So I started taking Zoloft 25mg on January 11 and after a week moved up to 50 mg which I have taken 2 doses of so far. My doctor prescribed it for GAD with depressive symptoms but she also thinks I have BPD and less chance but also possibly bipolar. She discussed me trying Zoloft and seeing if they eventually need to put me on a mood stabilizer. 

In general the Zoloft has made me feel worse mentally and emotionally (way more anxious than normal, mood swings are more intense than normal, moods cycle faster, I get REALLY hyper, last night I was really depressed for several hours, I have the strongest craving/need to do self destructive things like get drunk and do drugs and overeat because I sometimes am struck by terrible emptiness and feel so nihilistic at times, I haven’t done any of those things but I have been more impulsive and have been driving more recklessly than I did before Zoloft and buying dumb things, as well as needing to use my self harm alternatives) since taking the first dose, as well as physical side effects like my ears ringing ever since I went up to 50 mg. 

Anyways, today for more than an hour I’ve been suffering from derealization/depersonalization, which was common for me before Zoloft, except today it’s lasted more than an hour whereas before it only lasted while having a panic attack but I’m not having a panic attack right now, I’m just really anxious. Also I feel like I can physically feel sounds touching my ear drums like ASMR but it’s ALL sounds. 

I also don’t know whether this counts as paranoid ideation but I was freaking out on the way to work because with the DP/DR, the existence of other people became terrifying to me. Seeing them sitting in their cars driving was freaking me out and I almost started crying because I was scared. I also keep feeling panicked when I look at other people because I get the idea that maybe they are thinking about me or talking about me or following me. I KNOW NONE OF THIS IS ACTUALLY TRUE. I KNOW logically that these ideas are ridiculous, I know I’m not having full-blown paranoia or a break with reality, but everything feels really weird and surreal right now. Is that paranoid ideation or just anxiety? 

It’s taking so much effort to not be weird at work and to keep up the illusion I am normal even though none of the people I am talking to seem like they’re real but I still know I have to act like they are (and logically I know they are real and that the world is real even if it doesn’t feel like it)

In your opinion/experience, do you think my paranoid symptoms today are a side effect of Zoloft specifically or that maybe they’re symptoms of BPD/another mental illness that are becoming apparent because of taking the Zoloft? Should I call my doctor?

Sorry if this is an annoying question.