Firstly, I'm not a doctor so I can't give you medical advice. Secondly...

Firstly, I'm not a doctor so I can't give you medical advice. Secondly, I've been working in the mental health field for 15 years as a crisis counselor, case manager for the county and program manager for a foster care agency providing supports for 40+ patients. If you have any questions concerning any aspect of mental health in life or relationships I'd be glad to give you my professional opinion.

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I've decided I need to be on some kind of medication. I'm going to the gym and eating better but I am still listless and completely unmotivated. however, I don't want to be dependent on medication, would I need to stick with ssris for life? also, I would like to go to therapy but I do not have a decent income. any recommendations? thanks.

The medication best fit for you is entirely dependent on your diagnosis and precisely what supports you need. Going to the gym and eating better are definitely habits that contribute to a generally healthier, happier lifestyle but, as you've acknowledged, you need a little more support. As far as whether or not you would be required to take SSRIs for life, I don't know. I can tell you that in my experience I have not had many patients who were permanently on SSRIs. In my experience you would need to be suffering some pretty severe, pretty life-threatening depression in order for a doctor to not be comfortable with you ever transitioning off of them. If you bring up this concern with your doctor they would be more than willing to work with you to develop a medication plan that is consistent with your wishes. As far as therapy goes there's a offices who have sliding scale programs. You can also simply pay by the session and only schedule as many sessions as you can afford.

So without getting into a whole backstory, I'm getting evaluated for ADHD shortly. Trust me when I say that I fit a lot of the symptoms, but I'm not super confident that I'll actually be diagnosed.

Let's assume I do not get diagnosed. This was the only thing I've found that "fits" me. I don't fit the diagnostic criteria for anxiety. Though I am an anxious nervous person, I don't have panic attacks, I can leave the house just fine, I can talk to people most of the time, etc. I just realized this sounds like I'm "looking" for something to blame my problems on but I promise I'm not. I'm just not in a good place in life. I know this isn't something I should say or think, but I'm not in a place I "should" be. 24 with a part time job, no friends, never had a relationship, no school, sit at home all day on my computer.

I also just realized I don't really have a question here except: aside from continuing therapy, is there anything else I could do? I see my therapist once a week or two and in between sessions I just work and hang out on my computer and feel bad. I don't have any connections, nor do I even know what I like to do. idk I'm in such a pathetic spot.

How important is sex life and relations with the othet gender in general?

My relations with women basically my whole life have been soured by abuse and rape, with possibly even some incestuous behavior by my mother. I've been in therapy for a few months now, but lately I've been thinking, "What's in this for me? What am I going to get from muscling through this crap?"

Do you have any answers? What's on the other side? What the hell is going to make it worth reliving serious trauma almost everyday worth it?

The first thing I would encourage you to do is not get too far in the weeds as far as finding the one diagnostic criteria that you most identify with. It is more than likely that your symptoms could be associated with multiple diagnosis. While I understand the cathartic nature of being able to put definitive name to the thing that ails you I'd encourage you to internalize that being diagnosed or not diagnosed isn't necessarily a tangible step towards addressing your syndromes. Whether or not you technically fall under the category of ADHD doesn't change your symptoms nor does it change your relationship with it. It is exceedingly common for professionals to treat symptoms that don't necessarily come with a formal diagnosis.

Secondly, I highly encourage you to utilize your therapist to develop a plan to address the use of your time in between sessions. While therapy can be extremely helpful its effectiveness is extremely limited if you're simply going home to your computer and waiting until your next session. These kinds of issues are best address in unison with your therapist and a psychiatrist. Its obvious that you're struggling with the diagnostic side of things and could perhaps use some chemical supports to help push you towards making some progress outside of your therapist's office. Essentially, you need to elevate yourself to a place mentally where you are able to practice some of the techniques that your therapist teaches you in your spare time. You will not make any progress just sitting on your computer and feeling bad so, in my mind, the first logical step is finding some support for your anxiety and working with your therapist to begin traveling outside of your comfort zone and developing relationships.

>What's on the other side?
What is on the other side is unlearning a set of extremely negative and deeply seated internal mechanisms. The environment we are exposed to as children have an incredible, undeniably massive effect on the people we become as adults. Developmentally, the ages of 0-12 or so are the most important period in any human being's life. Additionally speaking, sexual abuse of any kind during these ages is one of the most impactful, damaging kind of experience you can put a child through. Without knowing too much about you it sounds as though you were instilled with some pretty serious sexual dysfunction as a child that you are obviously now exercising in the form of destructive relationships. I understand that this process is extremely painful and that sometimes it feels as though it is suffering just for the sake of suffering but I can say from experience that on the other side is the possibility of achieving a clarity beyond your childhood experiences. When we are taught as children to normalize abuse, rape and sexual dysfunction it takes an incredible amount of focus, hard work and extreme discomfort to unlearn these things. Every part of your brain is screaming at you and attempting to resist the things you relive in therapy because it is all it has ever known. It will be uncomfortable, user, but talking about these things and pulling them from your subconscious and thrusting them into the forefront is the only way you're going to be able to decouple yourself from these terrible things you learned. If you really think about it, the only other option is not talking about these experiences and you know as well as I do that stiffing these emotions not addressing them would be catastrophic for you. Stick with your therapy, there is a pay off.

Biologically speaking we are pack creatures. There are mechanisms in our brain that specifically drive us to connect with the people around us. As far as how much of a priority you place on sex and relationships over other aspects of your life is up to you. Choosing to prioritize a career over getting married or having children isn't inherently dysfunctional. With the burden of needing human connection comes the burden of managing these connections in context with the rest of our lives. For some people, having a companion is the most important part of life. For others, it isn't as crucial as, say, mastering the piano or traveling the world. How important sex and relationships are to you is a question only you can answer.

