How to tell the difference between "normal" anxiety or depression and something more serious.

In My Humble Opinion
1

Warning: somewhat long story ahead. I figure the back story is relevant to what’s going on now. I apologize in advance though if I made this too long, too detailed. For those who don’t want to read the whole thing- I’ve had a history of relatively minor depression & anxiety and am concerned that it’s entering the territory of being actually delusional.

I’m not asking for medical advice and I’ve been doing research on low cost/sliding scale mental health clinics in my area (I don’t have insurance). I went to a regular free clinic to see if perhaps I had a physical problem that was causing me to feel sluggish, un-motivated, etc. They did blood tests and an an overall exam and the results of those said I’m in perfect health. I felt uncomfortable telling them the extent of my feelings though because of some of their commentary regarding my answers when they were filling out a questionnaire about my general well being. For example when they asked me if I was feeling “persistently sad and hopeless” and I said no the nurse told me that I’d given the “correct” answer. When asked if I’d ever had sex without a condom the nurse replied “interesting” when I said no. There’s no use in complaining to anyone about their un-professionalism. The whole place seems like a mess, but that’s beside the point of my OP.

Anyway, in middle school and the beginning of high school I had a problem with depression which was probably more related to my friend group/being an angsty teen than a serious mental health issue, however my parents (mostly my mom) insisted on putting me on Zoloft when I was around 13 or 14. I met with several therapists- one diagnosed me with adjustment disorder, the other two thought I was just being a teenager. My mom stopped sending me when the last therapist told her that she thought my mom was the problem, not me. When I was 16 I refused to take the Zoloft anymore and by this point my parents were beginning the process of divorcing so they didn’t offer much resistance.

Fast forward to my last year of college when I was around 20. I started feeling depressed and anxious about various things such as feeling that my friends didn’t actually like me and worrying that I was about to be fired from my job. I went to the campus mental health center where I was diagnosed with generalized anxiety, depression, obsessive compulsive disorder and handed a prescription for Prozac. I took the Prozac for a few months until for some reason I totally flipped out on a friend I used to work with after we got into an argument about something stupid. I was very upset about the possibility of losing his friendship, apologized profusely and sent him a gift card to his favorite store however he said he was no longer interested in further contact. For the first time I fell into a deep, nearly suicidal depression (I was also having issues finding an internship for school that was necessary to graduate- I did end up finding one at the last minute though). I was able to hide it however because I knew rationally that despite feeling like I never wanted to leave the house again, not going to work, school and losing friendships by cutting off contact would make things much worse. I flushed the Prozac down the toilet, acted my best as if everything was normal and after a few months I felt better.

I am now 23 and have been out of college for two years. I work a full time job and effectively have the same group of friends from college. I have a lot of anxiety about the future, where I’ll be when I’m 30, how will I make my mark on the world, etc. I also worry a lot about money and have extreme anxiety about being fired. This is where I’m afraid that my current worries are leaving the territory of “normal” anxiety into “possibly delusional.”

My boss asked me if I’d made a bank deposit for x amount on a certain day. I said I’d made a deposit of a similar amount on a different day and told him the correct amount for the deposit on the particular day he’d asked about. He then asked me for the bank receipt which I sent him as well as the bank receipt for the deposit of a similar amount. On this same day, a co-worker who didn’t know how to read my paperwork correctly told my boss that I’d left the register short money, when I’d actually taken money out to pay a delivery person and had documented it. I explained that to my boss which got no response, me sending in my deposit receipts also got no response. I’m very concerned about them concocting a story about me stealing as a means to get rid of me even though I am not (so they can deny unemployment insurance) or possibly using me as a scape goat in the event someone else is stealing since I’m the one who handles all the banking. I was very upset all day because I did find a missing receipt, but it was from an old deposit that no one has asked me about so far and I have a copy of the deposit slip. I told my co-workers my concerns and they told me I’m being silly and that I’m way too valuable to the company for them to abruptly get rid of me without negative consequences and if they really did think I was stealing they would talk to me about it. A friend I confided in was of the same opinion. I’ve started keeping my bank receipts in a locked drawer that I only have the key to though and will make a point to scan them and always include them with my paperwork in the future (I hadn’t done this previously because the office manager of the company is notified by email whenever someone makes a deposit and she normally asks when one doesn’t show up).

A few weeks prior to this someone who is in between my boss and I was hired (I guess that makes him my boss as well) and apropos of nothing he lavishes praise upon my performance, tells me that everyone he’s met in the company says I’m wonderful, and compliments me on random things like my socks. It comes across to me as really bizarre and I’ve wondered if there is some sort of hidden motive behind him doing that. Again, I confided in my co-workers and the same friend from above and both had the conclusion that he’s a) telling the truth b) maybe he’s being overly excessive to gain my trust since he’s new to the company and c) perhaps he’s also a bit socially awkward and that’s why it comes across as weird. This guy has been on vacation since the bank incident so he hasn’t been involved in that.

