From a teen in Canada:  At a young age I was diagnosed with depression and social anxiety. I’ve been on medication for it for the past four years. However, I am becoming concerned that this diagnosis is no longer accurate. I am unsure as to whether I have a more serious problem or not, and I want to avoid self-diagnosing, but I’ve been noticing some increasingly worryingly symptoms in my life.

I’ve repeatedly been having issues distinguishing my dreaming state from reality. I often think that I’ve already gotten up and gone to work today, or that I’ve received a call or had a conversation that I didn’t.
I repeatedly have extreme episodes of paranoia, believing that someone is watching me or that there are people outside my house. I am also having major anxiety attacks almost weekly.

When I was younger, I hallucinated on a daily basis over the course of a year. I grew out of it in elementary school, but it’s still concerning to look back on.

None of this is to mention my constant social issues. I have trouble connecting with people and maintaining relationships. Social situations often give way to nausea and panic.
I don’ mean to sound like I’m complaining or just venting on this forum, but I’m getting rapidly concerned that there’s something wrong with me and I’ve no idea of a way to seek out a diagnosis. I don’t know who to talk to, or when what to ask.

Thanks for your time.

You are not “complaining” or “just venting”. You have some serious concerns that should be taken seriously. Thank you for writing.

The quantity and quality of sleep is one of the first questions I ask teen clients. If you aren’t getting 8 hours of sleep a night, it’s possible that you are suffering from a sleep disorder. Sleep deprivation can cause depression, irritability, poor memory and concentration, and even hallucinations. Some researchers suggest that poor social relationships are also connected to poor sleep quality. If you aren’t getting good sleep and enough of it, the answer to your problems may be getting more sleep. If you have trouble doing that, I suggest that you see a sleep specialist.

In addition, since you have a diagnosis and someone is prescribing your medication, that’s the person to turn to now. If the prescriber is your medical doctor, not a mental health professional, ask that doctor for a referral to a psychiatrist or mental health clinic. You need a proper assessment by a mental health professional who has the tools and experience to look at your history as well as your current symptoms. I also hope you will consider seeing a therapist regularly to monitor your symptoms and to provide you with support.

Please don’t hesitate to make those appointments. There is no need for you to continue to suffer. You may be right that your medication needs to be changed. You may be correct that a diagnosis made when you were younger is no longer accurate. Since it is the diagnosis that determines treatment, it’s crucial that diagnosis be revisited.

Generally, people who are taking medication regularly see their prescriber to talk about whether there has been progress and whether there are side-effects. If you haven’t been seeing your prescriber regularly for this kind of monitoring, that may be part of the problem.

Please take care of yourself and follow through with this advice. You have nothing to lose but a few hours of your time. You have everything to gain in terms of your level of worry about yourself and your daily functioning.

I wish you well.

Dr. Marie