What has happened to my brain?

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I got average 96% in my A-Levels at school. Cambridge University were actually asking for me.

Now almost seven years later, I am repeating my second year, part time, at university.

I don't get it how, having the apparent intelligence I do, that I'm struggling so much with university.

I do admit that I've been sectioned 4 times during my university course, and that last year I had severe migraines which damaged my exam performance.

But I just don't get it how I've gone from the first sentence of this post, to what I am now.

I keep having panic attacks / meltdowns that centre around my fear that I've lost my intelligence.

I have nothing that I like or respect about myself except my intelligence.

Now that I'm faced with the possibility that my intelligence is deteriorating downwards, I am wondering if there is any purpose in living.

People comment that I am "very intelligent" when they talk to me. And I have a very high recorded IQ (what exactly that means in real life is to be questioned however).

So why am I struggling?? Perhaps my current anxiety is masking my logical reasoning. I cannot think properly or efficiently right now.

Your last sentence provides the answer I think. Need to calm down and relax to free the mind up so you can go back to logic reasoning again. Do you exercise very much? I've found Tai Chi relieves the pressure and tension on the mind and keeps me physically fit. You could also look at your diet to check whether you are eating the right foods. Fatty foods make you tired and lifeless and unable to concentrate.
You're highly intelligent. Just hang in there. You'll get there. Uni is a totally different experience to secondary education. At secondary school you stand out from the others in terms of academic performance. When you get to Uni you're just one of a number of similar highly intelligent individuals. You no longer stand out. In my case it suited me, as I could just blend into the furniture, not worrying what other people thought of me.

Sounds like anxiety attacks. There is medication for that if you're not on it. My sis used to have them (strangely enough, for no apparent reason. She could be shopping with me at a grocery store for an hour no prob then POW it hit her) but with a pill they've not come back.

What is it that you're struggling with?
There are all kinds of things that impair cognitive abilities, e.g. lack of sleep, chronic stress, anxiety issues, sensory overload, lack of physical activity, certain medications.
There's also the psychological effect of being part of a larger community with more smart people compared to high school (or w/e it's called where you are).

These are good points.

I have bad anxiety issues. I used to be on antidepressants for my OCD (which also would treat anxiety as they were SSRIs and then Clomipramine) but they all made me go hypomanic so I had to come off them. I'm on above the BNF maximum dose of Olanzapine as that helps my OCD as well as my schizophrenia. However my anxiety is still bad.

I am going to review my diet. My mum said she will make me a salad to eat for when we meet up today. I've been eating junk food lately, mostly because I've been too anxious / depressed to cook.

Yes indeed the university I go to is the 3rd best uni in the UK, and has a global ranking too. So you're right that I'll just blend in with the other intelligent people.

I have this problem where I think I must score high in my exams, tests, essays etc., otherwise I will lose respect from other people. My dad said that people like me for other reasons than just my intelligence, but I am sure that if I get a low mark in biochemistry this year, everyone will think I'm stupid and worthless. I know you will say "but what does it matter what everyone thinks about you" - it matters to me because I hate myself, in my opinion I am scum, so when other people say they think I did well in something, it gives me temporary happiness.

I think I need to go back on an SSRI antidepressant, but my psychiatrist and I are concerned about me getting a hypomanic reaction again.

I think exercise will definitely help. Although I bought myself a rowing machine, it's not unpacked yet, but when it is I will be able to exercise without the pain of going out.

I just want to be happy.

For the anxiety and depression, I'd look into alternatives like tianeptine (interesting study here and here) and buspirone. Since they have a different mechanism of action than the reuptake inhibitors you've taken, these might be less likely to trigger hypomania. Your psychiatrist may be sceptical (especially of buspirone), but in my estimation they are worth a shot, especially if other things have failed. They both have a relatively nice side-effect profile compared to other alternatives.

Exercise will definitely help - there have been many studies linking physical inactivity to cognitive impairment and conversely, linking physical exercise to neuroplasticity, e.g. by elevating BDNF levels.

I have had CBT four times in my life. I could ask about DBT though.

Tianeptine is not marketed int the UK as far as the eMC says. As for Busprione I could ask but my psychiatrist is very cautious about prescribing things. Buspirone doesn't interact with any of my medications, and the insomnia side-effect could counteract my meds-induced tiredness. But I am not keen on this "nervousness" side-effect that is common. I had a severe behavioural disorder as a child and the resultant effect now is that I cannot take any medications that cause "nervousness" or "agitation", even though I don't have such severe behavioural problems as I had as a child. Anyway I'll ask my psychiatrist.

My back injury is recovering. On Tuesday I will be going cycling with my support worker at the cycle club. Sometime this week my friend and I will be putting my rowing machine together.

Thanks for the good information. I need BDNF badly. Sertraline may have increased my BDNF but I was hypomanic on it. People with psychosis are more likely to go hypomanic on antidepressants.

Interestingly enough, I read that second- and third-generation antipsychotics can, in some cases, improve cognition. I know that Olanzapine helps me think, even if it doesn't always help with negative symptoms (as you know negative symptoms are difficult to treat).

I've decided to incorporate exercise into my daily routine. My back injury is 90% recovered so I will go for a brisk 3 mile walk today.

I'll ask my psychiatrist about DBT as well, but NHS budgets means that they may not have the funding to provide me with it.