Could I have this schizophrenia?

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Hi all,

Do I have schizophrenia? That is a question I struggle with.

Doctors say yes, but I feel they are not really following the diagnostic criteria or even common sense. Not that I am an expert on diagnosis. Indeed, that is why I’m here posting and looking for help.

I would agree I am on a schizophrenia spectrum, where schizoid personality disorder (SPD) may be the mildest and hebephrenic schizophrenia the most serious.

I’ve been active on SPD forums, and I kind of fit in there. Meanwhile, despite my Asperger’s diagnosis, I don’t seem to find in on Aspie forums.

There was a time where I believed I might have the “simple” schizophrenia variant, which is like the negative symptoms in the absence of positive ones. However, I’ve since come to understand that schizophrenia is a particularly serious mental disorder, That is perhaps the major reason why I question my schizophrenia diagnosis.

I had an episode of auditory hallucinations, but that is more than 10 years ago now. It resembled paranoid schizophrenia, but it did not last long enough to meet diagnostic criteria.

It is not apparent any more that I have a personality disorder, but I still have a schizoid personality type/style. I don’t feel lonely, and I spend most of my time on solitary acitivites. I am anhedonic, and notably apathetic. On the other hand, I really enjoy socialising with the right people, and I prefer this over the solitary activities.

I also have residual depression. I got burnt out (“exhaustion depression”) in 1999, and my symptoms since took on a more typical form of depression. I am bipolar, and had my first obvious (hypo)manic episode in 2007.

I feel my negative symptoms are best accounted for by the schizoid PD and the bipolar depression. Meanwhile, the positive symptoms, ie. delusions, have a lot to do with impulsive and uncritical thinking that comes along with (hypo)mania.

Sometimes I have funny ideas and beliefs, but it is not clear that I have enough conviction in them in order to qualify them as “delusions”. I am not rigid about them, and I’m willing to talk about them and consider alternative interpretations.

I have had a number of unusual, largely spiritual, experiences. Maybe at times I have a touch of schizotypal personality disorder. Eg. I have experienced time travel, but only once, and only a few seconds back in time. I have been in a parallel reality (or universe?) on at least two occasions (meanwhile, it seems my body was at the same time in the ordinary reality, but I was not aware of it, and my best guess is that my alter personalities or subconscious were controlling it. These experiences were so real that they cannot have been any kind of ordinary dreams or hallucinations.

I mentioned alter personalities. I have dissociative identity disorder (DID) or at least dissociative disorder not otherwise specified (DDNOS). I lose time, have memory gaps, go unconscious, while some other personality takes over the body. This happens rarely, generally less than yearly. I cannot hear their voices. I have other dissociative symptoms such as depersonalisation and derealisation. Nothing feels fully real, it’s a bit like I am in a room in my mind watching my life unfold as if on a screen like a movie. There’s a bit of a “schizm” between my doing and my observing selves. Often, it’s as if I am on auto-pilot; I walk a lot, and most of the time I’m inside my mind and I’m not fully aware of my surroundings, and afterwards, I remember it only as a blur or as a few fragments that come to mind. I cannot describe what happened during a walk (or many other activities) in any kind of detail, but I’m usually aware of the route I took, in sketchy terms but I can’t say what happened, what I saw or heard, throughout that time. I would not be able to estimate how much time it took, but I use a stopwatch.

I have had pretty serious social phobia/anxiety. For some reason, especially after the “paranoid schizophrenic” episode in 2009 that I mentioned above, this social phobia has been diminishing.

As a matter of fact, after my psychosis, my personality has been evolving so much that I’m a whole other person. I was a kind of a materialist and a geek into computers and neuroscience, and since then, I’ve become a very spiritual and optimistic being, in spite of the depression.

Lately, especially after starting a tricyclic antidepressant, I’ve have become less “psychotic-like”. Eg. I think more critically and/or soberly about my experiences and beliefs. During the same period, I have also become less depressed, to the point that I cannot say I have a “mood” disorder any more, because there’s nothing wrong with my mood.

So, what do you think? Any questions I should ask myself to decide “how schizophrenic” I am?

I guess schizophrenia is just a name, a label, and my life and things will be the same whether or not this label is applicable to me. That said, some people take this label seriously, and eg. prescribe different medications based on it. I feel a diagnosis of schizophrenia serves to distract from my more distressing symptoms, because most people hearing about schizophrenia obsess about the positive symptoms of the disorder, especially the voices. If the average person (or doctor) were to learn I’m schizophrenic, they would assume I’m hearing voices or believe in aliens and conspiracies and things like that.

Cheers,
Albert.

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Welcome, have you been on antipsychotics? Did you share your doubts with your psychiatrist?

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Thanks for the welcome. And yes to both questions.

I’ve had many psychiatrists throughout the years, and I’ve discussed questions of diagnosis with pretty much all of them. Likewise, I’ve tried many antipsychotics. If I had to choose, my favourite is sulpiride, for its antidepressant effects, which sadly went away. If I had to choose the worst, it must be clozapine, for its disruptive effects on the swallowing reflex and its sedative effects.

