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Alicia_MSW, Psychotherapist
Category: Relationship
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Experience:  Specializing in relationship/family counseling
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Well, I had apsych appointment today. I was cheating on 1050MG

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Well, I had apsych appointment today. I was cheating on 1050MG lithium and he says to up it to 1800MG and if I do not oblige he will discharge me as a patient. Sigh what do I do? I'm really worried about high Lithium during me into a dull zombie, which would make my ambitions to not be alone even more diffficult, and may just make me lose interest in the idea at all. I'm so confused! I'm really scared to start taking this dose... even though it's wearing offthis "hypomanic" state over the last 5months or so has been so fun and hasn't really interfered with functioning. Well, I'm not that motivated lately, but that's due to the issue I stressed in prior posts :P. But I doubt more Lithium would really fix my problems..what do I do?
Hi there!

I understand your concerns, I really do, especially after all we've talked about in the past. If you want my honest opinion, it seems that you're best off following the advice of the psychiatrist. I can't tell you what to do because I'm not a doctor and I'm not your doctor, but if I were you, I'd follow what he's suggesting - I am assuming he thinks you need it and that if he didn't, he wouldn't have suggested it. Or perhaps you could talk with him to see if there is another mood stabilizer you could try (you might want to read this information before you talk to him: Let me know how it all goes.
Customer: replied 5 years ago.
He thinks I need it because he cannot fathom that maybe that issue I have repeated countless times in my life might actually really bother me... he just views things from a biological standpoint. I acknowledge that aspect but it is not so simple as drugging me up. I think I will continue to cheat if there are no drawbacks to low levels of Lithium in the blood. I know high can be toxic but can low have any bad side effects? Does it really HAVE to be in the therapeutic range? I really do not fancy becoming a dull uninteresting zombie. I was on Zyprexa for 10 months or so and although I didn't have a care in the world, looking back I realize what a lame life it was... a slow mind, excessive sleeping, disregard for appearance, no sex drive... lame.
It is not as easy as drugging you up - that I agree with. Have you considered seeing a therapist, in addition taking the medication (regardless of what you ultimately decide to do about that)? You shouldn't have to live like a zombie - no one wants to live like that. And if you're going to continue to cheat, then it's not really serving you any purpose... I think seeing a therapist might be a good addition to your treatment, though, because maybe that will help to address some of those underlying issues we've discussed in the past. And unfortunately, a lot of psychiatrists (due to time constraints, etc) can't devote as much time as they might like to individual concerns and so it might seem like he's just giving you a prescription and saying, see ya next time, without giving you a chance to talk about what's on your mind, what's going on, etc. (and talking to a therapist could help with some of those relationship issues we've discussed, too. Just something to think about!)
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Customer: replied 5 years ago.
Been seeing a therapist lately... 3 sessions so far of me kinda giving a life story and background. I'm skeptical. My problem is like.. hard to change because I genuinely feel it is just a situational problem that creates a mental disburbance rather than a mental disturbance creating a situation problem. And I'm not sure how a therapist can change the fact that I'm rather socially isolated with women. It takes some luck to break out of this hole.. it is not entirely within my control. We can control our lives but sometimes chips have to fall into place. By the way I am pretty agitated right now, I think I may see a prostitute today. I know it won't give me what I want, well.. won't give me everything I want... but maybe it'll shut my mind up for a few days. SIGH the money I blow.
I know what you're saying, and I know that it's always a combination of things (some things you can control, some things you can't), but it's good to know the difference, and to learn to change what you can (that's a long-winded explanation but I think you know what I mean). I think you should try to relax - realize that you're doing everything you can to help yourself. Remember what we said previously about not putting too much pressure on yourself (again, one of those things you can control, right?) and trying to relax. Keep in touch!
Customer: replied 5 years ago.
I can already feel my sex drive and feelings of isolation declining with the upped medication. This is so lame, I hope I don't slip into the zombie coma where I'm perfectly content with everything and therefore disregard this issue. also it's like burning to piss? Is that in any way Lithium related? I drink a lot of caffeine and water.. alcohol sparingly.
I'm so sorry to hear it, I really feel for you... As far as the burning pee, it could be from the lithium, from what I understand, but you should double -check with the psychiatrist. Keep an eye on your feelings and try to relax and get your mind off things this weekend. Hang in there and keep in touch, okay?
Customer: replied 5 years ago.
I feel lousy, ugh.

Maybe being a zombie wouldn't be so bad after all.

