I had the diagnosis of paranoid schizophrenia with depressive affects and I am still on medications, but I am seeking help to stop my weird behaviors as well as emotional hypersensitivity. I like being requested to go for counseling/ therapy/ medical interviews/ check-ups/ pressured into sex (I will even daydream about the process), I am an obsessive knuckle and joint cracker for no reason (whether in public or private), I get anxious or excited easily, I self-pity sometimes and enjoy it, and I always weep when I am alone after being criticized (should I try not to). Am I lonely and why? (Does that mean I need more emotional attachment and should seek marriage) Hope to get some input and advice from you. Thank you very much.

A. Perhaps some of your behaviors could be considered “weird” but some would not. You like being requested to attend treatment and being pressured into sex. What exactly do you mean by “being requested?” It may be that when someone requests that you attend treatment, you interpret it as them caring about you.

You also characterized your desire to “be pressured into sex” as being “weird.” Sometimes people have fantasies about being the submissive partner during sexual relations and this fantasy is relatively common. If I were interviewing you in person, I would ask you to explain in more detail what you meant by “being pressured.” Without that information I cannot characterize your behavior as being “weird” or not.

Obsessively cracking your knuckles and joints, being anxious and easily excited and crying alone after being criticized, may be indicative of anxiety. I would need to know how often these issues arise and in what situations, to determine if they are outside the norm. For instance, what do you mean by obsessively? Every day, all day? Only when interacting with certain people?

Without being able to gather more information about the aforementioned issues, it is difficult to provide an accurate assessment of the problem. I would recommend talking about this with your mental health professionals to determine if there is a problem. Only a mental health professional who interviews you in person could answer your specific questions and determine whether or not there is a problem. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

I see and hears things that none else can see, mainly demonic faces everywhere that looks like a zombie looking alien with huge goat looking horns, the other things i see could be black shadows that fly so quick past me or someone else with me that it looks like a black bird thats flew past, or even see things that im afraid of like when i seen millions of spiders all over the floor but was told nothing was there. i hear voices that tell me i should cut myself or try to kill myself and the voice sounds evil,not human, i sometimes also hear like as though the telly or radio is going off but nothings on at the time. there are times i end up having really high moods where i end up going out shopping spending £100s in a day on just stuff to use for all my ideas i have in my thoughts, when i think of lots of ideas i cant concentrate when others try talking to me, and i end up shouting at them aggressively just to be quiet while i think. according to my friends or family i dont make sense to them or think of too much and talk too fast for them to know exactly what ideas im talking about. I have told my doctor all of this and a counsellor but none of them seem to believe a word i say as though they just think im a freak or making the whole thing up, what should i do? as its getting worse every week.

A. Your symptoms are unusual. What you are seeing and hearing is distressing to you. Your symptoms seem indicative of an ongoing, untreated psychosis. You are also experiencing mood swings and having difficulty controlling your behavior. If you are currently in the midst of a psychotic episode, then it makes sense that you would have difficulty controlling your mood and behavior.

Psychotic episodes require immediate treatment. They typically do not get better on their own. Medication could significantly reduce or eliminate your symptoms.

I understand that you have told your doctor and counselor about the symptoms but it’s unclear why they have not taken action. If they continue to ignore your symptoms, then you must find a different set of mental health professionals who can help.

I am also concerned about the voices telling you to harm yourself. This is a common experience among people who hear voices. If you feel that you might harm yourself or someone else, then it’s imperative to go to an emergency room immediately. The hospital can protect you and ensure that you receive the proper treatment. They can also assist you in finding a treatment team who will take your concerns seriously. You must do what it takes to get the proper help. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

I think I have OCD, depression, and an anxiety disorder. I’m 41. I am going to see a therapist for the first time this week and I am kind of nervous. I don’t know how much to tell in the first visit. Should I tell her what I want to accomplish in my sessions? And how can I tell if this counselor will be right for me? Thanks!

