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Dear Dr. Saltzman,

I don't really know where to start, so I'll just start explaining and go from there. for several years now i have had serious bouts of depression. they started randomly and for no reason at all. the first time it got bad was my junior year of high school (i am now a sophomore in college). everything in my life was great, but i was constantly depressed. i began self injury a couple months into this. my self injury has been a severe problem since then, but it is something i am trying desperately to stop (for about the 6th time). suddenly things got completely better and i was happy all the time. this change has happened several times, but generally not very severe except for when i go back to the depression. i feel like i crash and every time it happens i sit on the ground shaking and crying, wanting to die.

I've acted on this urge several times, but it was never bad enough because i would manage to catch myself in time. anyway, I've grown accustomed to the depression having had it for so long, and being happy never concerned me (i was a teenage cheerleader--i was bound to be happy) but more recently things have changed. about 6 months ago i began getting serious social anxiety. i used to have panic attacks by myself when i was trying to stop self injury, but this was different. whenever i got in large groups of people i would get anxious. I've had many panic attacks. i get shaky, dizzy, sweaty, and have trouble breathing. I've thrown up numerous times because of it too. about a month after this had started (it still wasn't too bad at this point, i would just get shaky), when i was alone i would occasionally hear a lot of voices, like huge groups of people talking and laughing. at first i assumed they were outside as i live in a dorm and it gets noisy sometimes, but slowly came to realize that there was never anyone outside. this really didn't help my anxiety because hearing all the people would cause me to get anxious. since then, things have gotten seriously worse.

a few weeks after the "talking" started, i began seeing random things. i knew i was seeing them because they wouldn't stay (things like blood on my arm or other places, or a room would morph into a different room for a few minutes). while I'm at this point I'll mention my nightmares. since the anxiety started I've been having horrible nightmares. if you've ever seen the movie "Saw" imagine a scene from that. i mentioned that i would see rooms morph, well they would morph into rooms from my dreams. sometimes people would look disfigured. this has kind of decreased in occurrence and hasn't happened in a few weeks. but I've seen other things. people that aren't there, dogs that aren't there. in public i don't know they aren't there until i ask someone and they tell me they aren't. it really freaks me out. there are other times when they will be in random places.

I've seen the same person many times. i actually know his name too. one day at my boyfriends house, he was in the bathroom and i was alone in the bedroom. all of a sudden i hear a voice of a women telling me that the man I've been seeing is named mike. well i see mike randomly. sitting in chairs in otherwise empty rooms. in the backseat of my car. and watching me from across parking lots. on top of all of this I've become much more paranoid then usual (I'm a naturally paranoid person). I'll catch myself thinking that I'm being watched or that people can hear my thoughts. i realize this makes no sense, but continue to believe it. there are other things i believe, but my boyfriend tells me that they aren't. he calls me "delusional". Like ok i have this fear that something is coming after me. i just know it is. one night at his house i knew they were coming, i could hear them and i just hid my face in my boyfriends chest, and then i began feeling them grab me. my boyfriend was freaking out just holding me. once they left he swore to me no one was there. but i know they were.

i just don't know anymore what is real. its possible i could be delusional. i know i am at times. up til a few days ago, for the last few months i was insanely happy. talking fast, not being able to keep my attention on anything, rapid thoughts. just out of it and hyper. during that time i got in 3 strange fights with my boyfriend. i don't remember much of any of them. mostly just laughing a lot and yelling. i also remember calling him the devil and believing it. and i also accused him of being involved in those who are coming after me, saying he was leading it.

one more thing I'd like to mention is severe insomnia. on average i get about 2 hours of broken sleep a night. this has been on and off for 3 years. one time, (when i was actually put on meds for depression), i got about 5 hours in one week. i didn't stay on this meds for long, since they didn't help my sleep and caused me many other problems, such as making my mood swings much much worse.

i dunno, there is more, but i just cant think to say anymore. most of what i did write was out of order and didn't make sense.

anyway, I'd appreciate any advice u can give.

Thanks, (name withheld)



Hello--

Given your history of depression, self-injury, panic attacks, and other serious symptoms, you should, in my professional opinion, be under the care of a psychologist or psychiatrist. In addition, some of your more recent experiences are strongly suggestive of the onset of schizophrenia which should be treated immediately before it gets any worse. At a distance I cannot help, so please make an appointment right away with someone in your area.

Be well.











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page last modified January 10, 2007



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