fandomsecrets | [ SECRET POST #3021 ]

[ SECRET POST #3021 ]

⌈ Secret Post #3021 ⌋

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So, I'm kind of in a bind. I have periodic psychotic episodes. They're not typical in the fact they are due to a neurological condition, and they're pretty fleeting. Otherwise, I have a very stable baseline that does not include any elements of my psychotic episodes.

But they still do impact the quality of my life because I do start going into social and personal isolation, I get extremely agitated, or irritated over trivial things, and I'm paranoid 24/7 until it passes.

I have a hard time figuring out when to tell myself, "Look dude, your fears are probably not justified." I lack self insight during these times, and I especially lack the ability to reach out to others when I have some amount of insight.

Does anybody have any advice for me? About how I can personally manage these so that it doesn't fuck with my life so bad? I plan on mentioning it to a doctor type person soonish, but I need to deal with it rn.

(I mean, this was the first day in over a year where it was sunny, in the 60s, but fuck if I was going to go outside alone because they were gonna get me. I really wanted to enjoy the sun but heeeeey paranoia.)

Ah, paranoia my old friend. /sarcasm

Honestly, I don't know if what I do would help but...generally I try to look at what I'm afraid of logically when the paranoia is hitting hard. Like..."I'd really like to go out to into the sun...and really. How logical would it be for them to snatch me in broad daylight where others can see me?"

It doesn't always work, but it does help sometimes. Otherwise it's usually stopping me from something I need to do and I just kind of...whimper and do it because I don't have much choice if I don't want a guarantee of bad things happening later*

*Ex. missing a test

Something that helps me when I get paranoid as part of my mental illness is to have a friend literally walk me through stepping out the door. I'll call them and say "Hey, I'm paranoid and I know THEY will see me" (for me, it's nothing specific ever, just that bad things will happen if other people see me). Then my friend will say "Okay, well let's take two steps out your door. You don't even have to shut the door behind you. Just take two steps." I take two steps and they encourage me to take two more.

Rinse and repeat. I've also used instant messenger and chat on my phone to do this, as some of my online friends are more familiar with this sort of thing than others.

Sometimes I make it as far as the car and bolt back inside. But sometimes I manage to make it out and eventually relax. Even if I go back inside, I know I at least tried.

My sympathies - this shit really has a way of fucking with a person.

If you don't mind, could you disclose what your neurological condition is and how often you get the episodes?

OP here.

I have epilepsy, mostly complex partial seizures with a few possible generalized. I have paranoid delusions running up to episodes of increased seizures. Usually after I've had a few seizures, I'll start having hallucinations.

The paranoia happens once or twice every couple of months, usually persists for about a week. The hallucinations really only happen when I've been having more and more seizures, but also feeds into the paranoia.

To note: I'm on anti-epileptics, which can completely stop any psychosis, because it stops the mechanisms in my brain that start seizures, which is what causes the psychosis. Sometimes it's only effective in stopping the bad seizures, though, so some of the more "mild" seizure effects are the psychosis.

Not sure if or how this changes my psychosis, or differentiates it from other psychotic disorders.

DA

Dude, you need to have a chat with your GP and/or neurologist. The meds could be making you paranoid/psychotic, too.

OP

Fuuuuuuuuuuuck I hadn't though of that. 8<

Currently I'm in the "suspect everyone" stage, so it'll take me a while to be able to make an appointment, but I'll write it down to ask about when I can.

fml. Fuck all of it.

Also, after a quick google it looks like my meds may indeed have a psychotropic effect. This is so ridiculous I am going to laugh and cry.

AYRT

Make the appointment. Tell the suspicion to shove it, you've got more important things to do. Seriously. If your meds are impacting your functioning to this degree, and it's a known side effect, you absolutely have to let the medical professionals overseeing your care know. Just do it, anon.

OP

I will try. For reasons I explained down thread, I am uncomfortable mentioning the paranoia right now to doctors. I'm newly diagnosed, and I've already been given the brush off once before due mostly to my own representation, and I don't want to compromise what progress I have made. I mean fuck, I was seizure free for the first time in two years last month. That was pretty big for me.