A: Going to a therapist for the first time can feel like a huge leap of faith. I’m pleased that you are reaching for some help at this stage of your life with what, I’m sure, must be challenging feelings and behaviors. I’m guessing that those feelings have been with you for some time. From my point of view, however long you’ve suffered with depression and anxiety is quite long enough. Give yourself credit for taking steps to do something about it.

Please don’t worry about what to say or do. It may be your first time with the therapist but it’s not the first time the therapist has seen a client. She or he will know what to do. Usually a session starts with a little paperwork (particularly if you want to bill your insurance) and some small talk – just to help you get comfortable. Then the therapist is likely to ask an open-ended question like, “What brings you to see me?” Simply share how you’ve been feeling and what led you to finally call for a little help. Your therapist will help you tell your story by asking some questions and making some comments.

As far as knowing whether the therapist is right for you: Please trust your instincts. If you feel reasonably comfortable and think you can talk to this person, you probably can. If, for any reason, you have a negative gut reaction, trust that as well. If you feel judged or diminished in any way, you’ll be too on guard to talk as openly and freely with the therapist as you need to for therapy to be helpful. The relationship is central to the success of treatment. It’s perfectly okay for you to see a few therapists for a first session and to choose the person you feel most comfortable with.

I wish you well.
Dr. Marie

For about 10 years I have been struggling with depersonalization and anxiety and up until now I have been able to live with it. Recently after having my wisdom teeth out I had a very bad panic episode and started reading about schizophrenia and woke up in the middle of the night with intrusive thoughts of hurting my fiancé. I had slight auditory hallucination one night that I knew where inside my head and not real in addition to very vivid dreams and have had a slight paranoia thinking that people hate me. I did a lot of research and found that I might be suffering from ocd and I have been meeting with a ocd specialist and have told him all of my concerns and he has told me that I have ocd, anxiety, and depression. I fear that I am losing touch with reality because it seems my symptoms are getting worse. I feel emotionally numb and have constant night sweats and have had no appetite for over three weeks. Since I was 20 I have had episodic fears that I have angered god and that the devil is out to ruin my life. Overall I just feel crazy and feel very detached from myself like someone else has inhabited my body and mind. I have been to several therapists over the years and none of them think that I have a psychotic disorder. The most worrying symptom is that I feel like time has sped up, it feels like 15 minutes had gone by while in actuality 2 hours have past. Usually I have years where I feel 100 percent normal and then every 2 to 3 years I have an episode where I feel crazy for about eight months. I really have no clue what to do about all of this, talk therapy has never helped and every day I just feel further away from the happy person that I used to be. I just want these intrusive thoughts to go away so that I can go along with my life. Do you thinking checking myself into the hospital would be a good idea at this point?

A. I’m sorry that you are suffering. You stated that you have been in therapy for years and it has not helped. Medication might be useful in treating your symptoms.

With regard to checking yourself into a hospital, typically, in order to be admitted to a psychiatric hospital, an individual has to be homicidal or suicidal, or in grave danger of imminent death due to their psychiatric symptoms. This is true in most cases. Even if admitted to the hospital, your stay would likely be brief, especially if you are not actively exhibiting suicidal or homicidal thoughts. Alternatively, you may be able to check in to a private psychiatric facility but there are potential drawbacks. It might not be reimbursable by your health insurance company and it could be very expensive. You may want to call the hospital or your insurance company directly for more details.

A hospital stay is a short-term solution but you may need something more for this long-standing problem. Medication might be the solution. Some people are reluctant to take medication but they shouldn’t be. There are many psychiatric medications that specifically target the symptoms you have described. A low dose of medication might significantly reduce your symptoms. You may only need it temporarily. Many people regard medication as a “lifesaver.” It could help you immensely. Discuss this option with your treatment providers. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice

Hi! I get mood swings that can last from an hour to a day where I can be depressed or really angry and I just I cant control myself sometimes but I cant concentrate very well and sometimes I just cant sit still. I was just wondering could that be just normal teenage behavior or bipolar or ADHD? And I have ADHD and OCD in my family. Thanks

A: Thank you for asking this question. It must be difficult for you to have these mood swings and concerns and still try to manage. But there is too little information from what you’ve told me to know if there is a diagnosis. But what I can say is that what you have described sounds well within the range of symptoms that go along with being a teenager.