What is the best way of learning how to become independent after spending the first two decades of you life in a high control religious commune? And how do you deal with the depression that has caused?

I think the guidance of a therapist may be helpful. While the trial and error process of learning to become an independent adult cannot be helped the emotional toll that if causes on you can. I think having some people to support you while you embark on this new chapter of your life can be extremely helpful, especially if you feel like you suffer from depression. My recommendation is to reach out and ensure that you are not completely alone in this journey.

Hello I’m lonely. I’ve been using psychedelic and I created a beautiful meaning to life. I’ve realized I’m the universe but now I feel so alone because I’m convinced none of it is real and what matter is whatever you choose to matter. But I feel really unloved from my surroundings. People think I have a really good vibe to be around. The problem is I struggle to find anyone to have a deep connection with. Personally I think I’m 7/10 but my mind makes up for it. And yet it blows my mind how difficult for someone to establish a connection with me romantically. I guess all I’m asking is for advice

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Thank you

yes I tried to say that in my first post, that I'm not really concerned about the name. Just the stuff that is happening in my mind. If that has a name, cool.

practicing the techniques is a point I haven't brought up with her yet, but that I've been thinking about. I'm only 4 sessions in of course. this could be tied to the memory issues I have, or that I don't really know how to actually apply them to my life. the only thing I've been doing is trying to notice cognitive distortions. shoulds, black and white, etc. not actually doing anything with them yet, just noticing them.

thanks, I'll bring some of this up with her. I usually bring a list of stuff that I've been thinking about or concerned with. I've just been drifting through life you know? foggy and confused.

How do I let her go and get over it?

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My advice to you is to see a therapist and immediately discontinue using any kind of psychedelics to treat your symptoms. Prolonged psychedelics use can be incredibly harmful and has been linked to the onset of very severe depression and mood disturbances. Its time to contemplate the possibility that using psychedelics has not been a positive thing for your brain.

Compiling lists is a great way to stay on top of your goals in therapy. I think focusing on the things you can do in between sessions is really going to help bridge the gap between progress you make in that room with her and the progress you make outside of that room when you're on your own. Additionally, see a psychiatrist, if there's anything you can do to address the foggy/confused feelings you're experiencing then I think its worth a shot. Even a small dose of something to help build up your motivation and get out from underneath that fog can be extremely beneficial towards gaining some momentum in your progress.

Could you be more specific? Exactly what is it you're having issues with?

Here's the thing with a psychiatrist. I'm getting that evaluation soon right? It's with a psychologist though. PhD, but still just a psychologist. I assume that if I get diagnosed they'll schedule a psychiatrist (like 90% of ADHD diagnoses respond to medication), but if I don't get diagnosed, should I still ask for or find a psychiatrist? The place I'm doing all this stuff with in kind of an all in one big mental health organization where I live.

It's also a concern of mine the symptoms I have are so vague. Not just that I can't see them, but that the vagueness is the symptom. Like they don't even exist. Like I can't look at them directly. I might have to bring this up with my therapist is she can help me pinpoint more. I don't know. I'm going to bed now though (getting up at 4am yay!), I'll save this thread and refer back to it sometimes.

if you stick around for a few months I'll gladly give some sort of update. I'll just be "vague symptoms user"

hey doctor I have 8 months sober but I'm thinking about drinking. If I drink I'll definitely be caught in a piss test, and I'll be kicked out of my parents place. That would make it my third time homeless. I've struggled with drug and alcohol abuse for years, I've been on a wide variety of meds for depression and moods, currently only on selegiline at the moment, as I'm with a new psych after my last round of homelessness and he wants to test things slowly and knows I've struggled with other meds for the same symptoms. Also have a history of self harm and a suicide attempt. Currently working a job that a family member gave me that I'll definitely lose if I'm caught drinking or using again. I've just always been an emotionally unbalanced sort of guy and I'll make really stupid decisions in a 'mood' like picking a fight or hurting myself or whatever.

Despite all that I want to drink anyways. I had 3 years sober in AA once but it was a miserable time, and going to meetings only reminds me of those awful times I had there. I don't want to have to deal with years like that again. Idk man, I don't understand.

Got any advice?

>be me
>be le quiet shy mysterious guy whose actually just fucking weird
>One day make eye contact with this one girl and felt this weird shock between us
>the girl felt it too and I was too inept to do anything about it except talk to her a few times
>when we were actually going to get together I panicked big time and said a lot of weird shit that put her off every time we met
>get rejected
>its been 3 years and I still think about her
>other girls have been interested in me but I can't seem to ever feel as interested in them as I was her so I put off having a relationship because it makes me feel like an asshole

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>but if I don't get diagnosed, should I still ask for or find a psychiatrist?
Yes. A psychiatrist can still help address your symptoms even if they don't fall under a specific diagnosis. Symptoms being vague are perfectly okay. Your therapist can most certainly help you sift through your thoughts and symptoms and paint the clearest picture possible to present to your psychiatrist. .

That could be true but I sway more that it helps me. Yeah it has made me a tad bit suicidal, but that’s okay because dying is a illusion. I’m infinite. But besides that I live every single day extremely happy just because I chose to. My problem is that I feel alone because of the choices I’ve made to reach where I’m at. People always look at me differently. And I hate I’m just being myself and most of them see me as an alien. I just want to be accept for me being genuine

In the hierarchy of mental health priorities addiction always comes first. Nothing can be done to really address your mental health issues until your addiction is being adequately treated. No amount of drugs or treatment in the world is going to be effective if you still utilize drugs and alcohol as your own coping mechanism.