It's just so unusual, I was in the same social situation 2 months ago but was really energetic talkative and in a good mood...hypomanic if you will. Now I'm just being plagued by feelings of agitation frustration and loneliness and don't feel like talking as much. Still taking the meds, maybe I need to wait a few days for it to kick in..but this issue is deeper than that as you know. I can feel my energy and confidence waning... sigh. I can't win any money gambling lately either... my dad asks why I spend so many hours there, I just say... I don't have anything else to do :P.

I just feel a little bit sorry for myself that I have to come on here and talk about these things. I'd seriously rather have financial problems or a drug problem or something of the sort than this. Money doesn't even make me happy right now... not unless it's stupid amounts anyway.


Don't feel bad about talking about things here. It's often a lot easier to talk to a "stranger" about things than to discuss it with people you know. I'm glad to hear that you're still taking the meds. I know it's frustrating - and I'm not just saying that. On a different note, it sounds like you need to find some sort of distraction (maybe one that's not as costly as gambling :)), like exercising (even though I know that's difficult when you're feeling the way you're feeling now) or some sort of activity you find even remotely enjoyable (I mean in the sense of a hobby) just to get you out of your own head. Because if you're mulling things over so much in your head, then the feelings of loneliness and agitation and frustration just start to multiply of their own accord. And part of it is just enjoying your own company - you know what they say, right? You have to enjoy your own company before others can enjoy being with you. You sound like a really nice guy, and you obviously have a good sense of humor. You'll get through this - try to see it as a temporary bump in the road. The frustration and depression and loneliness will subside, just try not to give into them too much and try to keep yourself busy in the meantime (and stay in touch!)...
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Customer: replied 5 years ago.
I was exercising a lot prior to Vegas but got lazy ever since I came back. Oh well, my physique is alright, some even get tricked into thinking I'm an athlete. hehe.
I mean... I do enjoy my own company. I don't really hate myself. I just lament the situation I'm in, but do naturally begin to question myself when I'm so isolated. I should say isolated when it comes to women, I do have a lot of guy friends, maybe not super close ones but a lot, but that's just not sufficient for my mind.

I had these feelings a lot 2-3 years ago but they were stifled when I was drugged up on Zyprexa and during the manic episode... but now they seem to be returning. I don't think the issue ever went away, it was just suppressed.

Oh I still need to make an account for that site, been too busy losing money. I'll find time soon!

Thank you
I was going to ask about how it was going in terms of registering for the site, but I didn't want to pry :) Let me know!
Customer: replied 5 years ago.
Well, I was going through a stretch of severe boredom/depression recently worsened by the fact that I wasn't winning at all in poker. So I did what is natural, get a hooker. As it turns out this hooker went to my middle school and it seemed we had good talking chemistry. or so I thought ! We talked and texted a few days after and drove around one night looking for a room but were unable to due to a concert filling all the hotels. As we drive back to the whore's car she fellates me and as she is dropped off asks if I can "take care of her" and starts bitching about gas and bills and shit, so I pay her annoyed. I haven't seen her last few days and she does not respond to text and phone, and I have too much pride to blow up her phone and pester her. I guess this situation sort of mindf**ked me and now I feel a sense of hopelessness lol. I feel like a little bitch. I have to admit I have fragile emotions and sensitivity to even the smallest of things. I dunno why I for some reason expected more out of a hooker.

As my bitterness grows I start to behave irrationally. A week ago I began to become annoyed by a somewhat attractive girl who works at our carlot but I am unable to do anything with due to multiple factors. I ordered that my dad get rid of her and he did. I don't really feel bad about it either.

This issue feels so complicated. It is so much more complex than just sex, even if that is the root of all interests in opposite sex. Many people would be shocked at the lousy quality of my social life and extent of mental disturbances.. because on the surface I come off as somewhat confident, handsome, and successful.

Customer: replied 5 years ago.
A few more notes, the carlot girl I never expressed interest in because I was aware of the obstacles, but just her mere presence then was an irritant, and so she was axed

I guess the annoying thing about the hooker is that when you're alone, and may feel the delusion that nobody likes you, when you receive attention that turns out just to be a mirage it just makes you feel worse about the situation.

