Schizophrenia.com

Introductory post

Hi,

I recently experienced an episode of acute psychosis (comprising obsessive, manic grandiose delusions resulting in a significant impact on normality including accidental self-harm) that required hospitalisation as an interventionary measure.

Since the admission and subsequent discharge (one week in-patient stay at a psychiatric unit) it has been a month or so and I have received zero follow-up medical support other than what I have pursued (GP consultations). My GP is evasive towards commenting on the episode and is deferring all responsibility to my psychiatrist (who I had only seen twice before for an adult re-diagnosis of ADHD).

My mother-in-law was afflicted with shizoid-affective bi-polar before her suicide at age 27. I never met her because my now wife was only 9 at that time. The impact of the illness over the course of her childhood caused her significant trauma; as such, the similarity of the positive symptoms I recently displayed (coupled with some of the more subtle historic negative symptoms) has her in a current state of emotional distress.

I have tried on a few occasions to verbalise my concerns; particularly in order to gain a second perspective into potential delusional observations I may have become aware of myself making, but her emotional sensitivity makes it challenging to progress any conversation towards a mutually positive outcome.

As such, I wonder how you all go about reality-checking yourselves? And how do you do it without the process itself becoming yet another obsession subtracting from (self) normality?


About some of the issues …

A lot of my continuing delusions appear to stem from tactile perceptual distortions resulting from bilateral Carpal Tunnel Syndrome (CTS), which has dulled the nervous sensation in all of my digits and most of the palms.

As a result of being exposed to both Christianity (healing manifestation [delusion]) during a spiritual “awakening” process following a major existential crisis and; having studied self-massage techniques in order to relieve (my) musculo-skeletal pains (possible fibromyalgia), I believe my mind has begun filling gaps in my sensory input to perpetuate these delusions of supernatural (medically inexplicable) healing abilities utilising touch. At one point during the psychotic episode, I believed I was transmutating animals towards biped humanoid forms; delusions that remained intact and consistent over days of sleep/wake cycles.

My beliefs right now are that some of the touch I am experiencing as self-massage is indeed providing relief and is probably more efficacious than expected based on my level of training, (though I understand life sciences quite well and have an above average body-mind connection [possibly from meditation practice], which could possibly explain and support this judgement). I have jumped right back on the fence regarding faith/Christianity and have returned to the convenience of agnosticism, though the notion enters my mind more than it used to. I am choosing to steer away from Christianity, due to the healing manifestation being too easy a trigger.

That being said, I “feel” that there is “something more” going on with the massage thing - the positive results extend to my children (one who has a completely misunderstood condition like fibromyalgia and the other with Autism) and wife (postural and gut issues as well as plantar-fasciitis ) and also seem to take effect faster and last longer than any other professional they/'ve see/seen, AND I mostly use techniques not taught traditionally by any modality of massage therapy. I focus on the skin and subcutaneous fat layers as the main target for therapy, loosening tighter areas in various ways, but also by re-distributing mobilised matter around based on skin tension feedback. This appears to have great effect in reducing joint-pain (also increasing mobility immediately) and when applied to the cranium, appears to provide significant relief from all kinds of generalised physiological discomfort.

I accept these techniques could technically overlap with a lot of other established ones, such as lymphatic drainage (when it comes to the face, especially), but as I said, the results exceed expectations based on the above.

Moving on. I understand the nature of schizophrenic delusions, (prior to this ever being a disorder I’d even contemplated I might have), including the affected neurochemical mechanisms as well as the general psychology behind the behaviours, so I am fortunately able to be open and honest about (as above) my potential delusions, I am also capable of accepting they are noting more than just that - as well as accept that I may have the disorder, before I am formally diagnosed. The earliest psychiatrist appoint is still a month off.

