times, along with trips to the loony bin. I do not want to go back, ever. But people in the US are afraid of people like me, and think we need to be locked up to protect society. Just because you hear voices telling you to kill people, does not mean you're going to do it. 

I'm a good person, really. You should be much more afraid of our president than me. I got into some meaningless fights when I was a young child, but that was it. But I'm frankly very afraid of what the future holds in store. Trump has demonized almost everyone. If you hear voices, do you really think he's going to be sympathetic? He wants to jettison your health care. And then when you get psychosis because you can't afford your meds, he'll say,"see, told you so." 

I'm not an axe murderer. I don't have a malicious bone in my body. I just want to live as best I can, without being harassed all the time. And I don't think I should have to pay many times what everyone else does, just because I have several conditions, or not even get insurance at all. We had major risk pools. I was in one for a very long time. They don't work. People drop drop out, because they're too expensive, and the remaining people are so expensive to insure, that the premiums go through the roof. So eventually you're forced to drop coverage, because you can't afford it. And then The Whole thing collapses. 

I was in one because of my suicide attempts. And now it's even worse, because of my hip replacement (automatic deny) and knee problems (same thing). I have never been without insurance, but the companies will cancel my ass in a heartbeat, if given the choice.I have multiple surgeries in the pipeline, and my meds have often exceeded $1000 per month (I think the highest was $1800). They don't want to cover me; they want to jettison me. I am a nightmare for them. I have upper, lower, and middle back problems, knee problems, and hip problems that will require revision surgery. And with my bipolar and psychosis, I have a medication nightmare. They want me gone. And next month I may be. I can't afford to live without insurance. The situation was more navigable before before Obamacare. I have no fucking clue what happens next.

I hyperventilate all the time now. We should take care of our people, but Trump doesn't give a shit about them. He only cares what they say about him. I can only hope that history pegs him as the malignant narcissist that he is. If there is any justice, he'll end up in prison and not me. 

I'm very scared. You should be too. This is the most horrifying thing to happen since Hitler. He didn't damn the Jews to the ovens at first. He blamed culture, and Jews, homosexuals, and gypsies, and everyone fell in lockstep. So they rounded them up and put them in death camps. Today we have anti-Muslim and anti-brown people sentiment. They'll get rid of them, trust me. And when does the fire include "lesser" evils? He's a demagogigue of the highest order. He campaigned on it, and he'll deliver if he can. 

It's beyond disgusting. But what can we do at this point? We're powerless, for the most part. We can only really hope that  he chokes to death on artichokes and mushrooms.  

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21 minutes ago, aura said:

Amen, @Flash. I'm scared to have bipolar and psychosis on my record now. I'm lucky to get coverage through my PhD program, but that won't last forever. 

It's not funny. People have no idea how difficult it is to deal with this kind of stuff. But when people peg you as a threat, it's almost impossible to come back from that. And that's where I get really scared. I do not want to spend the rest of my days in a state mental health institution, simply because I had a random hallucination. I have not hurt anyone in decades. And when that did happen, it wasn't because of some crazy in my head; rather, it was because people were egging me on. I was a little kid. It happens. I have not laid a hand or even threatened anyone in over 36 years. But more than likely, the trump administration would like to throw me in the clink and lock away the key. But Trump, et al, sees me as a dangerous threat that needs to be put down. And he has a bunch of ideologues who think like he does. If you're bipolar, schizophrenic, or schizoaffective, you're a danger to society, and need to be locked away. 

I'm not a danger to anyone. I have a hard time leaving my home. It's a challenge to pick up my mail. It is a challenge to make it to my pdoc appointment. Using a vacuum cleaner scares me, to be honest. I just try to make it through each day as best as I can. I'm scared of almost everything, and when the shit conspires against me, it's that much harder. And nobody gets this stuff.  When the shit hits the fan, and you make it through the day, you thank your lucky stars. It's ridiculous to everyone else, but it's another story for you. It's not so easy when everything is working against you. You have all of these problems, and you can't jettison them so easily. You get scared and freaked out, and then most people want to put you in the loony bin. It's not so easy; it becomes complicated. It's definitely not as easy as you think.

We would all like things to be simpler, but that's just not the way things work. The world is more intricate. It's easy to imagine various alternatives, but the reality is another story. You can imagine all kinds of scenarios. Yep.

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I don't feel as threatened by society myself for having psychotic symptoms, I just feel instinctively that I should keep them a secret. I have always felt this this way, even when in general I did not know better. So I just feel uneasy about telling people about it without needing or even knowing a reason why. I am okay with people knowing I have a mood disorder, but just am not with people knowing I have a psychotic disorder unless I really trust them a lot. And this is even though at one level I don't think I really am that screwed up; after all, it could be a whole lot worse, so why am I scared? But maybe it is the thought of having the psychotic label itself, that what I think, feel, see, hear, etc. can no longer trusted; with my parents it is a fear of a loss of control, that such things can from that point on be questioned. My tdoc tried to talk me out of this logic, as she wanted me to bring in my parents so she could talk to them, so, e.g., I would be able to have them reality test for me, but I have a hard time thinking otherwise.

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On 1/22/2017 at 6:24 AM, strange eyes said:

why do you have to stereotype psychosis in the first place?  everyone's experience of psychosis and the course it runs is unique to them.  for example, i probably fit your notion of 'severe paranoid SZ' before i was medicated, but now, if you met me IRL, you would have no idea i had any sort of mental illness if i hadn't told you.

i accept that i experience psychosis on a daily basis because i am aware of the fact that i hear voices a few times a day.  i also draw on my past experiences where, like you, i had delusions (one among many) of unmarked police cars tracking my every move.  this was when i was severely psychotic.  i don't get delusions anymore.  i also have excellent insight into the nature of my disorder. 

anyway, i don't think psychosis is necessarily 'all-encompassing, disabling, associated with poor insight, etc etc.'   if you're having symptoms like hallucinations, delusions, paranoia, i would definitely classify that as psychosis, just as i classify my daily auditory hallucinations as psychosis.

I agree.

You probably already know this but I will say it just in case ... there isn't a "one size fits all" kind of psychosis. 

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