This is minor, but I sometimes feel that my co-workers past and present don’t like me and are talking about me behind my back. They are all polite and friendly to my face though and usually invite me to social events, but I worry that they don’t actually want me there. And no, I don’t talk all the time about my worries- it’s only come up once or twice.

As for non work related anxiety- I still have feelings that my friends don’t actually like me (clearly this thought is part of a pattern) even though rationally that makes no sense considering that I’ve been friends with them for years now. The fact that we don’t see each other as often can easily be explained by the fact that we’re older, have full time jobs now, etc.

This worry that I have really disturbs me though: My dad got me concert tickets for an artist I really like but have never seen and I have a persistent worry that the tickets are fake even though that would be pretty ridiculous for my dad to defraud me. I started getting worried when he didn’t send me an email confirmation for one of the shows I’m going to. He finally did send it and I have the tickets now, but I keep worrying about minor inconsistencies such as the receipt for the purchase saying that one of the tickets is for a Friday show when it’s actually for a Saturday one. It’s probably just an error on Ticketmaster’s part but I have this huge fear of getting to the venue and being denied entry. I haven’t told him anything about my concerns, I just told him I was concerned about not receiving the information from him because I wanted to send him a check to reimburse him in a timely manner/double check to make sure the ticket was for the right date.

I’ve lost my appetite and have been having trouble sleeping, but that could be attributed to the heat wave. I’ve also lost interest in things- I’m bored with my music collection and have neglected things like my blog and writing fiction which is one of my hobbies, and I haven’t been able to finish the books I’ve started reading. I can’t even get through a magazine. I keep up my appearance though and am able to force myself to do basic housework. I use a pick up/drop off laundry service so that’s one less chore to worry about.

I’ve done some online research and I don’t have classic symptoms of a delusional disorder such as thinking people are following me or that I am someone incredibly important, friends with famous people, and so on. I am also aware that my feelings are most likely irrational, although apparently some people in the beginnings of their illness do retain insight about their beliefs. It does sound like depression, but it’s different from the depression I’ve experienced in the past.

I know the answer is to see a shrink, but it’s hard to find one when one does not have insurance. I could get a referral from the free clinic, but as I explained above, I feel uncomfortable discussing it with anyone there. I don’t want them to jump to the conclusion that I am seriously delusional and have me locked up. I am also worried that I’m just being a hypochondriac and am getting worked up over feelings that are odd, but not necessarily batshit insane.

Thanks to those who read all the way through this.

2

Given that you don’t seem thrilled about meds, and are concerned about insurance/cost, how do you feel about working on it yourself? I’d suggest reading the book Feeling Good: The New Mood Therapy, and seeing how you do implementing the exercises. If it’s not working to do it on your own, then perhaps you could find a therapist that’s a good fit.

3

There’s a difference between being generally worried about everything (taking the extremely pessimistic stance on everyday events) and actually being delusional. You’re not saying that you have PROOF that your co-workers are conspiring against you, just that you’re WORRIED about it. You also state several places that you realize that there is in fact no proof to support your fears, but that you’re still worried and anxious.

None of that sounds like the sort of thing that would even recommend overnight treatment - not to be blase about your problems, but residential programs and in-patient treatments are really really expensive, and they have limited resources - they’re going to focus on the lady who thinks she’s Jesus, or the guy who sees demons in his shower in the morning, you know?

You sound really smart and logical, and so I think you’d be a good fit for something like CBT (cognitive behavioral therapy). I know you’re not interested in telling someone about your worries and fears right now, so I would suggest instead that you take a look at a workbook called The Anxiety and Phobia Workbook or something similar. Look for books that are specifically CBT related. Do some of the exercises they suggest, take a look at where and how your worries are triggered, and see if any of the suggestions (meditation, progressive muscle relaxation, guided imagery) help you out any.

If they do, then awesome! If not, then you’ll have a better handle (and correct terminology) to present to a therapist if you decide that you want to try that route as a next step in your treatment plan.

TL&DR- You don’t sound delusional, just really worry-prone. If you don’t want to go to a therapist, look into trying CBT practices on your own to get a handle on your anxiety.

4

Thanks for the book suggestions, I’ll check Amazon for both of those titles.

Not sure if this is similar to what is practiced in CBT (I read the Wikipedia article on it, but it doesn’t explain in too much detail about how it actually works) but I try to think about what would actually happen if these worst case scenario things came true. Such as, if I get fired I’ll at least have money for the rent and can hopefully pick up odd jobs for extra cash until I get something full time again. If I don’t get to go to the concert, well, I’d be really sad and disappointed, but my life wouldn’t be over.

