Lamictal as a mood stabilizer

I've been diagnosed with borderline personality disorder for a year, with significant mood disorders. I've only had one major manic phase in my life, but the rest were just hypomanias and a large majority of depressive phases. I take Lamictal 250mg and Prozac 60mg with antipsychotics. I have seasonal depressions every year, and my psychiatrist has indicated this week that I'm possibly on the bipolar spectrum, but it's still very unclear. I asked myself some questions before, but the information is recent. My father has a history of mood disorders, but I don't know any more. I'd like to have more information on this and look into it further, but my psychiatrist is ignoring all my questions on the subject, and is not paying any attention to my mood disorders... I didn’t even have tests. I'm wondering if it was possible that I was bipolar and not on the spectrum, because sometimes I have very short phases, as I had a single 3-month manic phase and my phases are mostly depressive. I know mood disorders are a delicate subject with bpd since it is known for the mood swings and all, but I told my first psychiatrist “I don’t know if cyclothymic or whatever or just mega bpd”. What do you think? I know you guys aren't doctors but I'm going for another psychiatrist and i need to get some ideas.
edit : More info : i’m not sure about my manic phase being an actual manic phase… maybe it was an hypomania . but this one was very long and violent

Hi there, recently I went on Briviact and my neurologist told me to reach out in two weeks it has been more than two weeks and I’ve reached out more than three times now.. I’ve told the people on the phone this as well as my neurologists nurse. I recently have had more than 5 absent seizures reached out because of this heard nothing, I’m possibly having some mood issues (but don’t know if it’s stress because I’m in a wedding) heard nothing , was supposed to begin tapering off Lamictal because it wasn’t working I’m on Zonisamide, Briviact and Lamictal at the same time and I’m just incredibly done with the side effects of being on this amount of medication. I’ve done everything I can would anyone recommend anything else or do I just keep being pushy and calling? He just usually isn’t like this and it’s weird! Thank you all!

Hi guys, I'm 25 & have had schizoaffective bipolar type since I was sixteen, originally diagnosed as bipolar one with psychotic features. I was on Lithium and Latuda for two years and had very little mood episodes but the side effects were aggravating so I switched to Lamictal. I got to the therapeutic dose around March which coincided with lots of stress, thus I've had lots of episodes over the last couple of months. This is frustrating, I really want Lamictal to work but I've only been getting worse. I'm in a hypomanic episode right now; I feel irritated, slamming doors, the world is magic, I understand everything, cohesion, drug addicts yelling at each other in the street, wanting to talk and talk. Anyone else have similar experiences with Lamictal? Thanks :)

This post has been a LONG time coming. So here’s the story.
I’m a 24 yo white male, who came out later in college. Only had bottomed a few times and even outside of college I’d say only a handful. I’ve always had anxiety around bottoming, but I’m also an extremely anxious person in general. I take a mood stabilizer and anti anxiety everyday but I’m just naturally tense which makes bottoming hard. On one particular night after going out this guy with a pretty large sized dick rammed it into me with no foreplay, causing some really bad fissures. This was two years ago. Ever since then I’ve had chronic fissures that would start to heal, then reopen, then start to heal, then reopen. I didn’t bottom for 9 months because of i was getting them constantly. I upped my fiber, did sitz baths, got a colonoscopy, AND got the cream. Essentially NOTHING worked. I had tried it all. The cream helped temporarily heal them but they would still open up super easily. I was at such a low point i just accepted the fact i could never bottom again. However, this past January I got into a relationship with the hottest and best guy on the planet. He’s a 6’5”, sexy ass dark chocolate man, with a THIQ 🍆. He’s also bisexual and was pretty much a player before he met me. After a few months of me topping him it got to the point where I really needed to figure things out because i wasn’t meeting his needs (also keep in mind he was super sweet about it and very patient the whole time). I went to a dietician for my gut since i have terrible stomach issues and started a keto/Mediterranean diet. At the same time i had seen on this Reddit page some guys had tried anal dilating and it worked for them. So. Here’s the combo that worked its magic. The cream i was prescribed healed the fissure initially the diet i had made going to the bathroom super easy, and the anal dilators (that were literally smaller than my pinky) helped the skin learn to stretch instead of tear. I “train” everyday for around 15 min just watching porn and using my dilators, slowly working my way up. I can now succesfully take my boyfriends dick and have zero fissures and it feels amazing:) hopefully this helps some of you out there as i was in such a low place with no answers and thought my days of bottoming were over!!!

I wanted to share in case this helps or provides hope to anyone struggling with severe mental health symptoms from Lyme. Even if the underlying cause is Lyme, pharmaceuticals prescribed for other mental health diagnoses can be extremely helpful — at least they have been life saving for me.
Depression/mood swings/rage:
If you’re like me and antidepressant haven’t done anything to help (or have made you worse)— have you tried mood stabilizers? Lamictal / lamotrigine saved my life. I was prescribed lamictal by my psychiatrist 7 years ago (6 months after a tick bite, but hadn’t been diagnosed or treated for Lyme at that point) because I started having suicidal ideations and severe depression and irritability, and nothing else we tried had helped.
It hugely improved my depression/mood swings and rage issues. I have been on it for years now with very few side effects. It is a mood stabilizer that is used off label for depression and bipolar. Safe long term, it is used often that way for people who take it for epilepsy. Can only be taken under guidance of a doctor though, because there is a rare allergic reaction some people can have to it in the first couple of weeks.
I know everyone is different, but this is the only pharmaceutical that helped with my mood swings & severe depression. Anecdotal, but I do wonder if traditional antidepressants maybe don’t work as well for depression caused by Lyme.
Chronic fatigue, lack of motivation, brain fog:
I was diagnosed with ADHD a few years ago, which I think is more likely just Lyme-related fogginess, forgetfulness, etc. Regardless, the stimulants (I’ve tried and benefited from both Vyvanse & adderall) used to treat it have made life so much easier. It definitely just covers up the fatigue, BUT it gives me a few more hours of energy each day and has improved my mood. It even had the unintended effect of helping a lot with my chronic anxiety.
Although mental health is only one part of the Lyme struggle, and I’m still sorting out everything else — these two medications have allowed me to almost completely control those parts of my symptoms, helped me continue to work/keep my job, relationships, etc. and I wanted to share in case they help anyone else on here advocate for what they need. Happy to provide more info.

