Is it Just Depression or is it Schizophrenia?

By Kristina Randle, Ph.D., LCSW

Q. For the past couple of years I have been extremely down and suicidal. I went to a counselor when I was 15 for 3 months but had a very hard time opening up so ended up lying. It was a waste of time and I felt equipped to handle things by myself so I stopped going. I was okay for about a year but then things began to get progressively worse. Firstly, I started to feel very sad about my whole life and then suicidal thoughts came. There were many times where I was desperate to kill myself but didn’t as I knew how selfish it was. I overdosed on sleeping tablets but managed to sick them back up, so no real damage was done.

I have always been a closed person, so none of my friends have any idea what is on my mind. I am a very fake person and a compulsive liar (something I have been since I was young but it has become a lot worse in recent years). After that I wasn’t so upset anymore. I feel very emotionless and never cry. Yet I still do not enjoy myself ever and always feel that life is more bother than fun. I have become extremely lazy and have quit all of my hobbies. I have become reclusive and hate socialising to the point that I have panic attacks if I have to go out. I spend my time holed up inside my room (I do not live on campus at uni, i live at home with my mum).

I have been to the doctors and they said that I was quite clearly severely depressed and in need of medication. They said that I was lying to myself and that even though I said I didn’t care about my parent’s divorce or my sister’s anorexia, that they clearly had affected me. I have been referred to The Priory to see a psychiatrist and follow methods of treatment other than counseling. The problem is that I am not so sure it is just depression. I have a hard time understanding what I feel due to my compulsive lying and my grip on reality is not too strong. I have times where I am not sure if I am making up memories in my mind or if they really happened. For example; I told my mum that I had been hearing voices but then I doubted myself and could not remember if I had or not.

I am a very angry person and dislike most of my friends. I have self harmed badly in the past and am becoming more and more aggressive. I am constantly restraining myself from hurting other people and my mind keeps telling me to hurt people — I am not hearing voices or having any hallucinations though. I am certain that there is some sort of poison or evil inside me that is rotting me away and controlling what I think. I know I am not as evil as my thoughts are, so something must be making me think like this. I don’t like society and know I won’t be able to cope living in it much longer. I want to be completely isolated but i know this is not possible. I am not hallucinating or paranoid but I do sometimes get the feeling that someone is with me, controlling my body and thoughts. During these episodes, I often do silly things (e.g. burn myself on a radiator, take 10 paractemol etc.) I don’t think this is just depression, but maybe I am overreacting? I probably am a hyperchondriac? Please reply…i need help.

A. I am sorry but I really cannot give a reliable or exact diagnosis over the Internet. Based on your letter, it does seem to be more than depression but what for sure I do not know. You mentioned that you lie compulsively and that you are paranoid. You also do self-mutilate and self-injure. It’s also possible that you were hearing voices. These symptoms do seem to indicate that there is something more than depression going on but without evaluating you in person, I cannot give you a precise diagnosis.

You mentioned that you have been in treatment in the past but it is not clear that you are currently in treatment. You also mentioned that it was suggested that you take medication but you did not want to take it. If you are not currently in treatment you absolutely need to be. Medication could also help you especially if you are paranoid or hearing voices. Thinking that something evil is controlling you is a paranoid thought. I am also concerned about your suicidal thoughts. I do not think that you should try to handle these symptoms on your own and I would strongly suggest finding a doctor and a therapist. Please consider some outside help. Take care.

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Last reviewed: By John M. Grohol, Psy.D. on 30 Dec 2007

APA Reference
Randle, K. (2007). Is it Just Depression or is it Schizophrenia?. Psych Central. Retrieved on September 19, 2014, from http://psychcentral.com/ask-the-therapist/2007/12/30/is-it-just-depression-or-is-it-schizophrenia/