Meanwhile, I have gone from full time employment (moderately above average income) to completely zero income, to enrolling into a Diploma, to withdrawing and becoming just a stay at home … um person. I can’t really say “stay at home dad”, as that would take away from my wife’s 80% contribution on that front. My mood swings (which seem to align with pain levels) are having a negative impact on the kids (and therefore my wife) and my family have gone off the radar as they think the whole psychosis was mismanaged by my wife and I’ve chosen her over them (over-simplification). Emotionally, I’m stable, just a little overwhelmed by the absence of medical follow-up support (current advice is “stop all medication”, which has really screwed with me), as well as other implications resulting from becoming made aware that I had been committing domestic violence (mostly persistent negativity) for years. I will have to attend a court hearing in order to dismiss a violence intervention order, as well as participate in counselling and parenting programs (which I’m happy to try and learn from, but it’s still confronting to the ego).

Anyway … TLDNR is becoming an overwhelming probability for the majority, so I will cute it off here abruptly.

Looking forward to making your acquaintance!

Cheers,
Polymorphed

I’m not the best at making reality checks but I do believe that it is important to check yourself before you wreck yourself. So I will bump your thread so someone else will come along and answer.

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Welcome to the forums. Recognizing issues is the first step in correcting them, so good job there. I sense there may be a bit (or more than a bit) of magical thinking related to massage, but that is definitely something to talk to your treatment team about.

Stopping meds… VERY bad idea for most of us (99.9%). There are the rare ones who can function well without meds, but I am certainly not one of them. I’m also the highest functioning SZ my own psychiatrist has personally seen, but even he agrees I need my meds. My wife certainly does. The last time I went off them … did not make anyone happy (I’m not the sort who gets mean or abusive, but I make bad decisions based on delusions while thinking I am rational.) It is agreed that I’m never messing with meds again.

Glad to hear you’ve kept your family together despite challenges and that you are willing to take the necessary steps to correct the problems you are aware you contribute to the mix.

You can read a bit about me here if it is of interest:

Cheers.

Pixel.
(Long-term med-compliant SZ and volunteer moderator.)

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Moving this post to Diagnosed as it is nowhere near ‘out there’ enough to live in Unusual Beliefs. :wink:

Pixel.
(Wearing moderator hat)

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Hey and welcome!

Like pixel said, you have insight which is wonderful.

I too had religious delusions and had to stir away from religion but it’s alright, glad you did it, it takes some strenght to find our own paths.

As for reality checking, it’s only on some rare situations, in the beggining it was more prominent.
I don’t know what you need to reality check about but simple questions might do the trick, like “did you hear that?” etc. If you don’t have anyone to reality check them, just dismiss the question all together, doesn’t really matter.

Going off meds it’s not a good idea at all, I would reconsider trying new ones.

Good luck, keep us posted.

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Thank you for the welcoming response and for volunteering your help. :slight_smile:

The medication I was on was an SSRI and a stimulant for ADHD. I have expressed my concern regarding stopping the SSRI, but if I go against GP orders I only attract negative attention and paranoia from my wife. She thinks I have Bipolar (which I’m open to, but no one else has suspected it) and that the stimulant was invoking mania - plausible theory from a neurochemical standpoint too. However, the stimulant medication significantly reduced ADHD symptoms and its cessation has left me feeling devoid of conscientiousness and completely lacking in energy both physical and mental: everything is a chore again. Fortunately I was already self-managing a downward titration of the SSRI and the psyhotic episode was only a week or two premature, so I don’t think as much harm has resulted that could have (Pristiq has its own withdrawal syndrome it is that bad!).

In hospital I was given Valium and nothing else and discharged with no new scripts or any take home medications.

My medical record still states ADHD. Nothing else. The accute psychotic episode has been recorded as an event, without any expansions into a new diagnosis. Two months is quite a while to wait to even be able to talk about it properly with a professional. Hence why I sought out this forum :slight_smile:

So, just to clarify in summary: I have never been prescribed anything other than the above and have no pharmacological support for schizophrenia or bipolar because a new diagnosis is being deferred to my psychiatrist by my GP - he just won’t touch it. If I could take a drug and it removed the burden of discerning reality from fantasy, then I’d be all over it.

So you’re waiting to see a psychiatrist?

Yes. I am not formally diagnosed, but I have detected elements that are most likely the perseverence of delusions, so a schizophrenia forum seemed the best place to seek peer-support, even if the diagnosis never results. Though on a medical certificate my GP put together (for Social Security), it very blatantly draws attention to there being an unspecified permanent psychiatric condition (other than ADHD).

