Scared and confused

Can you handle going to an ER and admitting you’re very paranoid and psychotic and would like an anti psychotic medication but that you don’t need or want to be admitted?

Hi there MuddyBoots. I'm not qualified to answer you but I did want to pass along that I saw a fellow who had trouble identifying what was real or not and he would use a trained dog to walk up to people if they were there when he asked the dog to. He also used a phone on video mode and if the object/being wasn't actually there it apparently wouldn't show up on the phone screen too. No clue if these are helpful or authentic but I wish you well.

Gosh that's so scary! I'm sorry this is happening!

What does you "medical team" consist of? Would your PCP be able to provide or refer you to urgent care or ER?

Having a PCP referral to urgent care or ER is better than just showing up somewhere. First, the ER nowadays really is only for strokes, cardiac issues, bleeding; everyone else should bring lunch, dinner and PJs for an overnight stay in the waiting room. The PCP could get you seen faster.

Second, the ER won't assume you're a drug seeker, hypochondriac or some other non medical case.

I'm not sure you'd be released in less than 3 days, though.

Have a clinic I go to with no consistent PCP, and a psych team (CM, T, and pdoc). I saw my new pdoc a couple times shyt it's weird we can communicate by using our fingers and not even seeing other people unless we can see them?, but yeah, she didn't press meds. I think she knew I would resist anyway, but they said they'd get me in next week and fit me in ASAP.

I don't really want to go to an ER for any psych stuff and answer their thousand questions that lead to "go home (without any meds) or get admitted" and being admitted involves, since it's a Friday, waiting until Monday at the earliest when a bed opens up to get transferred. Waiting in the ER hall until then.

Street seroquel? lmao. Probably has tranq in it and your little nap turns into a forever nap.

Have you been in touch with your CM since you got out of the hospital? I'm sorry it is so overwhelming.

I talked to her on the phone before I got discharged and she said someone on the team can call regularly to check in for a bit. Someone did call earlier and I told her and she told me to basic on the self care like making sure I have food and eat it and drink water and shower and try to use external stimuli to black out internal

I haven’t read your recent posts so I am not sure what you were in the hospital for, but I am shocked they discharge you in such condition. I am sorry you are struggling. I’d either take myself to a hospital or talk to pdoc and insist on higher level of care. Why aren’t they prescribing meds (although I think you refuse to take them). It’s terrifying. I hope your CM and pdoc do something ASAP

I don't NEED "higher level of care" that is BULL! Do you know what that even looks like? A FKING DAY OR MORE either in a gurney in an ER hall IF I'M LUCKY. and if I'm not, JUST AS LONG in a seclusion room,, being monitored by a bunch of security guards one of which groped me (yes, he's still there, saw him Tuesday and Wednesday). And then they have other "patients" (I know there's always one that's my ex is disguise) spying on me so he (ex) can keep stalking me. How the EFFF am I supposed to "get better" in an EVEN MORE stressful environment? At least here I know safe places and have ways to protect myself. There I can't have a knife or mace or anything.

Hospital was for my "schizophrenia" lmao fking demons

I didn’t mean anything extravagant by higher care, but anything more than what these medical professionals are doing. Not necessarily ER or being secluded, but pretty much anything as it doesn’t sound as they do anything? Just discharged you? Unmediated schizophrenia is hard and they just leave you with nothing and you are unwell.

Sooo what higher care do you mean? They're trying to fit me in to see my pdoc within the next week, I saw my CM today and we just kinda tried keeping it light but also made plans for the rest of the weekend. They are checking in on me frequently, but it's not super helpful when I still feel like they're against me. Maybe I'm against me and they're against the me against me though.

I don't have schizophrenia, I have bipolar but with psychotic features, but yeah, I could use some meds right now regardless. I was way worse before going, but I did sleep some because my potassium I guess is low (which again, went without being treated. When they checked it, it was at 3.1 but that was Tuesday). I'm pretty sure if my lack of potassium wasn't exhausting me I'd be running around like a chicken with its head cut off. Even just now I did some impulsive shopping (meant to get these sodas that I'm collecting the bottles, but ended up not even going to the store with those sodas and got a bunch of stuff. Nothing extravagant, but I'm broke af and $30 is a bit). I wanted to go to the batting cages, but my head is way out of it and I'd probably just stand on the plate lmao

I got there, first meeting with the doc I asked if I could leave (I mean, who wouldn't after over 24 hours in the ER only to be transferred and think everyone is talking about you and your ex is there in disguise spying on me), and he said sure. I looked at my paperwork and it said I left AMA, but it's not like he told me I should stay or anything so idk how that's "AGAINST medical advice" if there was no advice to stay.

