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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 38. This is the beginning of the thread.
Posted by porkpiehat on June 27, 2016, at 17:27:33
I've been having incidences of almost psychadelic (not hallucinatory just trippy in feeling)feeling that I'm losing control/going crazy and nonsensical thinking lately.
I've always had night terrors that were very similar but abate within a few minutes after waking. Lately this feeling of being extinguished/slipping out of my body/going insane will continue for an hour or more after I wake up and as soon as I drift back into sleep it recurs immediately, along with an electric feeling on the left side of my brain and body.
Lately this feeling has intruded into waking hours. I don't know how to quantify this feeling that "I'm losing control/my mind/reality" and "his face looks funny I almost don't understand it." But it seems to respond pretty quickly to even low doses of klonopin.
I'm somewhere on the spectrum of BPII/PTSD/Borderline with notable depressive and anxiety symptoms. I stopped Celexa in feb/March after 15 years. I'm still on Lamictal 150mgs and klonopin .5mgs.
I might just go to the emergency room the next time it happens rather than wait weeks for another doctor to shrug their shoulders at me.
please please PLEASE tell me this is a panic attack and not some kind of psychosis. I'm 44 and I don't think I've really ever had either yet.
Posted by SLS on June 27, 2016, at 17:44:31
In reply to developing psychosis or panic attacks?, posted by porkpiehat on June 27, 2016, at 17:27:33
Depersonalization and/or derealization are worth considering as sources of your experiences. These things often occur when anhedonia and anxiety are both present. This can be interpreted by the sufferer that they are becoming psychotic.
I guess you could petition your doctor to combine a benzodiazepine like Klonopin with Nardil.
What are the symptoms that indicate to you that you might be experiencing panic attacks?
- Scott
Posted by baseball55 on June 27, 2016, at 18:14:05
In reply to Re: developing psychosis or panic attacks? » porkpiehat, posted by SLS on June 27, 2016, at 17:44:31
Feeling like you're going crazy is usually caused by anxiety. People with genuine psychosis usually believe their delusions and do not think they are going crazy. I would talk to your therapist about this (if you have one - if you don't maybe you should get one). Therapists are generally very good at helping people learn to ground themselves when suffering anxiety attacks and derealization, especially if they have some CBT training. Also, the fact that klonopin helps suggests that anxiety is the issue. Maybe, since these feelings don't last that long, a shorter-acting benzo would be appropriate - I have used xanax very successfully for anxiety attacks.
> Depersonalization and/or derealization are worth considering as sources of your experiences. These things often occur when anhedonia and anxiety are both present. This can be interpreted by the sufferer that they are becoming psychotic.
>
> I guess you could petition your doctor to combine a benzodiazepine like Klonopin with Nardil.
>
> What are the symptoms that indicate to you that you might be experiencing panic attacks?
>
>
> - Scott
>
>
Posted by Phillipa on June 27, 2016, at 18:35:18
In reply to Re: developing psychosis or panic attacks?, posted by baseball55 on June 27, 2016, at 18:14:05
I agree with baseball. Phillipa
Posted by jonhed on June 27, 2016, at 18:46:15
In reply to developing psychosis or panic attacks?, posted by porkpiehat on June 27, 2016, at 17:27:33
There is a rule htat took me 1000 years to get:
If you think your having a psychosis, you don't have it.
But that doesn't make your symptoms less worse.
Depersonalization is common during panic attacks though, but be cool, they are not psychosis and can be treated :-)I don't agree with the xanax idea ( you got to get to have different opinions), i thinks you hae a extremely low dose klonopin, that dose is indicated for children under 6.
I think you should try 2-4mg for 10 days, before you try xanax.
Cause after one month of taking 2mg of klonopin, you have 3.5 mg clonazepam in your body.
And 4mg for one month you have 7mg in your body.That should help you in the long term, i hope and think so.
Posted by jonhed on June 27, 2016, at 18:53:00
In reply to Re: developing psychosis or panic attacks?, posted by jonhed on June 27, 2016, at 18:46:15
My psychiatrist is a professor in psychiatry and say that for depersonalization/derealization, klonopin in high doses are the only thing that doesn't make the perceptual dissociative changes worse.
Xanax definitively is better for anxiety, but it's two different things.Xanax can make you perception worse, and with you symptoms that can exaggerate your panic attacks.
It did for me.And be very careful with antipsychotics if you have depersonalization/derealization,
It can be very very very much worse and it's proven and it's a lot of abstract on it.
Posted by jonhed on June 27, 2016, at 18:55:22
In reply to Re: developing psychosis or panic attacks?, posted by baseball55 on June 27, 2016, at 18:14:05
And yes, CBT is the gold standard. It as been for me anyway, but it's a long way to go and it doesn't go away in 10 sessions. make it 100. but it can be worth it.
