Good morning, Confused:

“He diagnosed me within 20 minutes”, “He said… I am in the middle of a psychotic episode… He did say it’s a psychotic episode”, “He prescribed me (medication)… and he guaranteed that I will see difference immediately”, “He also suggested that the other psychotherapist isn’t helping because she is focusing on the wrong things… and she’s too young (she is 26)” –

I read that a psychotic episode involves one or more of the following types of symptoms: (1) Hallucinations (Sensing things that aren’t there, such as hearing voices, seeing things, smelling or feeling things without a source), (2) Delusions (Strong beliefs that are clearly untrue or disconnected from reality, such as believing someone is following you, or that you have special powers) (3) Disorganized thinking (Speech that is hard to follow, sentences that don’t connect, jumping from topic to topic)

(4) Disorganized or unusual behavior (Examples: acting in ways that don’t fit the situation, agitation, difficulty completing simple tasks, odd or unpredictable movements) (5) Negative symptoms (flat or blank facial expression, very little speech, withdrawal from others, lack of motivation, inability to carry out daily activities).

* There is such a thing as “early psychosis”, or a prodromal phase. This stage is not full psychosis, but it can precede it. It is usually gradual, not sudden. The most common features: A. Trouble concentrating- thoughts feel ‘foggy’ or ‘slowed’, difficulty following conversations, and feeling mentally overloaded. These are not hallucinations or delusions — just cognitive strain, B. Changes in perception- things like sounds feel louder or sharper, lights feel too bright, feeling ‘detached’ or ‘dreamlike’, feeling like the world is slightly ‘off’. This (B) can overlap with anxiety or dissociation.

C. Social withdrawal- avoiding friends, isolating, losing interest in activities, feeling disconnected from others. D. Emotional changes- blunted emotions, sudden anxiety, irritability, mood swings, feeling ‘flat’ or ’empty’, E. Functional decline- trouble at work or school, difficulty completing tasks, losing motivation, sleep disturbances.

F. Odd or unusual thoughts — but not full delusions- Examples: ‘Something feels strange, but I don’t know what.’, ‘I feel like people are looking at me more than usual.’

*** Early psychosis is not something a clinician diagnoses in 20 minutes. It usually unfolds over weeks to months and requires careful evaluation.

Next topic: a first psychiatric appointment is usually cautious, exploratory, and non‑committal. A psychiatrist may say things like: ‘We may need more than one session to get the full picture.’, ‘There are several possibilities we can explore.’ ‘Medication might help with X symptom.’, and ‘I can’t say for sure yet — we need more information.’. Psychiatrists are trained to be careful, measured, and non‑absolute.

Examples of a psychiatrist’s statements that are not standard or accepted practice: ‘I can diagnose you in 20 minutes.’, ‘You are definitely in a psychotic episode.’ ‘You will see improvement immediately — I guarantee it.’, ‘Your therapist is wrong / inexperienced / focusing on the wrong things.’ ‘You don’t need therapy, only medication.’, and ‘This is absolutely the diagnosis.’

Psychiatrists avoid guarantees, absolute statements, criticizing other professionals, and making firm diagnoses without full evaluation

Especially in a first appointment.

Psychiatrists know that medications affect people differently (so, guarantying that a medication will work, or guaranteeing immediate improvement is not medically appropriate.). They know that diagnoses require time and that symptoms can overlap (ex., anxiety and dissociation symptoms overlap with early psychosis symptoms), that mental health is complex, and rushing (20 minutes) leads to mistakes

The bottom line- guarantees, quick diagnoses, and criticism of other clinicians are not standard practice.

I hope the above is somehow helpful, Confused.

🤍Anita

Hey Confused:

A medical doctor, a psychiatrist, saw you for the first time in his life, for TWENTY minutes only, and following a conversation of about 10-15 minutes, diagnosed you with psychosis?

And bipolar disorder?

All in 10-15 min conversation?

🙄 Anita

Dear Confused: I will read and reply later this evening or in the morning.

🙄 Anita

Dear Mollie:

You are very kind and gracious 😇. Looking back, I wrote TOO MUCH in my last post (the “study”). I need to write less, in general, especially when it comes to other people’s childhoods and relationships with parents/ family.

It’s nice to read that you feel love and gratitude for your parents. Talking about love, my tattoo consists of 5 letters: ALULA.

What it means is “I love you”, which is what my nephew tried to say to me when he was a toddler. What came out was Alula, and ever since then, 30+ years later, whenever I talk to him on the phone (he lives in another country), I tell him Alula.

