When i was in the hospital, one pdoc said he didn’t think i had sza cuz he’s never seen my thoughts “disorganized” but another pdoc affirmed the diagnosis. Now I’m confused. He said that i do have borderline personality disorder and major depression and that when i have voices and delusions it’s part of those…but then another pdoc said i did have BPD but also sza. I know they purposefully “fudged” my diagnosis in the referral for dTMS cuz they said i needed a major depressive disorder diagnosis for the insurance to cover it…they told me they were fudging it on purpose and knew what they were doing. Now I’m just confused. I went in the hospital cuz i felt like my thinking was "sideways " and was having thoughts of killing my dog, so i burned myself to get rid of those thoughts, but now i don’t know if I’m sza or not anymore. I didn’t know a person HAD to have disorganized thinking to have sza…any thoughts?
No, you don’t have to have disorganized thinking for a diagnosis of sza. There needs to be a psychotic symptom (hallucinations or delusions or disorganized thinking) and a mood symptom (mania and/or depression).
I always appreciate it when you weigh in @Catman. Your answers are informative.
I was told I had Asperger’s syndrome before. They changed their minds later and said paranoid/undifferentiated schizophrenia and then schizoaffective bipolar type after that.
I think somewhere in-between they might have said I had Asperger’s and Schizophrenia but it doesn’t matter and I don’t really know/remember. My family doesn’t acknowledge the Asperger’s anyways.
I think most (every) doctor I’ve seen said I had schizophrenia or schizoaffective. I never got a diagnosis of a personality disorder, but it was brought up before.
I think it had to do with me complaining about derealization and depersonalization disorder. I had really bad dissociation and negative symptoms and even cognitive decline.
I’ve been on a lot of meds and switched doctors a lot before.
The meds don’t really cure me or make me symptom free. I’m not sure what disorganized thinking is, but was told many times I had a thought disorder.
I just deal with it now.
sorry for the confusion.
i wish my pdocs would question my diagnosis but instead they stick with sz and just increase the meds ive been taking for years
Thats a lot to deal with I know. It’s helpful to write down the issues you are having, examples, how you’re feeling and what was the inner and outer environment before the experiences.
This can help them to find the right diagnosis.
Please don’t burn yourself 
An ice cold shower can shock you out of it too
I could very well have Schizoaffective instead of Bipolar disorder according to these guidelines
It’s a crapshoot.
I agree with @shutterbug, you are always so informative @Catman
Well the thinking is BPD can cause psychotic thinking and some hallucinations but there’s usually an interpersonal theme and it’s not as frequent as in Sz/sza. This is why I was diagnosed with BPD originally, I was self harming and had delusions with mild hallucinations. But mine progressed and other BPD symptoms fell out so they changed my diagnosis to sza.
Depression can also cause psychosis as you probably know.
If you’re diagnosed with two conditions that have psychosis, and you do not have disorganized thinking, then I think it makes sense.
As someone who studied this stuff extensively in college, diagnosis isn’t always about fitting the diagnostic criteria. If there’s another disorder that fits better and explains all the symptoms that overlap with the other, or at least most, than one diagnosis makes sense more than multiple. This is what me and my therapist are figuring out too as I’ve collected a lot of diagnoses but so far they all seem to have a lot of truth.
How do they define ‘disorganised thinking’? Is it something that requires very loose associations and word salad type speech or writing? Or can it be more subtle than that? Disorganised- as in having (very)poor ability to plan and carry out tasks. Major deficits in organising and planning.
That’s only for them to know and us not to find out. @firemonkey
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