I'm not a moron that falls in love with every person I sleep with, but to think someone likes you because of their deceptive behavior only to find out you are just an ATM and once they'e maxed out abandon is just ... well, annoying given the present circumstances.
Hi there,

I'm hearing your frustration, trust me! And it IS kind of a complicated, multifaceted issue - but if you don't mind me saying so, it seems to me (as I've gotten to "know" you over time) that you might be making it even more complicated for yourself. To me, anyway, it seems like you're doing things that trigger those feelings of 'sensitivity' - so it's like you're hurting yourself on purpose (almost). Do you agree with that? And call me idealistic, but I don't necessarily agree that the root of all interests in the opposite sex is strictly for sex - you also seem to want that emotional connection, too. Maybe part of the issue is that you're objectifying women to such an extent that you don't even allow yourself to get in a position to be emotionally fragile because you're afraid of being hurt by them, underneath it all? I don't know for sure, I'm just throwing ideas out at you, as usual, but it does kind of seem to me that you have two issues going on - one is the desire to be truly intimate and close to someone, and the other is this throw-caution-to-the-wind promiscuity that is sort of self-destructive and just confirms those insecure feelings you have about yourself.
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Customer: replied 5 years ago.
What do you think I am doing that may trigger the sensitivity?

I guess it could be hanging around hookers. After all, if you want someone to give you genuine attention or to actually like you hookers are just a mirage. Is this what you meant? Elaborate if not.

I feel that the ROOT is sex, but its more complex. For me,... its like, to be in this state, it hurts my sense of pride in self. It's like, to go back to narcissism, if someone thinks they're special, unique, may be somewhat arrogant, and seeks attention... but ISN'T getting attention, it's just a huge blow to the mind lol.

It doesn't have to be a deep emotional connection. I'm not really a hopeless romantic.

I guess I cannot help but feel insecure right now. When people randomly start ignoring you it just makes you wonder what is so unappealing about you.

And I'm starting to get sick of this "hooker phase" I've been in. It just comes down to the annoying thought of paying someone for sex to feed you BS attention when you want real attention and acknowledgement. Also it gets too expesive. The problem with that lies in the fact that if unable to find anyone soon then what? Go months without intercourse? Eh, that's just annoying although I guess doable.

Woe is me!

That's indeed what I meant :) I think you kind of put yourself in this position where you sort of expect more from them than they actually are going to give you (emotionally speaking?) in that it doesn't seem that you're purely viewing it from a sexual standpoint. I am willing to be wrong about this, but I see this pattern occurring a lot in our conversations....I only point it out because I don't want you to hurt yourself on purpose and kind of confirm your own inner feelings about this situation (so kind of making you feel like, see, there really isn't anyone out there for me, the more this kind of thing happens.)

But I don't totally see why you need to pay someone for sex at all. I think you could very easily find someone who you could connect with - you say yourself that you're handsome, confident and successful (or at least you come across this way) and that's what almost every woman wants! I think going the "hooker" route is the easiest option for you right now, but I also hear you when you say you're getting sick of it. You can be with someone who can give you more than just sex - but I guess it's also like we've talked about before - that you have to look in the right spots or at least put in the time and effort (i.e. with the online dating sites.)

And I don't think you need to give yourself up completely and become a sap or anything like that (in terms of the deep emotional connection statement you made) but I think there is part of you that wants more than what you're getting now. I don't think (of course, I don't see you here but from what you've said) that there is anything so unappealing about you. I think it's just the vibes that you're putting out there right now that people might be picking up on... maybe it's just a matter of changing your mental "talk" and starting to see yourself as worth more than just being with hookers. You have a great sense of humor, you're obviously smart and you have a lot of insight - at least, this is what I pick up on from our conversations. You just have to start focusing more on those positive aspects and try to resist the urge to engage in "negative" behaviors that have a tendency to go overboard.
Customer: replied 5 years ago.
Hey I've only expected "more" out of the Spaniards and this particular hooker, not all of them. 8)

I am only told by others I'm handsome but I dunno if my mind accepts it as a reality. As far as confidence it's just an illusion whereas on the inside I'm brimming with doubt and insecurity.

That is what is so annoying about this particular hooker. The experience makes me feel like a moronic sap. BTW it has left me feeling really lousy and lethargic, almost as if we were in a 2 year relationship or something lol. I actually had to smoke marijuana last night because I was getting vexing racing thoughts about the whole ordeal.

I dunno, it's just days keep passing by and everything feels the same and nobody new enters your life... so you start to wonder if it's just going to be like this for a while. It's unpleasant. "Normal" people typically wouldn't have this problem due to a more solid foundation socially.

I feel... so lousy lol. Maybe this is the transition from being a little depressed but still functional to laying in bed and growing a beard :P.

