anxiety or psychosis?

[dontletanxietywin]

I went to see my primary care doctor today and she asked my why I don’t like to leave the house. I said I feel like people are staring at me and thinking I’m weird. She told me I may be experiencing signs of paranoia and psychosis. Every psychologist and psychiatrist I’ve seen has told me I’ve had social anxiety. Even though she doesn’t specialize in mental health, I’m so scared I might be psychotic. I’ve always been afraid that there was something else wrong with me and that it was more than just anxiety. I’ve been googling all day the difference between social anxiety and psychosis. I realize my thoughts are irrational and that people aren’t judging me or staring at me and it is just in my mind but I’m so scared that I am psychotic now. I keep on finding evidence to prove that I’m not really psychotic but deep down I believe it might be true.

I’m so anxious and agitated that I feel like crying. I need to know if I am really psychotic and need someone to tell me I’m not and reassure me. Idk what to do

[Depresseddoglover]

Don't panic! I think that paranoia can be a symptom of social anxiety. Diagnoses are at best a guess based on the symptoms presented. Don't let the label distress you. Try to distract yourself a little bit and reassure yourself that you are not psychotic (in the way that you interpret it to mean). I myself was put on 'anti psychotic' medication because my anti depressants were losing there efficacy. They simply helped to stabilize my mood. Try not to scare yourself.

[MothFir]

I am not a doctor and I don't know you, but you say that "every psychologist and psychiatrist" you've seen has said you have social anxiety, and only your primary care doctor, who "doesn't specialize in mental health," has mentioned psychosis. So if you were a judge in a court, who would you believe? The experts in mental health, or the non-specialist?

Regardless of that, your current distress seems to be caused by the classic common denominator of all of us with OCD - the absolute intolerance of uncertainty. The constant googling, the ruminating, the distrust of expert opinions, and the "need to know" whether you are psychotic or not are all classic OCD. How much do you know about OCD? Understanding how it works and how the brain functions has really helped me step back and get perspective on why I fear the things I fear, and how to live with those fears.

It sounds like you don't really believe you're psychotic, but you've had a nagging fear that you might be, and your primary care doctor's comments have just thrown a log on the fire. Now you have all kinds of alarms going off saying that everything you've feared is true after all. The thing with OCD is that all the alarms are going to feel genuine whether they are or not. The "fight-or-flight" part of your brain is supposed to get the attention of your rational brain, so even when it goes off for no good reason (as it does often in those of us with OCD), your rational brain tries desperately to figure out why. It will latch on to the flimsiest evidence and make you believe that you really may be psychotic, or that people are judging you, or that you left the stove on, or your hands are dirty, or whatever. That doesn't mean those things are true, just that the rational brain has a hard time accepting that the "fight-or-fight" brain is lying to it, because the alarms seem so real.

I'm in my 40's and have had various forms of OCD since I was 10 or so, including a few episodes of health anxiety. Over the years, I have known "for sure" that I had AIDS, leukemia, MS, ALS, lymphoma, impending heart failure, rabies, and probably a bunch of others that I can't remember off the top of my head. I am still here, and the only health problem I have for sure is the silly OCD.

My advice is to stop googling and ruminating and trying to prove to yourself 100% that you are not psychotic, because you will never get to 100%. All those health problems I mentioned in the previous paragraph? I may really have some of those, just waiting to become symptomatic any day now. I may also be killed in a car crash when I go to the grocery this afternoon, or I may buy tainted meat that will poison me and my family. No one can say 100% that bad things won't happen, and you'll ruin the only thing you have for sure - the present moment - trying to prove to yourself that they won't. You have to learn to live with probabilities: you probably are not psychotic, just as I probably won't be killed going to the store. I could know for SURE I won't be killed in a car if I don't go out, but then I'd have nothing to eat, and I could still get killed slipping in the bathtub or falling out of bed.

If you must, go back to one of your psychologists, tell them what your primary care doctor said, and get their opinion again. But only do this after you've decided that you will accept what he/she says, regardless of how you may FEEL about it. Expect that your OCD will come up with all sorts of scenarios for why the psychologist doesn't know what he/she's talking about, or didn't really listen to your symptoms, or whatever, because that's what OCD does. You'll still get alarms saying "What if I'm psychotic?!" But if you expect them, and have a rational understanding of why they're going off despite the evidence that you're not psychotic, you'll have the upper hand in ignoring them, and eventually they'll shut up.

Also, if you're not taking medication and/or getting therapy for OCD/social anxiety, you should try to do so. A professional who understands these disorders can really help you manage your anxiety so you can both go out of the house again and not obsess over why it bothers you.

[dontletanxietywin in reply to MothFir]

Thanks so much for your response! I’ve always thought there was something else wrong with me. I would ask my therapist “what is wrong with me?” And she would reply “ocd and social anxiety.” I always felt like it was something else, so when the doctor said psychosis, I was like there’s the evidence it’s something else!!

All those possibilities that you mentioned COULD happen, which is why it’s so frightening but it shouldn’t stop us from living our lives. I also thought what if I passed out and needed medical help and no one was there to help me and I’d just die, but the chances of that happening are probably slim.

[MothFir in reply to dontletanxietywin]

You're welcome! It's really hard when you have a fear in your head and then something comes along that seems to confirm it. Just remember that when you fear something your brain will find and/or magnify anything that seems to confirm its fears. The fact that you've had experts (psychiatrists and psychologists) tell you it's just OCD/social anxiety should set your mind at ease and help you start work on getting over them.