Cause for Concern and Further Inquiry?

By Kristina Randle, Ph.D., LCSW

I was diagnosed bipolar nos for some time. At 22 in 2006 things were not well with me in a way I could not put my finger on. I thought it was a medical issue. I would go numb, lose the ability to speak, lose the ability to see, have what appeared to everyone around me to be seizures. Tests showed nothing. I grew increasingly agitated and disconnected. I was in college and would swear it was a different day than it actually was, I saw blobs of colors, colored halo’s, the walls would move. People‚Äôs heads were gone replaced with colored lights. I couldn’t follow conversations I felt like I was permanently incredibly stoned. I had a conversation with someone for a good few minutes and then before my very eyes she changed into an entirely different person and I realized the person I was originally talking to had never even been there. The whole room moved. I retreated to the women’s center on campus. Pacing horrified agitated confused and someone touched my shoulder it felt like the intensity of a car crash I jumped ready to attack what touched me. I ended up calling emergency as I could not take this and wanted to commit suicide. I wound up in the hospital. Had a status exam and was hospitalized for mania and psychosis.

My diagnosis was changed to Bipolar 1 with psychotic features.

These symptoms had been building up for the duration of the last semester of school. I got out of the hospital, graduated, and moved in with a friend. There was a time shortly after that I became convinced that the only reason he had let me stay with him was that he had taken out an insurance policy on my life and was planning to kill me for the money. I scoured his computer his house opened his mail looking for “evidence” to prove this. I of course found nothing but the more I searched I only became more convinced that he was. Around this time I also sat and watched the television talk TO me about me once. This lasted for months.

Since college I have not worked have barely left the house. I feel “stupider”. I feel as though I can not think like I used to. I recently had another assessment and he took bipolar off the table and diagnosed no psychotic illness. I do not agree.

Recently I have become obsessed with the idea that I have some form of disease and will die of it I just have not found out what. I have also not been able to shake the idea that I am infested with intestinal parasites, worms. I believe this more or less strongly at different times but I have not been able to shake the idea entirely. And I feel it is pointless to test for it because they will find nothing, they never find anything, and when they don’t find it I will not change my mind. I will just know they didn’t do the right tests. I just “know” these things and can not shake them even though on some level I have insight as to the potential absurdity. I feel that others are against me. No one in particular, usually, unless something sets me off then I am excruciatingly paranoid and watchful of those individuals. But in general I feel as others talk about me behind my back are “out to get me” This feeling lessens sometimes but is always there. I feel constant threat.

I still see things now and then. Things changing sizes or perspective. People looking like they are importers… slightly off versions of who they are that are not really them. Mostly just smoke here or there or shadows the size and shape of little animals running along the floor out of the corner of my eye. I do not know if what I think is real or not and I cant get a hold of my thoughts. Rather than excessive my head seems vacant. I hear noises. I think. I don’t know. Sometimes I think I do other times I tell myself it is the neighbors or something out in the street. I hear laughter sometimes. Or things that I have recently heard on the tv or elsewhere echo inside my head and fade out. Nothing is ever directed at me or at anything in particular. And I can not make out what the noises words are half the time. But I listen intensely and ask them to speak up. I ask them, of course with my conscious voice not out loud because I don’t know if they are real noises or not and I don’t want others to know I’m hearing things. I don’t even know if I am. I do not hear it outside my head it is inside. Usually off to the sides as if I had an ear-bud in my ear and was playing a radio station that is in between stations very quietly and intermittently. I beg them to speak up or shut up so that I know for sure if I am hearing real noise or voices. I don’t want to ask for help until I know if it’s real or not. Sometimes the thought has occurred to me that perhaps they are noises in my head but that they are psychic. But I try not to think that way because that is how I got stuck on these other ideas like the parasites. Instead I just wait and listen. They are noises sometimes words that I don’t know if they are in my head or real. They are all sorts of different voices mostly female sometimes male. I don’t know if I should be concerned about these things and speak up about them or not.

I am kind of afraid that I may be developing schizophrenia of some form or another. As I know it can be an intermittent illness my first psychotic episode was at 22. Since I have felt no motivation for life or goals or old hobbies and joys I sit all day most of the time. Clean the house and sit. And I feel less intelligent. Other than that I appear normal. I have decent hygiene, I can carry on a logical conversation. I can express emotions appropriately. No one looking at me talking with me would have much of any idea of the things that occur with me sometimes unless I told them. They just think I must be depressed or lazy but otherwise the same as always. So how could this possibly be schizophrenia if other than occasionally seeing things, possibly hearing things, paranoia, loss of motivation, I am normal. I don’t know if anything is wrong with me or if its all in my head.

I do not know what to do here. What to be worried about. What to mention to a counselor. What to wait out. Any advice at all would be PRICELESS. As I am too confused and unsure of what is going on with me to tell anyone.

A. Despite having what seem like symptoms of psychosis, your thoughts are relatively organized. Your writing is clear and logical. Your experiences are abnormal but your presentation of those experiences is remarkably coherent. I find this very encouraging.

Early in your letter you mentioned having many physical symptoms. Having the symptoms prompted you to be evaluated for seizures. It was determined that there were no seizures. You may want to consider a second or a third opinion. People with psychotic disorders have described physical symptoms but yours seem unusual. It is important to rule out all medical causes.

I believe that treatment is warranted. You mentioned that you have been diagnosed with several disorders but did not say if you have ever engaged in treatment, aside from medication. Medication can be helpful in the treatment of psychotic disorders but once you are stable, psychotherapy may also be helpful. It could help you stay grounded in reality.

You asked what you should mention to a counselor. You should report everything you have written your letter. The therapist needs to know what you have experienced in the past and what you are currently experiencing. It may help him or her to determine a diagnosis and to formulate a treatment plan.

If you’re not interested in therapy then at the very least you should have a support system in place. It would be helpful to have at least one person whom you trust. It does not seem like you have anyone who you do trust. If you did that person could help keep you grounded in reality.

As I mentioned above, I believe you should enter treatment. You should not “wait it out.” Make an appointment with a therapist and be very detailed about what you have experienced. I know it may be difficult but it is necessary. Ignoring this problem may only make it worse. Here’s a link to a website that may help you find a therapist in your community. Don’t give up until you find someone who can truly help you. Please keep me updated on your progress. Thank you for your question.

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Last reviewed: By John M. Grohol, Psy.D. on 4 Feb 2010

APA Reference
Randle, K. (2010). Cause for Concern and Further Inquiry?. Psych Central. Retrieved on November 27, 2014, from http://psychcentral.com/ask-the-therapist/2010/02/04/cause-for-concern-and-further-inquiry/