But for me it hasn't gotten away, but it does not cause panic attacks anymore!
Consider cbt
Posted by Horse on June 28, 2016, at 14:16:13
In reply to developing psychosis or panic attacks?, posted by porkpiehat on June 27, 2016, at 17:27:33
I agree that it's panic and panic induced derealization. I don't know why this happens so strongly at night, unless your anxiety levels are very high. Do you have a sleep disorder like sleep apnea?
> I've been having incidences of almost psychadelic (not hallucinatory just trippy in feeling)feeling that I'm losing control/going crazy and nonsensical thinking lately.
>
> I've always had night terrors that were very similar but abate within a few minutes after waking. Lately this feeling of being extinguished/slipping out of my body/going insane will continue for an hour or more after I wake up and as soon as I drift back into sleep it recurs immediately, along with an electric feeling on the left side of my brain and body.
>
> Lately this feeling has intruded into waking hours. I don't know how to quantify this feeling that "I'm losing control/my mind/reality" and "his face looks funny I almost don't understand it." But it seems to respond pretty quickly to even low doses of klonopin.
>
> I'm somewhere on the spectrum of BPII/PTSD/Borderline with notable depressive and anxiety symptoms. I stopped Celexa in feb/March after 15 years. I'm still on Lamictal 150mgs and klonopin .5mgs.
>
> I might just go to the emergency room the next time it happens rather than wait weeks for another doctor to shrug their shoulders at me.
>
> please please PLEASE tell me this is a panic attack and not some kind of psychosis. I'm 44 and I don't think I've really ever had either yet.
Posted by Lamdage22 on June 28, 2016, at 15:16:09
In reply to Re: developing psychosis or panic attacks?, posted by baseball55 on June 27, 2016, at 18:14:05
What is "thinking to go crazy" if not psychosis?
I always have insight into the delusions.
Paranoid thinking? Pre-psychotic?
Posted by porkpiehat on June 28, 2016, at 15:40:51
In reply to Re: developing psychosis or panic attacks? » porkpiehat, posted by SLS on June 27, 2016, at 17:44:31
The anhedonia is an interesting observation and actually right on the money.
I don't want to take more klonopin I honestly think it contributes to the depression. One of the first "you should kill yourself" obsessive loops started shortly after starting klonopin.
I'm on a trial of SAMe again. Day two and I feel an uptick in mood, less social anxiety, more energy. Hopefully it's not a hypomania ramping up.
I went with "panic attack" because I googled "wake up feeling crazy" after waking up that was suggested. The symptoms match, however, I always assumed the would come after a build of of cognitive anxiety, which I didn't have (or I am just acclimated to it)
> Depersonalization and/or derealization are worth considering as sources of your experiences. These things often occur when anhedonia and anxiety are both present. This can be interpreted by the sufferer that they are becoming psychotic.
>
> I guess you could petition your doctor to combine a benzodiazepine like Klonopin with Nardil.
>
> What are the symptoms that indicate to you that you might be experiencing panic attacks?
>
>
> - Scott
>
>
Posted by jonhed on June 28, 2016, at 16:00:51
In reply to Re: developing psychosis or panic attacks? » porkpiehat, posted by Horse on June 28, 2016, at 14:16:13
Haha! Sorry for laughing.
I've had this debate with my psychologist that have had contact with me for 3 years straight and over 250 sessions, i always sais "something most be wrong, i dissociate when i fall asleep and so on, same thing for 3 years. I laugh because i took it up today again, and we laughed about it a little.
She says "you can't patologize everything, you do it all the time. maybe your under a lot of stress, maby something else, but dissociation it is NOT".
You know, from what i know, dissociation comes from something your mind does as a defense mechanism against trauatic experience. and if you have had contact with the psychiatric ward, they see directley if you dissociate, because that happens when you don't know it and during the day to.
It can be so many things, my guess is stress.
Sorry to say it.
Often it isn't that bad that you think..
I hate when people say that but, you get me..
Posted by baseball55 on June 28, 2016, at 19:52:15
In reply to Re: developing psychosis or panic attacks?, posted by jonhed on June 28, 2016, at 16:00:51
Thank you for clarifying about klonopin vs. xanax. Obviously, your psychiatrist knows a lot more than I do! I should stop trying to practice medicine without a license!
Posted by SLS on June 29, 2016, at 8:13:17
In reply to Re: developing psychosis or panic attacks?, posted by jonhed on June 27, 2016, at 18:53:00
> My psychiatrist is a professor in psychiatry and say that for depersonalization/derealization, klonopin in high doses are the only thing that doesn't make the perceptual dissociative changes worse.
> Xanax definitively is better for anxiety, but it's two different things.
