Do I have (prodromal) schizophrenia?

I am a 22 year old male who has had the official diagnosis of major depressive disorder, OCD, and generalized anxiety.

For a few months now I have increasingly become convinced that I am in the prodromes of schizophrenia or some other type of psychotic disorder. I exhibit all of the negative symptoms of schizophrenia–the avolition (I find myself unmotivated to look after myself), the anhedonia, the flatness in affect (I seldom smile or laugh), alogia (I find it difficult to carry on conversations with people, and when I do, I almost invariably give blunt, monosyllabic answers to their questions), and the overall lack of emotion.

As far as positive symptoms are concerned, I hear voices in my thoughts when I close my eyes to go to sleep. These voices often say random words or phrases and I have identified them to be female, male, my father, my aunts, and spokespeople for a commercial. The content of these voices vary from “I want a glass of champagne” to “I want to fly”, but I have not identified them to be negative, critical, nor threatening. Most of the time, the voices are just my thoughts repeating random words or phrases. As far as I can tell however, I am not delusional, nor am I paranoid. I get really awkward around people/social events, but I have been this way for as long as I can remember.

I have always been rather concerned about developing schizophrenia, but have now recently been in a panic about the issue ever since I started to depersonalize. This past December on a Thursday, out of nowhere, I started to feel like I was in a haze. I couldn’t focus on anything, and my concentration was shot. I can liken it to blurry vision, except that it was in my mind. I read that depersonalization is an early symptom of schizophrenia, so I started to panic, telling myself “It’s really happening. It’s really happening. It’s really happening.” These episodes of depersonalization always accompanied severe anxiety about going to work in the mornings and persisted into the afternoon, but weakened by the end of the day. I am now no longer experiencing the depersonalization ever since I’ve quit working, but I am afraid that it may resurface.

I have told my psychiatrist and psychotherapist about my concerns as well as the aforementioned symptoms, but they reassure me that it is extreme anxiety and depression. They say that the overlap in depressive symptoms and schizophrenia is mostly in the negative symptoms (which accounted for my exhibiting them), and they easily accounted the voices in my head for hypnagogic/hypnopompic hallucinations.

I know it may seem like I’ve answered my own questions, but I just need to be certain. I’ve been obsessing over this issue for almost a year now and it’s driving me mad. I have thoughts of killing myself, and have determined to do so if I notice just one positive symptom. I do not want to have this illness.

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Do you have any medical conditions (like hypothyroidism)?

Do you indulge in drugs other than prescribed meds?

Have you been under a lot of stress at work, in “love,” or with the family?

Are you alone most of the time?

Are you (or members of your family of origin) excessively perfectionistic?

Have you ever been psychologically or emotionally traumatized?

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Are you in therapy? Does help to have a sounding block to voice these concerns. Extra support doesn’t hurt either. Maybe join a offline support group as well. To to build up social skills in a less judgemental environment

Do you get out much like go for a walk each day? Or are you very isolated? Which does make a difference to our thinking and mental health.

I recommend that if this is bothering you, you try to go and get a quick evaluation. Here are some good resources:

http://forum.schizophrenia.com/t/early-psychosis-treatment-centers-how-to-get-great-help-for-free/12743

As far as I’m aware, I have no other medical conditions except for a mild case of childhood asthma. I was a chronic marijuana user for four years, but have taken to quitting the drug and have now been sober for a little over two months. I am ALWAYS under some form of stress with my generalized anxiety and my relationship with my parents (the people whom I live with) has been strained, what with my illness and their persistent belief that I’m really the one causing said illness. I have an absent love life and am not interested in pursuing any form of sexual relationship with anyone, as I find sex revolting. For two years now, I’ve been a shut in and only see immediate family. I sometimes see aunts, uncles, and cousins during family functions, but have started to dislike going to them. I suffer from black and white thinking and an all-or-nothing mentality. In fact, this self-destructive mentality is the primary cause for my having dropped out of university. I was either going to make perfect grades, or I was not even going to try. I have never had any emotional or psychological trauma.

Have you told your doctors that you’re having suicidal ideation? What did they say?

“…childhood asthma…” may be associated with chronic stress in childhood. Any overt child abuse, physical, sexual or verbal? (I did see the answer below, but still wonder, at least, whenever I see a history of asthma in early life.)

