u/Extension-Yam-7343

OVERVIEW (can skip if wanted):

I don't have the *most* severe schizotypal traits. I have mostly negative symptoms (flat affect, struggle to feel positive emotions, anhedonia, painfully impaired social skills to the point I'm assumed to be autistic and was misdiagnosed with Asperger's as a kid, etc.).

My other symptoms exist but aren't the most extreme; for example, I have ruminations and fixations on beliefs but can usually rationally tamp them down until the next time they resurface. Very "Must have been the wind" type thing. And I struggle greatly with self-disturbance/depersonalization/derealization, which manifests as a consistent belief of not being in reality. I don't know what constitutes a belief, but I consistently feel like I'm clearly not supposed to be here. Maybe it's a scientific explanation - like my brain is just not wired to handle this world. Or maybe it's because I was supposed to be, or even from, somewhere else. I usually rely on factual evidence when making decisions and approaching things to try to keep myself from slipping that line from belief to delusion. Because even if I'm not here, or not supposed to be here, you can still use the rules of this reality to semi-function. If that makes sense.

You get up, go to work/class/both, you need to eat and sleep and use the bathroom, you have to talk to people sometimes, get some hobbies so you won't be bored. And most of all - You can't question it. Because when my brain suddenly isn't busy with work or classes or whatever else, I remember extreme unsettledness that nothing is real. Maybe it is actually real, scientifically speaking. But it isn't to me. There are rules to this game. You don't pay attention to the things that appear in the corner of your eye, you don't pay attention to the strange noises that no one else heard or that have no logical source. You don't look at your environment for too long, things will start to look strange. You can't sit in complete silence, your mind will start taking over.

Things like that - just a general summation of those symptoms for me.

I did have a period of full-blown psychosis as a kid during a time a lot of traumatic events were happening, and although I try to push those old beliefs down - of being from another world, of being another creature, of being an angel cast down to hell and the wings ripped from his back, from having some sort of malicious purpose or mission that I have no details on, and especially try to push down the thoughts of being punished by God or - the opposite - getting saved by getting sucked into the alternate reality I made up.

STRANGE OBSESSION PART:

There are a lot of other things I could speak about - but the one I wanted to ask is something I haven't really seen described as something people with Schizotypal OD struggle with. Some people say they struggle with rumination, etc, or have OCD like thinking?

But I was literally misdiagnosed with Antisocial Personality Disorder (so a psychopath) because of my strange hobbies and obsessions.

They aren't intrusive thoughts; they are interests I have had since I was a kid that I actually enjoy. And I don't enjoy them much. I won't get too descriptive, for many reasons, but they mostly revolve around death, infliction of pain, anatomy, strange erotic fixations despite *not* wanting physical intimacy with self or others, etc., etc.

I am considered at risk for homicide/violent behavior/assault DESPITE the fact I said I would never act out on desires for a plethora of reasons. The idea I would actually do something like that is insane to me because I would risk having to go to jail, having my whole life disrupted, and actually have to figure out how to physically do those things. Which is just too much drama and effort and dealing with real people and reality.

Some of these interests have physical/external manifestations that I keep private, but they would only be considered odd or weird, maybe slightly disturbing, interests/hobbies versus the real thing.

But besides, the fantasies and worlds in my head are much better than reality.

Am I alone in this? Is there maybe something else- a disorder or issue it's connected to that I should look into?

My new psychiatrist - the one who diagnosed me - is very helpful compared to all the others I dealt with throughout my childhood. But I haven't told him about these things because of my past experiences.

Some psychiatrists have borderline threatened to report me - You can't report people for thoughts??? They'd say stuff like "Are you scared I'll tell people this?" Well, I wasn't because of HIPPA, but I sure am now.

One straight up said I might be possessed by demons. I live in the south, but that still should be something that should get her license stripped.

If anyone had a name or explanation for this I could use to start the conversation with, that would be very helpful.

No one has ever prescribed me an antipsychotic (to be fair, I was only recently diagnosed and was misdiagnosed in childhood with autism, OCD, and temporary psychosis), and only ever given anti-depressants, which semi-helped, so I stayed on them through my teen years since my mom wouldn't let me take anything else. I got off those at 18 (I'm almost 21) and felt like myself again, but old issues came back pretty quickly. I was handling them okay until I added full-time college to my full-time job and started being constantly stressed.

I sought psychiatric help, which took a very long time to find a competent one, but I felt I should only ask about them in a worst-case scenario.

My new psychiatrist agreed we should explore lighter medications first, so for a first tentative step, he put me on Lamictal in hopes it would help with the persistent irritation and anger and general struggle with emotional reactivity.

It barely did anything besides make conversing with people a little less irritating, but my emotional reactivity and anger persist.

THE PROBLEM: He recently put me on 15mg extended-release Adderall to see if it would get me out of my head and sort of "quiet" things, and help me focus on things.

It did actually feel like being slightly sedated and calm (which I took as a sign that it wasn't affecting me as it would usually affect someone who doesn't have ADHD). After getting over the physical symptoms (nausea, dry mouth, racing pulse), I was able to start taking it daily about two and a half weeks ago.