I’m still filled with the feeling of dread though imagining those scenarios (mostly the job one since that directly affects my overall well being) and wish I could just curl up and hide somewhere. Then I feel absurd because aside from the terrible things that happen in my imagination my life really isn’t bad at all.

5

You don’t sound like you have normal anxiety. That’s would be undue anxiety about things likely to happen. You’re off dreaming up things to worry about. My totally non-medically qualified suggestion is to try medication, if you can, to see what difference it makes.

6

Sorry you’re going through all this.

Moving the thread from MPSIMS to IMHO, forum for psychological anecdotes/advice/commentary.

7

Whoops, thanks for moving this to the right forum.

And TriPolar****, if it doesn’t go away on its own after a while I will make more of an effort to find a cheap clinic or suck it up and talk to these free clinic people and try and get a referral.

I’m a little bit concerned about meds because the Zoloft didn’t do anything as far as I recall- even quitting it cold turkey didn’t have any side effects. Then I had a really negative reaction to Prozac. I know it sometimes takes time to find the right medication though- not really sure if a free clinic psychiatrist would be willing to take the time to work with me on that however. Just based on my experience with the physical exam it seemed like they were completely overwhelmed and couldn’t really take the time to focus too much on each individual patient.

8

Just out of random curiosity, who is the band your father got you tickets to go see?

(I am pretty sure you can verify if the tickets are counterfeit or not by taking them to a TicketMaster outlet, giving you one less thing to worry needlessly about)

9

Morrissey.

That’s a good suggestion, I work next to a record store which is a Ticketmaster outlet.

10

In my considered yet not-at-all-a-doctor opinion, you aren’t delusional, nor are you its big brother, psychotic. All of the things you worry about pass the reality test, in that none of them are so bizarre they could not plausibly happen to some random dude on the street.

You are, however, anxious way beyond normal limits. You are not having trouble deciding what you can reasonably worry about (i.e., you are worried about counterfeit tickets, which happen in the real world, and not that Martians have swapped your tickets out so they can get you alone and unprotected for abduction, which doesn’t), you have a radically wrong idea of the odds that any of it will come to pass. You also aren’t hallucinating proof that any of it is happening. This is textbook anxiety, not delusional paranoia. You have not lost your grip on reality. Reality just for some reason looks really, really scary.

Sitting down to think rationally about what you might do every time your anxiety spikes might not be the panacea it seems. It’s good that you can say ‘and if it happens, it’s not the end of the world’, and you should probably keep that up. There are honestly very few things in life that cannot be fixed. The problem is trying to calm yourself by making a concrete plan of action to follow, should the feared thing occur. It eases the anxiety a little bit the first few times, but the more energy you pour into planning, the more the idea of having a plan for everything starts to normalize. The anxiety tends to be sort of free-floating, so once you’ve developed a plan, you start to fret about what happens if some part of the plan goes wrong, or if something else happens that’s outside your plan, and then you make a plan in case the plan fails. And a plan in case the plan-failure plan fails, and a plan in case the plan for failure of the failure-plan plan fails, and so forth. Eventually you get to the point where you’re planning ways to defend against nuclear first strikes from Canada every time you set out for the supermarket. All of your energy goes into planning to plan plans, and you’re no better off than before.

This is the flip side of that thing a lot of people who suffer from anxiety do, where they talk themselves into progressively more catatonic states, as they ask how things could possibly be worse than they fear and then, through the magic of human imagination, manage to come up with an answer. Try not to do this. Just take a deep breath and let it go, and realize afterwards that you’re still not dead. And if that’s not enough, keep phoning doctors until you get one who isn’t an ass.

11

You have generalized anxiety disorder, and should be on long term medication at the very least. Buspar is good for this. I would also recommend a very small dose of anti-anxiety medication such as 0.25mg of Xanax to deal with your racing thoughts. You could be bi-polar type II. You need to speak to a psychiatrist and/or counselor.

12

Somewhat OT but did they really ask you if you had ever had sex without a condom?!

That is odd, and brings up all kinds of Bill Clinton type so what is sex anyway ideas.

13

As others have said, what you’re describing is not delusional. It’s just anxiety. In particular you seem to be suffering from social anxiety. I say ‘‘just’’ anxiety because in the long run, if you apply CBT techniques, you may learn to think of it as exactly that. It sounds like you are already trying to address the cognitive issues on your own, and I do think you’d be a good fit for CBT. As one of my former therapists used to tell me, anxiety signals ‘‘Discomfort, not danger.’’ I use that as a mantra sometimes when I’m feeling very anxious.