-A.

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How are your psychotic symptoms if you don’t take antipsychotics?

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As far as I can tell, there is no immediate or obvious difference.

However, the antipsychotics may be keeping mania at bay, and if I don’t get manic (whether endogenously or in response to a drug), then I am not prone to develop those funny ideas (whether or not they qualify as delusions, they are at least a step on the way). When manic, I am also more prone to do stupid things, like vandalise my apartment or waste a lot of my money (and I’m not rich).

-A.

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Welcome to the forum!!! Can you ask your psychiatrist if you can try weaning off your antipsychotic? You might be functioning as well as you are because of the antipsychotic. But you could ask for a trial run where you wean off and then see if you’re able to go off completely or not.

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welcome to the forum =)
I’d also try going off the APs to see if it makes a difference. It sounds like you are not sure about that so I’d give it a go if you wanna.

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Thank you!

I wanna. Just trying to get them along with it. I did manage to get them to reduce it a bit, and I’ve continued improving after that reduction. However, I did also improve after starting it, which they sometimes suggest is due to the medication, and a reason to continue it. It’s impossible to know what to assume about my condition and response to the drug, without actually comparing what things are like both with and without it.

-A.

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I have suggested a washout, pointing out that it is unscientific to make assumptions about the effect of the medications without first knowing what my baseline condition is. Because I am in a hospital, this environment is in fact as suitable a place as any to try potentially “dangerous” things.

However, the doctors seem to be afraid. One thing they have mentioned (or used as an excuse) is that sometimes after quitting and re-introducing clozapine, the drug does not work as well as the first time. I’m sure that is true, but deciding whether to take that risk should be up to me, because it’s I who has to live with it.

I’d like to develop my medicinal regiment in collaboration, again, because it is I who has to live with it, and because I cannot write prescriptions myself. Otherwise, I would probably have quit it already “unilaterally”, because clozapine is not available as an injection. So they would have to switch to something else – I want to have a say in exactly what else, which is a reason I try to cooperate.

-A.

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yea changing meds is hard. There always is the chance you get off them or lower the dosage and you’ll react badly and then it might be hard to get back to a comfortable level.
I think it’s pretty brave of you to want to try it. And yea, if you are in a hospital then it’s the ideal situation to try it.

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Yes, but it really depends on the nature of the problems that emerge. In my experience, treating psychosis and/or mania is a lot easier than to treat depression. So if the depression got worse from quitting clozapine, it may indeed be hard to get back to the same level. But it’s not likely clozapine has any prominent antidepressant effect; for that purpose, there are several other antipsychotics that are more suitable; some of them even have approval for that indication. I initially agreed to try it because it is a drug with unique effects and one of the antipsychotics most likely to improve negative symptoms.

I guess I am naturally adventurous when it comes to drugs and medications. That is largely because of my fortunate experiences, such as being able to quit paroxetine (Seroxat) and sertraline (Zoloft) without withdrawal effects.

-A.

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If you have schizophrenia, then you will hear invisible voices and/or see visions without medication.

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Some people have no hallucinations but only delusions.

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Why were you put on Clozapine? Its a last resort med after all other antipsychotics failed and its used for treatment resistant schizophrenia. I tried 5 antipsychotics and was never prescribed Clozapine.

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I have no clue, I’m not a doctor. Best to stick with qualified medical advice. The best I can do is…

[rolls dice]

You are attacked by a Shambling Mound as you enter the swamp. You sustain 14 HP damage from it’s slam attack. How will you proceed?

(See what happens when you ask Internet strangers for medical help?)

Welcome to the community!

:blush:

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Good question. One reason is that the doctor in question has an overly optimistic view of clozapine. I don’t think that is unusual among psychiatrists. I was having more negative symptoms than I do now. I was not having any positive symptoms, except perhaps some debatable minor delusions. My depression is highly treatment resistant; I’ve tried so many different drugs for it. I thought that clozapine was worth a try, so we did try it.

-A.

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I find that those who suffer from a condition (schizophrenia in this case), often have a better understanding of it than doctors do.

Thanks.

-A.

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It puzzles me why people think this. I guess my threshold for ‘serious’ is different than it is for other people.

As for the rest of your post, I suggest you print it off and let a trained medical professional read it

When I have appointments I always write basically a letter explaining things.

Don’t rely on the internet. I have dug myself many a hole psychologically by getting obsessed and convinced by this or that article.

Not saying don’t do your research, but remember to get your doctor to mark the result. It will save them and you lots of time and hassle

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Maybe. For me, the relative seriousness of the disorder is part of the definition of it. For example, schizoid personality disorder and simple schizophrenia have much the same symptoms, ie. negative symptoms without hallucinations or delusions. The difference is that simple schizophrenia is a lot more serious.

I sometimes do that. Most recently I sent an e-mail including studies suggesting that trimipramine (a tricyclic antidepressant) has substantial antipsychotic effects.

-A.

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Coming off your med is a serious risk. Really put a lot of pros and cons consideration into it.

Good luck, and welcome to the community :slight_smile:

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