Psychosis and Schizophrenia

By Kristina Randle, Ph.D., LCSW

Hello. I am concerned lately as to the state of my mind in relation to psychosis. I have been diagnosed with Borderline Personality Disorder, however the symptoms I am experiencing fall out of the regular signs associated with this personality disorder.

Now, I was told in the past, that I was at high risk for developing schizophrenia. I have been having some persistent symptoms that have me worried that I may very well be heading in the direction of this diagnosis. I am not a professional and have no clue what is going on in my mind. I would just like some guidance and ideas as to what might be going on.

For starters, I have been experiencing some persistent confusion. I have difficulty ‘keeping up’ with my racing thoughts and logic. My mind seems to be taking me to places that I had no intention of going, and faster then I could possibly grasp. This leads me to feeling extremely confused and disoriented.

Secondly, I am having difficulty distinguishing my dreams from reality. Often times I will dream of simple, everyday activities, and upon mentioning, or asking if these events occurred, I will be told that nothing of that sort happened. I constantly experience hypnagogic and hypnopompic hallucinations, with and without sleep paralysis. I also have what I like to call ‘para-hypnagogic/hypnopompic hallucinations’. I use this to refer to times when I am not quite as far into the sleep cycle in which these hallucinations usually occur. More often then not, I am quite awake.

Thirdly, I am extremely paranoid! This is to the point that when i am having a paranoid episode I began acting out impulsively. A few examples include: jumping off a bus when I felt a paranoid panic that something horrible would happen. Hiding in bushes and behind cars when I felt that someone was following me, or watching me, and locking all my doors and windows upon being convinced that someone had followed me home with bad intentions.

At some points, I have actually hallucinated both auditory and visually someone watching me, or following me. I would not have known that these things were not real, had some friends and family not called me out on them.

I also experience intense depersonalization. I might feel I am in a dream, or that I am watching myself. I experience intense bouts of de ja vu and strange, indescribable feelings.

I have intense mood changes (yes, this has to do with BPD, mentioning for the sake of it). These vary in intense anger, to intense happiness. I am also extremely sensitive and the smallest degree of insult will leave me in tears for days.

I am often told that I jabber on about nothing and that my stories or conversations make no sense. This might be just a poor memory, but one can never be sure. I also have some thought disorder including trailing, and sudden stops in conversation. This is because I get distracted or totally forget what i am saying. This is another symptom that I was not aware of until It was pointed out.

I have experienced other auditory hallucinations on and off. Usually short comments or my name being whispered. Other times i hear footsteps.
All of these symptoms wane and wax and have been occurring for a little over a year. They have been most prominent over the last 6 months.
Help! Is this a sign of schizophrenia? Or is the psychosis surfacing from something else?
Thank you!

A. Research shows that individuals with borderline personality disorder (BPD) can experience brief states of depersonalization, hallucinations, paranoia and suspicion. They can also experience psychosis-like symptoms such as feeling as though they are losing their grip on reality. The symptoms you described may be part of BPD. I cannot say for certain whether your symptoms are associated with BPD or if they are a sign of another disorder such as schizophrenia but generally speaking, your symptoms are fairly consistent with BPD.

I would recommend having a psychiatric evaluation. An evaluation would be helpful in determining whether your symptoms constitute the development of schizophrenia. As I remarked above, your symptoms seem consistent with BPD but it is important to rule out a possible developing psychosis or schizophrenia diagnosis.

You did not mention whether you are in treatment. If not, you should be. It would be difficult to experience the many frightening symptoms you have described. I get the impression that you may feel like you are living in a fog, not sure of what is real and what is not. This is not a healthy way to live.

Psychotherapy may help to address symptoms such as mood instability, racing thoughts, confusion and memory loss. Medications might be helpful as well. Medicine may be particularly helpful for hallucinations and paranoia. Some physicians prescribe a low-dose antipsychotic to treat hallucinations and paranoia in individuals with BPD. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), have been found to be helpful for mood instability. These are all treatments you could explore with a therapist and a physician, preferably a psychiatrist because of their additional training in mental health.

Here’s a link to Psychology Today where you can search for a therapist in your community. Many individuals with BPD prefer to consult a therapist who is specially trained to work with this population. If possible, I would recommend you do the same. Thank you for your question.

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Last reviewed: By John M. Grohol, Psy.D. on 20 Apr 2010

APA Reference
Randle, K. (2010). Psychosis and Schizophrenia. Psych Central. Retrieved on December 20, 2014, from http://psychcentral.com/ask-the-therapist/2010/04/20/psychosis-and-schizophrenia/