Tag:

Paxil

Does My Partner Have Schizophrenia?

by Kristina Randle, Ph.D., LCSW July 21, 2024

written by Kristina Randle, Ph.D., LCSW

I think my partner may be experiencing Schizophrenia or something similar. Before I met my girlfriend she had been diagnosed with depression and general anxiety disorder. Within the last year she has stopped taking her medication (Paxil) because she felt it was no longer helping her. In fact her episodes of depression seemed to be worse. A month and a half ago we moved to Toronto and since that time she has been complaining about people we don’t know (customers at a local restaurant behind our house) are laughing at her and know what she’s been writing about in her journal. Furthermore she has, for the last four weeks, been complaing about people sending her sexually perverse images and sounds into her head. She can hear moaning, animals screaming, children begging not to do something, and a man with a deep voice bitching at a woman to stop. During this time she has been even more sexually insatiable than normal. She complains of being constantly sexually stimulated or abused by people who are just not here. At one point she claimed that it was people using magic (a cult of satanists, or pagans). She complains of feeling that she is not complete, that some part of her is where these practioners of magic (or whoever is responsible for this stimulation) are. She has on a few occasions asked, no begged, me to help her kill herself because of this unending torture. I have found her with a cable wrapped around her neck several times as if she had just tried to strangle herself. At first she believed that the people responsible were here in the neighborhood but now believes that they are further away and taking that part of her that is missing with them. Could you shed some light on this for me?

Thank you,
A concerned boyfriend

Dear concerned boyfriend, I can understand why you’re worried. Your girlfriend’s symptoms are severe. The most concerning aspect of her behavior is that on several occasions you found her with a cable wrapped around her neck ready to end her life. It does not seem as if she’s depressed. It’s as if she’s being driven to behave in such a manner by her delusions, paranoia and hallucinations.

Her symptoms may be indicative of a schizophrenia or bipolar-like disorder. It may also be a generalized psychosis. It’s difficult to diagnose an individual over the Internet so I can’t know with certainty.

If I could ask you followup questions I would want to know what, if anything precipitated her symptoms. Was there a stressful event that had recently occurred? Was there a recent trauma in her life? Did something in her life recently change? Was there a death in the family, loss of a job, or a move to a new town or city? Does she use illegal drugs or alcohol? Has she had a recent head injury? If I knew this information I might be better able to determine what is causing her abnormal behavior.

You also mentioned that she has recently stopped taking Paxil. Though it is rare, there are some occasions when abruptly stopping a medication causes a negative reaction. Usually these negative reactions are more commonly associated with other medications such as antipsychotics and not necessarily antidepressants. As I’ve mentioned, it’s rare but it’s possible that her behavior is the result of the discontinuation of Paxil.

Has she been to a doctor? It is unsafe for her to be left alone while she is in the condition you have described. This is evidenced by the fact that she has made multiple attempts to end her life.

Please do not ignore or avoid this problem. My advice is to bring her to an emergency room or to make an immediate appointment with a mental health clinician. She needs to be evaluated as soon as possible. Do not leave her unsupervised. Please let me know if there are any other questions I can answer for you.

July 21, 2024 0 comments

Mood Swings and Depression Caused By Birth Control?

by Kristina Randle, Ph.D., LCSW May 28, 2024

written by Kristina Randle, Ph.D., LCSW

I have a few questions about mood swings, depression, anxiety, etc. First, the background: I have been taking hormonal birth control pills for 16 years. After the first 3-4 years I began having terrible mood swings; I would cry over nothing, develop into a rage that would simmer for quite a while, and occasionally throw things and punch walls and pillows. I talked to my doctor about it and he put me on an antidepressant. First we tried Paxil, but it made me dizzy and it also made my sex drive vanish. Then we tried Effexor XR and I felt better almost immediately. Years later I thought that maybe my brain chemistry had changed and I tried to go off the Effexor but it was horrible to say the least. I had brain shocks, terrible headaches where I couldn’t even move my head, and I was back to the crying and rage behavior. I was also in bed for a solid week with the symptoms. I was so miserable that I went back on the Effexor and now I feel fine again. My question is this: Could all these issues be related to being on the birth control pill for so long? Did I maybe only need the Effexor to handle the side-effects from the birth control? I’m also worried that I have irreparably damaged my brain with these chemicals and will never be the same off them. I’m wondering too because my husband and I would like to have a child within the next 2 years or so, and of course I’ll need to be off both meds by that time. Also, I’d really like to stop putting all these hormones and toxins into my body on a daily basis.