I’m sorry with all the questions, but for how long are you feeling delusional? I ask because I think you have a lot of insight for a person with sz. Psychotic depression for example, people have insight into their delusions.

What you perceive as a lot of insight is the net result of a lot of conscious quantification and qualification, which I summarise as reality-checking. Sometimes, I have to even resort to metrics such as length, weight and photographic references. Questions I often have to ask myself include “Is the localised pain I’m feeling the RESULT of my own touch (massage) and was there really a pain there before I started?”, “Is the location of fixed biological matter, such as my skin, really moving and distorting at all, or is my memory just adapting to delusional expectations?”. The list goes on - the questions get crazier sometimes too.

At the end of the day, I tend to achieve non-psychotic conclusions, but it is an ever-present battle - UNLESS I take my ADHD medication, which inherently motivates me to actually do things (tying up my mind and body and preventing the frequency and duration of reality-checking being a necessity). The caveat is that when I do take it, as dopamine levels naturally rise towards the evening, the reality-checking comes back with whiplash.

I’m no doctor here, I was just making an assumption, I’m sorry.

Sounds like you think a lot, maybe rapid thoughts?

When is the appointment with the psychiatrist?

I have SZA and so whether or not I can reality test successfully seems to depend on two things"

  1. Is it still early on in some insidious delusion? I can reality check early on but lose the ability at some point.
  2. Is there a mood problem happening at the same time? Depression can make me think it’s totally normal if everyone at work hates me and wants to murder me, so that can impair reality testing.

So yeah basically I can’t reality test most of the time I’m having issues, but sometimes.

Plus I don’t have anyone close in my life who could reality test for me, with the exception of my mother, but due to our history together she is usually the first person I suspect of wanting to kill me when I start to go off the deep end, so it doesn’t work out, there’s no way in hell I’ll trust her enough to ask her in the first place.

I had to wait over a month to get into see a pdoc as well, felt like forever, and I was hanging out here the whole time, freaking out and whatnot while waiting lol. :flushed:

So welcome to the Forums, very chill people here.

Just to break the ice regarding my personality and hopefully put you at ease a little: I’m pretty sure I’m Autistic (my wife would love to read me admitting this), so what you may infer as a stern emotional state is probably just my robotic form of expression :slight_smile:

The anonymity of the Internet blunts the vulnerability my ego may be subjected to in more personal settings. I am actually quite grateful that you are sharing hypotheses and asking questions even when you feel they may upset me, but I think it is important to note that I’m completely calm and it’s very out of character for me to become defensive - so please feel free to carry on as you were.

The Psych app. is in 5 weeks time, middle of May.

Yes, I think a lot - I don’t know what “rapid thoughts” implies beyond what the words suggest, but my mind is ALWAYS over-active (unless I’m meditating). It may be a quality of Autism perhaps, but I view the world from a very hypervigilant perspective. I recently watched A Beautiful Mind with my wife and identified with a scene from the opening credits that portrays the protagonist’s perception of reality as a sequence of geometrical patterns applied meaningfully to objects and motions. It evolves into pure equasion afterward (which is not me at all), but I definitely do make a LOT of geometric and physics based calculations when simply observing the environment. It used to cause me a lot of anxiety, but after learning a fair bit about psychology, physiology and neuroscience I managed to completely and permanently eliminate anxiety from my life. So now, I just allow the advantages of this “applied thinking” approach to flow in naturally.

Yes, depression (and even some of the negative symtpoms of ADHD) and also Autism (possible in my case) could certainly facilitate delusional inferences of that nature. I don’t really feel too much persecution or paranoia right now, but during my acute psychosis I DEFINITELY did.

I have a similar issue with my own mother. She quite possibly denied me an Autism diagnosis and has kept it form me: this theory was verbalised to me by my wife before I admitted to thinking it too. Also, my mother refuses to acknowledge that my son has Autism (he’s formally diagnosed by the same paed that I saw as a child too). Her denial of me having problems is a problem. My wife’s own experience with her mother having SZA and her own plethoria of mental health issues (BPD the most pervasive) can also make her a difficult person to talk to.

