[rhz10]

Hello.

This is my first post here.

I'm very concerned about my girlfriend. Some background: She is a very intelligent, sweet, kind woman who has ADHD and has been seeing a psychiatrist for Adderall 30mg XR and a CBT specialist for depression, anxiety, and enmeshment issues. She is unemployed and socially isolated. I am her only point of contact. Recently, she suddenly quit therapy claiming she was happy and didn't need it anymore. She had been improving, but I was surprised she suddenly quit with her talking about it beforehand.

Details are given below (sorry for it being long). Thank you in advance for reading.

Over the past year or so, she has had perhaps three fainting experiences, usually coinciding with having an alcoholic drink without having eaten for the entire day. Recently, she has come to describe these episodes as transformative near-death experiences.

She has also had an interest in things like Astrology and The Michael Teachings. She found this stuff fascinating, studied it in depth and believed much of it. I didn't think much of it one way or another.

Around the time of the most recent fainting episode (about when she quit CBT), she claimed to have experienced a spiritual awakening, that she is in communication with her spirit, and that she has psychic/intuitive powers (she has always been highly perceptive, empathic, and intuitive). She asks her spirit questions and the spirit communicates with her, answering her questions, and can move her head to nod for yes or no questions, etc. The spirit also directs her head toward certain colors. She sometimes hears high pitched tones. People with ADHD can hyperfocus, and my girlfriend has devoted a tremendous amount of energy to understanding how to better communicate with her spirit (via experimentation and internet research), how to better interpret the responses she receives from her spirit. She finds it all simply amazing (in a good way).

She has always had a hard time making decisions, so she consults her spirit for many small decisions. If you ask, she says that her spirit is at least in part just her subconscious mind, but that there are other aspects to it to be understood in term of faith. She is lonely and has animated, lengthy discussions with her spirit, which bring her an almost giddy delight. At times, she has a strange smile and stares off in some direction (perhaps at the suggestion of the spirit). She sometimes greets me when I come home with a big hello in a tone of voice which is strangely chipper.

She has become highly sensitive to colors, and, after extensive internet research, has changed many of the lightbulbs in the apartment since the old bulbs suddenly bothered her. Recently, she has become very nervous before bed, says that she hopes she's OK, and feels better when I there with her as she falls asleep.

When I show concern about all these changes, she becomes defensive and claims it makes her feel uncomfortable and ill at-ease. She then needs time to center. When there is tension between us, she'll stay in the bedroom or bathroom for hours asking not to be interrupted and that she's doing something very important.

She eats very little, maybe one meal a day (we had this in the past because of Adderall). As for family history, her mother had two psychotic episodes in her life.

Her spiritual awakening has generated some concern on my part, and she does not like that at all. I told her that I'm skeptical, but not dismissive of claims of psychic powers. She says that she is also a skeptic, but that there's no denying what she's experienced. When I suggest that we talk to the psychiatrist about this, she refuses.

I don't know what I should do here. I'm tempted to call her psychiatrist without my girlfriend's knowledge, but I'm not sure if that's the appropriate thing to do.

Are there guidelines for when that's the right thing to do? She does not appear to be suicidal or in major distress. However, her behavior has definitely changed over the past few weeks. I'd really like for her to visit her psychiatrist, but obviously, I can't force her.

Thank you.

rhz

[Sometimes psychotic]

Sometimes the medicines used for ADHD can cause psychosis---I'm not entirely sure this is psychosis based on what you've described. Personally I would not contact her pdoc but keep pushing her to talk to pdoc-----if she becomes really psychotic it will be obvious to the pdoc anyway assuming they talk at all. If she does become full blown psychotic then you can contact her pdoc or take her to the ER. This right now just sounds colorful, like a personality element rather than anything else. Just my two cents.

