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Need advice - constant thoughts, hyperawareness, cognitive problems



New member
Jul 10, 2021
Hello everyone. I’m really struggling right now and haven’t found much help or answers so I would really appreciate if you took the time to read this and have any advice. Thank you :)

I've been having some severe mental health issues since January of this year. I'm a 20 year old female and I am in Physician Assistant school. It started out as bad anxiety/derealization/just not feeling like myself after a bad experience with smoking weed (it was like the 5th time I did it my whole life). After this, I felt very out of it and kind of like I was still high, very anxious, and felt like I couldn't act normal/talk to people normally. I didn't feel like my natural, outgoing, bubbly self with my friends, at work, at school, or even with my family. I was then CONSTANTLY thinking about my anxiety/state of mind, to the point where if I wasn't thinking about it/forgot about it for a few seconds, I would notice that...which would then make me think about it. I was also very hyperaware of everything I was doing - how I was talking/what I was saying, every move I made, and my thoughts. And I was thinking about how I felt and the fact that the world felt different 24/7. I started obsessing more and more, constantly researching, and trying to solve/fix it, to the point that my thoughts got so bad that I didn't sleep every other night for 2 weeks, it was like a pattern. I felt like I was going crazy, I was having delusions and irrational thoughts. I was so scared of having depersonalization/derealization disorder, and watched probably every YouTube video on it, that for some time I think I convinced myself that I had the symptoms, and I started feeling them. There was a point where I looked in the mirror and my face was swirling in a circle...I was so scared, and I was trying everything to make it stop, but it just got worse.

I finally saw a psychiatrist in April, and I was diagnosed with OCD. I had been on Lexapro since last year, and she switched me to Prozac 20 mg and Risperidone 0.25 mg. This helped a bit, but only with some mental clarity and reducing the irrational thoughts. The constant chatter and hyperawareness of myself was still there. I also had this dreadful, roomful feeling about the world, and when I looked at things, they just didn't feel the same. Like I didn't get the same feeling about anything - it was like someone else with different feelings was living inside of me, and my light/soul was gone. During this time I think I convinced myself I had DP/DR from smoking that weed, and I started to feel like an imposter, like I couldn't be myself, like I had a different character/personality. It's really hard to explain, but I was just not "me". This was so scary and even my friends were starting to notice I wasn't acting like myself, talking differently, texting differently, not making sense, not understanding or participating in conversations...

I also had very bad social anxiety and felt very awkward around people and couldn't speak naturally, fluidly, or normally since I was so hyperaware of myself and also had so much brain fog. My vision would get weird and distorted in class, and I would go to the bathroom and throw up because I was so anxious and hated how I was feeling so much. I was also having a lot of trouble learning, focusing, paying attention, and I was VERY mentally dull. I ended up having to move to virtual learning instead of being on campus, and I got accommodations from my school. My cognitive ability continued to get worse, and I just felt stupid. Like all my knowledge was gone. When I would study or read something, I would read it completely fine, but it was NOT processing in my brain at all. Like I couldn't make sense of anything barely. Also, when people would explain things to me, I didn't understand simple concepts - like nothing was "clicking" in my brain and I literally felt brain dead and useless. By some miracle I finished the semester and I did pretty well thanks to my parents basically doing half my work for me. I tried so hard, but I just didn't have the capacity, and needed a lot of extra help. This made me panic even more and get even more anxious about my state of mind because I was dealing with brain fog/cognition issues. By this time, I had barely left the house and had not hung out with my friends in months. I was so scared to go anywhere, be in public, talk to anyone because I felt like a different person and like I couldn't function.

Fast forward a little bit, I've gone through a mood & anxiety PHP, and that helped a little bit, but I feel like they didn't really understand what was going on with me. They would have me do exposures and go to stores by myself, go get coffee, drive thru places, etc. This helped a little bit and I was now able to do more things on my own, but the constant thoughts, hyperawareness, and derealization was still there. Eventually this all led to depression, and I was not getting much better, so I felt very hopeless. I was miserable every day, barely smiled, didn't laugh, didn't really have much of a personality - I was a shell of myself. Fast forward to about a month ago, I was put in an OCD program (virtual), which is ultimately where I think I needed to be. For me, my biggest fears were never feeling like myself again, never getting better, never feeling normal again, and never being able to stop thinking about this. SO I would constantly think and ruminate about this problem, and I think it became a habit, because no matter what I did, I was never not thinking about it. As soon as I would wake up, it would be on my mind, and then all day long, like a dark cloud over me and affecting everything I do.