“…chronic marijuana user for four years, but have taken to quitting the drug and have now been sober for a little over two months.” F-ing excellent, but… it may be the principal (at least a major) causal factor. THC withdrawal takes a long time for some because of the considerable neuroplastic changes THC makes to the limbic (emotion regulation) system itself, as well as the downlinks to the LS from the pre-frontal corteces. (The research is piling up; I just saw another journal article last week.)

“…generalized anxiety and my relationship with my parents… has been strained, what with my illness and their persistent belief that I’m really the one causing said illness.” Another likely causal factor, as I’m sure you know. Do you get away from the house at all? And… have your parents had historic boundary difficulties with you and/or each other? Have they been “invasive” most of your life?

“…absent love life… not interested in pursuing any form of sexual relationship with anyone, as I find sex revolting.” Are you aware of any particular reason(s) for this point of view?

“I’ve been a shut in and only see immediate family.” Are you at least able to get outside? Are you able to walk?

“…black and white thinking and an all-or-nothing mentality.” Excessive perfectionism is a major correlate of sz. Have you done any cognitive-behavioral or rational-emotive therapy? Have you done and/or can you do workbooks? There are some terrific ones for this stuff, mostly from New Harbinger in Oakland, CA. You can buy 'em cheap on amazon.com.

“I have never had any emotional or psychological trauma.” As long as you’re certain of that, where do you think your mind might have picked up the dichotomous thinking and perfectionism?

Have you ever heard of “learned helplessness,” a “victim identity” or “victim orientation?”

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thought i would say hi.
take care :deciduous_tree:

Perfectionism does make it more likely that you’ll attempt suicide. Be sure to keep your family or at least your psychiatrist informed about your suicidal thoughts.

No matter your diagnosis, you are obviously struggling with a heavy burden. Feel free to stay at this site, because people here are supportive. I hope you find the right answers. Welcome.

What the ■■■■ are you a psych student? You know your ■■■■

I must admit that I have been the victim of childhood verbal and physical abuse at the hands of my father. He was a strict disciplinarian and was heavy handed at the slightest hint of misbehavior or insolence. His explosive anger was what I feared the most whilst growing up. It was difficult to predict when his explosive temper would flare up, so I somewhat lived in fear of him.

I do affirm my parents’ lack of boundaries with me during childhood. They constantly fought with one another and most of these fights centered around their disagreement in disciplining my brother and me. My mother did not agree with my father’s heavy-handed approach and would often go into a rage herself whenever my father would begin to castigate us. Their confrontations weren’t only verbal, but physical. I remember their emerging from three-day long fights bloodied and bruised. I could only cry as I watched, but I soon become indifferent to their fights, as I became accustomed to them.

My aversion to sex largely stems from my aversion to my own homosexuality, as I am a muslim. I try to avoid having platonic relationships with men and I try to cultivate an air of indifference to other men’s offers of friendship, lest I find myself falling in love with them.

As I have said, I am a shut in, but am able to take walks outside, whenever I am able to muster up the motivation.

I used to participate in cognitive behavioral therapy, but have since abandoned treatment, as I found my therapist to be judgmental.

In all honesty, I do not know the origins of my perfectionism, but can only offer theories. One such theory stems from my parents’ diametric opposition to one another and the fights that resulted from their disagreements over almost everything. Growing up, I was always very aware of the dual nature of our household–on one side was my mother and on the other was my father. It is perhaps from this polarity and my being caught between that I attribute my perfectionism and black and white mentality to.

Welcome.

Anxiety can cause despersonalization. I have experienced that during heavy anxiety attacks.

Getting psychosis is not the end of the world. I used to think that too. But life goes up and down. Good days and bad days. Same as to “normal” ppl.

Your thought-voices sound normal to me. I too hear random stuff just before falling to sleep. BUT I also hear voices. Voices I hear happen while I’m wide awake. Those are voices. Whispering, yelling, talking.

Trust your doctors in this, maybe up the rate of appointments just to be sure - they’ll notice if you go psychotic. That being said it seems you come armed with a lot of insight into the symptoms, which can help to recognize a psychosis for what it is once it hits you.

