Psychosis, Delusions, Substance Abuse: Possible Schizophrenia?
I know I am suffering from symptoms of schizophrenia but I also know I am not a doctor & self diagnosing can sometimes be counterproductive. I am hoping you can lend some insight to my current situation. I was hospitalized on March 1, 2014 after suffering from my first recorded psychotic episode (psychosis, delusions, and cannabis abuse is what my discharge paperwork listed). I was held in the hospital for 12 hrs before being released to the care of my boyfriend, with a “follow up” appointment in May of this year. I am hoping to be seen before then by a psychiatrist, pending my finances. I am an alcoholic, 10 months sober. I only drank from the age of 20-23, but I drank so heavily I went into acute liver failure on May 31, 2013. I attend AA meetings regularly & have no desire to drink, I know it will kill me & I want to live. I also know marijuana can worsen or bring out certain symptoms of mental illnesses; my intent was not to abuse the substance but in retrospect I believe I did. I tried smoking cannabis one time when I was 21, hated how it made me feel, and didn’t touch it again until 3 months ago. I know I have a problem with substance abuse but I am now more concerned with my recent diagnosis, as I am worried a mental illness is contributing to my addictive tendencies, and overall making it impossible for me to live & be a productive member of society. I had my dream job but lost it as a result of my psychotic breakdown. The only medications I am taking for mental health are Zoloft for depression, anxiety, and occasional panic (I was placed on the medication before the psychosis). I’ve done a lot of reading on your website & on psychology today, I know I’ve exhausted all resources on my end as to what is wrong with me. Can you offer any insight? What should I expect? Should I see a Doctor before May?
A. You are correct about self-diagnosis, it can be counterproductive. You believe that you have schizophrenia and though I cannot know with certainty, your symptoms do not seem to warrant that diagnosis. My contention is further supported by your discharge paperwork which stated that you had “psychosis, delusions and cannabis abuse.”
Psychosis is a break with reality. People with schizophrenia have psychotic episodes, but in order to receive that diagnosis, your symptoms would have to have been present for at least six months. Related psychotic disorders, such as brief psychotic disorder or schizophreniform disorder, are characterized by having symptoms for at least one month and less than six months, respectively.
It is possible that your psychotic episode was induced by your cannabis abuse. Studies have shown that increased use of cannabis is associated with an increased risk of psychotic disorders such as schizophrenia.
Your ultimate goal is to “live and be a productive member of society.” To achieve that goal, you should focus your efforts on maintaining your psychological stability and abstaining from substance use. The most effective way to accomplish your goal is to seek counseling. A therapist can support and guide your efforts to maintain sobriety and psychological stability.
Yes, you should also see a psychiatrist who can design a medication regimen that targets your depression and anxiety symptoms.
It would be a mistake to ignore the advice of the hospital treatment team who recommended outpatient treatment. Going forward, it will be important for you to have the aforementioned support systems in place to prevent you from using substances and assist you in maintaining your psychological stability. Having those psychological supports in place will greatly assist you in reaching your life goals. Please take care.
Dr. Kristina Randle
Randle, K. (2014). Psychosis, Delusions, Substance Abuse: Possible Schizophrenia?. Psych Central. Retrieved on January 19, 2017, from http://psychcentral.com/ask-the-therapist/2014/04/03/psychosis-delusions-substance-abuse-possible-schizophrenia/