Different States

[idied]

Hi all, I was referred here by a friend and thought it wise to explain something that's been affecting me.

I was taken off my anti-psychotic medicine for nearly 5 days and I started getting more and more fearful afterwards. I began taking the medicine again but started to suffer severe anxiety. I do not have the classic symptoms of schizophrenia (hearing voices, imagining things) but I believe I may be suffering a low-form of psychosis. When I get extremely scared I might imagine something to be a monster and then it flashes back to reality. I know myself that I am instigating the images but I feel like I can't control my mind. I went through a psychotic episode in 2007 after dealing with trauma. I thought that was it until now.

For some reason I seem to be experiencing different "states". I don't know what they are or what they're related to (and I should probably tell my counselor) but sometimes I feel safe and secure and then something happens or triggers me into being scared. A lot of people I've seen think I have trauma-related issues but there was one doctor that thought I had schizophrenia/schizoeffective. Lately though I've seen that anxiety is the culprit behind these states and it's affecting me daily. I've lost my ability to focus and concentrate. Before I used to feel somewhat at ease and now I'm fearful of every little thing (I was also diagnosed with PTSD in 2008). When I feel good, like now, the anxiety comes that there's the possibility it will end and this transforms my level of consciousness.

For instance, if I go to sleep now the unpredictability of what will happen to me mentally worries me. Is this just anxiety or a form of some overlooked psychosis? (I get irrational phobias, feel like I'm compelled to do things, feel like I'm being controlled by higher forces etc.)

Also I had a delusion of some sort (like watching a movie) which I believe was an attempt to create a false memory. I explained this to my family (because it was a frightening delusion) but they didn't seem concerned or affected.

[spiritual_emergency]

Hello idied,

I have some information that may be helpful.

I was taken off my anti-psychotic medicine for nearly 5 days and I started getting more and more fearful afterwards.

As I understand it, if an individual is coming off psychiatric medication, they should do so slowly. This fellow explains the process well...

This biological mechanism is somewhat well understood now. The antipsychotics profoundly block dopamine receptors. They block 70-90 percent of the dopamine receptors in the brain. In return, the brain sprouts about 50 percent extra dopamine receptors. It tries to become extra sensitive.

So in essence you've created an imbalance in the dopamine system in the brain. It's almost like, on one hand, you've got the accelerator down -- that's the extra dopamine receptors. And the drug is the brake trying to block this. But if you release that brake, if you abruptly go off the drugs, you now do have a dopamine system that's overactive. You have too many dopamine receptors. And what happens? People that go abruptly off of the drug, do tend to have severe relapses.

Source: Interview With Robert Whitaker

Many people take themselves off medication but many psychiatrists also have a "preferred blend" and will take a person off medication abruptly so they can start on that particular cocktail. This practice of abrupt withdrawal is part of what has contributed to people believing that their "experience" or "illness" is chronic when it may well be caused by the med switch-up or reduction. The rule of thumb should always be to titrate slowly except in situations where your life is at risk (i.e., neuroleptic malignant syndrome).

I know myself that I am instigating the images but I feel like I can't control my mind.

Perhaps it would be helpful for you to learn some skills that could help you learn to turn your thoughts in a different direction. Just because something is pulling us in a particular direction doesn't mean we have to go down that path.

... sometimes I feel safe and secure and then something happens or triggers me into being scared. A lot of people I've seen think I have trauma-related issues but there was one doctor that thought I had schizophrenia/schizoeffective. Lately though I've seen that anxiety is the culprit behind these states and it's affecting me daily.

There is a connection between stress (this includes trauma) and psychotic episodes; psychosis itself can be quite traumatic. The fact that you can identify triggering events suggests to me that you are having a trauma response but I'm not a professional and might not know what I'm taking about. Have you sought or did you receive any form of talk therapy to help you deal with the trauma you experienced?

I've lost my ability to focus and concentrate.

Two possible culprits may be:

- What's happening in your life. Perhaps there is something going on in your immediate environment that is triggerering anxiety/flashbacks, or

- Medication can also produce an inability to focus, concentrate or retain clarity.

Talk therapy might help you to better understand and cope with what's happening in your environment or perspective and a med reduction or med change might help you with your mental clarity. A spiritual practice such as mindfulness might also be helpful for restoring focus. It may be that it's there but you simply need to "flex that muscle" more to strengthen it.

~ Namaste