Constantly Changing Diagnoses

By Kristina Randle, Ph.D., LCSW

I was first diagnosed in 2008 after I had been hearing voices for a little under a year. After 1 1/2 to 2 years I was stabilized with meds. No voices. Only a couple of suicide attempts. I then had a baby. About a year and 1/2 later, voices returned. Even more evil and cruel than before. Medication is not working for them, but makes it slightly more tolerable. My diagnosis has gone from bipolar with psychosis, schizoaffective, severe separation anxiety, PTSD, dissociation, and probably more. Can dissociation and anxiety really cause very real voices? They pick on absolutely everything, accuse me of horrible things, humiliate me, threaten to torture and murder me, constantly tell me their real, ask the same things over and over for 2 years now, tell me I’m psychic, etc.. why won’t this end? I’m in therapy and see a psychiatrist regularly. What could be going on? Why do they constantly talk sometimes begging for me to kill myself? It’s not tolerable at all. I can barely do anything anymore. Sometimes now I end up responding out loud in public, only to realize I probably look crazy, then panic attacks start. Please help me.

A. I’m so sorry for what you’re experiencing. There was a time when you were stable. That’s proof that at one time medication worked to eliminate the voices. Are you still taking that same medication? Try to think back to that time when you were stable. What was different about your life and what contributed to your stability? Answering those questions may be key to finding a solution to this current problem.

The medication you are currently taking is not working, but that may be because you are on the wrong dose, the wrong combination of medications or you need to try a new medication. It’s not uncommon that medication needs to be adjusted.

It’s good that you’re in therapy and have a psychiatrist. I’m not certain how much you are telling them about your symptoms. They need to know what you’re experiencing, in great detail. I would strongly encourage you to tell them about the voices, especially your psychiatrist, who can adjust your medications. Typically, the treatment for hearing voices is medication but therapy might also help.

You are experiencing anxiety, which may be exacerbating the voices. If your therapist could assist you in decreasing your stress levels, and thus your level of anxiety, your symptoms would likely diminish.

It might also be advantageous for you to undergo a medical evaluation to rule out an organic cause. On rare occasions, psychiatric symptoms, such as hallucinations, are the result of an organic brain disorder. Discuss the possibility of your having a medical evaluation with both your therapist and psychiatrist.

If there’s ever a time in which you feel that you might harm yourself or someone else, then go straight to the emergency room. The hospital staff can keep you safe and treat your symptoms accordingly. Your safety and the safety of others is of paramount importance. Please take care.

Dr. Kristina Randle

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Last reviewed: By John M. Grohol, Psy.D. on 20 Mar 2014

APA Reference
Randle, K. (2014). Constantly Changing Diagnoses. Psych Central. Retrieved on November 28, 2014, from http://psychcentral.com/ask-the-therapist/2014/03/20/constantly-changing-diagnoses/