Schizotypal Personality Disorder?

By Kristina Randle, Ph.D., LCSW

Hello; I was diagnosed with bipolar about four years ago but I’ve felt like all this time that it wasn’t really the entirely correct diagnosis. I really think I have a personality disorder. When I recently began taking an anti-psychotic,it seemed a lot of symptoms cleared up for me. Here’s the personality symptoms that I think line up:

-lots of social anxiety with people I’m familiar with. I’m usually alone and have a couple (kind of) close friends.

-had lots of magical thinking in the past; I’ve kinda quieted that down now. I thought I could will myself to Sainthood and went to church everyday then switched to Buddhism and attended all kinds of retreats with hours of meditation. And plenty of social anxiety I might add. I also thought I would be a famous artist and gallavanted around the streets of cities in Canada playing in the subways (music) or writing many books of poetry that now sit in a box in my basement. The music and artistic endeavors didn’t go so well with extreme social anxiety. And religious extremism. I also believed I could read people’s thoughts and emotions with all the extensive meditation. I had (sometimes)immense connections with people. The affair I had with my boss was supposed to end the (personal, emotional) pain and bring me to enlightenment. That didn’t work too well. I only ended up wanting to die.

-I did have unusual perceptual experiences such as supposedly sensing spiritual beings, sensing light inside others, which sometimes led me to false beliefs or putting people on a pedestal, and seeing light around people’s heads. So I thought I had this gift. Maybe some of it was real, I don’t know.I also had this spiritual ecstasy thing where my back would bend backwards and I would have a very powerful energy shoot through me. I didn’t know what it was. I thought it was from meditating so much.

– a lot of times I know I say wierd things, people say I’m wierd or crazy too. I have an extremely hard time trusting anyone… Usually “walled” off from others. I do act strange, peculiar, sometimes I can’t help the things I say or do.

I guess that’s about it for symptoms; well I’m sure there’s tonnes more but here’s the basics, anyway. I hope to hear what you might think, even though I know I would have to see my psychiatrist about it anyway. Thank-you.

A. Even though I cannot confirm a diagnosis, you have provided specific examples of your symptoms. This information gives me insight (although limited) into what type of disorder may be responsible for your symptoms.

You began taking antipsychotic medication and your symptoms improved. Antipsychotic medication may have worked because you were experiencing psychosis and not necessarily because you have schizotypal personality disorder. Psychosis can be associated with other psychiatric conditions including bipolar disorder, among others.

Psychosis can occur in individuals who have schizotypal personality disorder but it tends to be transient and brief. The fact that your delusions led you to the streets of Canada suggests that your psychosis was of longer duration.

As I mentioned in another answer regarding a similar topic, one of the main differences between schizotypal personality disorder and schizophrenia is that the individual with the personality disorder for instance may believe that other people are talking about them (ideas) versus the individual with schizophrenia who knows it’s true because they remember it happening (delusion). The key distinction is that the individual with the schizotypal personality disorder believes that a delusion-type event may be true but is not certain; the individual with schizophrenia is certain that their delusion is true.

If I interviewed you in person I would want to know more about the following: your belief that you can sense spiritual beings, see light around people’s heads, and the powerful energy you feel, etc. If you thought the aforementioned ideas were possibly true but were open to the possibility that they weren’t, this might be indicative of schizotypal personality disorder. If you’re certain about your beliefs then you may be experiencing another type of psychotic disorder such as schizophrenia.

Another concern is your lack of friendships. You only have a few close friends. Individuals with schizotypal personality disorder tend to be loners and have very few if any friends. The fact that you have developed friendships may not be consistent with a schizotypal personality disorder diagnosis. The details of your friendships and how you relate to these individuals would have to be examined to know for certain.

You believe another possible indicator of a schizotypal personality diagnosis is your tendency to say “weird” things. It would be helpful to know more about what you meant by that expression. This is a symptom consistent with schizotypal personality disorder but it is also characteristic of schizophrenia. It is not unusual for individuals with schizophrenia to make odd comments or to use unusual language. This is sometimes referred to as “word salad.” Word salad, or the technical term schizophasia, is when an individual uses words in a sentence, for example, that have no relationship to one another. Their language can sound jumbled and confused.

I am not certain how helpful my answer is because it is too difficult to give a simple yes (it’s schizotypal PD) or no (it’s not schizotypal PD) answer. Some of your symptoms are consistent with a schizotypal personality disorder diagnosis and some are consistent with schizophrenia. I would suggest talking to your treating physician about your concerns. He or she should have insight into your diagnosis.

What is positive about your situation is that you are in treatment. You also seem to have found a medication that helps your psychotic symptoms. Finding an effective treatment is sometimes more important than identifying a specific diagnosis.

Consider writing back to explain what you meant by the expression “weird.” It might help me to provide you with a more specific answer to your question. Thanks for writing. Please take care.

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Last reviewed: By John M. Grohol, Psy.D. on 19 Jul 2010

APA Reference
Randle, K. (2010). Schizotypal Personality Disorder?. Psych Central. Retrieved on December 26, 2014, from http://psychcentral.com/ask-the-therapist/2010/07/19/schizotypal-personality-disorder/