I guess my paranoia is more specific to individuals who have demonstrated consistent behaviours or perspectives that are confronting or misrepresent me.

I don’t know if an over-active mind is a sign of Autism, I have it and I’m not autistic at all.

We find all these ways to resolve ourselves with the environment, metaphysical questions, etc, resorting to science, religion and whatever is thought of, or thinking of answers ourselves falling in the delusion trap quite easily. Does that sound like you too?

A lot of us would like to identify with John Nash and his brilliancy, that’s good that you do.

I believe that it is a trait found within a multitude of human conditions. It is diagnostically Autistic to catastrophise; meaning to make mountains out of mole hills while jumping to related conclusions. This mental process of expecting the worst - and the worst literally being a long list of potential horrible ways to die or be tormented and everything between that and the butterfly effect of every decision and motion.

Back later to continue …

Hi Polymorphed! Welcome! This board is full of knowledgeable and friendly folks, so don’t worry, this is a safe place.

Wow! You are very well-spoken! As others have said, your insight is perhaps your greatest advantage right now. My diagnosis is major depressive disorder with psychotic symptoms, or psychotic depression, which is very similar to sz except I am typically able to tell my hallucinations from reality. A year ago I would have said “and I experience no delusions” with complete confidence, but apparently I am more delusional than I suspected, and not aware of it at all while it is happening. So that’s a learning experience right now.

Reality checks! I experience hallucinations often, auditory more often than visual, very rarely tactile or olfactory. My testing methods in the external physical world are pretty much science-based: there’s a man over there, does he cast a shadow or not? should he, given the lighting? is his appearance in any way odd or not visually similar to others in the area? if I focus on him, how does he react, if he reacts at all? does he have an odor? how does light fall on him, compared to others in the area?

Then there’s the emotional layer, which could be considered psychological, I suppose. That man who may or may not be a hallucination – do I have any strong feelings about him? is he familiar in any way, or is he supposed to be? what can I ‘sense’ from him, if anything?

My visual hallucinations are typically limited to shadow people, fleeting shapes in my peripheral vision (spies), and strange-looking animals or insects. I used to be terrified of the shadow people but now my emotional reaction to them is much milder. The fleeting shapes still make me paranoid but at least now I am able to recognize and label them, which reduces some of the fear. Possibly the worst of them all are the animals, because I often squint or try to approach them before realizing they aren’t real, and then experience a very clear and dreadful sensation of cognitive dissonance / separation from reality. I only see those when I am under a lot of stress, though.

For auditory hallucinations, I keep a running record of the most commonly heard noises / voices / events, and this record has not changed much over the course of several years. Most auditory hallucinations seem to come from behind my left shoulder (or atop it, in the case of whispering) and they may be related to my tinnitus which affects my left ear more than my right. I’ve named the two primary sources of voices, which makes it easier for me to communicate with ‘them’. It’s… complicated and kind of stupid, to be honest. It is my most common and most bothersome issue aside from the persistent depression.

Same, or similar, testing mechanisms: how far away is that sound, and could it logically be produced here? is it possible I misheard something and am not interpreting it correctly? is it very frightening, and if so, is there an emergency happening (in which case I try to remain still until I’ve decided what needs to be done)? who else is reacting to this sound? is it a noise made by a human, an animal, a group of people, etc., and how likely is it that it was produced at that distance, in this environment, etc.?

Then the emotional layer: how am I affected by what I’m hearing? do I believe what I’m hearing is true, am I purposefully choosing not to question its reality? what emotional state or change accompanies this sound, if any?

Sometimes my auditory hallucinations invoke a sort of trance state, where I am stuck standing or seated and staring off into middle space, completely unable to move, separate / floating from / tethered to my body, emotionally uplifted and in turmoil, unaware of my surroundings. These experiences seem to last for hours or days but have probably never lasted more than a few minutes. They leave me shaken, grateful, and fatigued. They do not happen often but their effect lingers for hours.