This may seem counterproductive and strange but the misery you experienced while in AA is, in some sense, a good sign. Sobriety can be a miserable experience, not just because you no longer have your coping mechanism but because you are now forced to learn how to process the ups and downs of life in a completely new way. Being unclouded and free from the influence of drugs and alcohol presents to us as mental health professionals a clear, unaltered picture of what your needs are and how to address them. I understand being without the crutch of drugs and alcohol can be frightening but before you can make any meaningful steps towards addressing your other issues you need to be, in no uncertain terms, raw. I recommend, if not AA, getting back into a treatment program and once your sobriety is stable working with a psychiatrist to address your other issues. Obviously, your sobriety is the first priority as the consequences of being homeless and without a support system would be catastrophic for you.

I really recommend you see a mental health professional as soon as you can. You've done some pretty profound damage to your brain with these chemicals and I very much so caution you against taking any more. Understand that the feeling of you being an "alien" in comparison to other people is likely a result of these drugs. You speak in a way that is very grandiose, hyperbolic and disconnected from reality. I know it may be difficult to see or understand that but taking more drugs will not be a positive thing for you, user. That is my professional advice on the matter.

It sounds as though you have some underlying social issues that are causing you some distress. Consider the possibility that your fixation on this event is much much bigger than just about who she was as a person. I believe that, to some extent, she represented an opportunity for you to overcome this anxiety and "weirdness" you feel. Obviously, reminders of that failure can feel a lot like being trapped with the problems that caused it. I think, on some level, you are more upset about the fact that you sabotaged this potential relationship than the fact that you don't have this specific person in your life anymore. This is all just me kind of projecting my experience with the matter onto you so please correct me if I'm at all wrong about any of this. I highly suspect that taking some meaningful steps towards addressing the issues that caused this relationship to fail will help you put it to rest.

It was 3 years in AA. 3 fucking years. There are people who wrote stories in the back of the Big Book with less time than that. I'd rather drink than go back to it. Life isn't worth so much that I'd stay in AA just to preserve it.

Then give me your genuine advice and not professional. Is it better to see the world for what it really is. As I do. Or live in the ignorance of our ego and say what is and isn’t right because it doesn’t meet our standards. I feel alienated because says I’m so interesting and all they do is dissect me. They tell these things

Reality is the way you view life because of the experiences in life. You saying I’m “disconnected from reality” is a insult because it doesn’t meet your expectations of what reality is.

I think youre on the ball as well since I think about my mistakes with her a lot but wrong about the specific person part. This girl is a 6/10 at best and I get girls much hotter than her hit on me but I think she is literally perfect and would choose her over any girl. I feel like i sound mentally ill somewhat typing this out

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Thanks pal

would you suggest I get into a relationship and try to work through this

>Life isn't worth so much that I'd stay in AA just to preserve it.
What your life is worth is up to you to decide. All I can do is give you my personal insight as to what methods are most effective in treating people with your issues. The fact of the matter is you cannot address your long term mental health while being addicted to drugs and alcohol. The next fact is that the most effective way to deal with drug and alcohol addiction is an ongoing, heavily structured recovery program. Whether or not you're willing to participate in that is your choice. I can't convince you to save yourself if that isn't what you want to do.

My genuine advice is to seek some mental health help. The fact that you've lost the ability to really string together coherent thoughts in a manner that is grounded in some kind of tangible reality is only further evidence of the damage you've done to your brain. These kinds of wild, hyperbolic and compulsively existential trains of thought make it very difficult for people to connect with you, I imagine. To put it bluntly, you say quite a few things that don't really mean anything. This is really a common trait among people who have abused psychedelics. Like I said, get some help. That's the only advice I can give you.

>I think youre on the ball as well since I think about my mistakes with her a lot but wrong about the specific person part.
As I said, I may be incorrect, but also contemplate the possibility that your failure in this relationship has caused you to some extent to romanticize this person and characterize her in your mind as the perfect girl for you. This kind of reaction is pretty common when it comes to "the one that got away". Like I said, I think the greater amount of your distress comes from the failed opportunity that this girl represents.

I wouldn't suggest that, no. I think getting into a relationship while you're still emotionally unable to overcome a previous relationship isn't fair to you or the person you decide to date. As I said before I think that taking some meaningful steps towards addressing the issues that have caused your relationships to fail will help you come to terms with those failed relationships.

AA has a 5-10% success rate. Depending on the study, thats about the same or worse than no treatment at all. AA would be a scam if they charged money, I'm not sure what you call so utter a failure when its offered as charity.

The guy you're talking to needs treatment, but it needs to be from someone with the letters "CADC" after their name, not Bill, his Big Book, and a room full of chain-smoking drunks telling war stories and beating on him for some perceived moral failing.

any tips to get over this???

I was clinically diagnosed with depression but since I felt I was being studied, I stopped therapy. I lied about my feelings to get out of therapy, and now 5 years later, I am still depressed. I hate being studied, being observed, having notes taken of me, and I am too embarrassed about my mental health. What to do?

