Avatar Posted by freakazoid 116 days ago (Question)
A few months ago, on top of general stress I had a specific worry/ anxiety which I couldn't stop thinking about. I saw my GP who said I had anxiety and gave me sleeping pills as I told him I couldn't get to sleep because of the worry. He booked me in to see him the following week. When I saw him next, my anxiety had got worse and was coupled with some paranoid thoughts which were a lot less rational than the original anxiety. He seemed to panic and referred me to this "crisis" team, who came and saw me at home the next day.

They gave me some anti-psychotics as they thought I was having an acute psychotic episode. I agreed a low dose with them as I was concerned about the side effects. Over the following week and a half I was off work as I couldn't think of anything other than my paranoid worries, but once the source of the initial anxiety was removed, my symptoms went away as quickly as they came on. I went back to work as normal and the "crisis" team discharged me.

I'm seeing a psychiatrist next month who specialises in psychosis. However, after reading about what the crisis psychiatric nurses said they thought I had, I disagree and believe I had severe anxiety coupled with paranoia. My basis for this is:

- I was very anxious and had other physical symptoms of anxiety, e.g. not being able to sleep, palpitations, constipation/diarrhea, weight loss through not eating properly, muscle spasms, pins and needles sensations, etc
- I did not experience hallucinations of any kind
- I did not have disorganised thoughts or speech
- I did not do anything "mad" or "crazy"
- My paranoid thoughts always had an element of doubt, e.g. at one point I had paranoia over the nurses being spies for a criminal gang, but it was not strong enough for me to refuse them to come into my house and see me, whereas if it was a fixed deluded belief, I would have been too afraid of them seeing me
- My symptoms quickly went away once the source of the anxiety had resolved and I returned to fully functioning and "normal" without having paranoid thoughts pre-occupying me

Additionally I have no personal or family history of any kind of mental illness, have never taken drugs, and don't drink much. I am generally quite a worrier.

Here is a summary of my paranoid thoughts:
I bought a car, it still had outstanding finance on it so I was worrying about that. It didn't have the documentation with it when I bought it so I had to wait for it to come through. So it went.......

- what if the car is stolen? I started looking on the internet at scare stories of people buying cars without the documentation present, and how they're often stolen.
- what if I get done for stealing the car?
- was my receipt sufficient proof? Hand written so anyone could do it?
- what if the dealer who sold it had set me up?
- what if the police are waiting outside to knock my door down and arrest me?

Those thoughts came over the course of about a week. Then I would start waking up (after the 2 - 3 hours sleep I could actually manage) expecting the police to be waiting outside for me. What would the neighbours think? What about my job? What about future job prospects with a criminal record? People tried to reason with me but for every argument I had a counter, which made things spiral more.

Then after a few days of that, even more irrational fears came in. I had some food that tasted wrong and noticed a tin of open paint in the kitchen near where the food was prepared, and the back door was open. What if the people at the car dealership had been in and poisoned me?

They had all my details (payment, driving licence, etc) - what if they committed identity theft? What could they do in my name? How much money could I end up owing? Had they sold my details to an organised crime gang? If it all came true, my only option would be suicide.

When the nurses started to come round...... what if they were sent by the gang? Were they simply spies?

I had about another week of laying around worrying and went from being anxious to being a bit depressed/ resigned to it all, and then the documentation for the car came through ok so my original anxiety was removed. My paranoia went away and I realised how stupid some of the thoughts I was having were.

Do you think my "breakdown" was severe anxiety with paranoia, or an acute psychotic episode? My current thinking is I want to see the psychiatrist next month with view to getting the diagnosis corrected (if the latter has already been formally made). Thanks for reading, and I appreciate any help/ advice you can offer me.


Answers

Written by Clyde 116 days ago Rating: 0 | Rate Answer: + -

It does sound like an acute psychotic episode, but then again, we dont know how many times this has happened previously.

Not necessarily this, but things like this.

If this was the only time, I would definitely consider it an episode, however, if anxiety has been present previously, and you have acted this way before with other anxiety ridden issues, then I would say that it could be more than just your garden variety episode.

To me, if you have had this happen previously, it is more than an episode, but if this was the only time (and I wonder if it was really), then it would be an episode.

Best,

Clyde

Written by freakazoid 116 days ago Rating: 0 | Rate Answer: + -

It was the first/only time I have ever reacted like that, but I am a natural worrier and things do make me anxious. I just don't get the "psychotic" part as it seems to make it sound worse than it actually was, and I think there's a difference between paranoia, and psychosis?

Written by Clyde 116 days ago Rating: 0 | Rate Answer: + -

Well, it does seem to be "over the top" a bit, though, with your worries. Most people would be upset that the car might be stolen, but then wouldnt go on thinking that the people coming to get the car had poisoned their food.

Its basically splitting hairs, though, fighting what it is, actually. Because it does seem to interfere with your life, it is imperative when you see the psychiatrist, you let them know how things have been progressing.

Best,

Clyde

Written by freakazoid 116 days ago Rating: 0 | Rate Answer: + -

Thank you. I will let them know how things have been progressing, i.e. back to normal and have been for a few months. They will know this from reports from their support team though. I had just read somewhere that paranoia and psychosis are different things, and believe what I experienced was the former. I know my worries spiralled to irrational thoughts (more than a bit over the top!), but that in itself is the definition of paranoia isn't it? The poisoning food one is a classic example. Psychosis sounds much more devastating and from what I've read, you experience hallucinations with it too and don't just snap out of it as quickly as I did.

I know the main thing is that I'm better, and it appears to have been an acute episode, but psychiatric diagnoses are a lot different to other conditions because there are no definitive tests and up to this point, I've been diagnosed by a nursing team who saw me for about 6 or 7 visits of 10 - 15 mins, on the basis of me explaining my paranoid thoughts. It just doesn't seem to be enough to go on to be able label someone like that. It feels like a punishment that will haunt my life forever. And the person who best knows what I went through is me - having read about acute psychotic episodes, and I know it sounds like denial, but I just don't think I had one.

Thanks for your replies.

Written by Edahn 115 days ago Rating: 0 | Rate Answer: + -

Hey freakazoid (can I call you "freak"?) (that's a joke btw :D)

I am not a clinician, but it sounds to me like it could be either. I would think that given your history of anxiety, the first (anxiety + paranoid delusions) sounds better, though psychotic episode also works because you were delusional, i.e., you don't need hallucinations.

I think you should definitely bring this all up with your psychiatrist. It's great how you are trying to stay informed and in charge of your mental health plan. Way to go.

Edahn

Written by freakazoid 115 days ago Rating: 0 | Rate Answer: + -

Thanks for your encouragement. The underlying stress/ anxiety has been the threat of redundancy hanging over me all year, coupled with flirting with negative equity following the property market crash here in the UK. I thought I was coping well with it all, but then the car buying experience turning into a nightmare seemed to tip me over the edge (perhaps because I thought, deep down, it wasn't a sensible thing to do?). When I thought I would be responsible for the outstanding finance on it, which was as much as the car was worth, I thought I'd have to effectively pay for the car twice. It was from that point I went into the panic mode. I've done some more Googling and think "acute paranoia" best describes my episode:

Acute paranoia, also known as stress-induced paranoia, is a form of paranoia that occurs rapidly and during times of stress. This form of paranoia typically goes away once the stressor is removed.1 This disorder is marked by feelings that someone is making fun of you, trying to harm you, or a feeling that everything is unreal.

I will raise this with the psychiatrist.

Thanks.


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