Thank you so very much for your reply and very sorry that it's taken me so long to reply. I haven't been checking my email daily.

You seem to understand the conundrum – I was in AGONY last night. I'll try to explain but the end result is not being able to discern if I am delusional or not. I am house bound (by choice) and I don't communicate with anyone except my caregiver. We don't have conversations so she would not be able to assure me at all.

My GI issues seem to be over. I will still see the GI doc Monday. I have a history of colonic bleeding so I need a colonoscopy anyway.

But I have a really big problem. Maybe. My current diagnoses are MDD, Severe, with Psychotic Features and Anxiety Disorder. From the time that I learned to write and through the early 1990's, I enjoyed writing. (I don't know if I covered all of this?) If I did cover this I don't know if I covered why I am frightened of writing but that I cannot stop. I have never been diagnosed with any sort of manic or schizo disease and I'm too afraid, now, to look up the symptoms.

Shortly after beginning Effexor, I wrote a 20 page letter to my new shrink to give to him on our first visit. It was an abbreviated autobiography of my history of mental illness. Our first session was great – after almost three months now I have complete trust in him. He is very observant, he 'gets' what is important and he is extraordinarily perceptive. I can't emphasize that enough. He is smarter than me (my experience has been that I'm brighter than my shrinks, just not a mental health experts) and I feel total comfort with him. The best that I've ever had.

We discussed ECT in our first session. It had worked for me in the past when no medication helped. I have a badly damaged heart, pacemaker, etc., but Doc Wilson checked with my cardiologist and a host of other experts who all agreed that, should I need the treatment again, they would all sanction it.

Back to Effexor and 20 pages of writing. Even before reading it, he said at the end of that first session that as I seemed to enjoy writing that my "homework" for our next session would be to write about X (a topic in line with my treatment). I started writing that afternoon and didn't stop (including editing and correction) until the morning of our next session. 70+ pages.

During that second session, after he'd read my first letter, he praised my writing and the effort that I was putting into my treatment. At the end of that session, he gave me another topic. He told me that my writing was probably cathartic and helping with understanding and memories. 50+ pages.

It's gone on and on and I came to a point last week, early in the week, when I was hit over the head with a baseball bat: what in the world was I writing about and who in the world was I addressing? My assigned topic was "what are the reasons that spouses cheat?" But I was sixty pages into a letter that seemed to be addressed to my best friend and I was writing of my opinions on pornagraphy, something I know NOTHING about. I've seen a handful of Playboy magazines in my 56 years, seen a portion of two X-rated movies, been exposed to some sexually graphic photos in pop-up windows in the early days of the web and that's it.

I re-read what I had written and after deleting the pages that had nothing to do with my treatment, I was left with three pages. And I still hadn't addressed my topic.

I couldn't stop writing, though, so I began a journal. I began writing it on the evening of August 17. It's now 230+ pages. I've just let my mind run free and although I'm making attempts to maintain some therapeutic value, such as my 'plan' or goals list, I can go for a full day writing about a girl that I didn't know well in college.

I can't stop. Before getting out of bed in the morning I grab my iPad and start the day with a paragraph about how I slept and how I am feeling. I either fall asleep at night with the iPad on my belly or I put it away as part of my preparing for bed ritual.

There is a connection between the Effexor and my compulsive (or compelling?) need to write. I've checked OCD and there's nothing there that 'fits.' I do remember reading about a side effect of Effexor in which one has a manic state of excitement, etc. but I can't find where I read that.

It scares me. I've never had any sort of addiction but that's what this feels like.

Last night I was outlining a sort of 'pre-plan preparation' paragraph and I was overwhelmed by anxiety and went into a full blown panic attack wondering if what I was writing made any sense whatsoever or if I was just completely delusional and insane (truly insane) and that if the pin-point clarity and the total absence of any confusion, which I have been attributing to Effexor, was an insane illusion.

That's what scares me now. That Effexor has caused an addiction and that within the addition I have gone mad. I thought that Effexor made me think clearly and erased my confusion. Now I don't know. I felt for a good while that it was allowing me more positive thought than negative side effects. I was hung-ho about it; the only antidepressant that had any effect on me.

I'm also concerned that I may be experiencing such great anxiety and uncertainty because I actually ENJOY the writing, that I fear it because I find PLEASURE and insight when I write. It has been over sixteen years since I have found pleasure in anything (anhedonia is one of my MDD tag along diagnoses) and I have felt STUPID that entire time, as well. I was once gifted and smart – I lost that and I really don't believe those are thing that you can recover.

So am I fearful of feeling pleasure again? Am I afraid of being able to process ideas with clarity? Are those fears real? Or are they delusions, too?

There are a few things that I am certain of. That Effexor is responsible for my addiction. That I am addicted and that I cannot stop. And that I need someone, preferably Dr. Wilson, to take the time to carefully read what I have written when I felt that I was delusional and give me some assurance that it is not a delusion or, if it is, alert me of it.

Only after I see the GI doctor on Monday and find if he's going to order tests, and I'm certain that he will, can I reschedule an appointment with Dr. Wilson. I have a September 9th appointment with him, but I feel like I need to see him sooner.

I am so afraid of losing my mind completely this time.

There is a mental condition known as graphomania that's defined as "an obsessive impulse to write". I experienced it before I read about it. Here's something from Wikipedia that describes it well – "An elevated level of general well-being, which allows people to devote themselves to useless activities." The 'funny' thing, if there's anything funny about it, is that Effexor HAS helped me achieve a BETTER, but I wouldn't go so far as to say "elevated" level of general well-being. Isn't that what antidepressants are supposed to do? I "feel better" and slightly less depressed (or less hopeless) since I began taking Effexor. If I had to choose, today, whether to continue taking Effexor and continuing with this obsessive impulse or discontinue taking Effexor with the assurance that the obsession would go away, I would choose the former.

I haven't, yet, read much about graphomania – until a couple of days ago I thought that it was the same thing as hypergraphia. But the latter is usually a symptom of epilepsy or brain damage. It's also much more interesting than graphomania because it can be utilized for highly creative and technical writing whereas graphomania, from the little that I've read just results in confused and rambling statements. And that's my fear – that I am, or will soon begin to, churn out nothing but rambling and confused statements.

If you've made it this far, you'll have experienced the rambling and confusion in my writing.

I'm planning on re-reading the pages that I wrote yesterday when the fear of insanity overpowered me. I intend to print those pages and have the doc read them while in session. He will be able to make a quick evaluation, I think.

Thank you so much for replying. During the time that I've been writing back my level of anxiety has dropped. I'm still not certain of my sanity.

Thanks, again,