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Old 11-11-2007, 02:36 PM   #1 (permalink)
 
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Default Paranoia, or just extreme anxiety/depression?

Hi - my psychiatrist recently told me that she thinks I may have some "psychosis" that goes beyond "simple" anxiety and/or depression. (She also mentioned something about my possibly having some "touch" of mania/bipolar - which really floors me. Me??? Manic???) Then she mentioned a class of drugs that include Risperdal, Navane, and Abilify (I believe these drugs are used to treat schizophrenia and/or bipolar disorder) -and is "gently" getting me to consider trying Abilify. Naturally, I want to resist this "diagnosis" - because for all these years, I thought my "paranoid" thoughts were just a product of extreme anxiety and extreme depression. Besides, I've already endured the hard-to-live-with side effects of the "mere" antidepressants I've taken - what would I have to endure taking a drug from that class?

I mean, don't people afflicted with severe anxiety have certain thoughts that others construe as "paranoia"?

I think the main cause of my psych thinking I may have some psychosis comes from a couple of letters I felt compelled to write to my therapist describing my devastation and indignation at some of the things he has done and said to me - and defending myself against his possible negative views of me. It's kind-of a long story that I won't really get into...but I had picked up on some "subtle" and not-so-subtle clues that my therapist may think certain negative things about me. This made me really despondent. Here are some of the concepts I mentioned in the letters. Are these more or less typical of someone with severe social-anxiety and general anxiety accompanied by severe depression - or is it, as my psychiatrist seems to be thinking, something "more"? Does anyone else have these type of thoughts?

~Obsessively worrying that my psychiatrist thinks I'm fake and pretentious - based on some "subtle" things he has said and done.

~Obsessively worrying about the time when my therapist harshly used the word "arrogance" to describe my attitude about something - which seemed to be his way of saying that I was arrogant.

~Obsessively wondering about his true motive for saying that I was being more "real", and "more articulate" during a particular session - a session during which it seemed pretty obvious to me that I was being less composed and articulate. Was this his way of saying that I was being fake before, by trying to sound articulate and intelligent?

~Thinking that his negative assessment of me is possibly influenced by some prejudice he has.

~Thinking that his cold, extremely matter-of-fact manner when I expressed thoughts of wanting to kill myself indicated that he doesn't care if I off myself.

~Thinking that those two occassions when he kept me waiting in the waiting room for ridiculously long periods of time (something like 35 minutes the first time, then a full hour the 2nd time - and when he came out this 2nd time, it wasn't to get me, it was to get his patient who was scheduled after me. He "didn't know" I had arrived.) - was his way of "getting back" or "teaching me a lesson" for those two times when I cancelled on the day of our scheduled session (which you really aren't supposed to do). No, he wasn't running behind schedule (he told me he wasn't) - and practically every other time, he's been pretty much on time. These were two "freak coincidences" that happened pretty much right after I made those cancellations. So why wouldn't I think that these "coincidences" were done on purpose?

Do these type of thoughts ring a bell with you guys? Or do you think these thoughts are paranoid and psychotic to the point of requiring some anti-psychotic-type drug? (Supposedly my psych says that she would try me on a very small dose of this drug - maybe in acknowledgment of the fact that I don't have "full-blown" psychosis.)

But I'm thinking that a large part of severe anxiety and/or severe anxious-depression is "mental overactivity" which includes obsessive, ruminative, "paranoid" thoughts such as these. Doesn't it?
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Old 11-12-2007, 02:06 AM   #2 (permalink)
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Default Re: Paranoia, or just extreme anxiety/depression?

From what you have written, there is no evidence of psychosis or true paranoia, only negative/judgemental thinking. I do the things you say too. You might want to get a second opinion. On the other hand, if you truly were psychotic you probably wouldn't know it. But you seem rational to me.

Interestingly, my therapist made the same offer to me about a year She never indicated that I had psychosis, just that it may help with my obsessive thoughts. I don't think you have to be psychotic to take a small dosage of abilify and risperdal... but you shouldn't take them without good reason either. They can have long term movement disorders on a handful of people and besides they all had interolabel short-term side effects for myself.
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Old 11-12-2007, 02:23 AM   #3 (permalink)
 
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Default Re: Paranoia, or just extreme anxiety/depression?

I don't think you are Psychotic either. Last week our Psychiatrist at work was talking about how being Paranoid doesn't mean a person is psychotic. You just have the negative feelings that we all have. I would try to stay away from those anti psychotics. They have too many side effects. I think an antianxiety med would be more appropriate along with cognitive behavioral therapy to deal with the negative thinking. I am wondering why your therapist thinks you are manic. People with mania usually don't sleep well, talk fast, have lots of energy, are very sexual, very impulsive.
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Old 11-14-2007, 10:00 PM   #4 (permalink)
 
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Default Re: Paranoia, or just extreme anxiety/depression?

I think because of everything you have said you should just start seeing a different therapist. That way you can start all over with someone else, see if you react the same way, and maybe they will have an opinion on whether there is more to it than just the anxiety. However, even though our society makes it such a big deal i have talked to my therapist about people that he sees that are schizophrenic and so on, and they are actually quite normal people they just have these fears , I was amazed when he said that a lot of his schizophrenic patients live very normal lives and some are very successful. I didnt realize how closeted mentall illness really was until I started talking to him about his other clients
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