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Mental Health (Expert Forum)
Psychosis and anhedonia
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Psychosis and anhedonia
by Simian, Mar 29, 2004 12:00AM
Six weeks ago I was sectioned because I was drinking too much alcohol and taking more tranquilizers than I was supposed to be. Within a few days of being in the mental health unit I became psychotic. At first I was hearing people saying bad things about me and talking about killing me then later it became a voice that said that it and everyone in the mental health unit could hear my thoughts and if I thought something bad about someone (which I couldn't help doing because I was constantly worrying about what I could think) they would look at me and sometimes call me a name. I also had a few visual hallucinations and I get lots wierd feelings (e.g. I feel like I'm wobbling around when I stand up and I feel like I'm breathing when I'm not). I was wondering if you have any idea what could have caused all this as my psychiatrist dosen't seem to know. The only things I can think of are the reboxetine (Edronax) that they put me on shortly after coming the the ward or the trauma of being put in a mental health unit after staying in my house with social anxiety for about five years (only went to the doctors and very occaisionally to get my hair cut).
Also, one to two weeks ago I completely lost pleasure in everything, which is absolutely horrible and even made me suicidal. The only thing I can think that might have caused this is the rispiridone that they put me on a few weeks ago for the psychosis although I have read that it can be a negative symptom of psychosis but I didn't have it at first. Maybe its because I'm still worrying that my mind might be being read. What do you think?
Also, one to two weeks ago I completely lost pleasure in everything, which is absolutely horrible and even made me suicidal. The only thing I can think that might have caused this is the rispiridone that they put me on a few weeks ago for the psychosis although I have read that it can be a negative symptom of psychosis but I didn't have it at first. Maybe its because I'm still worrying that my mind might be being read. What do you think?
Doctor's Answer
by Roger Gould, M.D., Mar 30, 2004 12:00AM
, Mar 30, 2004 12:00AM
I don't know the exact cause, but it is more than likely that this has been building up before you went to the hospital, and you have been trying to control it with alcohol and tranquilizers, and that lead to the hospital. The best thing you can do for yourself now is to get to a good psychiatrist who can work with to find the right combination of medications to get rid of your extreme anxiety so you can begin to funcion better and get more pleasure out of life.
I notice quite a slowness in his physical and some of his mental behavior. I wonder if he came become sharper or if the doctor could decrease the dosage.
comments welcomed....
He has been sick since he was 18 yrs. old and had been off medicine for over 3 years. All typical behavior problems...
My brother was drinking beer of an evening for many years. It was a situation of self-medicating for stress relating to owning his own business for 18 years. His life became one of two things - daytime work - evening drink. He eventually reached a point of burnout where he was no longer able to deal with the stress of owning his own business so after a year off he sold it.
Since that time - he has quit drinking twice. Both times the results were paranoia and extreme anxiety. After round 1, when he felt symptom free - he quit taking both his risperdal and his effexor. Unfortunately, he had also started drinking again, just not to the extent of his previous levels.
Due to a severe round with gout, a new MD suggested he quit drinking. (The new MD had not been made aware of the previous event) Within a week he was back to severe paranoia and anxiety.
We (the family) always felt he was not physically dependent on alchohol, only emotionally. Unfortunately it took a second more serious round to realize we were all wrong.
He had to be admitted to an Adult Mental Health ward for 8 days due to the severity of his paranoia and feelings of guilt for drinking. During that time he was put back onto the Risperdal at 3mg/daily and Effexor at 150 mgs daily. After 4 weeks it became apparent this was not working. Last week they upped the Risperdal to 4mg/daily and the Effexor to 225 mgs daily.
Some of our current concerns are the lack of concentration and short term memory loss he is experiencing. His mind is racing all of the time, unfortunately he is not able to overcome negative thoughts about EVERYTHING you could imagine, from personalized license plates to external conversations. He feels that everything evolves around him and not in a positive way.
