Psychotic Break?

By Kristina Randle, Ph.D., LCSW

I have a Dx of Bipolar Disorder and have had a few, brief dissociative episodes in the past (years ago before med compliance) in which I felt unreal, like I was floating and/or like time had stopped. However, something happened today that never has before. I was driving and very stressed for time due to work and I just became “unhinged” I guess. I don’t even have a vocabulary for it…I felt as if the universe was comprised only of the interior of my car, everything outside was a projection; I kept wondering what that sound was far off in the distance and realized I was screaming! My nails were scraping into the skin on my thigh and I’d been slapping myself in the face over and over again… my whole body was shaking uncontrollably and, when I realized what was happening and that I couldn’t control this, I started sobbing…I don’t know how I drove home and barely remember parts of the drive. Once I got home, I had a full blown panic attack and now, hours later, I’m still feeling “outside of my body.” I’m very frightened and don’t understand what’s happened. I have psychotic symptoms when manic (motion in my peripheral vision, delusions etc) but never in the absence of a mood episode. I’d been intensely depressed for months but feel as if that has begun to abate over the last month or so. I’d stopped taking my meds from 12/11 – 8/13 to try to conceive (did not conceive) but resumed them in August 2013. I take 300mg Lamictal p.o. q.d. and 50mg Seroquel q.d. at bedtime. What happened to me today???

A. It’s unclear what happened. It’s possible that it is the result of the medication or the discontinuation of the medication. It’s also possible that it is the result of an untreated medical condition. It’s important to report this episode to your prescribing physician. He or she might be able to determine what happened.

This letter is important because you have documented in detail what happened to you. You can take your letter directly to your prescribing physician or read it to him or her over the phone. Your doctor can assist you in investigating what happened.

I’m sorry that I don’t have a definite answer for you but it is worthy of investigation. Consider having a medical evaluation to rule out a possible physical cause. Please take care.

Dr. Kristina Randle

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Last reviewed: By John M. Grohol, Psy.D. on 22 Nov 2013

APA Reference
Randle, K. (2013). Psychotic Break?. Psych Central. Retrieved on September 1, 2014, from http://psychcentral.com/ask-the-therapist/2013/11/22/psychotic-break/