The more important thing is that they bother you. I would talk to your school guidance counselor or your parents and go to your general practitioner to get a checkup. He or she will know if these things are outside of the norm.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

I have only worked with counselors in training so I haven’t been officially diagnosed, but they hinted strongly that I have social anxiety and OCD. I am a pharmacy student so I really don’t have time to keep dealing with it, but I don’t feel like I’m making any progress in therapy and as more and more time gets spent washing my hands (I was almost to 350 times yesterday) and writing and re-writing things I really want to say to people, I get less and less done which makes my stress level go up which in turn makes me even more anxious and increases the washing and inability to speak, and I am overwhelmed and my grades are not really doing so well. Should I just give up now, or is there any hope that this can get better? Sorry for wasting your time if this is a dumb question.

A. Washing your hands 350 times a day is quite excessive. In addition to hand washing, you spend a great deal of time writing, rewriting and deal with a great deal of stress and anxiety. This causes problems in school. Those symptoms are putting your pharmacy career in jeopardy. If you can’t pass your classes, then you cannot graduate.

You should never “give up.” I’m not certain why you are seeing “counselors in training” but you should immediately switch to a licensed mental health professional with a track record of successfully treating social anxiety and obsessive-compulsive disorders. Seeking treatment with a licensed professional, one with a solid track record, is the most efficient way to deal with your problem.

In the absence of treatment, anxiety disorders tend to become progressively worse with time. That is why it is imperative that you seek help as soon as possible. Effective treatments exist. The “find help” tab at top of this page can help you locate a specialized professional in your community.

Contact at least three to five mental health professionals. Detail your symptoms. Ask if they’ve successfully assisted others with similar problems and then make an appointment with the one that makes you feel the most comfortable. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

I’ve been with my boyfriend For about 8 months now, and this is my first real relationship. It hasn’t been easy, we both have depression, and I’m a generally jealous person. Over the summer, his ex tried to get back with him, and although he rejected her, it’s lead to a great deal of insecurity for me. About a month ago, almost two months ago, things started to get terrible. The first thing I remembered was that he saw a picture which aroused him, and that upset me. I knew it was normal, but I felt horrible for about a week. and then after that, I started doubting he loved me, something I had believed for months (this wasn’t because the picture incident). The next week, my fears moved onto something else, and everything’s been rotating. A lot’s happened in these couple months. I confessed to cheating 5 months before that, he forgave me, we moved on. I continued worrying maybe there was something I hadn’t told him, although he told me I didn’t need to say anymore, that it’s okay and he wants to be with me. to sum things up, there’s always something for me to worry about, there’s no break. I recently realized I used to flirt with men, that I didn’t even like, just because when they liked me it made me feel better about myself. So I started being careful about everything I said to guys, making sure I wasn’t trying to attract them. But I still worried, and So I’ve stopped talking to men online. But now I’m worried that maybe I’ve been trying to attract females as well, when I’m straight. I feel terrible about everything I’ve done, and even though my boyfriend isn’t concerned about my cheating again, I just can’t trust myself. I could say hi to a person, and hours later wonder if I was intending to attract them. I can’t tell the difference between when I’m trying to be friendly or when I’m flirting, and it’s driving me insane. And the worst thing is that even if I move past this, I’ll be worried about something else the second after. My boyfriend’s become fed up of me talking to him about all of this, since he has his own depression to deal with, and I understand that. I just don’t know what to do anymore; I can’t stop over analyzing each of my actions, and I can’t stop worrying and picking out details of my past mistakes.

