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Concerned about Possible Future Break from Reality

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I’m 21, and just starting college again. I have no job, and have been able to find one that I can handle. As a child and teenager, I had issues controlling myself when angry. There was never a diagnosis that completely explained it, but Manic-Depressive/Bipolar Disorder and Aspergers were suspected. I have trouble making friends, but not talking to people. I am unable to attempt to initiate a romantic relationship. I try my best to avoid conflict, but go as far as inconveniencing myself to avoid inconveniencing others. I’m not afraid of a fight as much as being afraid of bothering that person and having them think less of me. I don’t care what people think of me, but I do. I feel unaccepted, worthless, and often a burden on others, even when by myself. I am afraid of being used by people and am skeptical of anyone that shows a romantic interest in be, likely because it has happened in the past.

My current concern is that I am slowly beginning to question my reality. Unfortunate and inconvenient things plague me constantly throughout the day. The logical part of my mind understands that this is normal, and everybody deals with such things. But another part of me is beginning to feel it is too coincidental. As if it is being scripted or planned. I am worried that this is the beginning of a “Truman Show”-type delusion.

I do not have mental-health coverage through my insurance, and cannot afford to see a specialist. Should I be concerned right now? Is there anything I can do to change my locus of control?

Concerned about Possible Future Break from Reality

Answered by on -


Any time there is a concern about your mental health, it should be investigated to prevent the development of future problems. You are doing the right thing by asking for help.

I have written about the “Truman-show” delusion in response to similar questions but to summarize, it is not an official mental health diagnosis. Its closest diagnostic classification might be delusional disorder, persecutory type. People with that disorder believe that someone is out to get them, someone is cheating them, someone is spying on them or otherwise mistreating them. The delusional belief centers on their being targeted and that certain events are not coincidental.

You ended your letter by saying that you lack mental health insurance coverage but this should not preclude you from seeking treatment. Many communities offer free or sliding-scale services through community mental health centers. Call your local community mental health center to discuss your options. You can also contact your local health department for assistance. The staff can refer you to free or low-cost services.

It may take some effort to determine if mental health services are available to you but it is very worthy of your time. When it comes to the potential development of a psychotic disorder, prevention and early treatment are of profound importance. Please take care.

Dr. Kristina Randle

Concerned about Possible Future Break from Reality

Therapists live, online right now, from BetterHelp:

Kristina Randle, Ph.D., LCSW

Kristina Randle, Ph.D., LCSW is a licensed psychotherapist and Assistant Professor of Social Work and Forensics with extensive experience in the field of mental health. She works in private practice with adults, adolescents and families. Kristina has worked in a large array of settings including community mental health, college counseling and university research centers.

APA Reference
Randle, K. (2018). Concerned about Possible Future Break from Reality. Psych Central. Retrieved on November 27, 2020, from
Scientifically Reviewed
Last updated: 8 May 2018 (Originally: 12 Nov 2014)
Last reviewed: By a member of our scientific advisory board on 8 May 2018
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