At the world’s top college of magic and technology, every day brings a new discovery -and a new disaster. The advanced experiments of the college students tend to be both ambitious and apocalyptic, with the end of the world only prevented by a mysterious time loop, and a small handful of students who retain their memories.
Surviving the loops was hard enough, but now, in his senior year, Vell Harlan must take charge of them, and deal with the fact that the whole world now knows his secrets. Everyone knows about Vell’s death and resurrection, along with the divine game he is a part of. Now Vell must contend with overly curious scientists and evil billionaires hungry for divine power while the daily doomsday cycle bombards him with terrorists, talking elephants, and the Grim Reaper himself -but if he can endure it all, the Last Goddess’s game promises the ultimate prize: power over life itself.
[Previous Chapter][Patreon][Cover Art]
“The not-so-good Doctor is all set up,” Hawke said. “You are cleared to infiltrate.”
“Good. You been reading Ragnarok’s book?”
“Yeah, except Helena took our only physical copy,” Hawke said. “I had to spend seven dollars on the ebook.”
“Oh. I can, uh, get you back for that, if you want.”
“Nah, it’s fine, this is actually an interesting read,” Hawke said. “You remember that Agent Fleming jerk who showed up two years ago? Apparently Skye’s dad almost dropped him in lava once.”
“Fascinating,” Vell said. “What’s it say about starting one of these things?”
“Oh right, yeah,” Hawke said. “Okay, apparently step one is the ‘information gathering and infiltration’. I think you’re supposed to like, interrogate his minions to find out where his base is and then break into it.”
“Makes sense.”
“I can tell you right now there’s a suspiciously death-ray shaped cloaking field on the roof of the senior dorms,” Hawke said.
“Yeah, I noticed,” Vell said. Doc Ragnarok’s cloaking tech was advanced, but the loopers had some pretty advanced observation equipment as well. “I think that’s too easy though, right? I’m trying to give Skye some bonding time with her dad here, we need to do things the long way.”
“If you insist,” Hawke said. “Samson, any ideas on how to do things the old fashioned way?”
“You might start with the generic eastern european goons lurking around the dining hall,” Samson said. He forwarded a picture to Vell, showing off a table of middle-aged men sitting around one of the tables, smoking cigars and playing poker.
“Those definitely look like henchmen,” Vell said. “I’ll go check it out.”
Even if they weren’t related to the apocalypse, a random group of middle-aged men hanging around a college campus was suspicious. Vell headed for the dining hall, stepped through the doors, and adjusted his tux as he approached the table.
“Gentlemen,” he began. “This is a non-smoking campus.”
“Ve are not stoodents,” one of the smooking goons grunted, in one of the deepest pseudo-slavic accents Vell had ever heard. He briefly considered asking if the accent was genuine, or part of the role, but thought that might be offensive.
“The rules apply all the same,” Vell said. “If you’re not students, then why are you here?”
“Vork.”
“What kind of v- work?”
“De none of yor beeznees kind,” another mook toned.
“On this campus, everything’s my business,” Vell said. He didn’t want it to be, most of the time, but it ended up that way anyway.
“Mebbe you lurn noddo steeck nose where idon belon.”
“Okay, I’ve been trying not to bring it up, but that’s beyond the pale,” Vell said. “That accent is fake, right? You’re all just playing up the fake mook role?”
The smoking henchmen shared a nervous glance, and one of them pulled a walkie talkie out of their track suit jacket.
“He’s on to us! Accelerate the plan!”
“Ha! I knew the accents were fake,” Vell said. His good mood was short-lived, as all the of goons at the table stood up, fists clenched, and squared their shoulders towards him.
“Should’ve minded your own ‘beeznees’, stretch,” one of them grunted.
“I’ve never been...I, ah, screw it, pretend I said something witty,” Vell said. “So what are the rules on this part, is it like, pin-based, or is there a flag football type of thing-”
One of the goons dove into Vell for a full-body tackle, and then punched him in the face while he was on the ground.
“Okay, full contact,” Vell grunted. “Seems a little harsh for a-”
Another punch to the face shut him up, and made Vell realize this was not the time to be talking. He covered his face to block another punch and rolled out from underneath the thug who had him pinned, before spinning around to kick him in the gut.
“Hawke, this got a little bit loud,” Vell said. “Could you call Kim and tell her-”
Vell got grabbed by the shoulders, lifted off the ground, and then slammed into a table hard enough to snap it in two. Though he never finished his sentence, Hawke assumed Vell’s intent from the context clues, and from the faint sound of punching in the background.
Kim had been scouting out potential disasters close by, so it did not take her long to arrive on the scene and pry Vell out from underneath a mountain of track-suits. A robot with flaming fists was more than any of the hired goons had signed on for, so they dispersed after a few of their own were knocked unconscious burning punches. Once she was sure they were all scared off, Kim helped a heavily-bruised Vell off the ground and wiped some blood off his chin.
“Damn. You’re lucky I saw the other twelve guys or I’d think you got your ass beat,” Kim said.
“Yeah, I think I did alright,” Vell groaned. “Christ, though, what was with that? I thought the goons were supposed to rush me one at a time, at least.”
“You’d think so,” Kim said. That was the usual henchmen approach. “Maybe Doc Ragnarok actually does know you’re dating his daughter. Wanted some guys to beat your ass about it.”
“He just doesn’t seem like the kind of guy,” Vell said. “If only because he’s weirdly obsessed with being an old-school supervillain.”
Vell popped an illusion rune that would disguise the bruises, and the damage to his tuxedo, and got back on track.
“Speaking of his weird obsession,” Vell said. He popped his runic scanning glasses out of a pocket and did a quick scan of the unconscious guards. “There we go.”
Vell plucked a keycard from the coat pocket of one of the unconscious guards.
“In retrospect, I probably should’ve just scanned first and tried to pickpocket this,” Vell said. “Something to keep in mind for next loop.”
“I think we’d all prefer you not get your ass beat,” Kim said. “Are you really sure you’re still on board with this, after aforementioned ass-beating?”
“I have to see this through,” Vell said. “I’m sure it was all some mix-up on Doc’s part.”
“I sure hope so,” Kim said. “That dude’s probably going to be your father-in-law someday.”
The illusion that hid the bruises on Vell’s face was not quite powerful enough to disguise the redness in his cheeks. He set off without a word and headed for the senior dorms, and the invisible death ray atop them.
***
“We did try to make the relationship work, but ultimately we just didn’t work out in the long-term,” Doc Ragnarok said. “We set up a very amicable co-parenting arrangement, and Skye is an absolute delight, so it all worked out in the long run. But still, don’t ever try to mix dating and mad science. It’s a field that requires absolute commitment.”
“Fascinating,” Helena said. She had no idea how Doc Ragnarok had managed to segue “mad science advice” into a discussion about Skye’s mother, but somehow he had pulled it off. “Now, about the death ray...”
“Oh, yes, that,” Doc began. He gestured to the massive laser beam currently being constructed in the core of their makeshift lair. “Now, obviously, the retrofuturist look is borrowed from old pulp sci-fi, but I did personalize it with the addition of those dorsal ridges, and the ventilation gaps near the beam emitters, all to resemble the fins and gills of a shark. It lends a certain menace to the design, and Skye absolutely adores sharks, which is a nice bonus.”
“Yes, very adorable,” Helena said. “But how does it function? What puts the ‘death’ in ‘death ray’?”
Doc Ragnarok did a quick double take between the death ray and Helena.
“This one? Nothing,” Doc said. “This is a practice exercise, Ms. Marsh, that ‘death ray’ is just a light emitter, essentially a very powerful laser pointer. I suppose you could blind somebody with it if they started right into the beam, but otherwise harmless.”
“Of course it is,” Helena said. She didn’t bother to hide her disappointment.
“Hey dad, you still in the death ray room?”
“Yes, Skye, what do you need?”
“Just thought you should know Vell’s on his way,” Skye shouted. “Coming by the main entrance.”
“Oh a frontal assault, very bold,” Doc Ragnarok said, as he hustled towards the center of his lair. “It is a shame he won’t see all the work we put into the ventilation system or underground entrance routes, though.”
“I’ll let him know about the laser grid later,” Skye said. “He and I, uh, talk. Sometimes. We hang out on occasion.”
“Well let’s give you something to really talk about,” Doc said. “He’s nearly at the main entrance.”
Doc Ragnarok got into position in his big fancy villain chair, crossed his legs, and waited as the lock on the door clicked. Then clicked again. And again. The handle jiggled slightly as Vell tried it out, but it was still locked, and the lock clicked once more as he tried it again. After a momentary pause, the door was torn off its hinges by a sudden burst of force, and Vell stepped through, standing atop the fallen door.
“Your door’s broken,” Vell said. “And not just because I broke it. Like, the lock didn’t work.”
“A momentary delay that makes you too late, Vell Harlan,” Doc Ragnarok shouted, hamming it up with full force. “Now, fall!”
A trap door beneath Vell’s feet opened up, which might have worked were it not for the fallen door acting as a bridge across the pit. Vell looked down and shrugged.
“Note to self, put pitfall traps further away from doors,” Doc Ragnarok mumbled. “No matter! Deploy the contingencies!”
Two hatches on the wall opened up and revealed cannons aimed at Vell, and he dodged out of the way of two nets fired at him. Next up, two robotic drones came rushing at him, grasping claws at the ready, and Vell grabbed one to swing it at the other, shattering both. The quick swing saved him from the robots, but made him easy prey for a forcefield that descended from the ceiling. He bumped an elbow into the glowing field surrounding him, and found it impenetrable.
“That should keep you contained,” Doc Ragnarok said. “Ms. Marsh! Escort him to the viewing chamber. I want him to watch my plan unfold.”
“As you wish,” Helena said. She tapped one of her crutches into the forcefield, and it started moving out of the central lab and down a side hallway. Doctor Ragnarok watched it move with a smug smile on his face. Once Vell was out of sight, he dropped the smile, and his supervillain persona, entirely.
“Well that was quite good,” Doc noted. “Dodging the first trap was a bit of an accident, yes, but the next two, very skillful.”
“I feel like he should have said something, though,” Skye said. “Asked you what you were planning, made a quip about escaping, that kind of thing.”
“Oh, that would’ve been nice, yes,” Doc Ragnarok said. “But frankly those exchanges can get a little trite, once you’ve done a few dozen there’s really no benefit to the banter. We both know why he’s here.”
“I thought you liked the banter.”
“I like good banter,” Doc said. “If the man’s heart isn’t in it, I don’t want him to force it. That’s how you get cliches.”
***
“I feel like I should’ve said something,” Vell said. “At least like, ‘you’ll never get away with this’, or something like that.”
“Oh no,” Helena said. “Haven’t you read this book?”
Helena held up her copy of Doc Ragnarok’s supervillain guide.
“That’s one of the biggest cliches to avoid,” Helena said. “You’re the one who should know these things, you’re the hero.”
“I skimmed, I have a lot going on,” Vell said. He kicked the side of the forcefield again, and found it impermeable as ever. “So. Are you enjoying yourself?”
“Barring Doc Ragnarok’s fatherly streak, yes, actually,” Helena said. “I could see myself doing this for a living. If I live.”
Vell bit his tongue. Helena had a way of making even the most casual chats a matter of life and death -though he supposed everything actually was a matter of life and death when a person was dying.
“There’s entire schools for this, you know, death ray workshops, speech classes focused on evil monologuing, the whole deal.”
Vell did know. Skye had given him some basic details on the courses now and then. Kraid had even attended some of them for a year or two, before getting expelled for being too evil for evil school.
“So, uh...on a related note,” Vell said. “All that stuff you said about being ‘driven to evil’.”
“Oh. I was just telling Doc Ragnarok what he needed to hear, obviously.”
Helena opened the door to a rooftop chamber with a view of Doc Ragnarok’s death ray, and shuttled the forcefield containing Vell into the center of the room. She tapped one of her crutches against the forcefield to remind Vell of his captive state.
“If I were really evil, I’d be using this opportunity to, say, experiment on your rune without your permission and accidentally kill you,” Helena said. “I’m not my sister, Vell.”
Vell nodded. He already knew that well enough -and it was exactly what worried him.
“You did blow me up that one time,” Vell said.
“For impersonal reasons. That was science,” Helena said. “Sure, reckless, maybe. Stupid, maybe a little. But not evil.”
“When you refuse to learn from them, recklessness and stupidity can be evil.”
“Actually, according to this great book I’m reading,” Helena said, holding aloft the supervillain handbook again. “Evil is just a word used by entrenched powers to derogate anything that challenges their hegemony.”
“That’s...an interpretation, I guess.”
“Doc’s a smart guy,” Helena said. “Speaking of, I need to ask him about his forcefield tech, that seems pretty sturdy.”
Helena walked away, leaving Vell alone in the viewing room, surrounded by the forcefield. He took a seat, poked the walls once more, and decided to leave it for a bit. “Planning his escape” was probably the best excuse to sit and catch his breath he’d get any time soon, and he desperately needed a bit of rest. His ribs still hurt from getting tackled by those goons earlier.
The respite, while much needed, was brief, as Vell soon found himself with another visitor. Thankfully, this one was of the more pleasant variety.
“Vell, hey,” Skye said. “Just checking in, you’re doing great so far.”
“Am I doing great? I’m in a forcefield.”
Vell tapped the translucent wall of energy.
“Getting captured doesn’t feel great.”
“Oh, everybody gets captured,” Skye assured him. “It’s part of the bit. Gives you a chance to pull off a cool escape.”
“Alright. Makes sense, I guess,” Vell said. He looked around his forcefield cage. “Are there any risks I should know about? Like, is any part of this going to electrocute me?”
“What? No, that’d be ridiculously unsafe,” Skye said.
“Yeah, well, those thugs of yours weren’t particularly safe either.”
Skye tilted her head like a confused puppy.
“Thugs?”
“Yeah, those slavic guys with fake accents,” Vell said. “The ones with the keycard, which, by the way, didn’t even work.”
“Vell, what are you talking about,” Skye said. “We don’t have any human minions -except Helena, I guess. You were supposed to find some drones in the robotics lab.”
“Well if they weren’t...hold on,” Vell said. “If there’s another bunch of thugs, and another key, doesn’t that mean there’s another-”
For the second time today, Vell was cut off by a thunderous crashing of waves. Thanks to the viewing chamber’s strategic vantage, he could see the waves part just offshore, revealing another towering skull-shaped structure rising from the water, but this time much larger, much darker, and much skullier. The massive structure was nearly as tall as the dorms they were on top of, and much like Doc Ragnarok’s lair, the peak had a very large raygun on top, aimed directly at them.
“There you are, you layabout traitor,” boomed a voice from within the skull-shaped fortress. “Cease your playacting and come witness true villainy!”
“What the fuck,” Skye said. “Dad!”
Dad was already on his way, and barreled through the door momentarily. He ran to the massive viewing window and pounded a fist into it.
“Bastard,” Doc Ragnarok mumbled under his breath. “Skye, we need to get out of here.”
“What about Vell?’
“Has he not escaped yet?” Doc said. He looked over his shoulder and saw Vell. “Oh, sorry, I’d assumed you got out already.”
Doc Ragnarok pressed a button and released the forcefield around Vell.
“You might be thwarting an actual supervillain today, Mr. Harlan,” Doc said. “That’s Mi-Go, an old colleague. Never really got over the fact that I quit.”
“Oh, Mi-Go, I remember him,” Skye said. “A real pioneer in genetic hybridization.”
The raygun aimed in their direction fired, bathing the room, and the entire island, in a blast of sickly green light. When the deathly glow finally cleared, Vell looked down at his hands, or rather at the pointed crab claws where his hands had once been. Skye and Doc Ragnarok had a similar set of misshapen, crablike appendages, and odd leathery wings sprouting from their slimy flesh.
“Not again,” Doc Ragnarok grunted from his new beak.
“I sure hope he worked on his genetic stabilization matrices,” Skye said. “Or else-”
Vell’s arm popped off his body and started melting on the ground.
“Or else that.”
Thankfully their brains melted first, so the rest of the melting didn’t hurt much.