If absolutely nothing else, I will at the very least call my neurologist's office and ask if I have cause to be concerned.

Check with your GP/family doctor first. Mention the side effects to them, explain the drugs are working well otherwise. Ask him/her for a referral to another specialist, if you feel the neuro you're seeing can't/won't help you.

ayrt

I would recommend that you to see your neurologist about this as soon as possible. That's too often for it to be a small deal. If fact, psychosis from epilepsy can be similar to symptoms of paranoid schizophrenia so it definitely warrants a trip to the neurologist.
You may want to take antipsychotic medication, but beware because some may make your seizures worse - which is why you need to talk to a qualified professional about this stuff!

Good luck anon!

*also, I read above. If it is your meds giving you the psychotic effects, it would be much better trying different medication for your epilepsy rather than starting antipsychotics.

The only thing I can recommend against paranoia (which, y'know, enabled the human race to escape being eaten for millennia in order to survive long enough to procreate, so) is cut out caffeine and any OTC meds you may be taking? Especially now that hay fever season is a blight upon the earth. There's a lot of OTC/off-the-shelf stuff that can make you hella paranoid, if you've got even slight tendencies towards it already. Caffeine, too, replace it with hot water or decaf/herbal teas (also look for chamomile tea, supposed to be anti-anxiety), at least when you're in a paranoid state. Drink lots of this, stay well-hydrated, hot water, hot tea, decaf everything (except coffee, whatever the do to decaffeinate coffee can make you anxious, too). Eat regular meals and try to stick to a strict schedule for eating and sleep. Best of luck, anon!

OP here

Thanks very much for the advice, although I am going through a litany of "fuck fuck fuck fuck", because haha yes I am taking like off brand Claratin, because it's the only antihistamine I can take where it doesn't potentiate my anti-epileptics and further depress my CNS. But apparently even that is too much for my wooby little system. What a fucker. If I could kick my CNS's ass without killing myself, I would.

Because yes, of course you are right. Some of the worst paranoid episodes and hallucinations happened when I wasn't on meds for my seizures, and was taking benadryl, which is diphenhydramine, which for anyone prone to seizure will mess you the fuck up.

Also yeah, I've been having way too much caffeine, which I will majorly scale back on, too. Although I heard tea has some magical properties that makes sure you don't get the jitters along with your caffeine, so I may switch to black tea.

Also the eating thing is probably a thing, also the sleeping thing. The sleeping thing I can't do much about because it's a facet of my seizure disorder, but the eating thing I can control.

Thank you anon!

AYRT

You're very welcome! I only get mega-paranoid when I fly, because the combination of jet lag and the industrial-strength decongestants I have to take, have me basically climbing the walls inside my own head. (Yeeeeah I don't travel well, so I don't travel if I can at all help it.) When it's full-on, I try to remind myself that, "Hey, Anon, this is a vestigial thing your brain is doing here, and the bonus to this is you have not been mugged or roofied or anything else sketchy at ~~Hellmouth~~ Heathrow yet, so it has its advantages." Do try and kick the antihistamines, dude! Gargling with saltwater, and using saline mist nasal spray helps during the height of allergy season.

Caffeine. Black tea has about 1/2 the caffeine of medium roast coffee, and dark roast coffee (as dark roast as you can stand) has the least amount. So, espresso shots also have the least amount of coffee. That's what I switch to, whenever I need to cut back. Chamomile tea is good for sedative/anxiety, though not at, like, medicinal levels, even if you brew it really strong. But hydration. Hydration helps everything. Can't stress this enough.

As for sleeping/eating...sleep hygiene is a thing (says the anon who is definitely not practicing good sleep hygiene right now I should have been screens off an hour and a half ago :P), and it's a thing that enables me, a lifelong chronic insomniac, to function like a mostly normal person in the 9-to-5 world. Try looking into that, it's rough to get sorted out at first, but well worth the effort after a month. Basically, you cut off caffeine and all light three hours before bedtime, stick to a strict bed TIME, i.e., go to bed at exactly the same time, and get up at exactly the same time, whether you sleep or not. (NGL here, the first 48 hours are gonna suck.) All electronics/light sources off at least two hours before bedtime.