>
> Xanax can make you perception worse, and with you symptoms that can exaggerate your panic attacks.
> It did for me.
>
> And be very careful with antipsychotics if you have depersonalization/derealization,
> It can be very very very much worse and it's proven and it's a lot of abstract on it.Interesting stuff.
If Klonopin exacerbates or causes depression, I wonder if Valium (diazepam) would be useful - perhaps in combination with a drug like Trileptal (oxcarbazepin) to substitute for the mood-stabilizing properties of Klonopin (clonazepam).
I imagine this idea is misguided. I know a few people who have dissociative symptoms that presumably resulted from the childhood abuse they suffered. One person in particular is doing very well. I'll see if I can ask her what type of treatments she undergoes to mitigate the dissociation. I know that psychotherapy has been a mainstay of her treatment plan.
- Scott
Posted by jonhed on June 29, 2016, at 11:52:13
In reply to Re: developing psychosis or panic attacks? » jonhed, posted by baseball55 on June 28, 2016, at 19:52:15
No don't take it like that. The things i write is just from my own experiences :-)
The valium suggestion can be a good idea to if you're not an addict!
Posted by jonhed on June 29, 2016, at 12:02:20
In reply to Re: developing psychosis or panic attacks?, posted by SLS on June 29, 2016, at 8:13:17
With perceptual i mean sight (the eyes). My english isn't the best it could be cause i'm from sweden.
I do not mean that klonopin is the only thing that works, but many other medications can make the feeling that "layers" is gone on objects. Like the world seems dead and with no life and the colors is flat or metallic.
I don't mean this in a philosophical way, but in a strictly "seeing" way.
Do you understand?Like my HPPD, which is a sort of dissociative disorder, becomes dramatically worse with antipsychotics and xanax + z-drug (therefore i'm tapering them now and it is not easy after 3 years of 15-22,5 mg zopiclone per day).
But please understand me right, and not as a all knowing besserwisser, i strictly mean the sight of the world. with the eye. i can't explain more.
Sometimes my feet looks like they're not made of flesh, like they are painted, and if i take risperdal then it become worse.
That is a lot of abstract about it actually, but i think i was sloppy in my description cause of my english.. I mean mostly HPPD symptoms.
Sorry.
I also have friends (including me) who has been abused, and then klonopin is not a wonderdrug :-)
CBT is though, for me!
Posted by porkpiehat on June 29, 2016, at 14:13:22
In reply to Re: developing psychosis or panic attacks?, posted by SLS on June 29, 2016, at 8:13:17
Avoid AAP's if you're having depersonalization symptoms? that's interesting because my worst bouts of it have been after or during trials of AAP's.
Scott you and I have had discussion about whether knowing an exact diagnosis is important in treating. Here's a good example! I am hovering between BPII and complex trauma systems. The AP's are indicated for the BPII, but if it's complex trauma then the AP's are going to worsen the depersonalization symptoms of trauma.
Interesting if this is true about the AP's, seeing as to me the depersonalization is the closest thing to "insanity" that I've probably ever felt, making me want to gobble seroquel by the handful
Posted by jonhed on June 29, 2016, at 15:24:56
In reply to Re: developing psychosis or panic attacks? » SLS, posted by porkpiehat on June 29, 2016, at 14:13:22
exactly, there's where i think some pdocs are sloppy.
Cause if you also have experienced worsening of DP symptoms when on APs, then i don't think it's just a coincidence.And if you read my post that i wrote some days ago, that i wanted to start an anti-psychotic again but can't because it's getting worse, then you feel the exact same thing as me.
My brain i telling me, "man, your getting totally insane and zyprexa has helped you in psychosis, you got to get some." But if i do, i escalate my DP symptoms 10 fold.
It's very tricky and i'm so freaking happy that my professor knows this to. She's very competent.
Posted by SLS on June 29, 2016, at 15:42:23
In reply to Re: developing psychosis or panic attacks?, posted by jonhed on June 29, 2016, at 15:24:56
I don't know if it would be helpful in your situation, but Trileptal (oxcarbazepine) can be effective in borderline personality disorder. Is there any overlap between BPD and DPD?
- Scott
Posted by jonhed on June 29, 2016, at 15:57:54
In reply to Re: developing psychosis or panic attacks? » jonhed, posted by SLS on June 29, 2016, at 15:42:23
Are you talking to me? I feel confused..
You could think that but no, there no overlap at all.
I'm very educated about my diagnose and have been worried about borderline a lot, and my psychologist says there is no indication AT ALL or some overlap between them.They can look alike, but there are a massive difference in why we act in certain ways.
I've been on lamotrigine, oxcarbamazepine, valrpoat, gabapentin and that stuff and no.
But thanks for the recommendation.
The overlap with DPD is Obsessive and Fobic.