The first thing I noticed was that issues I *already* had became more frequent, not worse just more frequent. Like, sometimes I struggle with speaking clearly, but it became more frequent. I also have always had a small level of perceptual disturbances, but I have never had full-blown hallucinations except when I had a full-blown psychotic state from ages 11-13.

My perceptual disturbances became more frequent, but not worse. They just happened every time I took Adderall, even when I was only taking it every now and then because of the nausea etc.

But ever since taking it daily, they have gotten a little worse. Instead of objects looking strange or seeing them in the wrong locations or the wrong for a few moments, I started having more frequent more severe ones that usually only happen every now and then. I've been hearing things, but not voices, just simple things like a phone ringing, the laundry machine jingle, or a door shutting when none of those happened. Visual disturbances that are usually quite harmless have become more disturbing; shadows move and look like people out of the side of my eye. I have become more paranoid, maybe because of the increased visual illusions, or maybe separately. I usually struggle with feeling like being watched or hunted, especially at night. But I've started sleeping with a baseball bat in my bed and pulling the sheets over my head and holding my cat close to me, even though she hates it. Sometimes I'll stare down the hall at the door to my office and be frozen because I'm convinced something is about to appear in the doorway.

I have also been irritable and emotional for no reason.

I have stayed on the Adderall because I was hoping the effects would go away. Maybe they still will? I just want to be able to keep this state of mind that doesn't get me stuck in there to the point of being unproductive. But it just seems to be bringing my internal thoughts into the external world.

Today was the LAST STRAW. I don't care what will happen if I go cold turkey; my next appointment is in a week anyway, and I am still shaking from what happened, and it was hours ago. I've barely been able to speak, and what I have said doesn't make any sense.

My friend and I live with another roommate. We're not very fond of her, so we made the extra bedroom into an office that we use instead of the living room. We heard a car door shut, so we went to check the window to see if it was her, because if so, we were going to leave the kitchen/living room area we were in, making tea. The living room blinds are half closed, so I had to bend down to see. From my angle, I couldn't see the two people's faces, just like the torso down. I did not know my friend was behind me and was looking too. So I said, "Ugh, she brought her friend or somebody with her without telling us." She gave me a weird look and said, "Really?" I assumed it was because she did not look with me and was also frustrated to learn this.

We "escaped" to the office, and she said, "Maybe it was her mom you saw? She did say she might be coming over later?"

I said no and told her they had matching clothes, black leggings and pink shirts, and they must have come from a party or baby shower or something that would have matching clothes as an element. We heard her come in, and she was loud as usual as she greeted her dogs but we didn't hear another person. After a while I mentioned it was really weird that we didn't hear her friend and her talking.

My friend looked at me and said, "I only saw one person."

I started saying "No there were-" But shut up, because I realized that she must have been right, why would there be someone wearing her exact outfit that wasn't talking with our roommate.

I have known my friend for a long time, she's the only friend I've ever had, but she knows nothing about my struggles besides the fact that they are complicated and too private for me to share.

I felt her staring at me for a long time, and I made an excuse to leave the room. I went to our roommate's door and heard nothing. The fear started creeping in. It became obvious when we continued to hear nothing for two hours until her mom showed up, who greeted the roommate, no friend. My friend also left the room to say hi, and there was no evidence of the person I saw ever being there.

I took a kolonopin so i wouldn't start breaking down and spiraling, but I'm still shaking. Not only does my friend know I saw someone who wasn't there, but she knows I was badly shaken, which clearly implies it was a serious situation.

I only figured it out because she was with me, I have no idea what else I could have seen that wasn't there.

I want to ask to sleep in her room because I'm terrified, but I have work in the morning and don't want to wake her up at 6am, and I also don't want to sleep on the floor.

I don't want to go back to the way I was before taking Adderall, because it's the only thing that has actually kept my mind focused and quiet. But this is clearly worse, and I have no idea if this will have permanent consequences, or if the only thing that will help is an antipsychotic, since clearly antidepressants, antianxiety meds, and mood stabilizers have been just a Band-Aid on a bullet wound. And apparently, stimulants treat the wound but cause another one.

It's so hard to explain myself to psychiatrists without sounding like I'm making stuff up because I have no words for what I feel. I did recently find the term "self-disturbance", which I think is just a way to say nothing feels real, and everything feels wrong, uncanny, and I always just feel "off", even when I'm not in a bad mental state.

QUESTION I NEED ANSWERED: Is there anyone who has struggled to explain themselves to their psychiatrist or find the correct meds, but found a way to express themselves accurately? Or maybe anyone who can calm my fear about antipsychotics or tell me that I shouldn't even ask for them because the side effects won't be worth treating my symptoms that, when at baseline, are not symptoms of full-blown psychosis?

And are there any self-soothing things I can do to make it through the week? And will going cold turkey on the Adderall possibly add to my instability?

I will take any help I can get, please.