[leejosepho]

Nothing you have described sounds to me like anything psychic, and I do not know where to draw a line for anyone other than myself while trying to distinguish imagination from at least borderline psychosis. Overall, I would suggest not challenging her about anything she might merely say -- never mind her words -- while watching for any actual *actions* displaying psychotic behaviour.

[junkDNA]

This is strange especially since the profound change has occurred over a short span

How old is your girlfriend?

[junkDNA]

Ask her questions to get the answers you want.. Like if she's hearing this spirits voice thru her ears. As an external persons voice. If she says yes she is having hallucinations. You don't have to ask outright. But from what you wrote she seems willing to share at least most of what she's experiencing.

[rhz10]

Thanks for the responses. She is in her mid 30s and only sees her psychiatrist for medication management every 3 months. Otherwise, no regular communication.
These changes have happened over the past month or so I'll ask her more questions. She is willing to share her experience.

[Bbop]

Rhz10,

It's good that your reaching out! You will learn a lot here on PC. I have ADHD and had been medicated for it sense I was a small child. 3 years ago I started Adderall to help me at work. After a year of treatment, I fell into psychosis hard. I was living in an altered state of reality. I became very ill until seeking treatment with a PDoc who was able to help me understand my new diagnosis of Scitzoaffective bipolar type. When starting my medication management we quickly removed the Adderall. Adderall was the gateway drug that began my psychosis however, it was my illness that took my mind from me. It would be interesting to see how she does without taking the Adderall for a couple of days. Encourage her to talk with her Doctor. Wishing y'all the best!

[rhz10]

We've been talking. It's difficult because she seems to get very tired after a few minutes of questions. She does not claim to hear voices or see things. She has had some odd body sensations (feeling a breeze when there isn't one, which scared her).

She does claim that she is in contact with her spirit and can ask her spirit for anything. The spirit communicates with her by nodding/shaking her head to answer yes or no. It will sometimes point her head straight up when the answer is more complex. She doesn't know what that means. The spirit directs her to look in certain directions and to observe the colors of the objects in her field of view. The colors have special meanings.

She has tried to prove to me that the spirit is real, by sitting still for 4 hours and doing something (meditating?) That didn't work, and she has no explanation for it. The spirit made other predictions which have not come true. When I ask her about this, she says that she'd like to answer but feels too tired.

She engages in lengthy, rambling conversations with the spirit when we're not talking directly.

She's not interested in seeing her therapist(s). I could mention adderall psychosis to her, but I worry that she'd be dismissive of it. I don't know what else to do. This is really heart-breaking.

[rhz10]

Things took a turn for the worse. Last night her head was directed in a peculiar direction. She asked the spirit if she's being harmed. The answer was yes. She also saw a "jesus audition" and wondered whether she was in Alice in Wonderland. She had trouble sleeping and was woken by flashes of "bad images." This scared the crap out of me.

I called her shrink, who said she needs to be evaluated immediately. I knew she would refuse. The shrink said to bring her in or she would need to go to the ER. It was bad, there was a 911 call, which was cancelled in the end. She was given the choice of her shrink or the ER. I brought her to her shrink. Needless to say, she is furious with me.

I know that I acted behind her back, but I was so scared for her, I didn't know what else to do. I asked myself what I'd want if the situation were reversed (which would be for my partner to take me to my shrink) and simply did that. I'd rather be the guy who brought his girlfriend to her shrink against her will (thus violating her trust in me) than the guy who watched as his girlfriend descended into madness.

[rhz10]

The shrink thought it may be Adderall Psychosis and poor sleep. She's been told to stop Adderall completely. I hope she will recover quickly. If this did come from Adderall, does anyone know how quickly this sort of thing resolves?

[rhz10]

I'll add that, unlike her mother's psychotic episode, there is no paranoia here. However, when the doctor suggested that she was experiencing delusions, she didn't vehemently deny that but certainly wasn't as convinced as he was (or I am).

Apparently, stimulants can trigger psychosis in those who are predisposed. I'm so worried for her. She absolutely hates shrinks and it will be very hard to convince her to get any kind of treatment for this.

