[kkrrhh]

Ok, so I just typed up a very long message that accidentally got deleted when I took too long and got logged out, so I'll just make this short. :P

I pretty likely have bipolar 2 (not sure about it, and pdoc is useless.) A little over a year ago, after what started with what may have been a mixed state, I went through a very bad spell including a psychotic spell. I'd never been psychotic before, and I have good reason to believe it was partially to fully caused by a bad reaction to a spell of a lot of very quick, irresponsible, med changes in a short period of time.
Things had been heading to a bad place before the meds, though, so I don't know whether a more mild psychotic depression would've happened anyway or not. I'm still confused about what was actually "natural" and "me," and what was caused by the meds and stuff, and I'm not sure whether I should actually consider myself "prone" to psychosis.
A lot of the worrying I've done since that episode has been useless and I know I'm gonna worry anyway because of anxiety. My mental health often gets worse in the winter, though, and things currently aren't great. It's likely normal depression and anxiety stuff, but some things have me worried or at least watching out for anything worse, though, so I was googlin'.

I've noticed that psychosis symptoms or warning signs I've read about can really overlap with depression symptoms, and be confused with symptoms of other things as well. How do you tell the difference?
This is the list I was reading just now:

Feelings – Not feeling 'right', not sure what's wrong: You might feel anxious or depressed. You might feel 'high' or stoned for no reason. It might seem like people are out to get you, and you may feel irritated or unsafe.

Actions – Not your usual self: You might have trouble sleeping. You might not feel like eating. You might feel just like being quiet and away from other people. You might be using more drugs or alcohol than usual. You might be doing things that seem odd to others, or even to yourself.

Thoughts – Too fast, too slow, hard to string together: It might be difficult to think, remember or concentrate. It might be difficult to make decisions. You might think very fast but be confused. "At first I thought I was coming down with the flu since the strange mental state I was experiencing was similar to the viral delirium that people get when they have the flu."

You may find that you are getting 'lost' a lot in the middle of talking about something, or going blank. "Sometimes I feel like the operator in my brain just doesn't get the message to the right place."

Low Motivation – Hard to move, hard to get things done: It may not seem worthwhile to get out of bed, to cook breakfast or even to wear clean clothes. It may not feel right to be around people. You might have a hard time starting tasks, or not feel much like doing anything. It may be impossible to perform as usual at work or school.

Delusions – It might not be what you think: A delusion is a false belief that is strongly held. Some people with psychosis believe that they are being followed or watched or that someone is plotting against them. Others feel that they have been chosen for special abilities or powers or that their thoughts are being controlled by others.

Hallucinations – They sound real, but only to me: Hallucinations are when a person sees, hears, feels, smells or tastes something that others do not. These sensations may feel very real and special, and it may be impossible to tell that they are not really there. The most common type of hallucination involves hearing things – such as voices talking to you about yourself or telling you to do things.

Other than the last 2 those are things I could experience from depression and/or anxiety, and the lines are blurred for me between those things causing them and them being "regular" symptoms, or other things causing them. My thinking and information processing definitely seem to be way off lately in a ton of ways, some of which could be depression of course, but some of it is reminding me of right before things started getting really bad before, which has me worried. Two of the other things that have me worried right now are motivation and social withdrawal (not on this list, but I've seen it on others). They can happen from depression for me, but there are a few spells in particular (right now is starting to look like one of them) where I remember them being particularly bad, or different almost. I've always thought of different depressive spells I've had as my different "types" of depression, because, ya know, symptoms can change but sometimes there's a sorta pattern. I also feel like the times when I've experienced a lot of paranoia have coincided with those symptoms being bad, but maybe I'm just overthinking things here. I just wonder whether I'm just worrying and over blowing things, or whether some things in the past that I've chalked up to "regular" depression and anxiety could've been on the psychotic side.

I've always thought of psychosis as either a big full blown episode, or super obvious, noticeable symptoms someone with severe mental illness has but it's "obvious" that it's psychosis. But then I've heard of it described as a spectrum, too, which confuses me. Can you have just mild symptoms of it for a spell, that never turn into a full blown episode? And if you're someone who could possibly go into a full blown episode, at what point does it become a real problem? I know I've heard about "depression with psychotic features" and similar things, I guess I'm just confused about what that actually looks like. And when do different med strategies become useful? I'm completely against taking antipsychotics, but then I wonder if I should go about my meds differently.

[Wanderlust90]

Reading this was confronting for me because you pretty much just described how I'm feeling & have felt with far more intensity previously. I have heard a voice, perceived with my ears, saying I was stupid when having most of the symptoms you described at the time. I still can't pinpoint whether it's bad anxiety or something more. Agitated depression? Dysphoric hypomania? I know I likely had an auditory hallucination but I was fully aware it was a hallucination. So I don't think I've ever been delusional. Expect maybe delusions of infidelity but that's a whole other thread haha. So I don't know if what you describe is psychosis but I'm only going from my own similar experience. I still have my feet firmly planted in reality, I'm just disconnected from it somehow. & also totally not up for antipsychotics even though both pdocs have suggested the same.