I’d actually recommend not checking about the tickets, because that’s basically a safety behavior, something you do to decrease the anxiety without actually addressing the problem of disordered thinking. In the long run all it will do is reinforce your anxious response to these kinds of events. And just try to be aware of the anxiety you have over it without necessarily buying into the thoughts. (I’m thinking that we’ll get turned away. I’m thinking that the disappointment will be unbearable. I’m thinking that my father will blame me… etc.) Remember that these are just thoughts, not facts. Feel the anxiety in your body, notice the discomfort in your chest and hands or wherever you feel it, and eventually you’ll learn to just view anxiety as essentially an uncomfortable physical sensation that does not necessarily have any predictive power about events in your life. If you really pay attention, you’ll begin to see the patterns, the relationship between your thoughts and those feelings. And eventually it will be,
“Oh, you again?” It will start to feel repetitive and less threatening. Anxiety isn’t fun, but if you try to accept it without allowing it to change your behavior, you can lessen its impact on your life, and eventually reduce those anxious feelings.

And yes, medication may help. Risperdal makes a huge difference for me.
That is my advice based on a lot of treatment for my own anxiety. YMMV as usual.

14

Wow, quite an authoritative diagnosis, Dr…I mean MrDurden.

(that last sentence is sensible, though)
mmm

15

I assumed MrDurden was just making a joke.

This made me laugh. Maybe thinking about Canada nuking us will work as a good distracting thought.

I’m glad to know though that while my anxiety is not entirely normal, it’s not delusional. The ex-wife of a family friend has been diagnosed (so my mom says) with paranoid schizophrenia and she has odd beliefs such as photos of her children should not be online because pedophiles will use them and she believed that her ex was in cahoots with the pedophiles because he made a (private) website for their daughter. My mom armchair diagnosed a neighbor as paranoid schizophrenic because the neighbor thought everyone hated her because she was Jewish, not because she was really nosy and annoying. Neither of those two examples show beliefs that are completely absurd and impossible to happen in real life. My mom isn’t a psychiatrist, in fact she has severe mental health issues that she projects onto other people, so probably from her I picked up that any odd thought indicates a serious mental health problem (she loves to tell me every random thing that her therapist has me diagnosed with even though I’ve never met the therapist and rarely discuss my personal life with my mom).

This jumped out at me because my mom “diagnosed” me with this a few years ago. I realize it’s an actual thing, my mom just randomly told me that I have it. Both my parents are unaware of my anxiety issues. I think I had challenged her on something and she said I disagreed with her because of “disordered thinking.”

Feeling the anxiety as just a physical sensation is a good idea. I try to do that when I have a headache and don’t want to take a pill. I guess not checking the tickets also makes sense (they’d probably just be like “wtf?” anyway unless I made up some sort of story about buying them from someone else, but that’s going too far). I would feel far better about addressing the underlying issue anyway rather than just putting a band-aid so to speak on the individual things that I worry about, because I’m sure I’d just move on to something else.

I googled Risperdal and see that it’s not an SSRI which Zoloft and Prozac are- if I find a doctor that’ll listen hopefully they’d be willing to prescribe something like that since it seems that I may not react well to SSRIs.

Haha- it was part of a series of questions about my overall health and lifestyle- they were also asking me about drinking, do I do drugs, etc. I’m assuming they wanted to know my risk for unwanted pregnancy, HIV or other STDs. Like Bill I was thinking that oral sex and so on are “not sex” and was only referring to never having actual intercourse without a condom. Maybe they meant all** sexual activity though and that’s why my response was so “interesting.” They didn’t clarify though so shrugs

16

Some people run through 10 or more different meds/med combinations before landing on a functional solution. I really hope you have the courage to keep trying.

But, I freely admit I am Queen Hypocrite when it comes to this myself. I only ever tried one med (Citalopram), and refused to try another one because it had devastating side effects. I wasn’t in a relationship at the time, but it, uh, hindered my relationship with myself. Also I think I was clinically dissociating and frequently felt like I was sitting inside a corner of my own brain, watching someone else live my life.

The side effects affected me so negatively that I cold turkeyed after taking it for a month and haven’t been able to bring myself to try something else. In particular, I’m really leery of ever trying an SSRI again… truly, I know how you feel. But if you can bring yourself to keep trying, please do. It would be the best thing you ever do for yourself.

17

I don’t think so. :rolleyes:

18

I don’t think so either and it highlights the danger of asking just anyone about a subject like this. Your opening question:

How to tell the difference between “normal” anxiety or depression and something more serious?

The answer: Go to a qualified professional—psychologist, psychiatrist, or my favorite, a psychopharmacologist—and they’ll tell the difference for you. I know you’ve talked about doctors above, too, but that really is the answer.

Do not trust anyone else who tries to diagnose you, much less treat you. Buspar. My god.

19

Do you live in a town with a graduate program in psychology or social work? If so, they may have a low cost clinic. Ours is $10 a session. You are seen by graduate students, but they are heavily supervised.

20

It took me 15 different meds and 10 years to find the right combination for me. I can’t even describe how much it helps. Don’t give up is all I’m saying.