As you can imagine, this is creating a massive amount of stress in our relationship. It's difficult for us to talk about it without me becoming anxious (some of which has resolved since she has now at least seen her shrink). She did indicate that she'd be willing to go to couples counseling with me, which may help a bit with our interaction.

The main question is how to treat this without medication or counseling. Interestingly, during her mother's second episode, my girlfriend moved home and, over the course of a year, used logical arguments with her mother to demonstrate to her that what she was experiencing were delusions. The psychosis lifted--although it's not completely clear whether it was because of what my girlfriend did or whether the condition had just run its course.

What are the chances that this sort of thing will just resolve on its own in the short-term (few more weeks)? How can I help her? She may be amenable to logical arguments, since she has a scientific orientation. When she is given logical arguments that what she is experiencing is not real, she'll sometimes get a little defensive or sometimes say that she understands my perspective, but doesn't have an answer for what's going on. She recognizes that what she is experiencing is uncommon and weird. She is looking for explanations.

[Sometimes psychotic]

Logical arguments don't help unless you're coming out of the psychosis already....honestly the best way to preserve your relationship is not to agree or disagree with what she's saying for as long as you can....but if she directly asks your opinion then be completely honest. There is something called reality testing that can be done by the patient but not directed by you......

Regarding how long it will take to resolve....honestly have only seen one other obvious case caused by ADHD meds here on these boards and in that case it was a kid, his mom was vehement that he stay on the meds and added an antipsychotic instead. Please keep us updated on her progress.

As far as communication you may want to look into the methods of Xavier amadoor.....he's got books etc.

[rhz10]

It may not be stimulant psychosis. Apparently, stimulants can induce psychosis in those who have a predisposition (her mother had two untreated episodes, the latter lasting a full year).

She professes to be happy and honestly appears to be happy and relaxed. According to her, her unhappiness and stress are the result of my anxious response to her claims of psychic powers and my worry when the spirit said she was being harmed. Of course, this has been exacerbated by my dragging her to her shrink against her will.

"I Am Not Sick, I Don't Need Help! How to Help Someone with Mental Illness Accept Treatment." sounds worth reading. I'll try it. Thank you for the recommendation.

[rhz10]

Another question please: Assuming that this doesn't resolve in a few days, what is typically the next step? I still don't think that she's going to consent to treatment. She doesn't see the need. She does not appear to be a danger to herself (assuming that she doesn't leave the apartment at least).

It seems that I should tell her family. Her mother is too fragile emotionally I think (two psychotic episodes and an Asperger's type demeanor). Her grandmother is 90. I haven't met either. Apparently, there's an aunt as well.

She is not paranoid per-se, but struggles to make sense of her experience. She completely didn't understand why I dragged her to her shrink and felt absolutely violated by that experience. When I explained that I was trying to help her, she was relieved. Before that she spoke about leaving for a hotel. Now things seem better.

The problems arise when we talk about the spirit. Asking for her to explain drains and frustrates her because she doesn't understand it herself and has been trying to figure out how it works.

[Sometimes psychotic]

Originally Posted by rhz10

Another question please: Assuming that this doesn't resolve in a few days, what is typically the next step? I still don't think that she's going to consent to treatment. She doesn't see the need. She does not appear to be a danger to herself (assuming that she doesn't leave the apartment at least).

It seems that I should tell her family. Her mother is too fragile emotionally I think (two psychotic episodes and an Asperger's type demeanor). Her grandmother is 90. I haven't met either. Apparently, there's an aunt as well.

She is not paranoid per-se, but struggles to make sense of her experience. She completely didn't understand why I dragged her to her shrink and felt absolutely violated by that experience. When I explained that I was trying to help her, she was relieved. Before that she spoke about leaving for a hotel. Now things seem better.