He is still struggling but hopefully he is gradually getting better. My advice to other families out there is not to second guess and assume there is no physical dependance on alchohol. Even just taking one drink can undo all of the benefit of the prescriptions that have been given to help them.
If anyone has any experience helping someone back from severe anxiety, guilt and paranoia from alchohol dependance, please share with me any advice you may have. Trying to convince him to close off the past and move forward is a struggle.
Thanks . . .
My brother was drinking beer of an evening for many years. It was a situation of self-medicating for stress relating to owning his own business for 18 years. His life became one of two things - daytime work - evening drink. He eventually reached a point of burnout where he was no longer able to deal with the stress of owning his own business so after a year off he sold it.
Since that time - he has quit drinking twice. Both times the results were paranoia and extreme anxiety. After round 1, when he felt symptom free - he quit taking both his risperdal and his effexor. Unfortunately, he had also started drinking again, just not to the extent of his previous levels.
Due to a severe round with gout, a new MD suggested he quit drinking. (The new MD had not been made aware of the previous event) Within a week he was back to severe paranoia and anxiety.
We (the family) always felt he was not physically dependent on alchohol, only emotionally. Unfortunately it took a second more serious round to realize we were all wrong.
He had to be admitted to an Adult Mental Health ward for 8 days due to the severity of his paranoia and feelings of guilt for drinking. During that time he was put back onto the Risperdal at 3mg/daily and Effexor at 150 mgs daily. After 4 weeks it became apparent this was not working. Last week they upped the Risperdal to 4mg/daily and the Effexor to 225 mgs daily.
Some of our current concerns are the lack of concentration and short term memory loss he is experiencing. His mind is racing all of the time, unfortunately he is not able to overcome negative thoughts about EVERYTHING you could imagine, from personalized license plates to external conversations. He feels that everything evolves around him and not in a positive way.
He is still struggling but hopefully he is gradually getting better. My advice to other families out there is not to second guess and assume there is no physical dependance on alchohol. Even just taking one drink can undo all of the benefit of the prescriptions that have been given to help them.
If anyone has any experience helping someone back from severe anxiety, guilt and paranoia from alchohol dependance, please share with me any advice you may have. Trying to convince him to close off the past and move forward is a struggle.
Thanks . . .
My brother was drinking beer of an evening for many years. It was a situation of self-medicating for stress relating to owning his own business for 18 years. His life became one of two things - daytime work - evening drink. He eventually reached a point of burnout where he was no longer able to deal with the stress of owning his own business so after a year off he sold it.
Since that time - he has quit drinking twice. Both times the results were paranoia and extreme anxiety. After round 1, when he felt symptom free - he quit taking both his risperdal and his effexor. Unfortunately, he had also started drinking again, just not to the extent of his previous levels.
Due to a severe round with gout, a new MD suggested he quit drinking. (The new MD had not been made aware of the previous event) Within a week he was back to severe paranoia and anxiety.
We (the family) always felt he was not physically dependent on alchohol, only emotionally. Unfortunately it took a second more serious round to realize we were all wrong.
He had to be admitted to an Adult Mental Health ward for 8 days due to the severity of his paranoia and feelings of guilt for drinking. During that time he was put back onto the Risperdal at 3mg/daily and Effexor at 150 mgs daily. After 4 weeks it became apparent this was not working. Last week they upped the Risperdal to 4mg/daily and the Effexor to 225 mgs daily.
Some of our current concerns are the lack of concentration and short term memory loss he is experiencing. His mind is racing all of the time, unfortunately he is not able to overcome negative thoughts about EVERYTHING you could imagine, from personalized license plates to external conversations. He feels that everything evolves around him and not in a positive way.
He is still struggling but hopefully he is gradually getting better. My advice to other families out there is not to second guess and assume there is no physical dependance on alchohol. Even just taking one drink can undo all of the benefit of the prescriptions that have been given to help them.
If anyone has any experience helping someone back from severe anxiety, guilt and paranoia from alchohol dependance, please share with me any advice you may have. Trying to convince him to close off the past and move forward is a struggle.
Thanks . . .