Early Signs of Schizophrenia?

By Kristina Randle, Ph.D., LCSW

For over five months now, I have been extremely socially withdrawn, have had obsessive thoughts of suicide, and delusions of how the world works. Let me expand on that statement.

My thoughts of suicide sound like me, but they are very persistent. They tell me “just jump out of this moving car”, or if I am the one driving, the thought is, “just drive off the bridge.” These thoughts repeat until I am forced to pull over, or lock the door for fear that I will actually kill myself. Now, being that I have no interest in anything usually makes me want to give into these thoughts, but I have a boyfriend that I live with, and love very much, that I would not like to leave behind.
My social behavior has changed dramatically. I am a sophomore in community college. I have only one friend, he is also my boyfriend. In high school I had many friends, and was very outgoing and social. Now, I find it difficult to have a social interaction with anyone, store clerks, fellow students, even my teachers. It keeps me from applying for jobs or even making a simple pizza order over the phone. I get a great sense of impending doom every time I approach someone. In public place I feel everyone is whispering about me, or talking bad about me, or even plotting against me.

On top of all this, I often get very depressed and burst into tears. I fell that I am very disconnected with this world and even my own body. I feel so terribly uncomfortable in my own skin that sometimes I have impulse to pull it off. I find it difficult to believe in scientific facts because of my own delusional thoughts that tell me how things work. I even get delusions that I have certain special powers that others don’t have or are jealous of.
I usually suppress one if not all of these symptoms because of fear that my boyfriend will leave me for being crazy. But recently I told him everything and he has agreed to help me get help. Trouble is I don’t know what type of help I should be seeking. Right now, I do self medicate with marijuana, because it’s the only thing that stops the thoughts, or “voices”.

If anyone has any advice it would be greatly appreciated.

A. I’m sorry you’re having such a difficult time. You are very fortunate to have a caring boyfriend who understands the importance of seeking help and who is willing to assist you in that process. Studies show that having social support, especially during the difficult times in one’s life, can have a major positive impact.

It’s difficult to know for certain if you have schizophrenia (because I cannot interview you) but based on your letter, it is a possibility. Some of your symptoms are consistent with a schizophrenia diagnosis including:

  • Magical thinking: the idea that you have special powers and others are jealous.

  • Hearing voices: they are telling you to harm yourself and sometimes they’re so real that you fear you might actually commit suicide. Hearing voices is a symptom of schizophrenia. In most cases, people with schizophrenia hear negative voices just as you have described, in which the individual is being directed to harm themselves or someone else.
  • Definite changes in your social behavior: You describe being emotionally and socially withdrawn to the point where you are barely able to speak to others. You did not mention this but the fact that communication is difficult may be affecting your ability to continue in college.
  • Paranoia: the belief that others are whispering or talking about you. You also describe believing that others are plotting against you. These are all symptoms of paranoia.

Other concerning symptoms include disassociation and your depression.

Your specific question is how to seek treatment. There are several ways to do this. If you feel that you cannot keep yourself safe (i.e. the voices are overwhelming) then go immediately to an emergency room for a psychiatric evaluation. At the hospital you will be interviewed about your symptoms by mental health professionals such as a social worker and a psychiatrist. They will be determining whether or not you need to be hospitalized. If hospitalization is unnecessary, they will generally either refer you to another treatment center or offer you a prescription for psychiatric medication to treat your immediate symptoms.

Other ways to seek treatment include:

  • Making an appointment with a primary care physician. At this appointment, bring a list of your symptoms and ask for a referral to a psychiatrist. You could bypass the primary care physician (depending on whether or not you have health insurance) and make an appointment to see a psychiatrist for psychiatric evaluation.

  • If you have no health insurance, then you should call a local community mental health center or your local health department. These phone numbers can be found in the white pages of your phone book or by doing a Google search. Explain to them that you want to be seen by a psychiatrist but that you do not have health insurance and you are seeking free or low-cost services.
  • Another option is to call the United States Department of Health and Human Services National Mental Health Information Center at 800-789-2647. They may be able to direct you to local services in your area.
  • Call the National Alliance of Mental Illness (NAMI). NAMI is a mental health advocacy network. Their informational helpline phone number is 800-950-6264. Click here to find local NAMI assistance. NAMI should be able to direct you to a psychiatrist or another mental health professional in the community.
  • Your community college: You may be able to receive mental health services or assistance in seeking mental health services at your college. Many community colleges have mental health services they offer free to their students

I want to also add that your letter was logical and well-written. This shows that despite the possibility of experiencing the early signs of schizophrenia, your thinking processes remain relatively organized and intact. It is also important to note that you seem to have a great level of insight into your symptoms. If you do have schizophrenia, then it is important to realize that this is not true for everyone with schizophrenia. In fact, it is relatively common for individuals not to be fully aware of their symptoms. I find it very encouraging that you wrote a logical letter, are aware of your symptoms, have support from your boyfriend, and are agreeable to seeking treatment. All of the aforementioned characteristics of your particular situation increase the likelihood of a positive outcome and prognosis.

I hope that I have provided you with helpful information. Please consider writing back and letting me know how you are doing. Please take care. Good luck. I look forward to your followup letter.

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Last reviewed: By John M. Grohol, Psy.D. on 24 Sep 2010

APA Reference
Randle, K. (2010). Early Signs of Schizophrenia?. Psych Central. Retrieved on July 22, 2014, from http://psychcentral.com/ask-the-therapist/2010/09/24/early-signs-of-schizophrenia/

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