Since starting the OCD IOP, I have made some progress. I feel a bit more like myself, thoughts aren't as bothersome, I have been hanging out with friends more, and I just went back to work last week. However, I am having a lot of cognitive issues. My psychiatrist won't take me seriously about it, because he thinks that with my OCD I have an irrational fear that I have a cognitive disorder, but I am actually noticing and having the symptoms...but with an OCD patient its written off as another intrusive thought or irrational fear that's not real. But it's really scaring me, I am about to be in my masters portion of my PA program, and I need my brain back. As for my current medications, I am on 60 mg Prozac, 100 mg Wellbutrin, and 10 mg Buspar 2x/day.

Now I will talk about my current symptoms and what has been going on with me. I am constantly hyperaware of everything I say, what words I use, how I say things, my mannerisms, etc. I feel like when I talk to people, I am faking interactions and almost trying to act like my old self, and it's very manufactured. Basically I feel like I don't have an identity and can't act natural or "cool". I've always had a sense of humor and have loved laughing, but lately I can't find anything funny, I don't understand jokes, and my sarcasm is non-existent...I feel like I feel very serious and literal and can't be light-hearted. I also feel like a different person when I am with my friends, like I don't feel completely comfortable around them, and I feel super awkward, and the conversation doesn't just flow because I never know what to say, and I am hyperaware of my interactions/talking. It's like I'm monitoring/hovering over myself in every interaction/move I make. This makes me feel very awkward and like I am always doing/saying the wrong thing or acting "weird". Also, in conversations, when I am listening to someone, I am hearing the words they are saying, but I am thinking about something else (unintentionally) and kind of zoned out, so I end up not being able to participate very much in convos. Like I can't focus/be fully present..because I'm ALWAYS thinking or hyperaware of what I am thinking about. In addition to these symptoms, I have been having some pretty concerning cognition issues. When I read something, I can't understand it and my mind will be somewhere else, and I have to read the line like 5 times before I can somewhat understand it. Also, when watching shows or movies, it's almost impossible for me to understand/follow the story line. Everything seems too advanced and like I can't understand what the characters are saying/what's going on. I just feel stupid. Also, one of the biggest things I've noticed, is that my vocabulary and word recall is like 50% there. When I am talking, I'll stop in the middle of a sentence because I can't think of what word to say. It's like I know the word, its on the tip of my tongue, but my brain can't pull it out. I'm also hyperaware of my speaking, so it kind of feels like when I am talking to people, someone is watching me and I can't fully let go and just talk without thinking about it, if that makes any sense... Also my memory has been HORRIBLE..I can't remember very well conversations that I've had, things I was planning on doing, etc. My long term memory is also very very fuzzy. My friends and family have brought up things from the past that I have no recollection of. It's very scary. I just don't feel mentally sharp or "on" at all. I'm not sure if these cognitive issues are due to an overworked brain from the constant thinking, or some other kind of cognitive issue...I've drawn some parallels and similarities to ADD, but I don't want to diagnose myself or add on another problem.

I'm sorry this was really long. If you have read this far, THANK YOU SO MUCH. I just hope somebody can relate to my story or any part of it, or have any advice at all. I have been suffering for so long, and I haven't really been "living", just surviving. As for the hyperawareness and thoughts, I have been trying to accept and live alongside it and hoping it will eventually go away the less I react/resist it.. I am still on my medications, and I have been researching nootropics and supplements to take for my brain fog/memory/cognition problems. I came across Gingko Biloba and Omega-3 Fatty Acid, and I ordered these supplements to start taking. I feel like I am running out of options. IF anybody has any opinions on these supplements, or if adding them to my current medication combination would be okay? Or if anybody has any other suggestions, I am open to hearing anything. I'm hoping that soon my thoughts will go down and I won't think about my anxiety as much and kind of distract myself and forget about it more, and as a result, maybe my brain power will come back because it will be more free? ANY help or suggestions/things I should do would be appreciated. My goal is to move in with my roommates at the end of August, go back to my other job at the hospital, and be able to go on vacation with my family. I really want to be able to do this and just stop thinking about my mental state constantly/not feeling like myself. Thank you so much again if you've read this far, and any help is appreciated :) Thank you!


