Slipping into psychosis: Living in the Prodrome

It’s a few years old, but this article was an interesting read.


Did part 2 ever go up?

Also, how do you feel about it? Do you recognize anything in it?

And did you read the PDF? Just starting that now.

This piece reminds me I was in four year college for many years and could not do the required reading. I still can’t!


Not in the symptoms she experiences, they seem very different from my own, however it does sound very much like progressed derealization.

The part I found most interesting is the comments regarding the ethics of treating prodromal subjects. I wonder if patients don’t develop schizophrenia because they did not have schizophrenia, or if they don’t develop schizophrenia because their treatment was effective. Based on the PIER model, there is evidence now that early prevention can be very effective,

I’ll have to look for part 2, i’ll get back to you on that.

Here is part 2:

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I’d say the biggest difference between me and her is that I have no delusional thinking whatsoever. I experience a lot of uneasiness bordering on fear sometimes, but it stems from overinterpreting my surroundings, reading too much into it, and drawing the wrong conclusions. The strange part is that it isn’t my mind drawing the conclusions, it’s my body beginning to react to the situation without my consent, the fight or flight mechanism, you know?

I’m still very early into it. My caffeine use probably magnified my symptoms ridiculously, could even have triggered them, and then I wrecked my car, so I sought help very very early. I also have a very close friend who is severely schizophrenic, so I know what it looks like, and I understand the thought patterns. When I began seeing them in myself I started becoming concerned.

I still have an immense amount of insight, and it is painful to watch myself become sick. I wonder what it will be like for you guys as I progress. I’m worried as to what the future holds. Prodromal is said to last 2 months to two years. I am past the two month mark now, we’ll see where this goes.

Yeah, you interest me because my symptoms seem subthreshold, too. I recognize them as psychosis, but attenuated psychosis. I’ve had most of them for far longer than 2 years, and so I would think I’d just be on the course of chronic nontraditional perceptual experiences, but there has been an increase in the past little while.

I do have some delusional thinking, but it’s nothing huge and I can be talked out of it easily. Paranoia is worse. I had the same concerns Anna did about particles, but never got to the point where I discounted strong and weak nuclear forces entirely, like she did.

Have you ever had a full psychotic break?

No. I feel like I’ve walked alongside the edge of a cliff for years but never fallen off.

and to describe the similarities between an apple and a banana. The correct response— “Both are fruit”—eludes some of the sicker patients, who instead home in on concrete characteristics. The psychologist who administers the exam told me that one of the most common wrong answers is “Both have skin.”

That weirds me out. Both have skin is what I would say, not because I don’t understand they’re both fruit, but because that’s so obvious, why say it?

Have you seen my posts about STPD? From what I have read, the diagnosis of schizotypal personality disorder is given to patients who make it through two years without developing the full range of criteria for a schizophrenia diagnosis, and at this point it is considered unlikely that they will. STPD is considered comparable to prodromal schizophrenia and residual psychosis

This is a great example of abstract thinking. You’ve chosen a different answer not because it better serves the question, but because it is less obvious. It represents a break from conventional logic and reasoning, because the goal of language is to predict another’s conceived meaning. Convention is the foundation of language, it is simply a group of agreed upon meanings.

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I don’t mean to say you’re extra sick or anything, i’m just trying to share my theories of the illness, terminology, and particulars of schizophrenia.

My doctor asked me if I had any interest in psychology, I told her I have a very vested personal interest in psychology haha

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Yeah, I’ve considered that. I had some conversations on your first post about that, how you and minnii and odile and I had similar experiences with different interpretations.

I’ve also considered psychotic depression, PTSD with psychotic features, or bipolar ii with psychotic features (though it seems bpii generally doesn’t involve psychosis). My symptoms are strongly mood-related.

Seeing my pdoc next week, so I should stop obsessing over what she’s going to say and let her say it.

Do you think this would be helpful in your meeting with the pdoc?

See, it’s important to distinguish whether or not your symptoms are affected by your mood, or if your symptoms affect your mood. That’s the difference between schiz and schizoaffective.

Schizoaffective is schizophrenic symptoms with a mood disorder. Schizophrenia and bipolar are closely related disorders, bipolar is actually the most closely related disorder to schizophrenia. It has been found that there is a genetic link between the two, and families with bipolar have children that are more likely to be schizophrenic.

In that case, uncontrollable and erratic mood swings would be its own symptom.

If my pdoc hadn’t asked me to fill out an exhausting-and-exhaustive ten page form much like it, I would definitely find it useful :smile_cat:

I’ve been waiting for this appointment since August, so I also have a crayon-colored notebook filled with thoughts, concerns, symptoms, hopes and expectations to bring with me. I’m maybe pinning too much on this.

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Is this your first time seeing a doctor?

Interesting - is this document you are talking about that your doctor gave you - is it something that was developed by your pdoc - for his clients, or something that looks like it is produced by someone else and he just buys them?

I’m curious about this form you have. Does it have a “Name” on it, or any other identifying information (e.g. a document number or something I can look for)

I was diagnosed with depression as a kid and did therapy for 10 years, the last 5 of them medicated. Pronounced cured, but have had a slow ramping up of symptoms for the past several years, with a sharp spike immediately following the death of my cat two years ago, culminating in a crisis at the beginning of August. So no, but it’s been a while. I’ve been under the watch of my GP since August while we waited for the pdoc appointment.