A: Since you are still in high school I would encourage you to take the time to talk to the school’s guidance counselor. At the core of your issue is that you cannot trust yourself. This is important work for you to focus on. While the relationship concern is front and center now, trusting yourself will be important for your well-being for the rest of your life, Make learning how to improve this feature in your life the number one priority and you will see how the conditions improve. Often we can’t begin to trust ourselves until we talk with someone who can help us see our lives differently. You school counselor is the person to begin with.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

I’ve been diagnosed with purely O OCD last month but I don’t know if my thoughts are obsessions or already delusions. I don’t know if I’m losing my grip on reality but just a good few hours ago, a random thought popped into my head: “What if everyone were cats or aliens and I’m just imagining them as people?” It never stops to bother me now and even though I know it’s completely ridiculous, I just can’t help but worry that I might start to believe it and see people that way. It’s like my belief systems are being challenged cause I don’t have a set religion as of yet. (i.e.: my OCD’s caused by some entity) and I don’t know what to do. I’ve always had faith in science and now it’s hit me that there’s probably some supernatural forces at work in my mind even though that sounds a bit absurd. I’ve found solace and comfort in the company of people when I have OCD panic attacks so maybe my brain did this for me to become more miserable. I just don’t know what to believe anymore. I’ve been on two meds and they helped me feel like myself again for two weeks but then it’s back to this situation as soon as I dabbled with the idea of something paranormal working against me. I just fear losing control and becoming clinically insane and non-functioning. :/ Do you think I’m slowly slipping into schizophrenia or insanity? Are these just obsessive thoughts or already delusions? I worry that I might convince myself into believing/doing these things and that horrifies me. Everytime I talk to someone now, a thought pops up in my head and says ‘Why am I talking to this alien?’ I know it’s too ridiculous but I don’t know what to do anymore. Please help ASAP! Note: I’m currently on Lexapro and Rivotril.

A. Individuals with a specific type of obsessive-compulsive disorder (OCD) commonly believe that they are developing a mental illness, often schizophrenia, because it’s considered to be the most severe and they fear it the most. They might become obsessed with the fact that they are going “insane” or developing psychosis. It is quite common. The thoughts that “pop into your head” are likely obsessions, a symptom of OCD. My sense of the situation is that your symptoms are most likely associated with OCD and not the development of psychosis but only an in-depth, psychiatric interview, with a mental health professional, could provide a diagnosis.

The fact that you have been diagnosed with OCD, and are being treated for OCD (rather than schizophrenia) increases the likelihood that your symptoms are not indicative of psychosis.

It is a concern that you are taking two psychiatric medications, yet continue to experience significant symptoms. It may mean that your medication needs adjusting. Report your symptoms to your prescribing physician who can then adjust your medications accordingly.

If you are not currently in psychotherapy, you should consider it. OCD is a complex disorder which often requires both medication and psychotherapy. One without the other is generally not recommended. Please take care.

Dr. Kristina Randle

Put simply, if I hear an argument that to me sounds illogical, incomplete, inconsistent or based on a poor factual footing, I will obsess over that argument. I lose sleep. I become difficult. I will yield and stop once the argument establishes what feels like consistency or correctness or a logical impasse (i.e. I don’t need to win, I just need the arguments to make sense). But until that point, I feel like I am going nuts. Topic doesn’t matter, it is the argument itself.

I recognize that the evaluation of the argument is a subjective thing – but that doesn’t matter, I still have the same reaction.

Is this common? Do other people report this? What is the source of it?

A. Some people compulsively wash their hands because they obsess about potential contaminants. Others refrain from stepping on cracks in sidewalks because doing so might bring about negative consequences. There are also those who are compulsive about symmetry. Everything has to be “even.” In your case, you obsess about arguments. There are potentially thousands of compulsions and obsessions, all of which are characteristic of obsessive-compulsive disorder (OCD).

OCD is a specific type of anxiety disorder. Individuals with OCD struggle with intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that if left untreated, significantly disrupt their lives. The latest statistics show that over a one-year period, approximately one percent of the American population has OCD. The average age of onset is 19 years old.

