Self-Disturbance and Cognitive impairment (possible prodrome)

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Hello everyone,
I am new to this forum and I am not diagnosed with SZ yet, however, I have a hypothesis that I might be in the prodromal stage. I would be grateful for anyone who will read and respond to my post.

So, to be short, my first complain is that I have problems with my sense of self. I believe this is not the same as depersonalization, but instead the disturbances of “minimal self” (like having no “inner core”). I found this article (

) about basic self-disturbance in schizophrenia prodrome and I can relate to many aspects of it. For example I’ve experienced such symptoms as Stream of Consciousness, Presence, Existential reorientation (you can find the description of them in the article), Diminished self-affection.

I guess that they are not very severe right now, but they are definitely present.
In addition, sometimes I have derealization moments (I’ve suffered from it for about 2 years), sometimes I don’t feel that I am actually “alive”, like I am a living object and a part of the society. I’ve also been having strange thoughts and sensations about life, “self” and other people. It feels like I am trying to understand what is life, what is “self”, consciousness and my mind kinda blows from these thoughts.

  1. So, my first question would be, does anyone of you suffer from these “self” disturbances? Do they go away or progress with time? Did you have that during your prodrome?

In addition, I’ve been having a lot of cognitive difficulties lately. I find it very hard to think most of the time, my ability to function in university has decreased. Sometimes I find it impossible to understand what is going on in TV, as my brain literally is not working. I’ve also found that I have some of the 9 basic cognitive prodromal symptoms, which are also mentioned in the article.

That’s why I would like to ask you,
2) What were your cognitive problems during prodrome? Where they severe, did you “feel” that they are happening (did you have an insight) and have they improved with time?

For now, of course I hope, that I won’t develop the illness, however, I tend to be realistic, so any opinion would be very useful. It would also be a relief to know that someone who had these symptoms has managed to cope with them ( or not a relief otherwise :slight_smile: ).

Thank you again for reading my post, I apologize if my English is not good or my post is an any way inappropriate for this forum.

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I had the symptoms you described before the onset of my psychotic episode, so I would advise you to go see a psychiatrist. But you shouldn’t diagnose yourself, it can be something else, or just stress. Everyone I know, people without schizophrenia, had some sort of symptom of it. So don’t worry too much and go see a psychiatrist. It can be nothing. Good luck

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It’s very good that you are so self aware. Many aren’t so lucky. When I was in my 20s and began experiencing problems I was in complete denial and lacked awareness. But I did notice things like isolating myself, not talking/socializing at school, missing classes then I completely stopped going, stopped grooming, room was a mess, smelled, people kept asking me if something was wrong and I said no even though I desperately knew something was.

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It could be something else, as @Minnii said. There’s a lot of overlap between the early beginnings of schizophrenia and other things, e.g. depression. So much so a lot of doctors can even get it wrong.

But get yourself checked out by a professional. Then maybe get a second opinion too.

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Thank you for your answer. Could you please describe what you experienced in your prodrome in some more detail please, if you don’t mind? How long was this period? Have your symptoms improved with time? And how are you doing overally in your life right now?

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Well first I used to feel this intense feeling of not belonging to the world, of being an outsider. I had experiences of feeling infinity, there is no way to describe that. I had thoughts that maybe I died and this was the next life, like a continuum of the previous life. I had constant questions about the nature of things, what reality is and so forth.

The period lasted for about four years before psychosis.
The symptoms only got worse, to the point of psychosis, and now I’m on meds, so feeling relatively normal and with no symptoms.

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Hi, I’ve already been to 3 different docs, one of them says I don’t have anything bad, but IMO he doesn’t know much about the symptoms I’ve described. The other one was the first from who I heard I might have SZ, but I was then afraid to visit him again :slight_smile: . And the last one was psychiatrist, who only prescribed me some antypsychotics, but didn’t talk much about what I possibly have. I’m not sure now which one I should visit and how to continue my treatment :smile:

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[quote=“yll, post:1, topic:34135”]
2) What were your cognitive problems during prodrome? Where they severe, did you “feel” that they are happening (did you have an insight) and have they improved with time?
[/quote]I had intense pain inside of my left-brain region, coupled with lots of high-pitch frequency ringing. The frequences are 24/7 to this day, but the pain is slowly & surely disappearing. I’d like to be pain-free, but then again I still feel like I will bare heavy physical symptoms - like lack of energy & pure exhaustion when I wake up for the day.

