Is This Schizophrenia?
Q. I understand that there are several people writing in asking whether or not they are schizophrenic and I am sorry to add to this list, however I did not feel that any of the other symptoms described felt like my own. I understand that you cannot diagnose me with schizophrenia, however I am unaware of what I should be doing or if I should be doing anything at all.
Over the past few years I have felt as if something was wrong with my emotional state and general thought process. Ever since I was a child I have had some signs of Obsessive Compulsive Disorder but nothing too severe. I often walk in certain patterns sometimes tripping myself or others not to break it, and I often feel the need to arrange things in a certain order. I eat in peculiar ways where none of my food can touch, I must chew food a specific number of times before swallowing, and I can only eat things one at time (for example, all of my chicken, all of my vegetable, etc.). More recently things have gotten worse where I have developed a system of checking my mirrors and moving my seat before I start my car, as well as counting every step that I take.
My speech has also been affected recently in the past couple of months. I am often stuttering, forgetting the meaning of common words, and often I have been mid sentence and forgotten entirely what I was talking about. I also feel that I can’t put things into words, that I do not trust their definitions.
I also feel that I am lacking emotions. I am failing out of my University and I am unaffected by it , I am entirely apathetic towards my future, and several years ago my mother passed away and I felt as if I forced myself to fake emotions so that others wouldn’t find it odd that it held no impact on me. I often hear of traumatic or shocking stories that provoke strong emotions from others while it elicits no response from me, often causing people to even ask why something doesn’t “bother me.”
Over the past year I have been going through phases. For weeks I am entirely depressed with thoughts of suicide. I lose weight dramatically, I am highly antisocial, and I sleep excessively despite always feeling tired and drowsy. At other times I experience almost the opposite, I am extremely irritable and aggressive, the smallest of actions cause me to be mad, I eat obsessively, and can hardly ever fall asleep.
And lastly, my thought process. Only recently have I discovered that my thoughts are different from others. I often hear voices in my head telling me to do something, nothing dramatic, but things I must go out of my way to do and if I don’t fulfill these actions I will be in trouble. Even though I know these voices are not real people, I am afraid they will harm me if I don’t do what they tell me to. I also have images of me harming my family and friends, or just something horrible happening to them in general. Occasionally they make me feel better despite the fact that I don’t want them to get hurt. However, I am never afraid that I am going to carry out these images. I am also unsure if any of my emotions are real, I feel as if certain things like anger, paranoia, empathy, depression, and even love are things which I am not really feeling though I tell myself I am. At any point in time I feel entirely numb, as if I can only feel physical pain, and even that I am unsure if it is real. I almost feel as if I am making all of this up as well.
Thank you for your time, and again I apologize for writing another letter along the same lines, but I did not feel as if any of my symptoms matched former questions. I understand that you cannot tell me for sure what is wrong with me but I am just looking for even the most general direction to look towards because I feel as if I am the only person with these problems. Thank you.
A. There is no need to apologize for your question. As you’ve said, your question is unique compared to some of the others related to schizophrenia.
You’ve experienced obsessive compulsive disorder tendencies, feeling depressed and having thoughts of suicide, as well irritability, aggression and not sleeping well. You’re also concerned about your thought processes. You hear voices commanding you to perform certain actions and that if you don’t, you’ll get into trouble. There are also the images you have of harming your friends or family. In these scenes you’re not afraid to carry out these harmful actions against them. You also describe not having emotions. This is sometimes referred to as “flat affect.” Even when you believe you are experiencing an emotion you don’t trust that it’s real.
Some of the above symptoms may be signs of schizophrenia. For instance, the voices that command you to harm yourself or other people are potentially symptoms of schizophrenia. Feeling as though you have no emotions is another symptom that has also been associated with schizophrenia. The same is true with regard to obsessive compulsive disorder tendencies. The other concern is related to your speech. You find yourself stuttering, forgetting the meaning of words or what you’ve said mid-sentence. There are also times when you’re completely unable to speak. Furthermore, there are occasions in which you do not trust the definitions of the words you’re speaking. Speech and language problems have also been linked to schizophrenia.
The symptoms you’ve described may or may not mean you have schizophrenia. The best way to gain an accurate diagnosis is to be evaluated by a mental health professional. You should make an appointment for a psychiatric evaluation.
What I found remarkable about your letter is how detailed and specific it was regarding your symptoms. If someone is having difficulty trusting their own thoughts, hearing voices or feeling paranoid, then understandably it may not be easy for them to discuss these topics. Sometimes individuals with the symptoms that you’ve described find it challenging to put their thoughts in a logical order. You were able to write about what you’re experiencing with clarity. The fact that you were able to be so descriptive and clear is encouraging. The tone of your letter also suggests that you’d be amenable to treatment. When it comes to schizophrenia, being receptive to treatment can mean the difference between recovery and non-recovery, a good prognosis or a chronic cycling of episodes.
I would suggest that you strongly consider seeking treatment or at the very least, having a psychiatric evaluation. If you are showing signs of schizophrenia (which you may or may not be) early treatment may prevent the illness from intensifying. Delays in treatment prevent unnecessary suffering and may increase the risk of having future psychotic episodes. Early treatment has been associated with better recoveries.
Let me reiterate that I cannot know based on a short letter whether you have schizophrenia or a related disorder. What I do know is that the symptoms you’ve described are not “normal” and early treatment, no matter your diagnosis, is critical. There are some people who have one schizophrenic episode and never have another. Generally it’s the individuals who seek early intervention that tend to remain stable.
If you have any future or additional questions I sincerely hope that you will not hesitate to write back.
Randle, K. (2009). Is This Schizophrenia?. Psych Central. Retrieved on April 18, 2015, from http://psychcentral.com/ask-the-therapist/2009/05/11/is-this-schizophrenia/