I had my first and only psychotic break last spring. Luckily I didn't leave the house but if someone had rang the doorbell I might have killed myself, I was pacing with a knife to my throat believing I was about to be swatted for everything 'bad' I'd ever done in my entire life, from infancy onward, and that everyone I'd ever known was part of a long-con to implicate myself.
I'd quit a serious 15-year drinking habit about a year prior and was about 6 months off of weed. I'd also been about a month off of Trazodone for sleep, it had started causing random, aggressive vertigo spells. That day I'd had a really pleasant, mild trip on maybe 100-200ug of LSD. Not wanting the tail end of the afterglow to end but the perceptual effects being essentially over I dug around the house for anything else psychoactive I could find and knocked back a small amount of OTC DXM gelcaps, only about twice the RD for a cough, then in a moment of weakness smoked some old weed I still had around, maybe a small bowl's worth tops.
I tended to get paranoid on weed anyway but the sensation was like typical THC paranoia growing and growing until turning into full-on psychosis. Eventually after some ill-advised phone calls and probably the weed processing out of my system I was able to talk myself down, thankfully. At the time I blamed high levels of intense work stress (I was trying to blow off steam after a shitty week), the previous Trazodone use, weed, and DXM interacting with the lingering acid in my system.
I'd been having bouts of minor paranoia I didn't think were irrational for about a year prior which persisted another 6 months or so after the break, culminating around this past new year in an abrupt run-in with some intense neurological symptoms - in addition to the general paranoia I had severe memory loss, tremors, panic, an uptick in intrusive thoughts, rapid heartbeat and heart palpitations.
It turned out that the PPIs and antacids I'd been on for years to combat the damage I'd done to my esophagus with liquor had caused major nutrient malabsorption, especially magnesium and some of the Bs. I was also really low on D. I'd been prescribed Prilosec and had been on it for a four or five month stretch (OTC recommendation is two weeks max) that was, apparently, the final nail. After quitting the heartburn meds and about two months of aggressive supplementation with magnesium, various Bs and vitamin D all the symptoms went away and I feel virtually no paranoia. There are some cautions there and balances that need to be maintained, do some research if you're curious. If anything now I'm way too blasé about things that should make me paranoid.
I also folded in psilocybin microdosing a few months in, between that and keeping my levels in check I haven't felt the active sensations of depression or acute anxiety in over 6 months. After a lifetime of battling depression, anxiety and intrusive thoughts it's a pretty wild turnaround for me.
I left out a lot of my substance use & abuse history but generally I'd always have a decent time on LSD but reliably went really dark on psilocybin... which has stopped happening since the turnaround, for now at least. Everyone's case is different and I'm definitely not meaning to suggest that some OTC supplements are magically going to cure anyone's tendency towards psychosis. If I'd had more than one break on LSD I'd probably call it quits too.
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