After going through therapy and different meds for 2 years I finally found my rhythm. I go to therapy every week and take lamictal every day
(I am not a doctor so take what I’m about to say with the smallest grain of salt)
I’ve read that people who have bipolar disorder should NEVER take antidepressants especially without a mood stabilizer.
I have always had bad side effects with antidepressants and they never helped only made things worse.
Some of us need to be okay with the fact that we might have to be on meds for the rest of our lives. Therapy is the most important.
It’s hard work to find the right medication and even therapist. It might take a while. But if you don’t put the work in you will be miserable for the rest of your life and it will effect everything that’s important to you.
You have to work for it 🩷

Hi all, I was wondering how people normally react to being put on a stimulant for ADHD while also having issues with bipolar 1 with psychosis? They are trying Ritalin but I’m also on a mood stabilizer, antipsychotic, antidepressant, and different as needed anxiety meds. What is your experience with adhd and bipolar in general? Thank you in advance for your insight!

(Warning for body image issues)
I am engaged to the love of my life, and am deliriously happy and ready to be married.
However.
I've been on a meds schedule for three years, with my psych and I settling on a variety of mood stablizers, antipsychotics, antidepressants and sedatives for sleep (plus anxiety and ADHD meds). I feel better than I can remember, and have been largely stable for a year and a half. Though there's obviously still ups and downs (...no pun intended) I do feel like my meds work well. I need to get my bloodwork done again, but last time it was good.
However.
I have gained a large amount of weight on these meds over the years, significantly.
As I prepare for my wedding, I'm being wracked with the worst body insecurity I've ever dealt with. My fiancé thinks I'm gorgeous, but I am struggling to think I look pretty in even my favorite dresses.
I'm getting to the point that I want to come off my meds just to drop the weight, but I know that's a bad idea. I think I'm just here seeking advice on... idk. Making peace with it? How to handle these thoughts? Reassurance that it's stupid to blow up my stability so I don't have a double chin in photos?
Well meaning family and bridal stylists keep asking me how much I'm going to lose before the wedding and I just don't know how to explain that those comments are making me self destruct.
Any advice or thoughts or anything would be appreciated. I hate how I'm feeling right now.
Thanks for listening, y'all.

This is a very difficult post to make for me so I apologise for my horrendous, typing, punctuation, spelling etc.
I really need some advice on what to do
I have been living in this house since April last year with no problems. Was a very peaceful and calm environment. My sister moved in ans a few months partner her new partner moved in. We are all on the lease. I am unsure of what to do as since they have mood in they have created a hostile and none welcoming environment for me. We also have a 4th housemate who thankfully isn't affected by any of these issues. I have had several arguments with my sister and her partner. One of which led me to attempt sucide. I have been diagnosed since 2018 with borderline personality disorder x complex post traumatic stress disorder. I am easily set off and and triggered but have gotten so much better at controlling myself throughout these past few years. But now it feels like all that work I've done on myself is getting earned. My sister and her partner came home from work not in good moods. They must expect me to be a mind reader because I didn't know they had bad days. We got into an argument (I'll save you the boring details as it was a petty argument ) but I said to then take your attitude and fck off inside. And my sisters partner turned around to me and said why don't you?. I had been sitting in this exact spot for the entire day. They entered where I was sitting after they came home. How should i be the one to move? Just go into your room? But anyways, I attempted to calm down but me being already heightened I said back " I shouldn't have to I've actually had a pretty good f*cking day till youse came home and decided to set me off". Long story short - he said something ridiculous and I just automatically went I have bpd what do you expect I just match your energy And he went "excuses excuses" Me "its litterly a chemical imbalance, tell that to the thousands on disability and all the doctors: Him" excuses"
I have seen online about the discrimination in accommodation laws but i am unsure on if his words count under that law? I want them out of my house. I do not feel welcome nor comfortable in my own home.
Im not allowed to ask how their day was either due to be yelled at by my sisters partner previously for simply asking how was work not knowing he "never wants to talk about work when he gets home". Which is fair I can understand that but also just have some basic respect towards me and just be like oj it was shit and move on? Instead he choose to have a go at me for asking and just attempting to be civil and nice.
There's several other arguments but they're all just small petty things. I hear them both laughing before I leave my room, I walk and instantly like I'm the biggest burden to them. Most of the time I talk I get ignored unless they're in a shitty mood. I've had friends over who have also seen how extremely rude they are. One waved hello and greeted them nicely only to get snarky looks in return. Another friend of mine sat in my room and waited till they left for work to leave my house due to how uncomfortable they made him feel. I have also been told I am not allowed to have the dog in my house which belongs to the 4th housemate. The dog sleeps in my room when she is not home and quite enjoys it. The 4th housemate knows about this and think it's very sweet and doesn't have an issue with it. I don't understand how someone can think it's right to tell me what I can and can't do over the owner.
Is there anything I can do I do plan to go into my real estate on Monday morning This is honestly taking a massive toll on me and my mental health. I haven't attempt to take my own life in many years and was on a very good road to recovery. I'm definitely not perfect and once set off I definitely can make some situations worse then they need to be but I'm only human and I work veey hard everyday to better myself. My medications have increased, increased again and now been changed to something alot stronger due to this situation. They have only lived here a few months I honestly cannot take this anymore and don't have the financial stability to move myself otherwise i would.
I would love to just have a calm and rational conversation with them but I've tried that to no success. It lasts about a day or two before things go back to this

This is a very difficult post to make for me so I apologise for my horrendous, typing, punctuation, spelling etc.
I really need some advice on what to do
I have been living in this house since April last year with no problems. Was a very peaceful and calm environment. My sister moved in ans a few months partner her new partner moved in. We are all on the lease. I am unsure of what to do as since they have mood in they have created a hostile and none welcoming environment for me. We also have a 4th housemate who thankfully isn't affected by any of these issues. I have had several arguments with my sister and her partner. One of which led me to attempt sucide. I have been diagnosed since 2018 with borderline personality disorder x complex post traumatic stress disorder. I am easily set off and and triggered but have gotten so much better at controlling myself throughout these past few years. But now it feels like all that work I've done on myself is getting earned. My sister and her partner came home from work not in good moods. They must expect me to be a mind reader because I didn't know they had bad days. We got into an argument (I'll save you the boring details as it was a petty argument ) but I said to then take your attitude and fck off inside. And my sisters partner turned around to me and said why don't you?. I had been sitting in this exact spot for the entire day. They entered where I was sitting after they came home. How should i be the one to move? Just go into your room? But anyways, I attempted to calm down but me being already heightened I said back " I shouldn't have to I've actually had a pretty good f*cking day till youse came home and decided to set me off". Long story short - he said something ridiculous and I just automatically went I have bpd what do you expect I just match your energy And he went "excuses excuses" Me "its litterly a chemical imbalance, tell that to the thousands on disability and all the doctors: Him" excuses"
I have seen online about the discrimination in accommodation laws but i am unsure on if his words count under that law? I want them out of my house. I do not feel welcome nor comfortable in my own home.
Im not allowed to ask how their day was either due to be yelled at by my sisters partner previously for simply asking how was work not knowing he "never wants to talk about work when he gets home". Which is fair I can understand that but also just have some basic respect towards me and just be like oj it was shit and move on? Instead he choose to have a go at me for asking and just attempting to be civil and nice.
There's several other arguments but they're all just small petty things. I hear them both laughing before I leave my room, I walk and instantly like I'm the biggest burden to them. Most of the time I talk I get ignored unless they're in a shitty mood. I've had friends over who have also seen how extremely rude they are. One waved hello and greeted them nicely only to get snarky looks in return. Another friend of mine sat in my room and waited till they left for work to leave my house due to how uncomfortable they made him feel. I have also been told I am not allowed to have the dog in my house which belongs to the 4th housemate. The dog sleeps in my room when she is not home and quite enjoys it. The 4th housemate knows about this and think it's very sweet and doesn't have an issue with it. I don't understand how someone can think it's right to tell me what I can and can't do over the owner.
Is there anything I can do I do plan to go into my real estate on Monday morning This is honestly taking a massive toll on me and my mental health. I haven't attempt to take my own life in many years and was on a very good road to recovery. I'm definitely not perfect and once set off I definitely can make some situations worse then they need to be but I'm only human and I work veey hard everyday to better myself. My medications have increased, increased again and now been changed to something alot stronger due to this situation. They have only lived here a few months I honestly cannot take this anymore and don't have the financial stability to move myself otherwise i would.
I would love to just have a calm and rational conversation with them but I've tried that to no success. It lasts about a day or two before things go back to this

This is a very difficult post to make for me so I apologise for my horrendous, typing, punctuation, spelling etc.
I really need some advice on what to do
I have been living in this house since April last year with no problems. Was a very peaceful and calm environment. My sister moved in ans a few months partner her new partner moved in. We are all on the lease. I am unsure of what to do as since they have mood in they have created a hostile and none welcoming environment for me. We also have a 4th housemate who thankfully isn't affected by any of these issues. I have had several arguments with my sister and her partner. One of which led me to attempt sucide. I have been diagnosed since 2018 with borderline personality disorder x complex post traumatic stress disorder. I am easily set off and and triggered but have gotten so much better at controlling myself throughout these past few years. But now it feels like all that work I've done on myself is getting earned. My sister and her partner came home from work not in good moods. They must expect me to be a mind reader because I didn't know they had bad days. We got into an argument (I'll save you the boring details as it was a petty argument ) but I said to then take your attitude and fck off inside. And my sisters partner turned around to me and said why don't you?. I had been sitting in this exact spot for the entire day. They entered where I was sitting after they came home. How should i be the one to move? Just go into your room? But anyways, I attempted to calm down but me being already heightened I said back " I shouldn't have to I've actually had a pretty good f*cking day till youse came home and decided to set me off". Long story short - he said something ridiculous and I just automatically went I have bpd what do you expect I just match your energy And he went "excuses excuses" Me "its litterly a chemical imbalance, tell that to the thousands on disability and all the doctors: Him" excuses"
I have seen online about the discrimination in accommodation laws but i am unsure on if his words count under that law? I want them out of my house. I do not feel welcome nor comfortable in my own home.
Im not allowed to ask how their day was either due to be yelled at by my sisters partner previously for simply asking how was work not knowing he "never wants to talk about work when he gets home". Which is fair I can understand that but also just have some basic respect towards me and just be like oj it was shit and move on? Instead he choose to have a go at me for asking and just attempting to be civil and nice.
There's several other arguments but they're all just small petty things. I hear them both laughing before I leave my room, I walk and instantly like I'm the biggest burden to them. Most of the time I talk I get ignored unless they're in a shitty mood. I've had friends over who have also seen how extremely rude they are. One waved hello and greeted them nicely only to get snarky looks in return. Another friend of mine sat in my room and waited till they left for work to leave my house due to how uncomfortable they made him feel. I have also been told I am not allowed to have the dog in my house which belongs to the 4th housemate. The dog sleeps in my room when she is not home and quite enjoys it. The 4th housemate knows about this and think it's very sweet and doesn't have an issue with it. I don't understand how someone can think it's right to tell me what I can and can't do over the owner.
Is there anything I can do I do plan to go into my real estate on Monday morning This is honestly taking a massive toll on me and my mental health. I haven't attempt to take my own life in many years and was on a very good road to recovery. I'm definitely not perfect and once set off I definitely can make some situations worse then they need to be but I'm only human and I work veey hard everyday to better myself. My medications have increased, increased again and now been changed to something alot stronger due to this situation. They have only lived here a few months I honestly cannot take this anymore and don't have the financial stability to move myself otherwise i would.
I would love to just have a calm and rational conversation with them but I've tried that to no success. It lasts about a day or two before things go back to this

