I don't think the AD is doing anything bad because it if were I would be mixed and I would know it. Things seem to happen in no uncertain terms in my brain. My therapist kind of triggered the paranoia by saying something completely innocent and actually kind but somehow frightening at the same time and that started the rest.

I did email my pdoc. I don't think there is a lot she can do easily so I will probably wait it out. I imagine the next option is lithium and I have a history of multiple toxicities so lithium is a scary drug although really effective and likely to wipe out the paranoia in a few days.

I will call and see about my therapist tomorrow. It's hard because I am so extremely tired that driving 75 minutes each way is not appealing at all and I worry I'm too tired to be safe.

Thanks for all the support.