The only way to know if the moodiness is being caused by the birth control pills is to stop taking all of your medication. I am not recommending that you do this, especially without the assistance of your doctor, but it may be the only way to untangle the truth.

It is difficult to determine a cause and effect relationship between the birth control pills and the moodiness. Moodiness is a common side effect of birth control. It is very possible that if you were not on birth control you would not need the Effexor. It may also be true that your brain chemistry has been altered because of the birth control, although that would be very difficult to determine. The only way to know that information would have been to have taken a chemical or hormonal reading before and even then there would likely be no clear answer.

I would recommend speaking to your doctor about this issue. Perhaps you are not taking the correct type of birth control pills. Given the fact that you had such a strong reaction to them, alternatives should have been explored. A different type of birth control may have had an entirely different and more positive effect on your mood.

It might also be helpful if you met with a professional therapist for assistance with the moodiness. He or she might be able to determine if your mood swings are related to the birth control or part of an underlying personal struggle or mood disorder. I would especially recommend seeing a mental health professional when and if you decide to discontinue the birth control and antidepressants, to have children. During that process, there will likely be a psychological adjustment that you will go through and having a therapist to assist you during this process is advisable. If you would like to search for a therapist in your community, please consult this directory. Thank you for your question.

May 28, 2024 0 comments

Treating The Correct Disorder When You Have Bipolar and PTSD

by Kristina Randle, Ph.D., LCSW June 28, 2011

written by Kristina Randle, Ph.D., LCSW

My therapists help me to identify long-standing bipolar I but is it possible to have that without having never been treated and never suffered any negative consequences. My manias fueled a high-pressure career and I’ve been able to self-monitor and control my tendencies to overwhelm people with my activity and talkative levels. I haven’t had a depression since 1991 and even though I know that one of my first depressive episodes nearly ended in a psychotic break, I was still able to get through it without intervention. My family says they’ve never had a problem with my behavior. Fast forward I also have a serious PSTD problem from living with violent people for 53 of my 58 years. I’ve had inappropriate adrenaline surges for the past 6 years which have been treated with increasing levels of Paxil (up to 60 mg/day now). I cannot get my therapists to focus of the PSTD problems (flashbacks and nigtmares and severe anxiety) and they want me on an anti-psychotic even though there’s never been any hint of a problem with the Paxil setting off the bipolar. Help — what do I do? I want them to trust me to self-report if I see any bipolar symptoms and not start an expensive drug when I don’t need it right now.

I cannot answer your first question: Is it possible to have bipolar disorder despite not having suffered any negative consequences? I would need more information. It would depend on what you consider to be negative consequences. Without knowing that information, I can only speculate.

It seems as though you perceive your symptoms as being advantageous. You are not alone with your beliefs. You may find the article, “Just Manic Enough: Seeking Perfect Entrepreneurs” (in The New York Times business section), to be interesting. It discusses a very similar point to the one that you are making. It essentially argues that in order to succeed as an entrepreneur, a certain amount of hypermania is necessary.

Many mental health professionals would disagree with the premise of that article. Many of them believe that mania, in all cases, is dangerous and would recommend psychological intervention. I can’t say with certainty but I believe that may be the opinion of your treatment team.

It is common for people with bipolar disorder to report that they like the feeling of mania. Tara Parker-Pope, who maintains the Well blog at The New York Times, featured a number of individuals who were willing to share their experiences with mania. One insightful quote came from Carter Goodwin, a 42-year-old artist with bipolar disorder, who said “I miss the mania…I love the mania. It feels so good to feel like I can do anything and like there is something really special about me. But it’s all chemical. It’s not true.”

Goodwin’s point is an important one. The mania makes him feel as though he has special powers and abilities but it’s a delusion. It’s not real and therefore has the potential to be harmful. To live in a world that is not based in reality is delusional.

Another complication of this situation is that you might have become accustomed to living with your symptoms and now they “seem” normal to you. You may now lack the ability to be objective about your symptoms. Thoughts and behaviors that seem normal to you may not seem normal to your treatment team.

You mentioned two additional issues regarding your treatment team. They do not focus on what you believe to be post-traumatic stress disorder symptoms (PTSD) and they want you to take a medication that you do not want to take. If you believe they are providing you with unsatisfactory service, then you might want to consider seeking a second opinion. If the second opinion is consistent with the first, it could be very telling. A second opinion could also provide information about how next to proceed.

If you’d like to write back and provide more information about how you define negative consequences, in reference to your first question, then I might be able to provide you with a more specific answer. I wish you the best. Please take care.

Dr. Kristina Randle

June 28, 2011 0 comments