Aside from hearing voices while wide awake one major signal for me is always a kind of revelation-like experience. Before I get fully psychotic I sense the world in an apparant ‘profoundly’ different way. Like there is some unarticulated meaning there, just about to be grasped. Like a promise of great insight or paradigm-changing perspectives or something like that. This can be both scary and exciting. Things that go typically unnoticed now seem extremely important but it is unclear why or how. It might be accompanied by the feeling that the world seems unreal. This feeling has the character of a mood, meaning it permeates the whole world of experience. It contrasts with depressive symptoms since in depression, typically not much seems to have a lot of meaning. In this mood, however, there is a lot of meaning, but it is undefined and mysterious. It is sometimes called delusional mood, or delusional atmosphere and often, though not always, precedes full-blown psychosis. This is a mood that is not easy not to notice, but may be hard to recognize for what it is, since it can be exciting and one may be lured to explore it. These explorations often result in full blown articulated delusions. As soon as you recognize something like this mood I tried to describe, know that nothing special is going on with the world, nothing is being revealed except that it is time to make a run to the doctor’s

I don’t believe you have schizophrenia. If you had schizophrenia, you wouldn’t have to ask any questions, you’d just know you had the illness. There’d be no doubt whatsoever. So, no I odnt think you have sz

To me it sounds like anxiety and depression as well. I would trust the professionals. Those things you heard before sleep were most likely hypnagognic hallucinations, something that anybody can experience, psychotic or no. Negative symptoms of the disorder that you mentioned are also common in those with depression.

Positive symptoms you should be worried about is thinking aliens are communicating with you, believing you’re God and control the universe, etc. or seeing/hearing things when you’re wide awake.

That’s my opinion anyways.

For example, a prodromal symptom I had was after the Rhode Island club fire, I became deeply immersed in the news story, and for two to three good long days, I actually felt the pain of those who burned to death in the fire, I was a burning, rage, emotionally and mentally connected person on overload. 3 to 6 months later I had a psychotic breakdown.

“I must admit that I have been the victim of childhood verbal and physical abuse at the hands of my father. He was a strict disciplinarian and was heavy handed at the slightest hint of misbehavior or insolence. His explosive anger was what I feared the most whilst growing up. It was difficult to predict when his explosive temper would flare up, so I somewhat lived in fear of him.I do affirm my parents’ lack of boundaries with me during childhood. They constantly fought with one another and most of these fights centered around their disagreement in disciplining my brother and me. My mother did not agree with my father’s heavy-handed approach and would often go into a rage herself whenever my father would begin to castigate us.”

This is regularly reported by observers of many parents of sz pts, tho not all.

“Their confrontations weren’t only verbal, but physical. I remember their emerging from three-day long fights bloodied and bruised. I could only cry as I watched, but I soon become indifferent to their fights, as I became accustomed to them.”

Which suggest the possibility of PTSD-induced psychosis, or if genetically vulnerable, PTSD-triggered sz. Were your parents alcoholic?

“And were either one or both “strong believers” in anything? My aversion to sex largely stems from my aversion to my own homosexuality, as I am a muslim. I try to avoid having platonic relationships with men and I try to cultivate an air of indifference to other men’s offers of friendship, lest I find myself falling in love with them. As I have said, I am a shut in, but am able to take walks outside, whenever I am able to muster up the motivation.I used to participate in cognitive behavioral therapy, but have since abandoned treatment, as I found my therapist to be judgmental.”

How did that therapist express his judgmentalism?

“In all honesty, I do not know the origins of my perfectionism, but can only offer theories. One such theory stems from my parents’ diametric opposition to one another and the fights that resulted from their disagreements over almost everything. Growing up, I was always very aware of the dual nature of our household–on one side was my mother and on the other was my father. It is perhaps from this polarity and my being caught between that I attribute my perfectionism and black and white mentality to.”

Useful insights all the way along. Are you also aware that those who were mentally or emotionally – as well as physically – abused by trusted caregivers tend to imitate their abusers? If the abusers were perfectionistic, the abusees are likely to be, as well… because the abusees saw how perfectionism (in this case) seemed to “work well” for the abusers and adopted it as an ego defense. But “too much of a good thing may not be.”

Do you know anything about Sufism? Or Rumi, Idries Shaw, or George Gurdjieff?

I want to pull you up on the idea that you will kill yourself if you have ‘one positive symptom.’ Should you have sz it can be treated successfully and your life is worth living.

But I also doubt that you have it. You have a lot of problems to solve, and worrying about what you might have is not solving them. I think right now you’d benefit from CBT, finding a job and leaving home.

I do, except for Gurdjieff. Brilliant stuff.