>AA has a 5-10% success rate.
That is beyond inaccurate. I know of what article you're referring to but at no point did that actually quantify precisely what a "success rate" is nor did they take into account the inclusion of supplementary treatments. AA add programs like it are, in my professional opinion, meant to be supplementary to larger, more comprehensive treatment plans. Never in my professional career have I ever suggested that an alcoholic use AA as their entire source of addiction treatment. AA, if anything, provides a community of people to hold each other accountable and provide support when the in-patient treatment ends. AA is not a miracle cure and it is not for everybody. Regardless of whether or not you like or support AA, the statistics on people who attempt sobriety without any support base or treatment whatsoever are far more conclusive than the ones you gave me. OP needs treatment and he needs out-patient support. If he chooses for AA to not be that support then there's nothing wrong with that but he needs to have a substitute.

>The guy you're talking to needs treatment, but it needs to be from someone with the letters "CADC" after their name, not Bill, his Big Book, and a room full of chain-smoking drunks telling war stories and beating on him for some perceived moral failing.
I specifically told him that he needed to be in some kind of treatment program, without or without the inclusion of AA. As I said previously, AA is not the end all for twelve-step programs or support groups. There are tons of options out there and implore him and anybody who is interested in sobriety to explore them.

Well, as a mental health professional I always encourage people to see professionals if they have concerns about their mental health but I also understand that this isn't a viable option for everybody. Honestly, I don't want to overreach my speculation here but, from an anecdotal standpoint this kind of thing happens a lot when you're young and inexperienced. Personally, I was a very nervous kid. I struggled a lot with anxiety and feeling isolated and I acted out a lot of that dysfunction in my relationships. I too had my "one that got away" and I was torn up about it for years. I'm in my mid 30's at this point so this was almost 20 years ago and the experience and wisdom I've gained over these past few decades have given me a lot of perspective about my relationships. Whether or not these are just kind of growing pains or some mental health issues that need addressing isn't for me to say but, regardless, maybe seeing a therapist and finding out for yourself couldn't hurt.

It seems as though overcoming your fear and anxiety about being treated are the priority here. While I cannot convince you not to feel anxious or to be embarrassed about needing mental health help I suspect there will come a time where the fear of being exposed to mental health treatments will be outweigh by the amount of stress that your depression is causing you. Understand depression is a potentially fatal disease. Gone untreated it can grow to almost unmanageable proportions. My recommendation to you is to see a therapist and do you damndest to be completely honest with them about your anxieties about being in therapy. It isn't something they are unequipped to help you with.

No study has displayed a dose-dependent response to AA. AA is demonstrably inferior to in-patient or medical treatment in involuntary populations and there is little strong evidence that it's effects are equal to similar treatments in intrinsically motivated populations. It's model also runs explicitly counter to fundamental substance abuse treatment suggestions such as avoiding other users and telling war stories. Also, the rampant caffeine, sugar, and tobacco use suggests that problem behaviors aren't being addressed so much as temporarily shifted.

We don't treat any other illness by telling people to go into a room with other sick people and admit they're morally inferior. You're welcome to your opinion, but from where I sit AA is the absolute worst example of "something is better than nothing" and "well, its cheaper than the alternative" thinking thats driven down quality and quantity of services in the mental health field for decades.

>We don't treat any other illness by telling people to go into a room with other sick people and admit they're morally inferior.
That is a wildly irresponsible mis-characterization of what support groups are.

>You're welcome to your opinion
My opinion is based on 15 years of first-hand experience in the field of mental health and addiction, working directly with people who actually utilize twelve-step programs. The point is I'm not going to argue with you. If you think reading a few articles gives you an educated enough perspective of drug and alcohol treatment to claim that they don't work then that's your prerogative but my real world experience says different.

My husband's been in AA a year and is now starting to sponsor. Sobriety itself could have saved our relationship but he replaced alcohol with AA, as most who go do. I've gone and learned about it, like affairs for newbies is common and kept hush about. He had an affair I wouldn't have known about had I not gone and poked around. There was a guy clearly coked out. Their "sharing time" consisted of talking about how horrible drinking (any amount) is and AA saved their life, nothing at all about how they saved their own lives and learn how to drink in a healthy way/not rely on substances to enjoy life. There is no "growth" out of AA, their slogan is "Keep coming back cause the meetings work" or some nonsense. The doctrine is the same as it was 30 years ago - being addicted is a spiritual problem, and a disease, and one that can ONLY be cured by the male God that is in AA... who doesn't give a shit if you cheat on your spouse or take advantage of newly sober girls. Says they're not religious, then say we're powerless without AA, and say the Lord's prayer at the end of every meeting. It's a cult that advertises itself as addiction therapy. The only positive side is most there are there for the same good reason (trying to save themselves) but it's all about villainizing alcohol and people who use/drink and performing. If you're not fully on the bandwagon, you're given the side eye, and if you're an attractive new woman all the men try to talk to you. I haven't drank in 3 months without AA. But our marriage is basically over. He stopped having sex with me because the Big Book told him he didn't have to ("if you find sex troublesome... help someone instead").

Oh yeah, you get to apologize to people who you said something "hurtful" to ten years ago who probably didn't give a fuck.

If you want to be dehumanized and reprogrammed into an AA pawn go for it. Good luck getting out.

