Hi. Firstly, an admission of defeat: as you might have expected, I haven’t found yet the answers to the ‘big questions’. But I have, however, been working during this fortnight on a possible alternative diagnosis. This is very much a work in progress, in no way written in stone, which I shall be discussing next Friday with my nurse and hopefully with my psychiatrist at some point in the near future. I would greatly appreciate any input or (respectful) criticism you may have.
Proposed Alternative Diagnosis: Depersonalisation/Derealisation Disorder and Existential OCD (with poor insight).
A few points:
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I’m not “in denial” of my SZ diagnosis. I freely admit to having mental health problems (including an OCD diagnosis and frequent bouts of depression), but I happen to disagree with how doctors have framed my symptoms as being indicative of a psychotic disorder. This might surprise you, but I’m not even biased against the idea of suffering from SZ. When I first received the diagnosis I actually felt relieved. Here was something that could provide me with an alibi for my oddities and shortcomings as a human being. Indeed, many of the creative types I socialise with, extremely tolerant of neurodiversity as they are, tend to view SZ as the embodiment of a very particular, even poetic, vital stance. But soon I developed some serious objections to this diagnosis, some of a more general and theoretical nature (antipsychiatric arguments which are not relevant here), and others more focused on the particulars of my case.
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Some of you might feel tempted to dismiss my case as typical of a SZ sufferer in denial. To those going down that road I’ll just say, fine, I don’t deny my symptoms or personal distress, but please consider which mental illness best fits those symptoms. I’d argue that my obsessive questioning and constant search for reassurance, the quality and intensity of my obsessions, my morbid preoccupation with radical doubt rather than with fixed beliefs (as it is the case with real delusions), my psychological solipsism (extremely typical in DP/DR sufferers as you’ll see below), and my general pattern of behaviour are better explained with my proposed diagnosis. Why so many polls, or the insistence in trying to convince others without being convinced myself? Admittedly, some of my obsessions have been coloured with religious, even bizarre elements, which may have given them a delusion-like feel, but this overly dramatic presentation is easily explained away when you consider my past as a hardened (but benign) internet troll.
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Some particularly shrewd critic might object that while my (extremely few) ‘positive symptoms’ are amenable to an alternative explanation, my negative symptoms are not. Well, even granting I’m not currently depressed, or taking Aps, my two main ‘negative symptoms’, apathy and avolition, can be explained by looking at how I acquired some of my personality traits. My severe OCD made me very adverse since very young to all kind of stressors. Over the years, I’ve found that this diligence has paid off in the form of decreased anxiety, but at the price of social withdrawal, and lately, a loss of ambition. This coupled with the ‘psychological’ effects of my separation from my wife, my poor work ethic, and the fact that I’ve achieved already some of my early goals, explains my terminal ‘loafer attitude’. In addition, my solipsism and derealisation have taken a lot of the glamour out of the shared world; it just doesn’t feel real enough for me to bother with.
Now the nitty gritty.
- DP/DR. Never mind the video. The comments’ thread is littered with testimonials showing the prevalence of psychological solipsism and the style of radical questioning seen in my posts. I’d like also to point out that the “self-disturbance” model of SZ can, arguably, provide an equally authoritative account of psychological solipsism in DP/DR.
An example: “My existential thought was: What if everything is fragment of my imagination”.
- Existential OCD.
A quote:
“For much of my life, I have been plagued by a terrifying question: “What if nothing is real, and everyone’s in on the joke, apart from me?””
I look forward to your replies. 
Oy vey.
I thought you might come back a little more insightful.
Sorry the break didn’t work.
Why does the diagnosis matter so much to you?
And the treatment for that would be what?
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Have you checked the links? The diagnosis matters when trying to get the right help. If you disagree with the points put forward please explain. You don’t need to agree, but it’d be interesting that you explained how am I diffferent from those people from the existential OCD and DP testimonials.
Therapy, and perhaps a better choice of meds.
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I think agency may be crucial
@NotSeksoEmpirico. I’m not sure that I understand why you are trying to diagnose yourself. Or why you are engaging strangers on the internet in this effort.
The trained medical professionals who are familiar with you and who have interacted with you IRL are in the best position to provide you with a diagnosis.
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To be truly free you shouldn’t really need the approval of others, so diagnostically this need for a sz’s, or a psychiatric nurse’s or a psychiatrist’s is self defeating.
Most nurses wouldn’t grasp the existential nature of your enquiry and a psychiatrist simply doesn’t have the time to explore these deep and long debates.
‘Let go or be dragged!’ is an expression that comes to mind.
‘Existential ocd’ isn’t really found in the DSM manual, I believe and that is the bible for psychs
In regards to depersonalisation, do you lose time? Are you always conscious, except when you sleep? Or is it that you feel spaced out, surreal and alien to your surrounding and body? If it is the latter, then grounding techniques is the first tool any psychologist would advise you to do.
And finally, why would this be one of your last posts? You make an interesting debate and are fun to read. 
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@Moonbeam Sorry, but it’s my OCD compelling me to act this way.
Do people claim agency over obsessions?
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Thanks. About the quote, well, it’s terrifying that psychiatrists should be so sloppy in their diagnostic practices. In typical OCD fashion I just can’t let go. Did you see the testimonials? Some seem carbon copies of my experience.
Not really, sorry if I’m not at my sharpest, but I don’t quite follow what you’re saying.
Can you work with your pdoc and therapist to address the OCD?
They have trained professionals to help with ocd.
Are you diagnosed as that, like from childhood? Does your ocd manifest in physical actions or are you solely concerned with an intellectual ocd?
There are meds and therapies specifically designed for it, as no doubt you are aware. Unfortunately, I know nothing on the subject of ocd but it is a devastating and llfe encompassing illness and needs professional help.
I first went to the doctor about my OCD over 30 years ago. Had of dozens of doctors and therapists but very little to show for it. My OCD got magically better when I had my breakdown (severe depression) two and a half years ago. So my objective is getting rediagnosed and having the SZ label removed. I have been misdiagnosed.
My OCD first manifested itself in its full glory when I was 12, and even then it took the form of existential OCD. Later I’ve gone through almost every form of obsession and compulsion, from number patterns to fears of poisoning. Much latter it settled into a purely obsessional form of OCD.
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Then sadly, you are looking in the wrong place for answers.
Make friends with a psychologist or psychiatrist and have dinner parties discussing the intellectual existential meaning to life!
I fear an obsession with the unknowable can never be answered perfectly, so you are on a hiding to nothing. You have ‘chosen’ a subject that cannot be answered. The only way around it is to work around it, reset the standing point and starting point.
Reframe the obsession using the strategies the therapists know about and turn it completely around so that you can eventually let go and not be dragged any longer.
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Done those, and back in the day it was me handing out perfectly rational answers like they were candy. The problem is that my interest in those questions is genuine, yes, taken to obsessive extremes, but like other people suffering from existential OCD (as opposed to SZ which I’m nearly certain I don’t have) I can’t let go or even want to let go. I’m not important, the problem is.
What surprises me the most is that the people on here that have experienced genuine psychosis don’t seem able to sniff me out. We trust psychiatrists too much for own good.
