While I believe it's important the 'Ask HN' poster talk to an expert or wise family/friends, I also think the grandparent 'pysch_skeptic' post has a fair perspective.

Definitively treating this as the worst thing it could be -- schizophrenia or some other issue requiring fast medical intervention -- may be unnecessarily alarming and stigmatizing. From the diversity of comments and sources cited in this thread, there are other explanations that require a long-term understanding-and-management approach, that might sometimes lean on medical experts, but don't involve simply "run to the first doctor that will see you; do what that doctor says".

I would say the most important thing no matter what course is taken is to have a local, in-person confidant who can monitor/discuss the situation daily for worsening, and who can know all the other details that can't (and shouldn't!) be shared here -- such as any other drug history (prescribed or otherwise), family history, or work and personal matters that could shed additional light on the situation.

Your point is well made if you believe that a mental illness and its treatment are comparable to a physical illness and its treatment. But I have a lot more faith in the medical establishment's ability to treat prostate cancer than I do in it's ability to treat something like schizophrenia.

Now, you can probably point to various statistics to demonstrate that the mental health community is doing something right, but from my personal experience their approach is completely wrong and I want to offer an alternative viewpoint to what you'll get from the pamphlet in the doctor's office.

Depression very clearly runs in my family. And I've personally had a long history of depression as well, psychotic depression at some points (hearing voices). So, in your view, I'd probably be an excellent candidate for having my condition treated like a physical disease (genetic basis, serious risk profile). And that's what I did after a couple of years. I went to a psychiatrist, took various drugs, and received therapy. And it accomplished nothing positive whatsoever: the drugs made me stupid and slow; when my friends and extended family learned of my 'disease' they began treating me differently (there really is a stigma); and I had real issues getting health insurance further down the line.

But most importantly, the whole message behind my treatment was "you are suffering from a DISEASE - it's like cancer - an occurrence of nature and beyond your control." But, in my view, that's not the solution - the solution is to come to terms with who you are, tell yourself that most things are under your control, and recognize that the failure to deal with your problems are your own fault. The day I started 'getting better' was when I quit the meds cold-turkey, cut off communication with my psychiatrists, and took responsibility for my own behavior and mental state. That was several years ago and my only regret is that I ever medicalized my condition in the first place.