I hate myself

I hope you know I'm not here to devalue anybody's experiences. As I stated several times, AA is not for everybody. People are messy, particularly people who struggle with addiction. Understand that the human element will always be a factor regardless of what kind of treatment you seek. Simply being in AA does not absolve anybody of their dysfunction nor is AA an umbrella that excuses any kind of behavior. I've seen AA work for a lot of people and not at all for others. I'm not here to wave a banner for AA. All I encourage anybody to do is to seek support, wherever that comes from. Trying to maintain sobriety alone is an incredibly difficult task, not to mention a nearly statistically impossible one. Whether or not the OP or anybody, for that matter, ever goes to AA isn't my concern but encouraging them to find somewhere they feel supported and they have structure to help them navigate the pressure of living a sober life is. I encourage people to question AA. I encourage people to be critical of the people around them, regardless of whether or not this person is a fellow addict, a therapist or even a doctor. I'm not saying its a perfect system. What I will say, however, is that the therapeutic benefit of having support from people who have been through what you have been through cannot be wholly discounted. I'm sorry about your experience. It sounds as though your husband just replaced one addiction for another. It is, unfortunately, exceedingly common.

I am at a point where I know what I want in life and what my goals are. I want to end a relationship to pursue them but I can’t find the motivation to do it. How do I convince myself a few weeks of emotional pain is worth it to not waste years in a relationship I no longer want to continue? How do I break up with an emotionally unstable person?

My boyfriend and fiance of 4 years left me. I'm probably going to be told I was cucked but here we go:
>have known depression
>take meds to function
>develope sexual disfunction
>still try to satisfy bf
>find out a friend was being sexually/physically by family
>bf suggests she moves in
>she has intense trauma
>often find her sleeping in strange places, scratching skin raw or having terrors.
>she gets drunk, huge meltdown triggers my own sexual trauma
>tell her she needs to go to therapy if she wants to continue living in our apt
>she constantly would monopolize my bf
>antagonistic towards me, then boohoos when I defend myself
>bf thinks I'm badguy.jpg

I was told she was afraid to live with me. he says I don't contribute emotionally but I really just didn't have what took to partake in that yikesfest. He believes he's the only thing standing between this dumb bitch and suicide.

Tldr; my bf left me to play emotional support to a emotional manipulator and I'm confused af.

Pic related is me.

I'm a 27 year old virgin with no social experience; never had a girlfriend, I have only 3 friends I see with any regularity and I'm not even overly fond of them- I just don't want to relinquish what little link I have left to the outside world.
In person, I'm an autistic mess that can barely communicate to strangers except through extreme supplication; eg. I always start my sentences with "I'm sorry to bother you, but...".
I'm also a void of charisma, I can't maintain a basic conversation for shit, and am also ugly and poor.

Any protips for re-engaging with society? I'd like to avoid becoming a wizard.

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Alright doc, how do I fix myself?
Details: I'm 23, depressed, unemployed, have no friends or girlfriend, and still live at home. I've had a job and friends and a girlfriend but my self esteem is shit, always has been. How do I gain some self esteem? Trying to claw my way out of this pit and get a job and social circle again but without self esteem it's even more difficult

Bump because if someone doesn’t help my pathetic ass I might have to actually go to a therapist

I’m really sorry but I completely disagree and don’t this it’s psychedelics that’s the problem I live being me and live what it has done and gave it a good non biased thought. Thank you for trying to convince me otherwise. I think the world is the problem. They’re living in their own ego. My reality is the true reality. You’re not seeing me as another human and that’s the problem

The unfortunate part about being in a relationship with an emotionally unstable person is that the dynamic often sets you up to feel responsible for this person; as if their mental stability is your job to maintain. The only effective way to get it done is a clean break. Change can be scary and it can be incredibly uncomfortable but obviously you understand that your only other option is continue to sink time into a relationship that you don't want. You kind of have to rip the band-aid on this one, user.

It sounds as though you have no business being involved in this situation. Your friend is an incredibly damaged individual and your boyfriend got completely sucked in to the manipulation and is not exercising his own hang ups by becoming her caretaker. They both got sucked into a codependent relationship and the good news is that you got out. I completely understand that this must feel like a gigantic betrayal, especially after dedicating 4 years to this person. However, at least you discovered this part of him now as opposed to many years from now. Your boyfriend was not ready for the commitment required for marriage. I'm sure you can see that now.

You're definitely going to need some kind of support. Autism (if you are indeed formally diagnosed) can be a crippling sentence to an individual's social life. I know I may sound like a broken record on this one but seeking the help of a therapist who specializes in autism, aspergers and/or social disorders could be invaluable to helping you adjust. Regardless of whether or not you agree with that idea I think you and I both understand that trying this on your own has been unsuccessful. It would be extremely helpful to have the support of someone who could point you in the right direction. Normal people, for lack of a better term, learn to socialize through trial and error. They develop relationships as children and through their experiences learn how to navigate them more effectively with time and experience. You, however, were not served by that process. You did not have access to the experience and connections necessary to build a social identity, therefore your best plan of action is to begin building that identity. It will require a lot of discomfort and a lot of leaving your comfort zone. This is why I so heavily recommend seeking the help of someone who can facilitate this process and assist you in processing the inevitable ups and downs that come with human connection.

Gaining self-esteem begins with identifying why you think so little of yourself to begin with. At this point in your life I'm sure you have some idea. While, again, I always recommend that these kinds of exploration take place in a therapeutic environment, I can say with a fair amount of certainty that your journey towards developing a confident self-identity must begin by determining when and how your identity was first broken.

You don't have to agree with me. It is your prerogative to live in whatever reality you choose. Regardless, I highly encourage you to see someone. You've experienced an incredible amount of brain damage and I think getting yourself checked out could possibly help bring you back down to earth a little.

I went to a therapist and they pretty much said the same but then transitioned from asking questions to telling me to get a job.
I have a few theories about why I'm like this but what do I do when I've figured it out?

