I wonder how this differs from obsessive neurosis. Looking back I wonder whether my fixation for decades with changing sex was typical of an obsessive psychosis. Certainly as the years have passed and I have gone from acutely to chronically mentally ill the intensity of that fixation has very much diminished.
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good luck finding your self. budy
Pretty much what one is taught in a good psych school:
Neurosis vs. psychosis:
The former is a state of appraisal of reality that is more functional and grounded in actual sensory experience of the environment. Neurotics can navigate in the real world to a much better extent that psychotics, but not as well as those who are merely caught in the consensus trance.
The latter is a state of appraisal of “reality” (maybe, maybe not) that is less functional and grounded in actual sensory experience of the environment. Psychotics have severe (acute and occasional ranging to chronic and permanent) difficulties navigating in the real world outside their delusions and distortions of it.
There is no absolute line of taxonomic demarcation, however. Under stress, neurotics can become temporarily psychotic, for example.
Over the course of time psychiatrists have been very ambivalent when it comes to me and the presence of psychosis . For 30 years they gave me psychotic diagnoses such as sz and sz-a but then did an about turn nearly 10 years ago and placed me in the non psychotic, PD category.
On one hand they will say things like “has psychotic symptoms” and on the other make a point of stressing that I am not presenting with psychosis . That doesn’t stop them tending to ask the kind of questions you would expect to be asked if you were dxed with sz or sz-a.
Treaatment -antipsychotic depot- suggests they prefer to hedge their bets re the psychosis/non psychosis question. It’s definitely more than a case of plain vanilla neurosis.
You sound like a walking, talking poster child for the specific dxing adventures typical of the '70s, then the '80s, then the '90s, then the early '00s. (Sigh.)
Reading your posts for several months now, I get the idea that you’re somewhat educated to the manifestations of the different dx’s out there, perhaps even to knowing how those lists have changes through the DSM II, III, IV and V periods through which you have lived. I will be so audacious as to assert on the basis of a a lot of observation that the DSM IV-R was the most accurate in the psychotic spectrum, and the DSM III-R was (mostly) best for the PDs.
When you dig online to get the dx requirements for sz or sza from the III-R and IV-R, where do you come out, and why? What specific listed manifestations are your experiencing regularly over the last year or so?
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Yeah â– â– â– â– what they did with scz in the DSM 5
Pre regular medication it was unusual thoughts(historically noted as having delusions) and paranoid thinking in terms of so called positive sz symptoms and on the negative side- poor drive and motivation and difficulty with thinking of goals.
Currently I would sum up my problems as predominantly being paranoid thinking, social interaction difficulties and social anxiety.
Online tests tend to suggest no schizophrenia but I am not sure they always cover the full range of possible symptoms .
However the diagnostic assessment tool at www.mytherapy.com came up with
Avoidant personality disorder, Generalised anxiety disorder, psychotic disorder NOS, Social anxiety.
What did they do wrong in your opinion?
Hmm. Sounds like mytherapy.com did pretty well compared to what you described in your post. I’m presuming this is on meds including at least one anti-P, yes?
If so, and I know I’m preaching to the choir in your case, I’d past the CBTs into the more experiential and more “easy-exposure”-based MBCTs. I’m putting my chips out that the GAD is really at ground zero cognitively for all the rest of it, so I would treat for that with stuff like…
The approaches are slightly different, but they’re all dynamite for cognitively and experientially driven general and social anxiety.
Are you on an anti-D, btw? If I may ask, which one and how long?
Yes this is on meds. The only med I am currently on is risperdal consta. A few years ago I was also on sertraline but GP wanted to do a drug assessment before prescribing further , which I never went so .
The assessment missed the paranoid PD but it can be hard to separate that and the social anxiety IMO.
They took away subtypes
i thought this would be about something else when i read the title, i’m sorry you are going through this troublesome time @firemonkey.
@mortimermouse i’ll have to research this getting rid of subtypes thing
I know a thing or two about obsessive psychosis or at least i have experienced it. I see shadow people. and i can’t get out of my head that they are watching me and judging me.
Do you feel better now that you’re off the Zoloft? Less “driven?” Less impulsive" Less anxious?
Social anxiety does not always (or even often) include florid paranoid ideation, but DSM IV Axis II Paranoid PD will almost always include discomfort around others believed to be “invasive,” “boundary-jumping,” “aggressive,” etc., whether they actually are or aren’t, with projections of one’s own aggressive impulses into those others.
See http://www.millon.net/taxonomy/index.htm. Millon wrote the first drafts of Axis II in the DSM III and IV series.
In my experience posting on an SA forum this may well be true. However that is not to say that paranoia and social anxiety never co-occur .
http://www.millon.net/taxonomy/summary.htm gives avoidant(paranoid features) and paranoid(avoidant features) suggesting some connection between the two.
I was told the anxiety was to be expected with my paranoia… I certainly do not see myself as an aggressive paranoiac and classify myself as a fearful paranoiac.
Although prone to paranoia and diagnosed as such I actually invariably score much higher for avoidant PD.
To be truthful it made no difference to drive(which was and is low) nor to impulsiveness or anxiety in terms of increasing them. The only thing it seemed to do was lift my mood very slightly.
Although I have been touched by psychosis before - currently my psychiatrist is telling me that I am presenting myself to be highly Neurotic as opposed to Psychotic.
Its a fine line between Neurosis and Psychosis at times
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[
Other Specified Schizophrenia Spectrum and Other Psychotic Disorder][1]
[1]: http://psychcentral.com/disorders/other-specified-schizophrenia-spectrum-and-other-psychotic-disorder/ replaced psychotic disorder NOS in DSM 5.