The testing itself has never become obsessive for me. I used to try to ignore the hallucinations, but that only made me feel more broken apart from reality, so my current tactic is to simply accept them and try to understand why I might be experiencing them. To be honest, I don’t focus on the “why” very much, I’m just trying to accept that things happen to me that others cannot validate. My perspective now is that these experiences are real for me, but that does not mean they are real in a physical sense, or that they should be treated as ‘true’. Just accept and move on.

Had to rush off earlier as the (wife and) kids got home and it was time to initiate their bed time routine.

The reason I described catastrophising is because it took over my entire childhood and resulted in the long term maintenance of numerous inhibitory irrational fears (most of them social in nature). Nowadays, especially since having the upper hand on anxiety, the process of “considering all possibilities” is more of a utility than a prison, but it still underpins a lot of my excessive thinking.

I think catastrohpising and existential depression typically go hand-in-hand and the combination can be debilitating and lead to ego-death in the worst case. I guess I’ve been fortunate in that sense, as I have managed to keep my mind predominantly in tact thus far. The recent (and first) acute psychotic episode was a timely wake-up-call that has really helped decelerate what could have progressed into permanent grandiose beliefs.

The mind has the capability of bending the evaluation phase of cognition to suit the expectation phase, which is partly why delusions “always have the answers” in order to preserve them.

I will have to be more … chatty … when I next see my Psychiatrist, as I only really saw him under the pretense of seeking an adult diagnosis of ADHD (after my life was starting to tear apart at the seams from poor conscientiousness). I was formally diagnosed at 14 (when it was still very controversial). There is definitely sufficient symptomology to justify a “high functioning ASD” diagnosis. All historic evidence indicates that my then pediatrician would not have simply “not noticed” nor “not mentioned” ASD to my mother. There are already so many overlapping symptoms between the two and yet more possible comorbidities (such as Bi-Polar - there is a lot of emerging research that identifies a statistically significant coencidence of comorbid bipolar/adhd). It would seem to me that ASD was not properly explored (and my Mother’s continuing denial of my evolving mental illness/es cements her role as a suspect)/

As an example of what caused the extended family division: my wife (obviously distressed) pleaded with my Mother to come and witness my (increasingly delusional) behaviour. She eventually agreed, but not without first dismissing and down-playing everything first. When my mum was around, I showed and described to her how I was discovering and removing physical deposits of debris from under my skin. My conclusions on what was happening evolved, but among the crazier of them that I communicated to my mum was that I was slowly reversing a lifetime of skin/hygine neglect, which had allowed the debris to be sealed underneath various layers of skin. This eventually evolved into Stigmata based delusions (ie “these scratches and all this dirt must be from when Jesus did x”). My mum maintained a psuedo-supportive stance and perspective while asserting “I guess I didn’t see where the debris actually came from as his hand was in the way. Seems harmless. Just let him go and see what happens.”.

Of course, what happened was, my psychosis escalated at an exponential rate until my wife decided to call upon my brother (who is a very blunt, self-confident, out-spoken kind of person whose convictions often push the border of NPD [Narcissism]) … When he arrived, I tried to convince him that I had the answers to the universe (how/what/when/why etc.) and he almost immediately became agitated and acused us (my wife and I) of being ice-addicts. His ignorance of mental illness in no way prevented him from discerning the loss of touch with reality I was demonstrating.

As such, my wife got my GP to visit the family home that evening and I was later “tricked” into going to hospital (under the pretense of there being a specialist team waiting for me to document the Stigmata, which I later became more and more obsessed about). My mum was not notified of my hospitalisation until after 3pm the following day (by me), so she feels she was denied sufficient involvement in the decision making processes. It’s more complicated than that, but anyway …

That’s enough of a side-venture for now, but it does provide a bit more context into my mother’s probable denial of Autism during her unrelenting quest to figure out what was wrong with me throughout my childhood.

There are many other signs of ASD that my wife gets to see a lot more than most, but my closer friends agree that it is a strong probability. It is something I will have to bring to the table with the psych.

