Severe Anxiety with Paranoia Vs Acute Psychotic Episode

[freakazoid]

Hi.

A few months ago, on top of general stress I had a specific worry/ anxiety which I couldn't stop thinking about. I saw my GP who said I had anxiety and gave me sleeping pills as I told him I couldn't get to sleep because of the worry. He booked me in to see him the following week. When I saw him next, my anxiety had got worse and was coupled with some paranoid thoughts which were a lot less rational than the original anxiety. He seemed to panic and referred me to this "crisis" team, who came and saw me at home the next day.

They gave me some anti-psychotics as they thought I was having an acute psychotic episode. I agreed a low dose with them as I was concerned about the side effects. Over the following week and a half I was off work as I couldn't think of anything other than my worries, but once the source of the initial anxiety was removed, my symptoms went away as quickly as they came on. I went back to work as normal and the "crisis" team discharged me.

I'm seeing a psychiatrist next month who specialises in psychosis. However, after reading about what the CPNs said they thought I had, I disagree and believe I had severe anxiety coupled with paranoia. My basis for this is:

- I was very anxious and had other physical symptoms of anxiety, as well as my persistent worries
- I did not experience hallucinations of any kind
- I did not have disorganised speech
- I did not do anything "mad" or "crazy"
- My paranoid thoughts always had an element of doubt, e.g. at one point I had paranoia over the CPNs being spies for a criminal gang, but it was not strong enough for me to refuse them to see me, whereas if it was a fixed deluded belief, I would have been too afraid of them seeing me
- My symptoms quickly went away once the source of the anxiety had resolved and I returned to normal

Additionally I have no personal or family history of any kind of mental illness, have never taken drugs, and don't drink much. I am generally quite a worrier.

Do you think my "breakdown" was severe anxiety with paranoia, or an acute psychotic episode? My current thinking is I want to see the psychiatrist next month with view to getting the diagnosis corrected (if the latter has already been formally made).

[Charlene]

It's difficult for us to say with any accuracy whether or not you had a psychotic break. Maybe it really was all anxiety related. It's possible, it certainly isn't impossible.

Sometimes people with anxiety think up strange, unrational thoughts. Thoughts like "If I drive across a bridge, what if I freak out and drive over the guard rail and kill myself?" or "If I'm around sharp knives, what if I grab one and go running out into the parking lot and start acting like a lunatic?" or "What if while I'm bathing my baby I go nuts and drown him?" (Don't worry folks, I don't have any kids)! These are just made up examples of thoughts that can enter a "newbie" anxiety sufferer's mind. They don't know what's going on and they begin to think they're losing their minds and start to think up unrational, scary thoughts. It's very, very common amongst people with this disorder.

So, if those examples sound somewhat similar to what you or your doctor considered to be paranoia, then it is quite plausible that you were just freaking out by your anxiety.

[freakazoid]

It kind of went like this...

Bought a car, it still had outstanding finance on it so I was worrying about that. It didn't have the documentation with it when I bought it so I had to wait for it to go through. So it went.......

- what if the car is stolen?
- what if I get done for stealing the car?
- what if the dealer who sold it has set me up?
- what if the police are waiting outside to knock my door down?

Those thoughts came over the course of about a week. Then I would start waking up (after the 2 - 3 hours sleep I could actually manage) expecting the police to be waiting outside for me. What would the neighbours think? What about my job? What about future jobs with a criminal record? People tried to reason with me but for every argument I had a counter, which made things spiral more.

Then after a few days of that, even more irrational fears came in. I had some food that tasted wrong and noticed a tin of open paint in the kitchen near where the food was prepared, and the back door was open. What if the people at the dealership had poisoned me?

They had all my details (payment, driving licence, etc) - what if they committed identity theft? What could they do in my name? How much money could I end up owing? Had they sold my details to an organised crime gang? If it all came true, my only option would be suicide.

When the CPNs started to come round...... what if they were sent by the gang? Were they simply spies?

I had about another week of laying around worrying and moving from being anxious to being a bit depressed/ resigned to it all, and then the documentation for the car came through ok so my original anxiety was removed. My paranoia went away and I realised how stupid some of the thoughts I was having were.

[freakazoid]

PS. As well as the anxiety and paranoia, I had physical symptoms, e.g. trouble sleeping, muscle cramps, pins and needles feeling in hands/ feet, occasional palpitations, and weight loss due to less interest in food.

[freakazoid]

No-one else experienced anything similar? Or any opinions on what I experienced being anxiety/paranoia Vs psychosis??

[Charlene]

Hi freakazoid,

Absolutely! Your feelings and thoughts are completely normal for an anxiety sufferer. I remember, many, many years ago I used to think my food was being mystically poisoned. And something as silly as having a bottle of floor cleaner next to a bottle of water would make me second guess myself...."Did I just take a swig of the cleaner or did I drink the water?" It's your mind playing tricks with you, trying to get you more and more scared. Why we try to scare ourselves silly with strange scenarios, god only knows. But if done often enough, it becomes habitual. And trying to break free of it becomes very difficult, but it can be done! :)

[joey9]

I experienced a severe anxious episode last year which I thought verged on psychosis at one point. It went from being stressed, to becoming over anxious about events that were happening in my life, to worrying beyond reality - a kind of losing touch of what had actually happened, what might be real etc. This also extended to issues beyond what I was actually stressing out about in the first place, and paranoia was a huge feature - I think the anxious mind generalises to any old trigger that comes along. Looking back its fascinating but at the time it's completely scarey. Anyway, with time, rest, self-help, herbal supplements, and meditation I haven't had it back (the 'psychosis' - I still have the odd anxious wobble from time to time). With regards to your diagnosis, how important is it to you to get a formal diagnosis? These things can come and go, and the most productive thing you can do is learn about yourself - what your triggers are, how you can deal with these, how you can prevent stress, how you can look after your body to make these episodes less likely to occur again. I'm not in any way trying to dissuade you from seeking help because it can be great to talk to someone but, unless this is a major ongoing problem then I wouldn't worry too much about trying to put a label on what you have experienced.