As you noted, this problem causes you to become “difficult.” It’s proof that this problem is disrupting your life.

It would be advantageous to consult a mental health professional. You may not need many sessions to decrease your symptoms. Length of treatment will depend on the severity of the problem. Psychotherapy for OCD typically involves coaching, in regard to tolerating anxiety, and learning more appropriate responses and reactions to situations in which anxiety occurs. Depending on the type of psychotherapy, the therapist may focus on the cognitive thoughts that arise with the compulsion to argue. In some cases, medication is recommended for OCD in combination with psychotherapy. Please take care.

Dr. Kristina Randle

I have been wondering this for a while now, because I have a weird habit of eating things off of my body. I don’t eat like, soap or rocks or paper or anything, but I eat like, scabs, dandruff, boogers and eye mucus.i am concerned because I do not know what it could do to my body by eating this stuff. I have been doing it for as long as I can remember and I’m 18 years old now and still doing it. I would see a doctor about it but have no insurance or money to do so. Could I get someone’s honest opinion please?? Thank you to all.

A: Anxiety may be the underlying cause here rather than pica. Just as when people bite their nails or pick their skin, stress and anxiety may be at the root of it. You may want to explore meditation or regular exercise as a way of coping if therapy isn’t an option.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

I am worried that I have an anxiety issues. While that being said, I am curious as to which one. Recently, I have been stressed which has caused what symptoms of anxiety I have to skyrocket. Sometimes I find myself thinking strange thoughts such as random horrible things that could happen to my family members and it becomes a constant worry. Such as simple things like my relative tripping and busting their head open at school. I continuously have dreams of being kidnapped or that I am being watched. I refuse to shower when I’m home alone. To a certain extent, I am very paranoid. I am scared a lot. I don’t like being alone, and my fear of the dark is at an irrational level. I constantly have thoughts that someone is in my room or that I might wake up and my family will have been murdered while I was asleep. Also, I find my rational fears to lead to irrational outcomes. Such as me being terrified of dying while on a roller coaster. My parents tried to take me on one and rid of the fear, but I cried and had what I believed to be an anxiety attack. If I’m in a rut or maybe stuck in traffic or in a situation where I’m not completely sure what to do, I freak out and get very frustrated and angry. I also find myself feeling nervous a lot for no apparent reason. My muscles will clench up and when I realize it I try to loosen up and I begin to shake. I am worried that my anxiety is past regularity, and that I may need it checked out. I would just like a little feedback to inform me if I am being a drama queen, or if it is something that needs to be looked into. I would also like to add that I was raped at age 14 and I haven’t done anything to cope with it. I pushed it aside and haven’t really done anything about it. I believe that plays a high role in what I believe to be my anxiety. So my questions would be: Do I have anxiety to the point that it needs looking into? Do I seem to have a disorder that needs to be looked into also? And is there anything that can rid of these fears and paranoia? Thank you so much for your time.

A. You are not a “drama queen.” Your anxiety is significantly disrupting your life and causing you great distress. It is “past regularity.” Though anxiety is clearly a problem for you, determining which specific type of anxiety disorder is difficult to do over the Internet. You may have symptoms of obsessive-compulsive disorder and panic disorder but I cannot know that with certainty. Clinically, your symptoms fall under the broad umbrella of anxiety.

It is advisable to be evaluated by a mental health professional. Choose a therapist who specializes in anxiety disorders and who has a proven track record of assisting clients with these disorders.

In the meantime, you may want to consider completing anxiety workbooks or consulting other self-help materials. A particularly effective anxiety workbook is The Feeling Good Handbook by Dr. David Burns. Dr. Burns utilizes a cognitive approach to overcoming anxiety and phobias. Cognitive therapy is a therapeutic approach that focuses on identifying and correcting dysfunctional and irrational thinking.

Psychiatric medication may also help. Medication doesn’t cure anxiety disorders but it can significantly decrease the severity of the symptoms. Please take care.