BonBonSquad: Thanks for taking the time to share your experiences and the compliment regarding my command of English :slight_smile:

The scientific reality checks you perform are logical and practical - they represent subsets of other techniques I have been using and they definitely help me too. The trouble is that the moment I relax my mind, it becomes possible for me to begin allowing and accepting delusions to coexist with my perceptions, as a lot of my delusions share common ground with reality and aren’t immediately grandiose. They kind of evolve into grandiosity the longer they go unchecked.

I can also identify with the sensation of cognitive dissonance you described - the ego is put on trial and one’s identity enters a state of extreme vulnerability … fortunately my own hallucinations do not involve the perception of other conscious entities, so I don’t typically experience paranoia. I do, however, often find myself massaging or experimenting with/analysing my body obsessively and often enter a state of logic conflict whereby I cannot discern the greater evil between 1. if I stop and what I was doing was actually helping, am I just subscribing to a health stasis and giving up on physiological progress and; 2. if I continue I could perpetuate magical thinking and cause physical harm to myself .

The most common visual distortions I experience are manifestations of my expectations after self-touch (massage) and the most common paranoia is that each touch intrinsically imbalances the surrounding untouched areas; thus perpetuating an OCD type need to continue. Sometimes I notice myself thinking (illogically) that if I don’t re-balance the area, I will possibly choke (throat specific) or whatever …

I have gotten a lot more control over these things of late though, but the hallucinations are still happening; I simply ignore them and use metrics to make grounded evaluations of threat to self.

It must be very difficult living with delusions that involve the perception of other unknown entities. You have my admiration (and support, if I can be of any?)!

Cheers

please pardon any spelling errors, i am dealing with a partially broken laptop and some minor muscle control problems today

I have found, in the past, the best way to counter magical thinking is with more magical thinking. At least it works for me and I am suggesting it as a method to try, not a perfect solution.

for examle, when i am stressed i feel a need to control situations, and can become very rigid about this. if i’m on the bus in this state i cannot make eye contact because i have to watch the road or “the bus will crash”. this happened during childhood, too, and was sometimes the focus of arguments between me and my mother, because i was “refusing” to look at her.

during a suicidal phase last year i rsolved not to watch the road at all while on the bus, because i wanted it to crash. so i rode the bus and ket my eyes closed. the bus, of course, did not crash – but i felt that it was due to some higher power stepping in to stop this from happening. i “tested” this theory by continuing to close my eyes while riding the bus, and came to the conclusion that my need to watch the road had more to do with my own anxiety than any power i might exert over reality.

perhas if you are feeling like you can’t sto self-massage, or that stopping will be harmful, you can supply yourself with a curative: a lotion or a massaging motion that automatically balances the sub-dermal debris, or that allows it to leech out through the epidermal layer. this way you can control when you “end the ritual” without having to be harsh or defiant with yourself. or you can use it as a pause button: “this lotion will keep my situation in check long enough for me to [do dishes, finish my shopping, go out to lunch, etc.].”

i have some strange beliefgs about the properties of hot water, so drinking tea or taking a hot shower is like an “emergency brake” relaxation method for me. rain, too – those are my curatives, my methods of ending ritual.

i used to worry a lot about “sounding crazy”. now i realize i can’t sound any other way, because it’s part of my experience as a human, and my experience is important. the “truthfulness” or “sanity” of my experience does not matter and is completely objective.

anyhow. I found your post above, about your mother, very interesting – some parents fear mental illness, especially older parents who were raised during the time when mental illness was really taboo, so they simply avoid the issue and persist in denying it exists in their family. my grandmother was that way, and it made her treatment of her depression extremely difficult because she refused to admit she was ill. she’d scold herself and relatives for being lazy, for obsessing over problems, for being weak – and all of it was a genetic predisposition towards depression, which went untreated and unacknowledged until mid to late adulthood for most of us.

my son is autistic and may be exhibiting signs of bpd, so hearing that there is some research linking the two is both surprising and encouraging. i’ll have to link into that and talk to his doctor.

mental illness is so much a family problem, yet results in so much family fraction and friction. tragedy.

anyhow i have gone on long enough. i hope something i’ve said has value to you, polymorphed, and that your weekend has been generally pleasant.