>I have a few theories about why I'm like this but what do I do when I've figured it out?
I recommend finding a different therapist. If you were unsatisfied with your last one it couldn't hurt seeing somebody else. I say this because, in essence, there is no special trick to therapy. Therapy is simply sitting in a room with someone who has no emotional investment in your life and can give you straight forward, objective opinions about who you are and how you can change. I'm not saying that there aren't ways to help address your self-esteem issues on your own but you could use the support. Additionally, your depression should be the priority here. It will be very difficult for you to start addressing any deeper issues while you're struggling with depression. Seek help for your more pressing problems at first then as those get sorted away you can start digging into the details.

I'm not against therapists, I know she was shit. Every one that takes my insurance has no openings or just plain didnt respond except for her. Guess I know why

When should we consider couple's therapy? What is the cut off where things go from typical disagreements to actually needing a third party to get along?

Any advice for not really having a goal or career that interest me? I've considered dozens but always see way more cons and not really any pros.

I've got schizoaffective disorder, spent 2 years straight in rehab, that didn't work. Spent 9 times in psych wards as well and I was wondering how fucked I am in regards to work and relationships. Haven't had a job nor s/o in years so my question to you is should I accept my fate or keep trying?

aw fuck I had a whole paragraph and accidentally closed the tab. well essentially it was thanks for the help. I'll discuss these things with my therapist.

Got checked out and turns out I’m completely fine. Thank you for your shitty advice about how I “damaged my brain” they were surprised I got checked out and kept asking me why I was there they did a MRI scan and notice I have more brain activity and they’re convinced I created more pathways for my brain to communicate with itself. They said they’re not sure what it means but they say it’s nothing bad. Thank you for wasting my time

How did your occupational journey start? What kind of education did you need to end up where you are today? Sounds like an interesting path to take.

Also, I need your wisdom. I've been struggling badly for the past ~2 years. Had to take a sick leave from my university studies. This was partly due to arising delusions and hallucinations, but what I considered my main problem was what I personally perceived as majorly troubling disorganized thoughts and speech. However, I think my social skills and tremendous cognitive efforts covered up the severity of my disorganization for the most part when I got myself evaluated about a year and a half ago.

About three months of anti-psychotic medication later, the doc said I was good enough to bother someone else with my issues, so I went back to uni and dropped the meds after I ran out. However, once I went back it didn't take long until I started having hallucinations again. To this day, the second coming of my hallucinations have remained mostly mild, but I've recently understood that my conviction that 'aliens' are reading my mind, placing thoughts inside my head and monitoring my life as some sort of simulation experiment aren't normal and may justify some concern. I've also become almost completely emotionally numbed and stopped longing for any form of social interaction with other people. I don't even want to talk to my closest friends anymore. It has nothing to do with paranoia at this point. I've simply lost all interest and I'm perfectly content with complete solitude. With that said, I assume others may find these things clinically concerning as well.

I suspect I may be exhibiting early signs of some schizo-disorder. My question to you is whether or not my schizo-guess is even seems reasonable, what a recommended course of action would be beyond possibly considering seeking medical attention, and what the possible negative repercussions of a schizo-diagnosis could be.

This is definitely in your head, Ive been there. Get an injury or get sick? That pain gets pretty real user. Life is going to be as real as you make it. The discomfort and alienation you’re feeling is probably because, you’re mistakenly believing the drugs effected you profoundly, when you haven’t learned anything actually. Beleiving the world is a simulation changes nothing whether or not it is, because it still functions the same way doesnt it. So you’re probably talking pretentiously like you’re doing right now, and you brains all nervous and fogged up from those sweet delics. So you can either shut up, enjoy the simulation like everyone else is without complaining, or be an embarrassment to yourself & keep distracting yourself from reality.

Holy shit man. Youve brought too much back with you brother. Psychedelics must be treated with utmost respect.
While your under the influence everything your 6 senses experience are extremely impactful. Now think about how youve been using, and how frequently.

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Yeah, sounds about right. Thanks.

When I used them I used them once a month. Ive used them for spiritual growth and create my own religion. Haven used them in months but I developed HPPD, I enjoy it. Life is just seems more colorful. I’ve learned I’m God and been enjoying existence.

It changes everything you can be a slave to the simulation, or understand what it is and manipulate it. It’s through self awareness we can see past the physical

That most awesome time was when I took 450 ug, 4 grams of penis envies, and .2 of MDMA. They call that Jedi flipping. That day I truly understand who I was and what I meant to the universe. I learned we have no free will and everything is already set in motion. I’ve learned as soon as all life ends in the universe another Big Bang happens exactly as before. We are experiencing the past, the future and the preset at the exact same time

My past is killing me doc,im paranoid all the time that the things i did in the past will resurface and ruin my image,im not the thing i was, i want ti become a musician and im afraid that the past decisions i made will destroy my future

Why would you lust for something that isn’t real? Yeah it’s only as real as you make it but it’s still an illusion at the end of the day. I wish to find truth not being deceived by our wants and desire man has.

Your reality that youve created for yourself couldnt have been possible wiithout mind altering drugs. The reality itself seems pretty un healthy. Its okay to "be your own god" but according to what ive read you genuinely believe in your drug induced narrative. Sure maybe on acid or whatever psych of choice youve had this revelation, feeling as if you really are a god. Its not super uncommon. But take it with a grain of salt and think about what this means. Instead of literally being a god perhaps take it all less literally. You are tripping balls remember. Also what were your dosages in ug?