The problems arise when we talk about the spirit. Asking for her to explain drains and frustrates her because she doesn't understand it herself and has been trying to figure out how it works.

If it doesn't resolve the next step is medication....there's really no chatting your way through this. Did the psychiatrist ask for some kind of follow up appointment.? Like I said earlier though I would not drag her to the shrink.... get her to the point where she wants to go or don't go at all, you can't forcibly medicate someone in an outpatient setting so there will be no result by simply taking her there unless she were to be hospitalized but it doesn't sound like she's a danger to herself or others so that's unlikely. You have to remember foremost she has the right to choose the outcome....if she likes being like this you won't accomplish much. What you're describing sounds pretty mild, it may take some paranoia or hallucinations to make her want treatment.....if you get meds from the psychiatrist they can always be around if she later decides she wants the help.

[rhz10]

Thank you for your response.

We may be nearing the point where she may be more open to hearing my perspective on what's happening to her. When that time comes, I'd like to show her some online resource which clearly explains why psychosis may be the cause of what she's experiencing. The resource should have a list of risk factors (e.g., social isolation, family history, etc.) and symptoms (e.g., types of delusions, poor self care). Can you (or anyone) please recommend such a resource? It should be somewhat complete, because she will latch on to the facts that she's not paranoid, not hearing voices, not seeing things, etc. to demonstrate why she doesn't have psychosis.

Thanks again.

[Sometimes psychotic]

Originally Posted by rhz10

Thank you for your response.

We may be nearing the point where she may be more open to hearing my perspective on what's happening to her. When that time comes, I'd like to show her some online resource which clearly explains why psychosis may be the cause of what she's experiencing. The resource should have a list of risk factors (e.g., social isolation, family history, etc.) and symptoms (e.g., types of delusions, poor self care). Can you (or anyone) please recommend such a resource? It should be somewhat complete, because she will latch on to the facts that she's not paranoid, not hearing voices, not seeing things, etc. to demonstrate why she doesn't have psychosis.

Thanks again.

If you google it the top result is good, not an actual page, you know how Google has health conditions it comes up as that goto the symptoms tab......it's sourced from the Mayo Clinic but is more clear than their site really. Alternatively there are books but most center on schizophrenia rather than psychosis per se.....example surviving schizophrenia by Torrey. Frankly I wouldn't go near anything schizophrenia because it can be scary to think you might have that.

I'm not sure this approach will work though, you need to latch onto something she thinks is a problem and say the meds will help with that. In my case I couldn't sleep so they gave me a sleep aid that's also an antipsychotic.....

[Sometimes psychotic]

Originally Posted by rhz10

Thank you for your response.

We may be nearing the point where she may be more open to hearing my perspective on what's happening to her. When that time comes, I'd like to show her some online resource which clearly explains why psychosis may be the cause of what she's experiencing. The resource should have a list of risk factors (e.g., social isolation, family history, etc.) and symptoms (e.g., types of delusions, poor self care). Can you (or anyone) please recommend such a resource? It should be somewhat complete, because she will latch on to the facts that she's not paranoid, not hearing voices, not seeing things, etc. to demonstrate why she doesn't have psychosis.

Thanks again.

I think what you need really for this to work is a dsm.....because it says you only need like 2 of the symptoms but it's an expensive book, not sure where you would find one.

[rhz10]

Thanks. One can get snippets of the DSM online. The "at least two" thing is good. It would be great to find something like that with a bit more explanation for her.

Otherwise, as I had indicated, I think that ideally her family needs to know about this. This is problematic though for a couple of reasons. First, she would learn that I went behind her back again, and it would destroy trust. She's already a little suspicious of me. Second, I'm worried that this kind of news could negatively impact the mental health of her mother. Her grandmother is 90 and while quite lucid is a bit of a loose cannon and will likely tell the mother. There is an aunt as well, but I don't know how to contact her.

I suppose that the shrink could call the grandmother, but I really don't know what that would unleash. The ideal thing would be for her to tell her family, but this can't happen either for obvious reasons.