This is a very difficult post to make for me so I apologise for my horrendous, typing, punctuation, spelling etc.
I really need some advice on what to do
I have been living in this house since April last year with no problems. Was a very peaceful and calm environment. My sister moved in ans a few months partner her new partner moved in. We are all on the lease. I am unsure of what to do as since they have mood in they have created a hostile and none welcoming environment for me. We also have a 4th housemate who thankfully isn't affected by any of these issues. I have had several arguments with my sister and her partner. One of which led me to attempt sucide. I have been diagnosed since 2018 with borderline personality disorder x complex post traumatic stress disorder. I am easily set off and and triggered but have gotten so much better at controlling myself throughout these past few years. But now it feels like all that work I've done on myself is getting earned. My sister and her partner came home from work not in good moods. They must expect me to be a mind reader because I didn't know they had bad days. We got into an argument (I'll save you the boring details as it was a petty argument ) but I said to then take your attitude and fck off inside. And my sisters partner turned around to me and said why don't you?. I had been sitting in this exact spot for the entire day. They entered where I was sitting after they came home. How should i be the one to move? Just go into your room? But anyways, I attempted to calm down but me being already heightened I said back " I shouldn't have to I've actually had a pretty good f*cking day till youse came home and decided to set me off". Long story short - he said something ridiculous and I just automatically went I have bpd what do you expect I just match your energy And he went "excuses excuses" Me "its litterly a chemical imbalance, tell that to the thousands on disability and all the doctors: Him" excuses"
I have seen online about the discrimination in accommodation laws but i am unsure on if his words count under that law? I want them out of my house. I do not feel welcome nor comfortable in my own home.
Im not allowed to ask how their day was either due to be yelled at by my sisters partner previously for simply asking how was work not knowing he "never wants to talk about work when he gets home". Which is fair I can understand that but also just have some basic respect towards me and just be like oj it was shit and move on? Instead he choose to have a go at me for asking and just attempting to be civil and nice.
There's several other arguments but they're all just small petty things. I hear them both laughing before I leave my room, I walk and instantly like I'm the biggest burden to them. Most of the time I talk I get ignored unless they're in a shitty mood. I've had friends over who have also seen how extremely rude they are. One waved hello and greeted them nicely only to get snarky looks in return. Another friend of mine sat in my room and waited till they left for work to leave my house due to how uncomfortable they made him feel. I have also been told I am not allowed to have the dog in my house which belongs to the 4th housemate. The dog sleeps in my room when she is not home and quite enjoys it. The 4th housemate knows about this and think it's very sweet and doesn't have an issue with it. I don't understand how someone can think it's right to tell me what I can and can't do over the owner.
Is there anything I can do I do plan to go into my real estate on Monday morning This is honestly taking a massive toll on me and my mental health. I haven't attempt to take my own life in many years and was on a very good road to recovery. I'm definitely not perfect and once set off I definitely can make some situations worse then they need to be but I'm only human and I work veey hard everyday to better myself. My medications have increased, increased again and now been changed to something alot stronger due to this situation. They have only lived here a few months I honestly cannot take this anymore and don't have the financial stability to move myself otherwise i would.
I would love to just have a calm and rational conversation with them but I've tried that to no success. It lasts about a day or two before things go back to this

This is a very difficult post to make for me so I apologise for my horrendous, typing, punctuation, spelling etc.
I really need some advice on what to do
I have been living in this house since April last year with no problems. Was a very peaceful and calm environment. My sister moved in ans a few months partner her new partner moved in. We are all on the lease. I am unsure of what to do as since they have mood in they have created a hostile and none welcoming environment for me. We also have a 4th housemate who thankfully isn't affected by any of these issues. I have had several arguments with my sister and her partner. One of which led me to attempt sucide. I have been diagnosed since 2018 with borderline personality disorder x complex post traumatic stress disorder. I am easily set off and and triggered but have gotten so much better at controlling myself throughout these past few years. But now it feels like all that work I've done on myself is getting earned. My sister and her partner came home from work not in good moods. They must expect me to be a mind reader because I didn't know they had bad days. We got into an argument (I'll save you the boring details as it was a petty argument ) but I said to then take your attitude and fck off inside. And my sisters partner turned around to me and said why don't you?. I had been sitting in this exact spot for the entire day. They entered where I was sitting after they came home. How should i be the one to move? Just go into your room? But anyways, I attempted to calm down but me being already heightened I said back " I shouldn't have to I've actually had a pretty good f*cking day till youse came home and decided to set me off". Long story short - he said something ridiculous and I just automatically went I have bpd what do you expect I just match your energy And he went "excuses excuses" Me "its litterly a chemical imbalance, tell that to the thousands on disability and all the doctors: Him" excuses"
I have seen online about the discrimination in accommodation laws but i am unsure on if his words count under that law? I want them out of my house. I do not feel welcome nor comfortable in my own home.
Im not allowed to ask how their day was either due to be yelled at by my sisters partner previously for simply asking how was work not knowing he "never wants to talk about work when he gets home". Which is fair I can understand that but also just have some basic respect towards me and just be like oj it was shit and move on? Instead he choose to have a go at me for asking and just attempting to be civil and nice.
There's several other arguments but they're all just small petty things. I hear them both laughing before I leave my room, I walk and instantly like I'm the biggest burden to them. Most of the time I talk I get ignored unless they're in a shitty mood. I've had friends over who have also seen how extremely rude they are. One waved hello and greeted them nicely only to get snarky looks in return. Another friend of mine sat in my room and waited till they left for work to leave my house due to how uncomfortable they made him feel. I have also been told I am not allowed to have the dog in my house which belongs to the 4th housemate. The dog sleeps in my room when she is not home and quite enjoys it. The 4th housemate knows about this and think it's very sweet and doesn't have an issue with it. I don't understand how someone can think it's right to tell me what I can and can't do over the owner.
Is there anything I can do I do plan to go into my real estate on Monday morning This is honestly taking a massive toll on me and my mental health. I haven't attempt to take my own life in many years and was on a very good road to recovery. I'm definitely not perfect and once set off I definitely can make some situations worse then they need to be but I'm only human and I work veey hard everyday to better myself. My medications have increased, increased again and now been changed to something alot stronger due to this situation. They have only lived here a few months I honestly cannot take this anymore and don't have the financial stability to move myself otherwise i would.
I would love to just have a calm and rational conversation with them but I've tried that to no success. It lasts about a day or two before things go back to this

This is a very difficult post to make for me so I apologise for my horrendous, typing, punctuation, spelling etc.
I really need some advice on what to do
I have been living in this house since April last year with no problems. Was a very peaceful and calm environment. My sister moved in ans a few months partner her new partner moved in. We are all on the lease. I am unsure of what to do as since they have mood in they have created a hostile and none welcoming environment for me. We also have a 4th housemate who thankfully isn't affected by any of these issues. I have had several arguments with my sister and her partner. One of which led me to attempt sucide. I have been diagnosed since 2018 with borderline personality disorder x complex post traumatic stress disorder. I am easily set off and and triggered but have gotten so much better at controlling myself throughout these past few years. But now it feels like all that work I've done on myself is getting earned. My sister and her partner came home from work not in good moods. They must expect me to be a mind reader because I didn't know they had bad days. We got into an argument (I'll save you the boring details as it was a petty argument ) but I said to then take your attitude and fck off inside. And my sisters partner turned around to me and said why don't you?. I had been sitting in this exact spot for the entire day. They entered where I was sitting after they came home. How should i be the one to move? Just go into your room? But anyways, I attempted to calm down but me being already heightened I said back " I shouldn't have to I've actually had a pretty good f*cking day till youse came home and decided to set me off". Long story short - he said something ridiculous and I just automatically went I have bpd what do you expect I just match your energy And he went "excuses excuses" Me "its litterly a chemical imbalance, tell that to the thousands on disability and all the doctors: Him" excuses"
I have seen online about the discrimination in accommodation laws but i am unsure on if his words count under that law? I want them out of my house. I do not feel welcome nor comfortable in my own home.
Im not allowed to ask how their day was either due to be yelled at by my sisters partner previously for simply asking how was work not knowing he "never wants to talk about work when he gets home". Which is fair I can understand that but also just have some basic respect towards me and just be like oj it was shit and move on? Instead he choose to have a go at me for asking and just attempting to be civil and nice.
There's several other arguments but they're all just small petty things. I hear them both laughing before I leave my room, I walk and instantly like I'm the biggest burden to them. Most of the time I talk I get ignored unless they're in a shitty mood. I've had friends over who have also seen how extremely rude they are. One waved hello and greeted them nicely only to get snarky looks in return. Another friend of mine sat in my room and waited till they left for work to leave my house due to how uncomfortable they made him feel. I have also been told I am not allowed to have the dog in my room which belongs to the 4th housemate. The dog sleeps in my room when she is not home and quite enjoys it. The 4th housemate knows about this and think it's very sweet and doesn't have an issue with it. I don't understand how someone can think it's right to tell me what I can and can't do over the owner.
Is there anything I can do I do plan to go into my real estate on Monday morning This is honestly taking a massive toll on me and my mental health. I haven't attempt to take my own life in many years and was on a very good road to recovery. I'm definitely not perfect and once set off I definitely can make some situations worse then they need to be but I'm only human and I work veey hard everyday to better myself. My medications have increased, increased again and now been changed to something alot stronger due to this situation. They have only lived here a few months I honestly cannot take this anymore and don't have the financial stability to move myself otherwise i would.
I would love to just have a calm and rational conversation with them but I've tried that to no success. It lasts about a day or two before things go back to this

So right now i’m finishing my sophomore year of high school and at the beginning of my junior year i’m going to the USMC recruiter to talk about enlisting. I have a history of ADHD and depression/anxiety, I was hospitalized once for 8 days in 2020 voluntary, I had minimal self harm scars and no suicide attempts. I was put on medication for my ADHD and depression but I shortly switched to mood stabilizers to replace the depression medication. since then i’ve been on those medications but I just talked to my psychiatrist the other day and she ended my prescriptions so I can gradually get off my mood stabilizers because it takes a few weeks, and I stopped taking my ADHD meds a little while ago. I still have two more years of high school and i’m aware that you need about 24 months being off medication so hopefully it will work out. I am very aware that I will need waivers to join and that I will most likely have to go to MEPS more than once. I have been in therapy consistently since 6th grade as well. If the USMC doesn’t work out I was thinking of the army because I know they accept lots of waivers as well. Now that you know some background I’m gonna list some questions below.
1) Do I have to cut off my therapist to join?
2) Does MEPS look at genesis before or after they ask me psyc questions and do the physical examination?
3) Can I apply for a waiver while i’m still in school before it’s been 24 months of no medication?(because I want to join ASAP)
4) Does MEPS look at my IEP?
5) Do I have to get records from the hospital I went to?
6) does genesis show when I started and ended my prescription?
please help me out, thank you!