[jacky8807]

The first 5 sound like things that happen in an episode but don't sound like psychosis to me
If your pdoc is useless is it possible to find a better one?
Wishing you luck

[unlockingsanity]

Just so you know, if you have any psychotic episode, you're considered bipolar 1, not 2.

[Keegan2015]

Originally Posted by unlockingsanity

Just so you know, if you have any psychotic episode, you're considered bipolar 1, not 2.

I don't think that's true, psychosis can occur in a variety of mental disorders, not just BP.

[kkrrhh]

Wanderlust90, I can somewhat relate. It's like having symptoms that are very "mild" as far as that stuff goes but just seem on a different level than anxiety and depression. They're not quite like bad psychosis but then, for me at least, it makes me wonder whether it's something that points to something worse or whether it can really be simple anxiety/depression just causing those things here and there.

I've heard people with just anxiety talk about having paranoia, so I usually attribute it to just being that mixed with my complicated overthinking mind. But then I know there's kinda the use of paranoia when people really just mean really anxious, worrying and on edge, and then technical paranoia where you have an actual truly belief you're being persecuted or whatever. I know during the one particular bad spell, I was definitely having the second and wasn't even really aware I was delusional. But then other times I've experienced things that aren't quite that, but then seem worse than just anxiety. For example, for a spell whenever I'd get to my car in a parking lot especially at night, I would check inside it but then while driving just feel like someone had to be in my back seat. I wouldn't 100% believe it, but I'd be turning my head back to look quickly while driving down the road. And, I have social anxiety but had had more severe spells before where I would really feel like people were talking about me in public, even sometimes "hearing" things said about me when, yes, the person was talking but I know they hadn't actually said what I heard. That sounds like delusions, but at the same time I've heard of that happening with social anxiety. On top of it all, I know I have depersonalization and derealization sometimes and I just automatically attribute soo many weird perceptual experiences and things to that, which could be right but I'm not sure. Sorry, I'm babbling haha.

Thank you, jacky8807. I'm pretty sure he's the only option covered by my insurance without a huge wait list, unfortunately. I still remember how he diagnosed me on my first visit when, after I'd basically only told him I have anxiety and depression, he asked (almost his exact words), "do your moods sometimes go up and down?," and when I said yes he said I might be bipolar and prescribed gabapentin. I do think based on symptoms that I possibly have bipolar 2, but his "diagnosis" was more a lucky guess.

unlockingsanity, oh, yeah, hmm. I've just never experienced a psychotic episode "naturally" for lack of better way to put it, and I'm not sure if this one counts because of all the artificial mixing up of my brain chemistry going on at the time. I mean all within 2 or 3 weeks I quickly tapered off Nardil, then switched all around with Parnate, Emsam, Lamictal, and possibly others, quickly going on and off Parnate multiple times.
(This was all because I was in an outpatient program with 2 different psychs I'd see on different days who did not collab well at all, and I was so mixed up and desperate to get better I went along with what they said, btw.)

[Wanderlust90]

I just feel like everyone is against me. I don't feel like they are trying to kill me or hurt me physically but I do feel like they think I'm pathetic & lying. That they don't believe that there is anything wrong at all. That they expect more from me. That they are happy to ignore any symptoms because that's easier for them, denial denial denial.

When I bring up stuff to my family they have a habit of telling me that what I'm experiencing is normal & everyone goes through it & I just have to figure out a way to deal that doesn't impact on their lives. I'm SOOOOOOOOOO angry at them. How dare they play down how I feel & what I experience. How dare they suggest im being a hypochondriac when they have little to no understanding of mental illness. I'be been told by my parents & partner that suicide is just the weak selfish way out. I mention I've been suicidal in the past & even had a plan & procured the means to carry it out & my partner yells at me & asks me how I think that makes him feel. Then after escalating the focus is on how I should be sorry for saying things to upset him! WTF! & im the one the pdoc wants to ****ing medicate! In fact I've been told by my parents & partner that I wouldn't have any problems if I didn't take meds. So I haven't taken said meds for over 2 months, it's not getting any better!!!!!!!!!!!!!!

I really feel like I'm never taken seriously, & I really believe this is only due to other people not wanting to deal with it because it's too hard. Maybe if every single staff member in the hospital wasn't overworked & underpaid people wouldn't be so dismissive because they would have the time & mental resources to help.

I'm sick of being lost in my head & acting normal. How long can you act? How long until something gives & im mad?