The visual hallucinations are decreasing as well, and so are the audio hallucinations, but in the beginning they were immediate & vivid. I was definitely seeing “ghosts” and definitely hearing them talk from time-to-time.

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Feelings of dementia.

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If you have suffered symptoms for more than two years and not developed the full range of diagnostic criteria for schizophrenia, it is not likely you will.

http://www.mayoclinic.org/diseases-conditions/schizotypal-personality-disorder/basics/definition/con-20027949

You may notice that the diagnostic window for STPD is two years, this is because the range for prodromal symptoms is generally agreed to be between two months and two years. I’m currently in the prodromal phase, and my psychiatric team considers me to be a very textbook case. My major symptom is derealization, generally referred to as a dreamlike state with a loss of connectedness to others.

One of the first things most patients will experience in the prodromal phase is an over acuteness of the senses. For instance I have become very sensitive to light, it’s hard for me to be out in the daytime. As well, I can now hear things clearly from very far away. I also have issues with spatial distortions, things constantly shifting and moving slightly, as if everything was made out of a softly disturbed waterbed.

It’s different for everybody, and not everybody develops the same range of symptoms at the same time, there is a lot of variation.

Look out for spatial distortions and lapses in short term memory, a feeling of mild delirium. Those were my earliest symptoms.

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Oh yeah, your age and caffeine intake are also very important.

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Hi! For the last 2 years I only had some form of derealization, and then only a couple of months ago I’ve started to experience the other symptoms I’ve described.
I am sorry, you’re struggling with all these symptoms. Are you receiving any medications right now? Do you doctors tell you anything about the possible prognosis of your illness?

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What is your caffeine intake like?

Also, what is your age? These are very important questions.

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I am 19, I drink maybe 2-3 cups of black tea daily. I don’t drink coffee usually.

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Ok, that’s good. Make sure you keep your caffeine intake to a minimum, if you are suffering from early signs of psychosis, it will worsen your symptoms and increase the likely hood for progression. Drugs and alcohol can also have this effect, but caffeine is most often overlooked.

Can I ask what country you are from? Based on the experiences you are having, it would be a good idea to get an evaluation. Symptoms generally start appearing in the late teens and early 20’s, especially following changes in life. It’s not at all uncommon for symptoms to appear during college. I’m 20 years old myself, and I believe a spike in caffeine use during a period of being severely overworked at my job to have triggered my illness.

If caught during the prodromal phase, a patients prognosis is drastically improved. There is a lot of evidence for this based on trials of the PIER model here in the US.

http://www.mmc.org/pier

Preventative measures are very important.

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I live in a small country in Europe and I doubt that I can receive a relatively good evaluation here. I was only given a test with ~400 questions, but there was not much about SZ, especially prodromal symptoms I have, this test was about mental health and life in general.
Unfortunately, I believe that unlike you my condition was caused by a single synthetic drug use 3 years ago, this was a huge stress to me and also I had another traumatic expreience at the age of 14.
Thank you for your advices, I’ve also been researching a lot about prodrome recently and searching for possible treatment options :slight_smile: Sorry for asking you again since you haven’t replied, are currently on any medication?

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I doubt it, i’ve done a lot more drugs than you haha

They don’t cause schizophrenia, they worsen the symptoms once they appear or begin to appear. Marijuana is actually one of the worst drugs for schizophrenia. I’m thinking the list probably goes weed, amphetamines, caffeine. Although I hear coke is pretty rough too. My buddy Conor used to do a bunch of coke and then meditate for hours. It was very strange.

If I hadn’t started drinking so much caffeine, it could have been a long time before I figured out anything was wrong.

Are there any state programs? The state tends to keep at least some sort of hand on mental illness, because it can be very damaging to a country. Poor treatment of the mentally ill is a problem in many parts of the US over here.

You said you have taken a test? You should try to find out what treatment plans are usually like in your country, then you can start looking for doctors. Is it possible to go to another country to see a doctor? I used to live in Germany, and I remember it wasn’t that far to drive to other countries from where we were haha

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If you think you might be prodromal - then go and get an evaluation. The best place to go are the early psychosis treatment centers:

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

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He says that the mental health system in his country is not great

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Perhaps you can go to an early psychosis treatment center at a larger country near you? There are many good programs in Germany, Sweden, the UK, etc. and since they are usually affiliated with an academic center they are usually free.