Anyone in here experience postpartum psychosis? I did after my first-born and was jacked up on high dose antipsychotics and lamictal. Luckily I was able to taper within a year of starting everything. When I became pregnant with my second, I sought care under a high-risk perinatal psychiatrist and was started back on lamictal during my second trimester as a preventative measure. I had zero postpartum mood issues. I hate to credit the medication 100% though, I was in a MUCH better life-circumstance. I figured that psychosis experience was a one-time ordeal…
Well, 7 years later I found myself being restrained and forcibly injected, hospitalized for 6 weeks against my will (3 different facilities.) The entire experience made everything 1000x worse. By the grace of God, I was able to leave AMA. I got off of the antipsychotics, but maintained the lamictal as a preventative. I’d like to come off of that as well.
I will say both “episodes” were completely different/opposite and I thoroughly believe “psychosis” is just a blanket term.
Now, I’d like to have another baby… but I’m just so terrified of another “episode” and I also don’t want to take lamictal through pregnancy again…
Thoughts? Advice? Experience? TIA!

New Toyota RAV4 GR SPORT
The RAV4 is the latest Toyota model to be made available in a GR SPORT version
Sporty and sophisticated styling and equipment specification inspired by TOYOTA GAZOO Racing, Toyota’s multi-World Championship-winning competition arm
RAV4 GR SPORT suspension retuned for focussed handling performance
Available with a choice of powerful and efficient 2.5-litre hybrid electric or plug-in hybrid electric powertrains
Featuring fully digital driver’s instrument panel and more powerful multimedia system
The Toyota RAV4 has always been at the cutting edge of the car market since it originated the concept of the easy-to-drive, highly versatile recreational SUV almost 30 years ago. Today, it consistently ranks not just as the world’s best-selling SUV, but also as one of the best-selling cars across all types and genres.
Year after year, Toyota has made sure the RAV4 keeps ahead of the game where customers’ tastes and preferences are concerned, adopting new technologies and design thinking to keep the car’s appeal and its capabilities up to the moment. The latest chapter in the RAV4 story is the new RAV4 GR SPORT, an addition to the range that comes with styling and equipment features that express sportiness and sophistication that are inspired by TOYOTA GAZOO Racing – the cradle of Toyota’s mission to create ever-better cars through motorsport.
The GR SPORT theme has already been successfully applied to a wide range of other Toyota models, ranging from Yaris, Yaris Cross, C-HR and Corolla to the mighty Hilux pick-up. The RAV4 now picks up the baton in its own inimitable style.
Exterior Design
A series of exterior design details distinguishes the new RAV4 GR SPORT, broadcasting its sportier character.
The car’s front end makes a statement with the prominent grille finished in the GR-exclusive G-mesh pattern, which creates a deeper 3D-effect. The same pattern is applied to the enlarged fog light bezels, which also have distinctive boomerang-shaped frames, giving added prominence to the vehicle’s strong stance. Adding to this effect, the lower bumper has a dark grey metallic finish, in place of the silver featured on other RAV4 models.
At the rear, the back window’s appearance has been thrown into sharper relief by a gloss black garnish that extends the width of the vehicle, between the glass and the licence plate. The G-mesh pattern appears again in the rear bumper, which also has air-bleeding openings to improve aerodynamic performance. Further emphasising the RAV4’s purposeful look, the lower bumper has a dark grey metallic moulding across its bottom edge.
Discreet GR logo badging on the front grille and back door also signifies the grade.
GR SPORT Wheels
The exclusive GR SPORT 19-inch alloy wheels are engineered for reduced weight and higher rigidity. Their robust, five-double-spoke design stands out with a gloss black finish and a fine line-cutting technique, applied for the first time which creates eye-catching pinstripe detailing around the spokes’ margins.
Colour Choices
The principal paintwork options for the RAV4 GR SPORT follow the famous white, red and black livery of TOYOTA GAZOO Racing’s competition stable. In the case of this road-going model, the options are Platinum White Pearl, Flame Red and Attitude Black. Customers can also opt for Silver and Grey metallic and Dark Blue mica.
The same colours – apart from Attitude Black – are available in a bi-tone finish, combined with a gloss black roof, front and centre pillars and rear spoiler.
Interior Design
The GR SPORT’s interior likewise features styling details exclusive to its status.
The principal colour theme for the upholstery and lining is black, creating an atmosphere that puts the focus firmly on driving. The seats are upholstered in a combination of a grippy, body-holding suede-like materials for the shoulder, back rest and cushion sections and synthetic leather for the bolsters. Silver grey stitching adds a smart contrast on the seats, steering wheel and shift lever. The front seat head rests are embossed with the GR logo in black-on-black.
The sophisticated cabin look is enhanced by dark grey metallic trim details on the steering wheel, air vent bezels and the centre console frame around the shift lever. The GR logo is also applied to the steering wheel and the carpet mats.
The GR SPORT’s high equipment specification includes power adjustment for the front seats and a new version of Toyota’s Panoramic View Monitor, which includes an underfloor view to help the driver check the terrain surface and precisely locate the wheels when manoeuvring at low speed. Further assistance is provided by a new digital reversing camera that provides higher quality real-time images compared to the previous analogue system.
Digital Driver’s Instrument Display
The 12.3-inch driver’s instrument display is fully digital with pin-sharp graphics and the option to customise content to suit the driver’s mood or the journey through four themes: Casual, Smart, Tough and Sporty. The options include three different layouts for the principal meters, while each version keeps a central digital speedometer and shift indicator. The background illumination automatically changes with the selected drive mode.
The display has three distinct multi-information zones. The central section presents the most frequently used information, such as indicators of the car’s advanced safety systems. Those to the left and right provide details of fuel consumption, audio selection and other data; the driver can also personalise the display with a widget highlighting their preferred information.
Multimedia
The RAV4 GR SPORT is fitted with the latest Toyota Smart Connect multimedia system operated using a 10.5-inch touchscreen display. Mounted centrally on the dashboard and shaped to harmonise with the angles of the car’s interior design, the monitor has a seamless black surface and presents graphics in high definition for sharpness and clarity in all lighting conditions.
A permanent, icon-based menu is presented on the driver’s side of the display. Users can also connect their smartphone or tablet to the system – both wired and wirelessly if using Apple CarPlay® or with a wired link for Android Auto®.
The multimedia package includes access to cloud-based journey navigation, which uses constantly updated real-time traffic event information for accurate and efficient route planning. There is also an embedded navigation system that can be used when no data connection to the cloud is available. This has additional functions including highway sign recognition, local weather information and driver alerts when the vehicle is approaching restricted low emission zones (LEZs).
Using voice commands has been made easier with a new “Hey Toyota” on-board voice agent. This will respond to spoken requests to adjust the climate control, choose multimedia options, make a phone call, or open and close the windows. “Hey Toyota” is designed to understand conversational speech, so if you say “I’m cold” it will respond by closing the windows or raising the cabin temperature. With two microphones installed in the instrument panel, the system will recognise and respond to commands from both the driver and front seat passenger. It will also recognise commands amid background noise, so there is no need to turn off the audio.
There is further convenience with any future software tweaks or upgrades delivered seamlessly over the air, via the car’s data communications module (DCM). This means there is no need for the car to be taken to a workshop for a system update. Likewise, the system can be used to update software in the Toyota T-Mate/Toyota Safety Sense.
Remote Services via the MyT App
The driver can access a number of useful functions remotely, via the MyT smartphone app. The familiar worries about whether you have left a window open, the doors unlocked or the lights on after you’ve walked away from your car are addressed with remote notifications to confirm the vehicle is secure. This feature is standard on all RAV4 models.
You can also lock and unlock the doors – a handy feature if someone without a key needs access, for example to drop off a parcel or to clean the car. The hazard lights can also be flashed, making the vehicle easier to spot in a big or busy car park. These features are newly standard on mid-grade models, together with remote operation of the climate control to warm up or cool the cabin before making a journey.
Vehicle status can be checked, including the fuel level and cruising range, health warnings and details of the latest vehicle health check.
Suspension
The RAV4 GR SPORT goes beyond styling and equipment features to deliver an enhanced driving experience with a more handling-tuned suspension.
The front and rear coil springs have been stiffened to put the focus on agility and responsiveness. Changes to the spring coefficient are matched by appropriate adjustment of the shock absorbers’ damping force. On the plug-in hybrid electric model, the spring rates have increased from 30 to 36 N/mm at the front and 49 to 55 N/mm at the rear; on the hybrid electric GR SPORT the respective increases are 28 to 30 and 40 to 46 N/mm.
The well-proven suspension set-up on the RAV4 uses front MacPherson struts with rear double wishbones – both with anti-roll bars.
Powertrains
Hybrid Electric
The hybrid electric RAV4 GR SPORT features Toyota’s well-proven fourth generation full hybrid technology, engineered with lighter and more compact components to help deliver sharper performance and higher efficiency. Full system output is 222 DIN hp/163 kW, enabling 0-100 km/h acceleration in 8.1 seconds.
The powertrain marked the introduction of a 2.5-litre Hybrid Dynamic Force four-cylinder petrol engine. Achieving world-class thermal efficiency, this Atkinson cycle unit delivers a strong balance of fuel economy and power. In the new RAV4 GR SPORT, WLTP combined cycle fuel consumption is 5.8 l/100 km with CO2 emissions of 132 g/km.
Plug-in Hybrid Electric
Toyota delivered the most powerful RAV4 yet with the introduction of a plug-in hybrid electric system that produces a maximum 306 DIN hp/225 kW. This level of power enables acceleration from rest to 100 km/h in 6.0 seconds; raw speed apart, the powertrain is engineered for driveability, with 50% more power available at 60 km/h. Even when driving in all-electric EV mode, performance is brisk, with acceleration comparable to a 2.0-litre petrol vehicle.
Its efficiency is maximised by the car running in EV mode by default, then switching to self-charging hybrid electric running when the charge in the lithium-ion battery is depleted. On a full charge, the RAV4 Plug-in Hybrid GR SPORT can cover up to 75 km (WLTP combined cycle) and reach speeds of up to 135 km/h.
Intelligent, Electric All-Wheel Drive
The RAV4 GR SPORT models are equipped as standard with an intelligent, electric all-wheel drive system – AWD-i. This returns better fuel economy in urban driving, quieter performance at high speeds and improved traction in slippery conditions. It is also more compact and lighter in weight than mechanical AWD systems, so fuel consumption and space inside the cabin and load compartment are not compromised.
AWD-i efficiently generates drive torque using power from the vehicle’s hybrid system and an additional electric motor on the rear axle. This format reduces energy losses, saves weight and optimises all-wheel drive performance in different driving conditions.
Toyota’s development of the technology delivers more torque to the rear wheels, to a maximum 1,300 Nm – matching or surpassing the typical torque achieved with a mechanical system and giving the RAV4 more sure-footed performance, for example when pulling away on loose, slippery surfaces. The front/rear drive torque split can vary from 100:0 to up to 20:80, according to the driving conditions. The ratio is automatically optimised to give improved handling, stability and off-road performance. In particular, the driver will notice more faithful line-tracing through bends in slippery conditions.
AWD Integrated Management
All-wheel drive performance is further improved with AWD Integrated Management (AIM), a unique feature in the RAV4’s class. This automatically adjusts different vehicle systems – steering assist, brake and throttle control, shift pattern and drive torque distribution – according to the drive mode selected, NORMAL, ECO or SPORT. In SPORT mode, AIM modifies the steering assist, throttle control shift schedule and drive torque distribution to gain better on-road performance.
“Escape” Capability with Trail Mode
First introduced with the current generation RAV4, the RAV4 GR SPORT with AWD-i has the added benefit of automatic limited-slip differential control – Trail Mode. This ensures the best possible grip and control on slippery surfaces. It can also provide valuable assistance when tackling challenging off-road conditions.
This counters the risk of the vehicle becoming stranded if a driven wheel loses contact with the ground on very uneven terrain. In this scenario, the driver can engage Trail Mode using a button on the centre console, braking the free rotating wheel and directing drive torque to the grounded wheel. Throttle control and the transmission shift pattern are also adapted to help the driver keep the vehicle moving.
Advanced Safety and Driver Assistance
The new GR SPORT benefits from the enhanced Toyota T-Mate package of safety and driver assistance features introduced across the model range for 2023. This includes additional functions that can warn the driver and help avoid a wider range of common road accident risks.
The Toyota Safety Sense’s Pre-Collision System (PCS) gains intersection support that can help with safer turns at junctions. Provided on both the hybrid electric and plug-in hybrid electric models, this will detect if the car is about to cross the path of any oncoming traffic, and if there are any pedestrians crossing the road into which the vehicle is moving, alerting the driver and, if necessary, initiating braking control to help avoid an impact.
Emergency Steering Assist (ESA) is also newly provided, helping the driver avoid a pedestrian who has stepped into the road, while keeping the car under control and within its traffic lane. On the plug-in model, ESA can additionally detect and respond to a cyclist or a stationary or preceding vehicle,. On the RAV4 Plug-in Hybrid, the system will also recognise and react to bicycles and parked vehicles. The RAV4 Plug-in Hybrid’s PCS also gains the ability to detect oncoming vehicles in the car’s traffic lane in daytime driving and reduce the risk of a head-to-head collision.