I'm also trying to avoid going back home where I wreaked havoc. I don't know if I can handle seeing some of the permanent damage I've done (well, I mean not PERMANENT but I'm considering having to repair wood on the porch and patching a wall pemanent because it's more than an easy fix). I do need food and to sleep though.

I don't know when I'm supposed to see my pdoc this week, but I don't know what I should ask for. I haven't tried Loxapine, perphenazine, pimozide, thiothixene, trifluoperazine, (and rexulti and caplyta for not 1st gens, but I hear they're not good for mania). I've had awful experiences with FGAs (every one gave me akathisia, two gave me urinary retention, two caused suicidality, and one gave me involuntary facial movements) so I'm a little reluctant to try anything that might fking help. If I get akathisia on top of this fking shyt I WILL kill myself as soon as I feel it. Yeah, I know it's not rational because I can just stop, but will I care in the moment? I know I won't.

wtf man. I'm starting to think I'm doomed to off myself before I'm even 30. Off meds I'm crazy enough to do it, on meds the side effects will make me think it's rational because I know I don't like that and I don't like unmedicated either.

Fk this shyt. I hope the cops follow me again and maybe I'll...eh can't post that

Well, in the meantime, you taught me a new word: Akathsia

It turns out that's what my wife is like. It's why she got a hole in her leg because she couldn't just let a shipping box sit around in the kitchen.

Well, anyway, would it comfort you if I say you are in my thoughts and "prayers?" I don't "pray" for anyone without his or her permission.

You have my permission to say it, but I'm not saying it brings me comfort.

Glad to add a word to your vocab

You didn't end up trying Caplyta, right?

No. I'm told it's more for depression and a lot of times will trigger mania.

Can you just show up at your pdoc's office & cause a stink in the waiting room until you get seen? Or maybe a doc at the clinic would prescribe an AP short term?

Mine prescribed 21 mg, half the therapeutic dose, to try it short term, initially without dropping Lybalvi. The idea is to eventually see if perhaps I can be on it instead of Lybalvi and without the hunger Lybalvi causes. Caplyta is the only distinct SGA not yet tried. The pdoc says that after my reaction with EPS to a minuscule dose of Thorazine, it makes no sense of trying more FGAs because they were developed to cause EPS, hence the name neuroleptics. I am too prone to EPS. Muddy, I think you are, too.

Yeah, I am very prone to akathisia but less so the other movement disorder stuff. I actually did okay with Thorazine because I guess it has some built in anti-akathisia mechanism that works for some people, but it also at a high dose was the only med to cause TD symptoms (I forget what exact dose, but this most recent trial we only went to 200mg and it didn’t do this).

I hope the Caplyta works for you, but if you have to stick to Lybalvi have you ever tried using something else to manage the hunger (I think I had a pdoc that put people on Zonegran, Topamax, or metformin first for that and if none of those kept people out of the obese category on Zyprexa (before Lybalvi), he would try a stimulant if it was tolerable. He was a little unhinged by psychiatrist standards though.)

Do you have something like the bridge clinic there? I'm on 2 antipsycotics and congenton. Just having one does nothing for me. And I still have symptoms daily.

Oh by the way guys this original post was in 2024 but TCJ was looking for info on Caplyta (which I did not try) (in the meantime I did try Rexulti and that was an absolute shyt show I didn't sleep for 5 days straight and didn't eat for 7 unless you count compulsively biting myself).

But I'm doing okay without an antipsychotic (knock on wood) on my three anticonvulsants and stimulant right now.

Zonegran caused mania and a facial rash.

Topamax made me forget words. I forgot the name of my own direct report! And it is not that I had hundreds of direct reports, no, just a dozen.

Metformin did nothing, good or bad.

Stimulants do erase my appetite, true, but then they come with other side effects that are undesirable and I have to stop them. Same with oxybate. But I haven't tried all stimulants yet and will continue trying.

I am lucky in that regard and either Lybalvi alone, at the lowest dose, or medium-dose Geodon plus low dose Seroquel keep me stable, while Gabapentin+Vit B6 protect against EPS so that I need no Cogentin, but either Lybalvi or Seroquel cause hunger, day and night. But at least I have no symptoms of bipolar disorder.

It is very tough, to be on two APs, needing Cogentin, and still have symptoms.