Borderline is in a hole nother cluster so they can't overlap if you know what i mean.
That would go against icd and dsm.
If you have borderline, you have to rule out dependent and vice versa..
Posted by jonhed on June 29, 2016, at 16:18:11
In reply to Re: developing psychosis or panic attacks?, posted by jonhed on June 29, 2016, at 15:57:54
DPD persons can be clingy but not in the same way.
DPD are clingy, but don't want to be seen in a room and if they feel they get rejected from a partner, they get more and more submissive, as the borderline put up more and more demands to have the same partner around.
DPD looks for a new person to lean on directly after breakup (can be friends or whatever), because they feel like they can't do anything by themself. Even choosing what to wear to the store is hard and i want some one else to say what to wear, even if i don't really like it, because i just want to be taken care of.
As the BPD get angry and semi psychotic if the partner or friend say they don't like their clothes, and then accompanied with extreme anxiety and self hurt often.
Just small examples.
You see the BIG difference?If not, take my word on it, they can't in some way overlap. It's impossible.
I can explain more later, now i have to sleep ( its 11.10 am/pm night anyway in sweden, and i work tomorrow.)
Please don't argue about that it could overlap, so many people think i'm borderline til they get to know me and i get so frustrated and humiliated that people don't believe me at first.
But after two weeks with my psychilogist, she said "i've ruled out BPD forever. Never think about again." and now it has been over three years.
One more thing.
I'm very big at explaining things forever because i don't want no misunderstanding, i can't take that cause it gets me so anxious that i sometimes hurt myself cause i don't have words when people don't believe me. I can't take that a person don't like me, and that makes my kife very hard. I always do everything everyone says to me to do cause of this.I'm so called "self defeating"
That doesn't mean that i want people to agree with me, but just when it comes to borderline and DPD, it's a very weak spot cause it manifests itself alike for someone who don't know the reason why i act in a certain way.
Medicines though, i love when people challenge my thoughts :-)
Posted by porkpiehat on June 29, 2016, at 18:15:46
In reply to Re: developing psychosis or panic attacks?, posted by jonhed on June 29, 2016, at 16:18:11
I came up with my own BPD Dx on my own. Other people don't exist outside of my insecurities; rage that precipitates around situations of abandoment; most jobs and relationships failed. etc etc.
Every time I read the description it hits me like a ton of bricks and I'm inconsolable for a solid week.
the doctors/therapists have been off so many times that I find it hard to trust them.
Anyway I had a bad acid trip once where everything I looked at had a fearful and somewhat menacing connotation to it. That's kind of what these attacks felt like. That's why I worried about psychosis. Grandmother was schizophrenic and father is BP.
Posted by baseball55 on June 29, 2016, at 20:20:01
In reply to Re: developing psychosis or panic attacks?, posted by porkpiehat on June 29, 2016, at 18:15:46
I identify with what Jonhed (sp?) said about things seeming ugly and strange. I have had that happen a lot when I've experienced derealization. For me, though, AAP's helped almost immediately -risperdal in particular.
Posted by porkpiehat on June 29, 2016, at 23:01:59
In reply to Re: developing psychosis or panic attacks?, posted by baseball55 on June 29, 2016, at 20:20:01
Wow I had the exact opposite reaction to risperdal years ago. It helped me feel remarkably self-possessed until the depers/dereal stuff happened and I started feeling like my family weren't real people and other strange affects and violent impulses. I took too much ketamine once in my party boy days and it was similar.
Then the akasthesia and serious anxiety kicked in. My doc said "take more" and I said "you're fired"
I am new to this whole notion of dissociation/derealization/depersonalization and only fell upon it the middle of the night, needing to know why I was falling out of my body. Luckily it doesn't happen much during the day but now it's nearly every night.
What were they treating with the risperdal?
Posted by jonhed on June 30, 2016, at 13:40:10
In reply to Re: developing psychosis or panic attacks? » baseball55, posted by porkpiehat on June 29, 2016, at 23:01:59
Can it be that you have the same thing as me?
I have HPPD and Flashbacks from lsd, psilocybine and mostly dmt and salvia.It sounds like it.
I was on a lot of dextromethorphan when i was young and ketamine as well.
cause i have the same reaction to you when it comes to risperdal so, consider it?
Posted by jonhed on June 30, 2016, at 13:44:10
In reply to Re: developing psychosis or panic attacks?, posted by baseball55 on June 29, 2016, at 20:20:01
HPPD is chronic and it's the thing that causes derealization and DP for me anyway.
I think it can be different if it comes from other things maybe?
Or have you DP and that sort of things from psychedelics to?
I don't say that risperdal doesn't work for dp and dr, but not when it comes to HPPD, even as it is the same thing and DP is a symptom from HPPD.
The brain is complex, that's all i know!
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