Is it normal to receive so many diagnoses at once? Has anyone else had this experience and/or do you have any co-morbid conditions?
Our assessment was 1 hour and 45 mins long. (I was diagnosed with ADHD from a previous Psychiatrist so that was an easy one for him)
Diagnosis: ICD 11 6B41 Complex post traumatic stress disorder 6A05 Attention deficit hyperactivity disorder 6A61 Bipolar type II disorder Need to rule out ICD 10 F 60.3 Emotionally unstable personality disorder-Borderline type
Current medication: Consider mood stabilizer such as Lamotrigine PRN Promethazine to help with sleep
However, in the "impression" section I have: "From the ITQ Questionnaire she certainly has some features of a complex PTSD. However, in my opinion, there is a significant overlap between emotionally unstable personality – borderline type as well. She also seems to have sustained periods of depressed mood alternating with elated mood , which would fulfil the criteria for a Bipolar affective disorder.
I think medication such as Lamotrigine, a mood stabilizer might help, but the main therapy , she needs is longer-term psychological therapy. I think therapies such as Dialectical Behavioural Therapy (DBT) would help her. However, if she is feeling low and suicidal, she would need to attend as a day patient as well. Given that she has predominantly depressive episodes, I think it’s important to manage these with a mood stabilizer which helps with mostly depressive episodes and should she become manic, she needs to have anti-manic medication for that period. She would also benefit from being prescribed a hypnotic such as Promethazine as required to help her sleep."
I interpreted the above as him saying: "meets some criteria for C-PTSD, but in my opinion it's borderline, but she also meets the criteria for Bipolar type II" Have no idea how to process or where to take this or what to focus on. I seem to be diagnosed with a hat trick of developmental, trauma and mood based disorders.

Is it normal to receive so many diagnoses at once? Has anyone else had this experience and/or do you have any co-morbid conditions?
Our assessment was 1 hour and 45 mins long. (I was diagnosed with ADHD from a previous Psychiatrist so that was an easy one for him)
Diagnosis: ICD 11 6B41 Complex post traumatic stress disorder 6A05 Attention deficit hyperactivity disorder 6A61 Bipolar type II disorder Need to rule out ICD 10 F 60.3 Emotionally unstable personality disorder-Borderline type Current medication: Consider mood stabilizer such as Lamotrigine PRN Promethazine to help with sleep
However, in the "impression" section I have: "From the ITQ Questionnaire she certainly has some features of a complex PTSD. However, in my opinion, there is a significant overlap between emotionally unstable personality – borderline type as well. She also seems to have sustained periods of depressed mood alternating with elated mood , which would fulfil the criteria for a Bipolar affective disorder.
I think medication such as Lamotrigine, a mood stabilizer might help, but the main therapy , she needs is longer-term psychological therapy. I think therapies such as Dialectical Behavioural Therapy (DBT) would help her. However, if she is feeling low and suicidal, she would need to attend as a day patient as well. Given that she has predominantly depressive episodes, I think it’s important to manage these with a mood stabilizer which helps with mostly depressive episodes and should she become manic, she needs to have anti-manic medication for that period. She would also benefit from being prescribed a hypnotic such as Promethazine as required to help her sleep."
I interpreted the above as him saying: "meets some criteria for C-PTSD, but in my opinion it's borderline, but she also meets the criteria for Bipolar type II"
Have no idea how to process or where to take this or what to focus on. I seem to be diagnosed with a hat trick of developmental, trauma and mood based disorders.

Title: Understanding Fentanyl: Uses, Risks, and Controversies
Introduction: Fentanyl, a potent synthetic opioid, has gained significant attention in recent years due to its role in the opioid epidemic. This article aims to provide a comprehensive overview of fentanyl, including its medical uses, associated risks, and the controversies surrounding its widespread misuse.
Medical Uses: Originally developed for managing severe pain, especially in cancer patients, fentanyl is an analgesic that is 50 to 100 times more potent than morphine. It is commonly used in medical settings for pain management during surgeries, chronic pain conditions, and palliative care.
Risk Factors: While fentanyl is effective in controlling pain when administered under medical supervision, its misuse poses serious health risks. The drug's high potency increases the likelihood of overdose, leading to respiratory depression and, in extreme cases, death. Illicitly manufactured fentanyl, often mixed with other substances, has been a major contributor to the rising number of opioid-related deaths.
Controversies and Illicit Use: The illicit use of fentanyl has sparked controversy and public health concerns. The drug is often clandestinely produced and added to other drugs, such as heroin or cocaine, without the user's knowledge. This has resulted in a surge in overdoses, as individuals may unintentionally consume lethal doses of the opioid.
Law Enforcement and Regulation: Governments and law enforcement agencies worldwide are grappling with the challenges posed by the illicit production and distribution of fentanyl. Efforts to regulate its manufacturing and distribution are ongoing, with stricter controls in place to prevent diversion into illegal channels.
Treatment and Harm Reduction: Addressing the fentanyl crisis requires a multi-faceted approach, including expanded access to addiction treatment, harm reduction strategies, and public awareness campaigns. Naloxone, an opioid receptor antagonist, has proven effective in reversing opioid overdoses and is increasingly available to first responders and the general public.
Conclusion: Fentanyl, with its remarkable pain-relieving properties, has become a double-edged sword in the realm of healthcare. While it serves a crucial role in medical settings, its misuse poses severe risks to public health. Efforts to combat the opioid epidemic must focus on education, regulation, and treatment to strike a balance between managing pain effectively and preventing the tragic consequences of its illicit use.
Narcan, also known by its generic name naloxone, is a medication used to rapidly reverse opioid overdose. It works by binding to the same receptors in the brain that opioids target, effectively reversing the life-threatening effects of opioid toxicity. Narcan is commonly administered in emergency situations where an individual is experiencing respiratory depression or unconsciousness due to opioid overdose.
Emergency responders, healthcare professionals, and even some non-professionals, such as family members of individuals at risk of opioid overdose, may carry naloxone. The medication is available in various forms, including nasal sprays and injectable formulations, making it accessible for different situations.
The prompt administration of Narcan can restore normal breathing and consciousness, providing crucial time for the affected person to receive further medical attention. It is an essential tool in harm reduction strategies aimed at preventing opioid-related deaths and is a key component of public health initiatives addressing the opioid epidemic.
Suboxone is a prescription medication used in the treatment of opioid dependence and addiction. It is a combination of two active ingredients: buprenorphine and naloxone.

1. Buprenorphine: This is a partial opioid agonist, meaning it binds to the same receptors in the brain that opioids bind to but with less intensity. It helps to reduce cravings and withdrawal symptoms, allowing individuals in recovery to better manage their addiction.
   
2. Naloxone: Naloxone is an opioid receptor antagonist, which means it blocks the effects of opioids. When taken as directed, naloxone remains largely inactive. However, if someone were to misuse Suboxone by injecting it, the naloxone component can counteract the opioid effects, reducing the risk of misuse.
   

Suboxone is often prescribed as part of medication-assisted treatment (MAT), a comprehensive approach to opioid addiction that includes counseling, therapy, and support services. It can be used in the detoxification phase as well as for long-term maintenance therapy. The goal of Suboxone treatment is to help individuals gradually reduce their dependence on opioids, manage cravings, and improve their overall quality of life during recovery.
It's important to note that Suboxone should only be used under the supervision of a qualified healthcare professional, as improper use or abrupt discontinuation can lead to withdrawal symptoms or other complications.
Precipitated withdrawal refers to the accelerated onset of withdrawal symptoms, often more severe than typical, when an opioid antagonist is introduced to the body. This occurs because the antagonist displaces the opioid from receptors, leading to a sudden and intense withdrawal reaction.
For example, if someone is currently dependent on opioids and receives a medication like naloxone or naltrexone, which are opioid antagonists, it can rapidly trigger withdrawal symptoms. This is a safety mechanism, as these medications are often used to reverse opioid overdose or as part of addiction treatment.
The term is commonly associated with medication-assisted treatment for opioid use disorder, where medications like buprenorphine (a partial opioid agonist) are used. If buprenorphine is administered before other full opioids have cleared from the system, it can displace those opioids from receptors, leading to precipitated withdrawal. This is why healthcare providers carefully time the initiation of medications like buprenorphine to avoid this intensified withdrawal reaction.
Understanding the potential for precipitated withdrawal is crucial in the context of addiction treatment to ensure safe and effective transitions between medications and to minimize discomfort for individuals in recovery.
Using Suboxone involves adherence to a specific treatment plan under the guidance of a qualified healthcare professional. Here are some key aspects related to the use of Suboxone:

1. Prescription and Medical Supervision: Suboxone is a prescription medication, and its use should be initiated and supervised by a qualified healthcare provider, typically in the context of medication-assisted treatment (MAT) for opioid use disorder.
   