ALSO. I am the anon above reccing you to discuss this stuff with your doctor and/or your specialist. They can help, too, or should be able to. That should be your first action, above all else.

Best of luck!

Re: Coffee and hydration: In addition to the anxiety, Coffee is a diuretic, so it can make you pee before you should, so that can have a demineralizing effect on you, and mineral imbalances in the brain are their own fun brand of problems, so there is one reason to try and diminish it during these periods.

And yes, water! Drink water. Sometimes getting your water from beverages and soups doesn't cut it.

Seconding quirkytizzy's advice above; I was going to suggest that you get a friend who understands your difficulties to either accompany you or literally walk you through it.

I can appreciate that finding a trusted friend when you're going through all this is tough, so maybe think about setting that sort of support system in place while you're not suffering an episode so you know you have that safety net in future. That way there won't be that huge amount of pressure to reach out when you're at your lowest, which I empathize is very difficult.

If you're still having trouble reaching out, then you might want to create your own set of mantras or reassurances when you're not feeling this bad. Record yourself telling yourself it's okay, to take one step, then another. Write instructions to yourself, reminding yourself that this is an episode, and it will pass. Having something tangible to focus on helps sometimes. So do any comfort items that can help ground you. Basically, build a toolkit for yourself while you're not having an episode that you can dip into when you are.

My (non-psychotic) mental health issues involve a lot of paranoia and, like you, the total lack of self-insight and self-judgement when these epsiodes are hitting hardest. To me, my reactions and fears seem completely realistic and possible, however unlikely they truly are, and even "unlikely" isn't reassuring enough sometimes when I can't even tolerate a 0.003% chance of something happening. Having someone else who's aware of what's going on with you helps a lot at times like that, because you can base your response off theirs (e.g. "this person isn't worried right now, so chances are there's nothing to worry about").

Challenging your thoughts can also be helpful. Rate how likely or logical something is on a scale (1-10, 1-100, A-F, whatever you're comfortable with) and reassess it as you go along. Sometimes it'll go up, and sometimes it'll go down, but the fact that you can see it fluctuating helps remind you that it's reacting to you and your frame of mind, and not anything external.

Look after yourself. -hugs-

OP

As currently I wouldn't trust a single person to help me or see me like this, I'll take it under advisement, but I'm not sure if it's something my situation is capable of supporting, or something I am capable of setting up. Like, I'd sooner walk around a city totally paranoid and fucked up sooner than I would ask someone to help, because 3/4 of my paranoia is not trusting people. Even for something innocuous. Even people whom I'm intimately familiar with.

Like, my paranoia is specifically thinking people are watching or observing me for Purposes. What those Purposes are are not yet clear, but if I get away fast enough, and don't stay in one place long enough, they won't catch on. Even my friends and family can inadvertantly let slip information to people who have these Purposes. So I am very non-interactive during these episodes, and try my best to seem... normal? Even though in retrospect I absolutely seem a fucking crazypants.

But I think the physical toolkit, or other grounding mechanisms would be very helpful. At least in helping me not feel fearful, not sure in dispelling the paranoia. Though that ha had limited success in the past, after having some very vivid hallucinations I went to go snuggle a cat because I was so terrified I was crying, but I just had a purring cat and was still afraid.

And yeah, the reassessing has been helpful so far in identifying the paranoia, And it has helped me identify when I'm having paranoid thoughts, so that has helped, so I'll keep that in my back pocket.

Honestly? I'd talk to a neurologist about what kind of medications you can include in your toolkit for times like these. There are a great number of very effective antipsychotic medications out there, and chances are one of them will be of aid.

Until then cut out caffeine and chocolate and other stimulants entirely.

OP

I think I am going to have to work up to this. I'd been having paranoia with my seizures for like 2 years before I actually sought qualified medical help. This was only after I had been hospitalized once, and it still took me a year past that point to like go get it handled.