Schizoaffective is a tricky disorder and rarely comes uncoupled with other diagnosis. I'm assuming that your 9 committals were at least in part due to the danger you presented to yourself or others. This presents a very unique and frankly difficult approach towards developing a treatment plan. I would in no way say that you are "fucked" but I think that you would best be served by continuing to work with your team of providers. Helping manage the waves of delusion and mania that often come with schizoaffective requires pretty consistent monitoring and support. I don't know anything about your particular case but, of course, I implore you to keep trying. I've seen more than my fair share of schizoaffective clients come back from the brink and stabilize into productive lives. I just had a vocational rehabilitation meeting today for one of my clients to get a job. Two years ago she was addicted to caffeine pills, meth and on one occasion I had to physically stop her from slicing her own wrists open with a razor blade. She starts her new job next month. Anything is possible, user. Don't give up.

Depends some we’re 600 maybe 1000 then others were 200 maybe 300 mostly in the 200 range. Yeah acid stop being a drug and become a next state in life. When the drug became more real than real. That is when shit for awesome because all my worries left, all my pain, everything that was bad suddenly disappeared and I realized no matter what. Everything will always be okay and there’s never not a reason to no smile. Because when’s there no point to anything what the point in being sad about being pointless. Happiness is a realization that you don’t need to achieve or do anything to be happy besides want to be happy

You remind me of one of my good friends. Hes only just dipped his feet into psych use but he has a rather similar worldview, although hes not at the center of it. He often wanders around to touch/sense/feel trees, has an astral garden that he goes to when deep in meditation. Hes not as detatched as you seem to be after exploring psychs.

>How did your occupational journey start?
Its a family business. My father was a mental health professional who worked as a foster parent, a case worker for children and then eventually a licensed foster home provider. My mother is a crisis counselor who worked as a intake specialist for our state's prison system for awhile and now manages her own department at the Behavioral Health unit in our county. I've been involved in the mental health field for as long as I can remember. My degree is in social work but my experience is mostly in crisis intervention. Working in long term care is a fairly new path for me.

As far as your question goes my best advice to you is to obviously seek medical attention and most importantly, do NOT under any circumstance go off your medication without being monitored by a doctor. I cannot express this enough. While I cannot even begin to speculate about what your diagnosis is I can say that the symptoms you've described are consistent with kinds of symptoms my clients with schizo-disorders report. The paranoia is what I would most highlight in your visit with your doctor. Paranoia and delusional thinking are the two symptoms in my experience that can and will spiral out of control without the proper chemical supports. I don't want to frighten you but I've seen perfectly functional, perfectly productive clients with apartments and jobs completely spiral into disaster once they make the decision to go off of their medication without medical supervision. I would just really encourage you not to take the fact that your symptoms are mild for granted. Please do not ignore this. I don't know you that well, obviously, but I can say that living a productive life with a schizo-diagnosis is an obtainable goal. I have had dozens of clients who have found the right medication plan for them and have stabilized. The most important part is not trying to make sense of these symptoms on your own and see a doctor as soon as possible.

Grandiose, disconnected and compulsively existential thought is very prominent in people who abuse psychedelics. The most prominent things I've seen is paranoia and mood disturbances which take on a very existential quality to them; for example I had a client once who, after years and years of LSD abuse, was convinced that there were different version of him in another universe that were trying to harm him because of his "knowledge". He was always vague about what this "knowledge" was but it was always something about the "truth" he'd learned about the universe or such.


What exactly about your past is concerning you?

Do you believe psychedelic use is outright harmful?

I suffer from an extreme lack of energy and drive. I find the most mundane of tasks very tiresome, like answering to emails or even taking a shower. If the task is slightly more complicated, like applying for a job, I'd rather not do it at all and procrastinate until it's too late. Every failure kills what little motivation I have left. I also tend to seclude myself out of fear of doing/saying something stupid. I have a photographic memory for shameful moments and I regularly have flashbacks that make me audibly cringe. Being alone sucks, but I can't stand being with people either.

What's wrong with me? Is it depression?

Here is what I believe; if you put nearly any substance, compound or chemical on the planet under a microscope you could find some kind of detriment to its use in the human body. I understand that it is unrealistic to expect people to not experiment or to not be curious about mind altering drugs. What I believe in is being realistic and educated about what you put inside of your body and understanding the risk vs. reward involved. The fact of the matter is that long term psychedelic use has been linked to severe mood disturbances, depression, paranoia, anxiety, cognitive issues, visual disturbances, long and short term memory issues and even erectile dysfunction. Are you going to permanently damage your brain through one or even a handful of uses? Probably not. Long term exposure, however, is a risk vs. reward that is, in my professional opinion, pretty objectively imbalanced. Its the difference between enjoying a drink for dinner once or twice a week and getting hammered every day. One is a realistic, relatively low-risk approach to substance use and the other is not. People have this idea that because psychedelics aren't chemically addicting that they are harmless and that couldn't be farther from the truth. I've seen the consequences of this mindset first hand. I think if anyone is so desperate to alter their consciousnesses that they'd be willing to risk permanent brain damage and a permanent detriment to their quality of life to do so then that is obviously an issue. I don't have any inherent problem with recreational drug use but any risk you take should be an educated one. Bungee jumping is a risk but we negate that risk by following safety precautions and being educated about the activity before taking the leap. I don't think risk taking is inherently damaging. Uneducated and romanticized risk taking is the damaging part.

It seems as though you suffer from a pretty persistent fixation on fantasy. Something about the pressure and/or stimulus of living in reality has caused you to escape to a world of your own making. I know this may seem extremely vague but getting to the root of that is going to be where you start to make some progress. If you've never seen a therapist before I highly recommend it. Some kind of incident/incidences/circumstances have caused you to shun away from reality and persistently mask life with fantasies. Finding out what caused you to develop this coping mechanism in the first place is going to be key in helping you unlearn it. A therapist is the best person to assist with this.