I think you give 'normal' people too much credit :) Part of it is just accepting the realities of everyday life -it is usually not exciting all the time and most people have the same daily routine of going to work and coming home and maybe some sort of fun on the weekend. It sort of sounds like you're having an existential crisis - maybe you need to read some Nietzsche :) And broadening your social circle wouldn't hurt either - meeting someone new who you connect with on a higher level who you can talk to about some of the things you're thinking about, for example...
Customer: replied 5 years ago.
I feel that if I talk about some of the things I'm thinking about to some people they will just view it as pathetic, lame, or weakness.

So I often have to put on facades put maybe throw in subtle clues at underlying concerns.

I dunno, the emptiness and lack of fulfillment seem to linger with me all the time. My mood was a little elated for a week or so due to the stripper/hooker lol, but now it is just back to anger and mild depression. I nearly got kicked out of the poker club today for some of my berating of the other players. I have so much bitterness ugh.
I was just going to send you a message because I was concerned about how you were doing after our conversation yesterday. I might not have all the answers but I am always here to listen :) Why do you think you are so angry and bitter?
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Customer: replied 5 years ago.
I dunno, I guess it is just the issue of women yet again. This sense of being ignored or rejected, or being alone just bothers my emotions. As I drove back from the poker club today it crossed my mind that I wish I had someone to talk to and do something with right now. Granted it was 4 AM but the point still stands, an empty feeling. And then now I become bitter anywhere where I see women. When I see people with their girlfriends and things of the sort it seems to upset me a little inside. Maybe it's jealousy or just that it reminds me of my situation. I mentioned the firing of the girl from the carlot, about 2 weeks ago another girl who had vexed me in the past entered the carlot and I started berating her in the worst way even in front of customers. In Vegas about 2 months ago I felt ripped off at an Asian massage parlor and started saying the worst things and racial slurs to the ladies lol. I cannot help it my frustration is really high.

Then there's just a mental conflict. I have narcissistic views of myself I cannot deny it. I like attention, I have fantasies, I think highly of myself. But the lack of women is negative feedback which makes me question those views. It really is like a pride issue.

And then as this issue lingers doubt and insecurity enter my mind which makes me feel like I'm trapped in a cycle where my isolation warps my mind such that it becomes more difficult to break out.

Even though I haven't mentioned sex, it seems I would be unsatisfied with nonsexual relationships. Almost as if sex is a vehicle of acknowledgement and attention that I want, rather than enjoying it for an emotional bond or pleasure. That is why hookers aren't completely satisfying, because it is not the type of acknowledgement I seek... even though I've pursued quite a few this year.

I feel I am just rambling here lol, did any of this make sense?

In other news the skin on my penis is kind of burning. Surely just a passing fad si?
Ah, I can't speak to the burning skin on your penis but I'd say you might want to get it checked out if it doesn't stop in a few days - especially if you haven't had a check-up in that department lately (no offense intended but I'm just being careful here!)

I do understand what you are saying when you say you feel jealous or upset when you see people with their girlfriends. It makes sense because it's something that you want - and I guess you feel like you don't really know how to get it (but I would throw out the idea at you - as trite as it might sound - that you often get what you want when you stop looking for it. Maybe you're focusing too much on that issue right now...) And it also makes sense from the "narcissistic" viewpoint - so everything you are saying really does make complete sense to me - not that it's totally functional, but I understand it. I get what you mean when you say sex is - for you - more like a way to feel acknowledged and appreciated (in a sense) than an emotional bond. But I think the reason it's not coming along could be just from the vibes you're throwing out there. You know - you say you feel negative and bitter, and I don't think that's something that's going to draw a lot of women toward you. Don't get me wrong - I understand why you feel that way and I think it's completely justified in light of your "circumstances" - but I'm just saying that in order for things to change you kind of have to change your thoughts - which is not easy. Have you ever tried cognitive-behavioral therapy? I'm not sure if we've discussed that before but you might want to give it a try, because I think the whole problem is stemming from your thought process, which has become this self-defeating cycle - and it can be really hard to break out of that on your own.
Customer: replied 5 years ago.
I feel like a problem with women is just.. I'm not really put in situations to meet them and don't know how to create those situations on my own. It seems so natural for people with "normal" social lives but my social life is really not normal due to swapping high schools and quitting college. But I'm 23 now, yet those events seem to have a lingering effect. I don't even have many female friends, it's just guys.. as if I'm invisible or in occulted when it comes to women. Regarding the "vibe" it is not as if I am put in situations to meet people and ruin it with a vibe. Plus I am not angry all the time, just recently :P.