Well-known member
Jan 26, 2020
Modesto, CA
Very long article. Keep seeing that doctor and therapist regularly for sure. If your hyper aware you may be become more mindful and aware like they discuss in eastern religions.


New member
Oct 23, 2021
Hazleton pa
Hello Milofrankmcg how are you feeling? I feel like im going thru some of the things you mentioned in this forum?


Well-known member
Jul 29, 2021
I go through these things everyday, but to put it bluntly I think you're overthinking everything. It doesn't mean that you don't have some cognitive issues or that you haven't had DR/DP episodes. I've had two episodes and many hypnagogic/hypnopompic hallucinations. I have trouble focusing because of OCD. I have phases where I spend way too much time on this forum. I have a dictionary of words in my head just bursting to escape and scenarios that replay in my head as if on TV. I worry about did I say this, that or the other right. I take excessive time to write a text to a friend or a message on this forum. I have health anxiety, too, but it's getting better.

We OCDers are tortured by a whirl of thoughts and a quest for certainty that all will always be well when in fact all is well. But our minds are in fight or flight mode so we can't calm the storm to see that all is well. In addition to ERP, perhaps DBT for you, if you haven't tried it yet with a therapist. I know workbooks are popular, but I can barely stand to look at them or use them. I journal then share my thoughts with my therapist and ask for practical feedback.

I take various anxiety meds+Lexapro+a mood stabilizer. I encourage you to not get wrapped up in supplements (I've been there), to practice mindfulness as another commenter suggested when he mentioned Eastern religions, and to distract yourself with non-health related interests and activities as much as possible. I know it's hard to slow down enough to practice mindfulness but there are journals on Amazon with mindfulness prompts and breathing techniques that take just a few minutes. Some Buddhist, Sufi and Eastern Orthodox Christian prayer practices are very helpful for centering oneself and stilling the storm. Not trying to convert you, just tell you what's helped me. If you want to discuss specifics about anything including meds, I'm happy to chat privately.


New member
Nov 18, 2021
You just explained me, lol. I made this just so I could reply to you, and hopefully you see this. I starting dealing with something very similar about a year ago. It has been hell and so hard for anyone to understand. I had a really tough time vocalizing it to anyone and I've always struggled putting things into words, so I'm impressed that you were able to. I just want to let you know, the answer out of this is actually easier than you think. Stop trying to think your way out of it. I know that sounds TERRIFYING. Because I wanted to control it and I felt if I let go, I would start to go crazy again. But the second I was able to identify that I didn't need to cognitively figure this out, and instead, focus on shifting my focus out of my thoughts and into life again it started to change for me. I'd literally resist the impulse to start going into my head and did something else instead. I reminded myself that it was just rumination and I was actually fine. It's taken me awhile, but I finally am starting to feel like myself again. It;s like I was swept away in this anxiety for that past year that doesn't matter at all, and that I could relax in the present moment and everything would be fine. But our habits become our patterns, if we worry, its just going to breed more worry...so if you start to slowly focus on the world and less time in introspection, you can slowly start to have that be your norm- I promise. I am living proof and I went through this for a year.

I've also started looking at more body based types of psycho education and learning about the poly vagul theory has been SO helpful for me. It was important for me to create some sense of safety with being in the present moment. I'd also reccomened meditating so that you can learn to witness your thoughts without getting overly attached to them. Also, I've learned some DBT skills which have been very helpful with times when I start having a lot of anxiety again and help reground me. Just know that what you're going through is curable, I really want you to hear that and believe it. I know how horrid it is. I felt like I couldn't connect with anyone for over a year and I felt like giving up. But now I'm able to be around people without being in my head and it is the most glorious thing ever :) Remember, life is too short to be ruminating. Also, if you want to talk anymore feel free to email me
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