I don't like myself. I don't want to like the person I am right now. I want to be better. I don't know what "better" is, or what traits of myself I hate, I just know I hate something about myself. I am also often envious of others. I'm not genetically gifted like others, I'm short, ugly, and frankly, most likely stupid. Other people get to have high status friends and party all day and night and beautiful women, whilst I hang out with autists and rejects even worse than myself. Women are also something I want, but It's friendship, or rather a group that I want to be part of which I really want.
But women are also part of my worries. The only ones that were interested in me were fat or ugly, whilst my friends had better looking ones fawning over them. And it's not just sex, it really isn't. I want a beautiful woman to, if not possible love me, than at least be attracted to me. And I have no idea how to achieve this.

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The heart of your issues, as you've already guessed, is self-esteem. The thing that we often don't understand about self-esteem is that it is just as much of an external reaction as an internal one. All you have to do is turn on the TV or look at our phones and we see people being just handed validation and esteem simply because they have nice hips or large breasts or nice clothes. Its often difficult to rectify those kinds of images with the reality that, as regular people, we often have to work really hard for the validation and esteem that other people just seem to be handed for nothing. As far as your desire for a beautiful woman goes I think it would benefit you to understand the origin of that compulsion. I may be going out on a limb here but I highly suspect that the high status friends, parties and women merely act as proof of your worth. If you were able to acquire a beautiful woman you would finally be able to internalize that you are worthy of love; that you are a good enough and desirable enough person to "deserve" someone so good looking and socially valuable. What I think you want, more than a beautiful woman, is to just be viewed as the kind of person who deserves a beautiful woman. Whether or not obtaining a woman beautiful enough for your liking is possible, I don't know. What I do know is that working on the way you view yourself will also help you with the way you view the world around you. Maybe visiting a therapist and expressing to them that you'd like to work on building self-esteem would be helpful. I highly suspect that feeling better about who you are as a person will help address the kinds of things and people you need in your life to feel secure.

Youve pretty much laid out my take on the matter here but much more articulate than i could put it. Psychs arent toys. I read as much as i saw necessary to ensure that my first experience was controlled to avoid set and setting distruptions. I had a reliable and accurate dosage (100ug). You need a fit mind in order to keep your wits about you and choose the thoughts you pay attention to carefully. quite a few of my friends abuse of acid disgusts me. Theyd Take it to see wacky crazy stuff or whatever misconception theyve come up with and then break themselves mentally, go into thought loops etc because theyre retarded or something. I dont think people should jump to psychs to fix something wrong with them. They should be used to reflect. In my opinion.

Why is a director at work such a dickhole to me when I haven't done anything other than my job?
He is not my boss, he almost runs me over, he just yells no matter what whenever he talks, he's fatter than 4 of me combined, and he just gives dickish vibes to me.

I haven't done shit to him and don't intend to, but he is provocative.

I don't want to feel better about who i am as a person. I want to be better than who I am. I'd also like to work on my social skills, but I don't know how. I'd like to make friends and connect with people, and be able to hang out with them

It’s a good thing I’m not that guy. I’m not afraid of myself. I’ll kick my own ass

I was called a weirdo by everyone.(even changing school doesn’t help). There only 2 persons I could relate too and we mostly talk about maths and science. I don’t understand why my behavior is label as weird. Sure I have shown some adhd sign but I’m not autistic.My iq is only 130 so I shouldn’t be that different from the rest of my peer.(since 130 is just above average intelligence).

My first attempt at speaking with a therapist was a dud, it took four sessions for him to determine that I was a boring and cynical person and this of course took multiple months trying to dance around an unreasonable schedule.

I'm not entirely opposed to trying again with someone else but it can't work like that. Do you think it would be ok to just put summarize as much as possible in an email or something to save session time?

>I don't want to feel better about who i am as a person. I want to be better than who I am.
Again, I encourage you to appreciate that in the context of your perception of yourself these are very often the same thing. I'm not saying that self-improvement is not a worthwhile go. I'm merely asserting that working on your self-perception and how you view the things you like and dislike about yourself is more powerful of a tool than you realize.

I think coming to a therapist and very clearly laying out what kinds of things work and don't work for you in the very first session is a very reasonable approach. Therapy is a working relationship. If there are things on your end that you need then a good therapist will be able to either accommodate that or refer you to someone who can. Your first experience gave you a lot of valuable insight as to exactly what you need in a therapeutic relationship. I view that as a good thing.

Having difficulty socializing and connecting with people is a very generalized kind of issue and is often very common in young people. I think you'd have to be more specific as to what you mean by "weird". What exact qualities about you do people tell you are weird?

just being me. people keep telling me I am different. the way I think,act and talk

maybe because of my adhd

Alright. To clarify, my psychologist said it was alright to stop taking my medication once my hallucinations disappeared last year, so it wasn't some careless decision I made on my own. I believe he in turn had discussed the matter with my psychiatrist.

Your advice sounds good to me, and I'll be sure to follow it. Is there anything else I can expect to happen beyond simply getting back on meds if I seek psychiatric help? I don't actually understand the consequences of a potential diagnosis. I assume there will be many occupations out there that I will no longer be legally allowed to pursue, that my driver's license may be revoked and maybe some other privileges like the chance to adopt anytime in the near future may also be stripped away?

Should I see a diagnosis as something good and helpful, or something to worry about the aftermath of? Right now I feel very conflicted because I fail to predict which negative consequences will follow.