From the U.S.: I have seen a few therapists and am on medication right now (Seroquel 50mg)(Ativan .5 mg) but have not been officially diagnosed. Also I am not really good at keeping my appointments. I am always moody and my family looks at me scared because they don’t know how i’m going to react to things.

I am very irritated and have severe anger and rage issues and also homicidal thoughts. I lie constantly and it doesn’t bother me, and I also have trust issues and think most people are lying TO ME. I am very very paranoid about peoples intentions and what they say. I fantasize constantly about sex with almost every person I see and on T.V and the media. The intrusive thoughts are what concerns me the most. My brain is overloaded with suicidal, homicidal and sexual thoughts DAILY. I also feel like I am smarter and better and more special than other people sometimes. Most days I do not feel like I will act on my thoughts but some days I really want to and it scares me. I obsess about the littlest things people say to me and what it might mean. I get obsessed about the way some things should be done and get upset when they are not done the way I want, but only SOMETIMES.

A: I can’t make a diagnosis on the basis of a letter, of course. But someone has. You could not be prescribed medication without a diagnosis. Go back to your prescriber and ask for that information. Then talk about the fact that your medication doesn’t seem to be enough to quiet your symptoms. You may need a different medication or a different dosage.

You certainly need to be talking to a talk therapist as well. If you connected with one of the therapists you’ve seen in the past, please make an appointment for further care. If you didn’t connect with any of the therapists you’ve seen, ask yourself how it is that you haven’t stayed with any one therapist in order to get treatment you clearly need.

I suspect that your paranoia and trust issues are played out in therapy just as they are in your every day life. If that’s the case, it’s something to talk about with the therapist, not a reason to flee treatment. To get better, I think you need to make an appointment with a therapist and make the commitment to talk right from the start about whatever makes you want to leave therapy despite the fact that it would probably be helpful to you.

I wish you well.
Dr. Marie