2. Dosage: The healthcare provider will determine the appropriate dosage based on the individual's specific needs and response to the medication. It's essential to follow the prescribed dosage and not adjust it without consulting the healthcare provider.
   
3. Administration: Suboxone is often administered sublingually, meaning it is placed under the tongue and allowed to dissolve. This method allows for the absorption of the medication into the bloodstream.
   
4. Timing: The timing of Suboxone administration is crucial. It is often started when the individual is in a mild to moderate state of withdrawal to reduce the risk of precipitated withdrawal. The healthcare provider will provide guidance on the appropriate timing.
   
5. Regular Monitoring: During Suboxone treatment, individuals are regularly monitored by healthcare professionals to assess progress, manage side effects, and adjust the treatment plan as needed.
   
6. Counseling and Support: Suboxone is typically part of a comprehensive treatment plan that includes counseling, therapy, and support services. This holistic approach addresses both the physical and psychological aspects of opioid addiction.
   
7. Gradual Tapering: Depending on the treatment plan, there may be a gradual tapering of Suboxone dosage as the individual progresses in their recovery. Tapering is done under medical supervision to minimize withdrawal symptoms.
   
8. Avoiding Other Opioids: It's crucial to avoid the use of other opioids while taking Suboxone. Combining opioids can lead to dangerous interactions and diminish the effectiveness of the treatment.
   
9. Side Effects and Reporting: Like any medication, Suboxone may have side effects. Common side effects include headache, nausea, and constipation. Any unusual or severe side effects should be promptly reported to the healthcare provider.
   
10. Pregnancy Considerations: If an individual is pregnant or planning to become pregnant, it's important to discuss this with the healthcare provider, as the use of Suboxone during pregnancy requires careful consideration.
    

Always follow the guidance of your healthcare provider and inform them of any concerns or changes in your condition during Suboxone treatment. Successful recovery often involves a combination of medication, counseling, and support tailored to individual needs.
Suboxone, when used as prescribed under the supervision of a healthcare professional as part of medication-assisted treatment (MAT) for opioid use disorder, has a lower potential for abuse and addiction compared to full opioid agonists. This is because Suboxone contains buprenorphine, a partial opioid agonist, which has a ceiling effect on its opioid effects.
Buprenorphine's partial agonist properties mean that it activates opioid receptors in the brain to a lesser extent than full agonists like heroin or oxycodone. As a result, the euphoria and respiratory depression associated with opioid abuse are less pronounced with buprenorphine.
However, it's essential to emphasize that any medication, including Suboxone, should be taken exactly as prescribed by a healthcare professional. Misuse, such as taking larger doses or combining Suboxone with other substances, can increase the risk of dependence or addiction.
Abruptly stopping Suboxone can lead to withdrawal symptoms, emphasizing the importance of a gradual tapering plan under medical supervision when discontinuing the medication. It's crucial for individuals using Suboxone to work closely with their healthcare provider to ensure proper management of their opioid use disorder and to address any concerns or side effects during the course of treatment.
Withdrawal symptoms from Suboxone, or buprenorphine (the active ingredient in Suboxone), can occur when someone who has been using the medication for an extended period stops taking it abruptly. It's important to note that withdrawal symptoms can vary in intensity and duration based on factors such as the individual's overall health, the duration of Suboxone use, and the dosage.
Common withdrawal symptoms from Suboxone may include:

1. Nausea and vomiting
2. Diarrhea
3. Muscle aches and pains
4. Sweating
5. Insomnia or sleep disturbances
6. Anxiety
7. Irritability
8. Runny nose and teary eyes
9. Goosebumps (piloerection)
10. Dilated pupils

It's important to distinguish between withdrawal symptoms and precipitated withdrawal. Precipitated withdrawal can occur if someone takes Suboxone too soon after using a full opioid agonist, leading to a more rapid and intense onset of withdrawal symptoms.
Withdrawal from Suboxone is generally considered less severe than withdrawal from full opioid agonists, and the symptoms tend to peak within the first 72 hours after discontinuation. However, the duration and severity can vary from person to person.
If an individual is considering stopping Suboxone or adjusting their dosage, it's crucial to do so under the guidance of a healthcare professional. Tapering the medication gradually, rather than stopping abruptly, can help minimize withdrawal symptoms and increase the chances of a successful transition to recovery. Seeking support from healthcare providers, counselors, and support groups is essential during this process.
Kratom is a tropical tree native to Southeast Asia, specifically in countries like Thailand, Malaysia, Indonesia, Papua New Guinea, and Myanmar. The leaves of the Kratom tree have been traditionally used for various purposes, including as a stimulant, a pain reliever, and to manage opioid withdrawal symptoms.
The active compounds in Kratom, called alkaloids, interact with opioid receptors in the brain, producing effects that can vary depending on the strain and dosage. These effects can include:

1. Stimulation: At lower doses, Kratom may act as a stimulant, promoting increased energy, alertness, and sociability.
   
2. Sedation: At higher doses, Kratom may have sedative effects, leading to relaxation and pain relief.
   
3. Pain Relief: Kratom has been used traditionally for its analgesic properties, and some people use it as a natural remedy for pain.
   
4. Mood Enhancement: Some users report improved mood and reduced anxiety after consuming Kratom.
   

However, it's important to note that Kratom is not regulated by the U.S. Food and Drug Administration (FDA), and its safety and effectiveness for various uses have not been clinically proven. There are potential risks associated with Kratom use, including dependence, addiction, and adverse effects such as nausea, constipation, and increased heart rate.
Due to these concerns, Kratom has been a subject of regulatory scrutiny in various countries, with some regions imposing restrictions or outright bans on its sale and use. It is essential for individuals to exercise caution, seek reliable information, and consult with healthcare professionals before considering the use of Kratom, especially for medicinal purposes or to manage opioid withdrawal.
Methadone is a synthetic opioid medication used primarily in the treatment of opioid dependence, particularly in the context of medication-assisted treatment (MAT). It is a long-acting opioid agonist, meaning it activates the same opioid receptors in the brain that other opioids, like heroin or morphine, do.
Key points about Methadone include:

1. Opioid Dependence Treatment: Methadone is often used as a maintenance medication to help individuals reduce or quit the use of illicit opioids. It helps by reducing cravings and withdrawal symptoms.
   
2. Long-Lasting Effect: One significant advantage of methadone is its long duration of action. A single daily dose can help stabilize individuals, preventing the highs and lows associated with short-acting opioids.
   
3. Supervised Administration: In some cases, methadone is provided through supervised administration in specialized clinics to ensure proper use and minimize the risk of diversion.
   
4. Tolerance and Dependence: Like other opioids, individuals using methadone can develop tolerance and dependence. Therefore, the dosage needs to be carefully managed, and discontinuation should be done gradually under medical supervision.
   
5. Reduction of Illicit Drug Use: When used as part of a comprehensive treatment plan, methadone has been shown to reduce illicit opioid use, lower the risk of overdose, and improve overall health outcomes.
   
6. Potential Side Effects: Methadone can have side effects, including constipation, sweating, drowsiness, and changes in libido. It's important for individuals to report any adverse effects to their healthcare provider.
   
7. Regulated Use: The use of methadone is tightly regulated, and it is typically dispensed through specialized clinics or healthcare providers who are authorized to prescribe it for opioid use disorder treatment.
   

Methadone treatment is part of a broader approach that often includes counseling, therapy, and support services. It has been a valuable tool in harm reduction strategies aimed at addressing the opioid epidemic and helping individuals achieve and maintain recovery.
Narcotics Anonymous (NA) is a 12-step program that provides support for individuals recovering from addiction, particularly those struggling with substance abuse issues. It is important to note that NA, like other 12-step programs, does not have an official stance or opinion on specific medical treatments, including medication-assisted treatment (MAT) for withdrawal.
The approach to medication assistance in withdrawal can vary among individuals within the NA community. Some may find success and support in MAT, while others may choose alternative methods or prefer an abstinence-based approach. NA encourages individuals to share their experiences, strength, and hope, but it does not dictate specific treatment choices.
The primary focus of NA is on mutual support, fellowship, and following the 12-step principles, which include admitting powerlessness over addiction, seeking spiritual awakening, and helping others in recovery. Members of NA are encouraged to respect each other's choices and paths to recovery.
It's essential for individuals seeking support for addiction to find a treatment plan that aligns with their needs and values. Consulting with healthcare professionals, attending support groups, and considering various treatment options can be part of a comprehensive approach to recovery.
SMART Recovery (Self-Management and Recovery Training) is a science-based, secular alternative to traditional 12-step programs like Narcotics Anonymous. SMART Recovery emphasizes self-empowerment and utilizes evidence-based techniques to support individuals in overcoming addiction.
Regarding Medication-Assisted Treatment (MAT), SMART Recovery takes a neutral stance. The program acknowledges that MAT, when prescribed and monitored by healthcare professionals, can be a valid and effective part of a comprehensive approach to addiction treatment. SMART Recovery recognizes that different individuals may have unique needs, and treatment plans should be tailored to the individual's circumstances.
SMART Recovery's focus is on teaching self-reliance, coping skills, and strategies for managing urges and behaviors associated with addiction. The program encourages participants to make informed decisions about their recovery, including the consideration of medications that may be prescribed by healthcare providers.
Ultimately, SMART Recovery emphasizes a holistic and individualized approach to recovery, allowing participants to choose the methods and tools that best suit their needs and align with their values. This includes being open to the potential benefits of MAT for some individuals as part of their overall recovery plan.
Several treatment modalities are available for individuals struggling with opioid use disorder. The most effective approach often involves a combination of different strategies. Here are some key treatment modalities for opioid addiction:

1. Medication-Assisted Treatment (MAT): MAT involves the use of medications, such as methadone, buprenorphine (Suboxone), and naltrexone, to help manage cravings, reduce withdrawal symptoms, and support recovery. These medications are often used in combination with counseling and therapy.
   
2. Counseling and Behavioral Therapies: Various forms of counseling and behavioral therapies are crucial components of opioid addiction treatment. Cognitive-behavioral therapy (CBT), contingency management, motivational enhancement therapy, and dialectical behavior therapy (DBT) are among the approaches used to address the psychological aspects of addiction and help individuals develop coping skills.
   