[Sometimes psychotic]

Originally Posted by rhz10

Thanks. One can get snippets of the DSM online. The "at least two" thing is good. It would be great to find something like that with a bit more explanation for her.

Otherwise, as I had indicated, I think that ideally her family needs to know about this. This is problematic though for a couple of reasons. First, she would learn that I went behind her back again, and it would destroy trust. She's already a little suspicious of me. Second, I'm worried that this kind of news could negatively impact the mental health of her mother. Her grandmother is 90 and while quite lucid is a bit of a loose cannon and will likely tell the mother. There is an aunt as well, but I don't know how to contact her.

I suppose that the shrink could call the grandmother, but I really don't know what that would unleash. The ideal thing would be for her to tell her family, but this can't happen either for obvious reasons.

When I got sick my mom and dad told the whole extended family....I was pissed but what's done is done.....she might forgive you later if her psychosis resolves but it can take a while even with meds.....if she pushes you away you won't be able to help her anymore so be careful.

[Bbop]

Once my psychosis started, triggered by the Adderall, i didn't get better. 😩 I was diagnosed with Scitzoaffective disorder. The medicine just initiated my diagnosis. Hopefully she will recover completely in a couple of weeks once it works out of her system! Thinking of y'all!

[rhz10]

Originally Posted by Sometimes psychotic

When I got sick my mom and dad told the whole extended family....I was pissed but what's done is done.....she might forgive you later if her psychosis resolves but it can take a while even with meds.....if she pushes you away you won't be able to help her anymore so be careful.

Guess I'll hold off for now. The only other way to have this happen would be for the shrink to call her family.

[rhz10]

Originally Posted by Bbop

Once my psychosis started, triggered by the Adderall, i didn't get better. �� I was diagnosed with Scitzoaffective disorder. The medicine just initiated my diagnosis. Hopefully she will recover completely in a couple of weeks once it works out of her system! Thinking of y'all!

She taking 30mg/day XR for a few months now. That's not a huge dose. I think it will be hard to track down the cause with so many possibilities.

If the best case scenario is a few weeks, I'm not sure that I can manage her that long. She can become irritated with me which causes her to think about moving out. I've succeeded in calming things down to the point where she stops talking about that, but then the cycle continues 1-2x per day. Most of the time she seems fairly stable, but I'm scared to leave the apartment for more than a couple of hours.

[Bbop]

Can y'all go to walk in clinic or Er to see a doctor sooner? I know it's hard for you. Does she realize she is in psychosis? I thought everyone was wrong and that I my reality was write. It does not feel good to feel like that at all. I was started on Seroquil it helped the psychosis right away. I feel for y'all!

[Findingreason]

Originally Posted by rhz10

Thanks. One can get snippets of the DSM online. The "at least two" thing is good. It would be great to find something like that with a bit more explanation for her.

Otherwise, as I had indicated, I think that ideally her family needs to know about this. This is problematic though for a couple of reasons. First, she would learn that I went behind her back again, and it would destroy trust. She's already a little suspicious of me. Second, I'm worried that this kind of news could negatively impact the mental health of her mother. Her grandmother is 90 and while quite lucid is a bit of a loose cannon and will likely tell the mother. There is an aunt as well, but I don't know how to contact her.

I suppose that the shrink could call the grandmother, but I really don't know what that would unleash. The ideal thing would be for her to tell her family, but this can't happen either for obvious reasons.

I would exercise caution with that. Back in late 2015 when I had my depressive breakdown and hospitalizations, my mom freaked and told my whole family at a Christmas party gathering. I did not talk to her for a while, and was extremely embarrassed and ashamed. I have half forgiven her, but I have made sure she does not know of my hospitalizations anymore because I care to not repeat those events again. Trust can be a very fragile thing, and confidentiality is an important component of that with sensitive topics. Be careful.