You asked me to tell you more about myself, so I will- tomorrow morning when I have the use of a computer.

Take care and again thank you for being appreciative and kind. 😇🙏

🤍 Anita

Good 🌄 Confused:

Sounds to me that you’re idealizing her (“her heart is pure”) and you’re idealizing the relationship in the past (seeing it now better than it really was).

And part of you wants to stay there, in that idealized version of reality rather than experience real life here and now.

What do you think, any truth to my perception this 🌄?

👀 Anita

Dear Thomas:

The Sounds of Silence 🔕 playing ▶️ loud in your mind?

Songs 🎵 get stuck?

I know the experience, the feeling: into the night 🌙, Right now, I am hearing the Doobie Brothers’s “Without Love Where would you be Now?”

Without Love.. where would you be right now?

You’re not alone, Thomas, getting stuck in music, there’s so much to us.

I become the music 🎶 I never dared to sing, the movement I never dared to dance 🕺 🎶

“You know how I feel .. and I’m feeling good” (don’t know who’s singing).

Parts of me is being heard by someone else’s singing.

“You need me, call me, I’ll be there in a hurry” (Diana Ross)

It really doesn’t matter, it’s the Singer within, the Dancer within, that comes alive.

Last I danced 🕺 was late last year, I did to live music, after a couple of glasses of 🍷 – it was beautiful.

When’s the last time you danced. Thomas?

I am not dancing now, but I’m drinking 🍷 and listening 🎶 to old music.

An old woman listening to old music and feeling Young and Alive. Isn’t it the point. Thomas?

To experience Youth at No Matter What Age?

Please 🙏 feel free to ignore all of this post. Thomas. I’m tipsy 🤪 and young.

“And if you want it, you got it… Maybe tonight… Let the music… ” (Marvin Gay.. Who was shot by his father).

What is it, this Youth refusing to succumb to Old age, Thomas?

“I’m so in love with you, whatever you want to do is Allright with me” ( reverend Green) “the good and bad, the happy and sad… you… baby… together… Let’s stay together…”

“I don’t care what they say… about anything they say, but being with you… I don’t care about anything else but being with you… one thing I know for sure”-

What would that be, Thomas, what do we know for sure?

For me, the answer is.. know for sure, I AM YOUNG, right now, tonight. I AM Y.O.U.N.G.

“I heard it through the grapevine and I’m about to lose my mind… Honey 🍯..”

“Stop, in the name of love before you break my heart… STOP in the name of love”

The name of love has no age. 16 can be depressed. 61 can COME ALIVE.. Just like that.

Strange, how at 60+ I am younger than 16.

🤪🎶🎵✨️ Anita

Dear Caroline, unforgettable Caroline:

July 1, 2024 is when you posted last. 1 year, 7 months and 22 days ago. I wish 🤞 to read from you again.

🌙 Anita

Dear Robi:

Interesting, you started this thread on Feb 18, 2024 and we talked on Feb 23, exactly 2 years ago. On this day (2 years ago), you got a job interview in Spain for March of that year.

Not very long ago, really.

As to what you shared today (Mon night, your time), I can understand your frustration in regard to your girlfriend. You wrote something to the effect that you’re exhausted and may not make sense, but truly, to me, you make perfect sense. The way you present the conflicts with her sounds fair to her, objective, seeing 👀 both sides’ validity.

As I 👀 it (I’m using my 📱, and when I do, all these emojis show up and I can’t help but click on them, and sometimes I ask for them), the fact that (it seems to me), she’s enmeshed, or emotionally fused with her mother, is a big problem because it means that.. if you choose the daughter, you also choose the mother 😱 ?

Is she at all troubled by her emotional dependence/ enmeshment with her mother?

Of course, ongoing arguments 🙄 are not considered the basis of a healthy relationship.

I am curious about what an argument 🤔 between the 2 of you looks like, like who starts it, what does she say, what do you say.. and I wonder: in what specific, concrete ways do you need her to be invested in you (which she is not)? Is it that she’s not willing to pay all of the rent until you are able to contribute?

And I understand you may be too exhausted 😩 to answer this.

Which brings me to the thought 🤔 that a relationship should Energize 🔋, not Exhaust.

Hope to read from you soon enough. I wish 🤞 you Clarity and the Energy 🔋 that accompanies clarity.

😱👀🔋🌙 Anita