3. Support Groups and 12-Step Programs: Participating in support groups like Narcotics Anonymous (NA) or 12-step programs can provide valuable peer support, encouragement, and a sense of community for individuals in recovery.
   
4. Detoxification Programs: Medically supervised detoxification programs help individuals safely manage the acute withdrawal symptoms associated with stopping opioid use. These programs often serve as the initial phase of treatment.
   
5. Residential or Inpatient Treatment: Inpatient treatment programs provide a structured and supportive environment for individuals to focus on recovery. These programs may include a combination of medical supervision, counseling, and therapeutic activities.
   
6. Outpatient Treatment: Outpatient programs allow individuals to receive treatment while living at home. This flexibility can be beneficial for those with work or family commitments. Outpatient treatment often includes counseling, therapy, and medication management.
   
7. Holistic and Alternative Therapies: Some individuals find benefit from holistic approaches, such as acupuncture, yoga, meditation, or mindfulness practices. These can complement traditional treatment modalities and contribute to overall well-being.
   
8. Peer Recovery Support Services: Peer recovery support services involve individuals with lived experience in recovery providing support, guidance, and encouragement to others going through similar challenges.
   

The most effective treatment plans are often individualized, taking into account the specific needs, preferences, and circumstances of each person. Collaborating with healthcare professionals to develop a comprehensive and tailored approach can significantly enhance the chances of successful recovery from opioid addiction.
The withdrawal timeline for fentanyl, a potent synthetic opioid, can vary among individuals based on factors such as the duration and intensity of use, individual metabolism, and overall health. Fentanyl withdrawal symptoms typically start shortly after the last dose and follow a general timeline:

1. Early Symptoms (Within a few hours): Early withdrawal symptoms may include anxiety, restlessness, sweating, and increased heart rate. Individuals may also experience muscle aches and insomnia.
   
2. Peak Intensity (24-72 hours): Withdrawal symptoms usually peak within the first 24 to 72 hours after discontinuing fentanyl. During this time, individuals may experience more intense symptoms such as nausea, vomiting, diarrhea, abdominal cramps, dilated pupils, and flu-like symptoms.
   
3. Subsiding Symptoms (5-7 days): The most acute withdrawal symptoms generally begin to subside within about five to seven days. However, some symptoms, such as insomnia, anxiety, and mood swings, may persist for a more extended period.
   
4. Post-Acute Withdrawal Syndrome (PAWS): Some individuals may experience a more prolonged period of withdrawal symptoms known as post-acute withdrawal syndrome (PAWS). This can include lingering psychological symptoms such as anxiety, depression, irritability, and difficulty concentrating. PAWS can persist for weeks or even months.
   

It's crucial to note that fentanyl withdrawal can be challenging, and seeking professional help is recommended to manage symptoms safely and effectively. Medical supervision can provide support through the detoxification process, and healthcare professionals may use medications to alleviate specific withdrawal symptoms and improve the overall comfort of the individual.
The withdrawal process is highly individual, and some individuals may find additional support through counseling, therapy, and participation in support groups to address the psychological aspects of recovery. Always consult with healthcare professionals for guidance on the safest and most effective approach to fentanyl withdrawal.
Xylazine is a veterinary sedative and analgesic medication. It belongs to the class of drugs known as alpha-2 adrenergic agonists. While it is primarily intended for veterinary use, xylazine has been misused in some cases for recreational purposes, particularly in combination with other substances.
In veterinary medicine, xylazine is commonly used as a sedative and muscle relaxant for various procedures, including surgery and diagnostic imaging. It is often administered to calm and immobilize animals.
However, the use of xylazine outside of veterinary settings, especially when combined with other drugs, can pose serious health risks. Misuse of xylazine has been associated with adverse effects, including respiratory depression, cardiovascular issues, and central nervous system depression.
It's important to emphasize that the use of xylazine for recreational purposes is highly dangerous and illegal. The drug is not intended for human consumption, and its effects can be unpredictable and potentially life-threatening.
If you have concerns about substance use or encounter situations involving illicit drugs, it is crucial to seek help from healthcare professionals, addiction specialists, or local support services. Misuse of veterinary drugs or any substances not prescribed for human use can have severe consequences and should be avoided.
PAWS stands for Post-Acute Withdrawal Syndrome. It refers to a set of prolonged withdrawal symptoms that some individuals may experience after the acute phase of withdrawal from substances like opioids, benzodiazepines, or alcohol. PAWS is not limited to a specific substance and can occur with various drugs.
These symptoms are generally more subtle than the acute withdrawal symptoms but can persist for weeks, months, or, in some cases, years after discontinuing substance use. PAWS can vary widely among individuals and may include symptoms such as:

1. Mood swings
2. Anxiety
3. Irritability
4. Insomnia
5. Fatigue
6. Difficulty concentrating
7. Memory problems
8. Reduced impulse control
9. Cravings for the substance

PAWS can be challenging for individuals in recovery, as these lingering symptoms may contribute to relapse if not effectively managed. Supportive interventions, such as counseling, therapy, and participation in support groups, can be beneficial for individuals experiencing PAWS. Healthy lifestyle choices, including regular exercise, proper nutrition, and adequate sleep, may also contribute to the overall well-being of those in recovery.
It's important to note that PAWS is not experienced by everyone in recovery, and its severity and duration can vary. Seeking guidance from healthcare professionals or addiction specialists can assist individuals in managing PAWS and maintaining long-term recovery.
Quitting substance use "cold turkey" involves stopping the use of a substance abruptly without tapering or gradually reducing the dosage. It's important to note that quitting cold turkey can be challenging, and the level of difficulty varies depending on the substance, the duration and intensity of use, and individual factors.
If you're considering quitting a substance cold turkey, here are some general recommendations:

1. Seek Professional Guidance: Before making the decision to quit cold turkey, it's advisable to consult with a healthcare professional or addiction specialist. They can provide guidance based on your specific situation, assess potential risks, and offer support.
   
2. Create a Support System: Inform friends, family, or a support network about your decision to quit. Having a support system in place can provide encouragement, understanding, and assistance during challenging times.
   
3. Understand Withdrawal Symptoms: Be aware of potential withdrawal symptoms associated with quitting the substance cold turkey. Withdrawal symptoms can vary depending on the substance but may include anxiety, irritability, insomnia, and other physical or psychological effects.
   
4. Stay Hydrated and Nourished: Maintaining proper hydration and nutrition is crucial during the quitting process. Stay hydrated by drinking water and consuming a balanced diet to support your overall well-being.
   
5. Exercise: Engage in regular physical activity. Exercise can help alleviate stress, improve mood, and contribute to your overall physical and mental health.
   
6. Consider Professional Treatment: Depending on the substance and the severity of dependence, professional treatment options, such as inpatient or outpatient programs, may be beneficial. Medical supervision can assist in managing withdrawal symptoms and ensuring safety.
   
7. Therapy and Counseling: Consider participating in therapy or counseling to address the underlying factors contributing to substance use and to develop coping strategies for a successful recovery.
   
8. Plan for Triggers: Identify situations, environments, or emotions that may trigger the urge to use the substance. Develop a plan to cope with these triggers without resorting to substance use.
   

It's essential to approach quitting any substance with a comprehensive strategy, and individual circumstances vary. Seeking professional advice ensures that you make informed decisions about the best approach for your specific situation. If you are experiencing severe withdrawal symptoms or have concerns about quitting cold turkey, it is crucial to consult with a healthcare professional for guidance and support.
Tapering refers to the gradual reduction of the dosage of a substance, typically a medication or a drug, over a specific period. Tapering is commonly used in the context of addiction treatment, where it involves slowly decreasing the amount of a substance to manage withdrawal symptoms and minimize the risks associated with abrupt discontinuation.
Key points about tapering include:

1. Medication-Assisted Treatment (MAT): Tapering is often part of medication-assisted treatment for substance use disorders. For example, individuals dependent on opioids might undergo a gradual tapering of medications like methadone or buprenorphine.
   
2. Reducing Dependence: Tapering is employed to reduce physical dependence on a substance by allowing the body to adjust to lower levels gradually. This helps minimize the severity of withdrawal symptoms.
   
3. Individualized Approach: Tapering plans are typically individualized based on factors such as the substance used, the duration and intensity of use, and the individual's overall health. Healthcare professionals design tapering schedules to meet the specific needs of each person.
   
4. Supervised Tapering: Tapering is ideally done under the supervision of a healthcare professional to ensure safety and effectiveness. This is particularly important in cases where abrupt discontinuation could lead to severe withdrawal symptoms or complications.
   
5. Psychological Support: Tapering is not only about physical adjustments but also addresses psychological aspects of dependence. It provides individuals with an opportunity to develop coping skills and strategies for managing life without reliance on the substance.
   
6. Preventing Relapse: Gradual tapering can help reduce the risk of relapse by easing the transition to complete abstinence. It gives individuals the time and support needed to adjust to life without the substance.
   

Tapering is a careful and structured process that should be guided by healthcare professionals. Abruptly stopping certain substances can lead to severe withdrawal symptoms and potential health risks. Seeking professional advice and support is crucial for a safe and successful tapering process, whether it's part of addiction treatment or the discontinuation of a prescribed medication.
Engaging in activities during withdrawal can help distract from symptoms, provide a sense of accomplishment, and contribute to overall well-being. Here are some ideas for keeping busy during withdrawal:

1. Reading: Escape into a good book or explore topics of interest to keep your mind occupied.
   
2. Movies or TV Shows: Watch movies or binge-watch a TV series to pass the time. Choose lighthearted or inspirational content.
   
3. Exercise: Engage in gentle exercises like walking, yoga, or stretching. Exercise can help improve mood and alleviate some withdrawal symptoms.
   
4. Creative Hobbies: Explore creative outlets such as drawing, painting, writing, or playing a musical instrument.
   
5. Mindfulness and Meditation: Practice mindfulness or meditation techniques to calm the mind and reduce stress.
   
6. Gardening: Spend time outdoors, tending to a garden or plants. Nature can have a positive impact on mood.
   
7. Puzzle Games: Solve puzzles, play Sudoku, or engage in other mentally stimulating games.
   
8. Listening to Music or Podcasts: Create playlists of your favorite music or listen to podcasts on topics of interest.
   
9. Cooking or Baking: Experiment with new recipes and treat yourself to nourishing meals.
   
10. Journaling: Write down your thoughts and feelings. Keeping a journal can be therapeutic during withdrawal.
    
11. Educational Courses: Take online courses or watch educational videos on platforms like Coursera or Khan Academy.
    
12. Board Games or Card Games: Play board games or cards with friends or family for some social interaction.
    
13. Self-Care Activities: Take relaxing baths, practice skincare routines, or indulge in other self-care activities to nurture your well-being.
    
14. Volunteering: If possible, consider volunteering for a cause you're passionate about. Helping others can be rewarding.
    
15. Stay Connected: Reach out to friends and family for support. Having a support system is crucial during withdrawal.
    

It's important to choose activities that align with your interests and energy levels. Remember that withdrawal is a challenging time, and it's okay to prioritize self-care. If symptoms become severe or unmanageable, seeking professional help is recommended.