I'm newly diagnosed (dec 2014), even though I've been having seizures for 2 years. Part of this reason was my paranoia interfering with me seeking medical help because then They Would Know. And I really don't want to spook a neurologist into saying, "Whoops, nope, you're just crazy," and yank my anti-epileptics.

Logically, would they do this? Probably not. The seizures have improved drastically since I've been taking meds. The paranoia has been very well behaved, unless there are a lot of precipitating factors that override my meds' efficacy.

Do I have some inkling of justification? Yes. The first time I sought help, the neuro said basically to eat and sleep better, and ran me through a few tests and left me to my own devices. But this was only because I hadn't told him my whole history, bc paranoia.

Wow I am a fucking wreck.

BUT all this aside, I will... try. Try really really hard to make sure to get it mentioned. When I am not quite so paranoid.

If you take any of my advice, cut out the caffeine immediately. Even tea. If you're experiencing paranoia related to ictal activity, chances are that the reason you experience the paranoia is that you are actually having a what can loosely be termed a low-grade seizure. What happens is that stimulants (including caffeine) indirectly increase the amount of glutamate available at synapses, thereby worsening epilepsy symptoms (in many cases).

For patients with MTLE, for example, that low-grade ictal activity can manifest as auras, gastrointestinal distress, sudden sexual arousal... that sort of thing. You haven't mentioned what type of epilepsy you have, but chances are the manifestation of paranoid episodes is your brain telling you that you have an overabundance of excitatory activity happening.

I realize it can be difficult and trying to explain these things to a neurologist, especially when you have very real fears of being taken seriously, but I promise you if you describe your symptoms as you have just described them to me, no neurologist worth her/his salt will tell you you're crazy.

I hope you feel better, OP. I really do. I can't imagine how hard this is to deal with on top of a chronic medical condition.

Best of luck.

OP

Thanks very much for all this info. I'll definitely cut back on the caffeine, and if I can I'll drop it entirely. Given that I've been going through the agitated/restless/insomnia stage I think I can be alert without caffeine.

I'm not sure exactly what type of epilepsy I have either? Other than they've labelled it as catamenial, but since I have a very irregular cycle, it's hard to tell what is aggravating what at what time.

Some time over the next few days I'll call my neuro's office and see what they have to say.

(As for feeling better, I do right now, but that's because I fucked up and self medicated with some alcohol, so now I feel like I'm on a rolling ship, but I am too fucked up to be paranoid. I'm kind of sensitive to CNS depressants, so that was a stupid move.)

Mention it anyway, even though you're paranoid. Suck it up and do it, dude, ASAP. Any good neuro won't yank your meds, trust me (They literally cannot do that to someone with diagnosed epilepsy--assuming you had the EEG? Yeah, no one's going to tell you you're crazy.), and any good neuro will absolutely have the toolkit and familiarity with the drugs/the side effects to be able to suggest alternatives.

If you're worried the neuro you're seeing now is a bit sketch, ask your GP for a referral to a different specialist, and explain why. (Diet and sleep as contributing factors to seizures? Yeah, no.) Your GP should be able to offer some advice on dealing with the meds/side effects as well.

OP

I've had 2 EEGs; both have come back normal, but this may be due to the fact that I pretty much only have seizure activity around certain periods of my menstrual cycle. But hopefully they would still reconsider yanking my meds because they've been so effective so far (leaving aside the paranoia).

I have been thinking about a different neuro, who is a good deal closer and was recommended to me by a friend who also has epilepsy. I'll keep it under consideration if I feel like I'm not getting anywhere with my current set up.

I think I just have to fucking not listen to my paranoia and get a hold of my neuro. So far everyone has been fantastic once I stopped withholding information, so I can only imagine this to be a continuing trend.

AYRT

Yes, your last paragraph is correct, pay attention to/take care of yourself, OP. And very best of luck!

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[ SECRET POST #3021 ]

Advice for psychotic episodes?

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