I know some of my thoughts are irrational, but I grow skeptical that this dilemma is entirely due to my thoughts. It just feels like circumstance and poor luck, maybe in combination with some of my personality traits and thoughts. What is CBT exactly?
I know what you're saying in the first part of your message, and that some of it has to do with circumstances. I'm not denying that part of it at all - and certain factors do have a lingering effect (although you can have some influence over that, to a certain extent.) Bad luck does, unfortunately, play a part, too - but sometimes you can influence your luck as well - putting yourself in the "right" circumstances, for example. I'm not saying it's easy and it doesn't always work, but it's also not 100% external. It's usually a combination of external and internal factors.

And I get that you're not angry all the time - I haven't really picked up on that vibe until some of your more recent messages. And it makes sense, don't get me wrong on that one, either. I'd probably be angry if I was in your shoes, too.

CBT is a type of therapy (usually short-term, so it's not like you'd necessarily be in treatment for years and years) that is probably best described here:
I just thought you might be interested in it, since you do have a lot of insight - and if you've never tried it before, it could be worth a shot.
Customer: replied 5 years ago.
I got discharged by my psychiatrist lol... he suggested anti psychotics and referred to my poker as high risk behavior so... I kinda snapped and got kicked out of the room and discharged. hhmm.

I bought a watch today to try and fill my emptiness. It didn't work.

Also this mild burning in penis is kinda irritating. *sigh*...
I think I may be going to Vegas next week, one way. 4-6 weeks. Thoughts?

Oh, that's really unfortunate. I do understand how you might have felt when he suggested antipsychotics, though, and how it made you more angry - especially when you are already feeling so angry in general. Would you be willing to try working with a different psychiatrist? Not that I necessarily think they would suggest a different course of action - but it's often a good idea to get a second opinion. As far as the burning goes - you should check it out with your GP. It's a long time to have this feeling and I can imagine that it's a bit ore that irritating.
And as far the trip to Vegas - it is probably not the smartest move right now in the state of mind you're in, if I am being completely honest, but (although I don't agree with it) it seems to be the only thing that brings you some relief. If there's any way you can channel your energy into something more productive, though, I'd much rather see that happen...
Please stay in touch (even if you decide to go on the trip).
Customer: replied 5 years ago.
I saw the stripper/hooker 2 more times and almost became borderline obsessed with her. She entered my mind so much. It becomes annoying actually liking someone but having to pay for intercourse. So I meet her one day at strip club and meet another stripper. I give number just to become friends with her. I stupidly LOAN her $ the next day and in an attempt to collect the loan the day after get set up for robbery at weapon point. At the hospital (I tell cops to take me there to calm me down) I talk so .. "manic" that they put me in a mental institute for 4 days. It was pretty lame. I'm out now and lost $1200 more on top of the $1500 I lost getting robbed while playing poker lol. Talk about a lousy week. At least I'm alive, I was in a really dangerous part of the city. It was a complete lapse in judgment. Now I'm alone though and my hooker won't talk to me :(. She is the flaky type, maybe she'll come back. I miss her!
I'm glad you stayed in touch. I was beginning to wonder how you were doing! And I am sorry to hear about this whole situation. BUT... In light of these events, I hope that you're now starting to see that it's obviously a good idea to stay on the medication - and I hope that you are considering either going back to your psychiatrist or seeking a new one. I'm worried that your symptoms are going to get even worse if you don't - and you see in the end that it's not really worth the rush of feeling manic (right?)... Stay in touch.
Customer: replied 5 years ago.
I couldn't stay in touch because i was in the mental hospital lol.. I dunno, I feel lie being around good people and maybe meeting some nice girls instead of the "meh" I've seen lately would really help. I do take the Lithium still and haven't cheate on doss.. Unfortunately I don't think it'll change soon because I am still planning a long Vegas vacation... where I'll probably just meet hookers. My sexual life is so poor... not in quality of beauty hehe.. but, ya know.

I don't feel as manic as i used to which is a shame, it's almost like a guard against feelings of loneliness and hopelessness
Yup, I know that NOW but I didn't know that before :) I'm glad to hear you're still on the lithium. Just take it easy in Vegas and try not to go overboard. I know it's tempting, but going to extremes can, in the end, just increase those feelings of loneliness and hopelessness. Just try to relax and "be" with the feeling of "not" being manic - if you get used to that feeling, you might even start to like it (and you might get to the root of some of those feelings of loneliness, you know?)