[thedayturnedaround]

I have an experience with psychosis that may give you some more insight. I became manic and took myself off all my medications, including an anti-psychotic I didn't realize was an anti-psychotic. For the next two years, I lived in my own world, which interacted with others in an almost incoherent way. I would send email messages to people I hadn't seen in years, with "coded" meanings only I would understand. I believed the NSA was communicating through radio waves to my brain. When I watched television, I believed that the shows contained special secret messages intended for me. I believed that I was part of some royal holy bloodline, and that songs and albums were written about me entirely. I was obsessed with the idea that I was being tracked everywhere by satellites, and my house was bugged all the time. In bursts of creativity, I would perform several hours long one-man telethons for these bugs in my house, "broadcasting" myself doing "comedy acts" like playing characters who make fun of psychiatry. I told people I was working for NASA and the CIA. And last but not least, I was convinced the government controlled all the weather, including hurricanes.

Back on medicine again, now I go to school online, play Call of Duty, and chat with women. I don't have any thoughts about being bugged, even though I am a tech junkie and I know about Edward Snowden's leaks. Psychosis for me is all about a blended delusional reality, where you can go order a sandwich, and then rant at a telephone pole on your way home.

my psychiatrist once pointed out that, in a way, panic attacks are 'psychotic' in that you lost touch with reality momentarily (e.g., believe you're dying). I once 'saw' blood seeping into my eyes and 'knew' my brain was leaking, causing me to totally freak out for about 30 minutes until a friend brought me back down. But I was told that this wasn't considered a 'true' psychotic episode because it wasn't a sustained idea/narrative...like people following me, controlling my mind etc. It more in the panic-attack 'family.' I also used to worry people were poisoning me or slipping me drugs, but not enough to not eat/accuse them. In other words, the thoughts crossed my mind and I considered the possibility, but was able to talk myself out of it, even if there was some residual 'what ifs'/paranoid thoughts. I remember these being described as "pseudo-delusions."

I guess my point is that there are lots of semi/psuedo/sort-of versions of 'psychosis', if you define it as a loss of touch with reality, but I personally wouldn't say I've ever been psychotic because I was able to 're-connect' with reality pretty quickly. Anxiety and depression can seriously distort how you think and perceive the world...you can't think straight or sleep or interact normally and that can make anyone feel like they're losing touch, but the fact you can recognize that you don't feel right, at least to me, is a good sign you aren't experiencing 'true' psychosis.

[Victoria'smom]

Even small things skewed thinking is considered Psychosis to my psychiatrist and therapist. I can take a small bit of information and run with it until I think something is true that can't be. The sad thing is I know it's not but still can't shake it. So I thought those weren't psychosis but they are. who knew? So I regularly have a tactile hallucination that there're bugs crawling on me. I know it's not real, I see it's not real, but the sensation feels real. no one would guess when I am psychotic because my daily life isn't effected I learned ways around it. 4-ish people (friend, husband,pdoc,T) and PC know when I get extremely psychotic the rest would has no idea.

I'd be crying because my husband angered me, not He has a plan with my parents to take my kid away from me while I'm staying with my parents. Or me being mad that he took the puppy to the kill shelter because he really wants me to kill myself or if I start a tummy tuck they'd have to finish it at the hospital to save me. Simple things that look normal on the outside but are far from it. The ones that I can't justify with logic are the scary ones and they only last about 30 min.

I'm completely against taking antipsychotics may I ask why? I was for years too.

[kkrrhh]

Thank you all for the responses.

Wanderlust90, I'm sorry to hear about your family being that way. My family is the same way sometimes, and I think what you said about people just not wanting to deal with it is very true. To a certain extent, trying to be reassuring and tell someone things probably aren't as bad as they seem can be useful. But there are times where they're just straight up denying the truth and it's insulting.

thedayturnedaround, that was really helpful, thank you. I experienced soo many similar things the one time I was in a definite psychotic spell. It's so weird to me how peoples' brains can be so different, but seem to follow similar trends with what their brain decides to make up during psychosis. I don't think the thing about the government controlling the weather is one I remember hearing from anyone else, and I definitely had that one too, so that's comforting, somehow.

[kkrrhh]

thepterodactyl, that makes sense. I guess that's actually where I really start to wonder. It's just crazy the things even anxiety and depression "alone" can make you think in the moment, and sometimes it just seems too crazy to me and makes me wonder.

Miguel'smom that's a big problem I have, too. My anxious brain can pick something and, like you said, run with it, and take it to a level that's pretty "insane", but not quite 100% disconnected from reality.
And I think my biggest worry is the possibility of irreversible side effects. Second to that is weight gain, and while I could be wrong about this and oversimplifying it, I feel like the dopamine antagonism in most (all?) antipsychotics can't be good for me with how my main issue is depression and it seems I have dopamine issues already. Seroquel made me super depressed to where I couldn't even stay on it longer than a few days a couple times, and I tried Abilify and remember not liking it, though then again that was during the psychotic break so I'm not sure I could accurately judge it. Rexulti miight be on my list of meds to try if I run out of options, because I've heard it's good for depression.

[Victoria'smom]

Please think about trying it again. Some of them do help with depression. It's made my life and family's life so much better. It's a med that I would keep above all.