Dr. Kristina Randle

Im 13 years old and im in middle school. I have a problem with picking my skin, its not too bad but for me its horrible. I bet if i asked for help (my parents) they would gladly give it to me, but im to embarrased to ask for help. I dont know whats gotten into me i play tennis and volleyball, i have a good family , and good friends, and i think i would actually be pretty if i didnt pick. I guess im the kind of person that needs help just acts like i dont need it but i do. i think i might have Dermotillomania. I dont know for sure but ive researched it and it seems like i have symtoms. IMy family is not wealthy, but i think we could afford getting help , but im to embarrased. Thanks.

A: Thank you for writing. And thank you for having the courage to confront your problem. Skin picking is not only unattractive. It is also potentially dangerous because you are vulnerable to infection. Believe me: Your parents would much rather get you the help you need to overcome this habit before it gets so serious that you are battling an infection.

Dermatillomania is an impulse control disorder. There are similarities with obsessive-compulsive disorder. Once a person gets started with this kind of habit, it is difficult to stop on one’s own. Fortunately, there are treatment options. There are medicines that can help you control the impulse and there is therapy to help you find less self-harming ways to deal with whatever anxiety may be underlying the habit. Get yourself into treatment and you can conquer the urge.

Please follow your own good instincts and ask for help now. If you could have stopped picking on your own, you would have already done it. You describe a generally healthy and happy life. If you keep picking, people are going to start to ask you what is going on with your skin. That could make you withdraw from the activities and friends you enjoy which would be a shame. Get the help you need now and you can build on the good start you’ve made for your teen years.

I wish you well.
Dr. Marie

I need help. I wake up in the morning and go to bed thinking about my “overjet.” It is something that I didn’t know much about until a few months ago. I have done a ton of research about it which, I suppose, contributes to the constant thoughts about it.I have always hated my teeth but I just recently became obsessed with fixing them. I barely think of anything else. I feel so disgusting and I feel like I will never be happy because of this. I don’t date and I believe that NO ONE will ever ask me out because I can hardly look at MYSELF. Please help me. I feel like this is running my life and I realize how psychotic I sound but this gets in the way of everything else in my life. Also everyone in my life makes me feel like I am shallow for wanting to feel pretty like everyone else.

A: Being concerned about protrusion of your teeth is a common orthodontic problem that people seek remediation for. In that way your concerns are very normal and understandable. You are not shallow for wanting to look good.

The part I would focus on is your belief system that because of this you will never be happy. One of the best books on the subject is by The Resilience Factor by Karen Reivich and Andrew Shatte. This will help you challenge your thinking and not feel so obsessed.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

My mind scares me. The way that I think. Sometimes I can’t even control it. I try to stop doing things or saying things but I just can’t. I really want to kill someone. Sometimes, I just have urges to hurt people. I am a compassionate person and I don’t like to hurt people, but I want to, if that makes sense.
My hands shake a lot.
I do have anxiety.
I am really extremely paranoid.
I have had a fear of being kidnapped since a very young age.
I don’t like to be alone or go places as I believe everyone is watching and out to get me.
Recently, I’ve even began to think that my family is plotting against me.
I don’t trust people and I don’t like to open up but i’ve began to think that I need serious help.
I sometimes think that other people are in my mind.
Like, hearing my thoughts and telling me stuff.
I believe I am a werewolf.
Seriously, no joke, I believe that I will turn into a werewolf soon. I don’t know why but I feel that I am one.
I sometimes think I have super-powers, like that I try to use.
I am very, extremely claustrophobic.
I have symmetrical OCD.
Sometimes, I just have very random, irrelevant requests that I feel I am not in control of.
The other night, I really, really felt the need to play twenty questions with my sister.
I don’t know why and it felt like an uncontrollable feeling.
I kept following my sister around, asking her to play it with me.
Doesn’t sound so bad, except I wasn’t trying to keep asking her or be a creep, but it was just happening.
Then, she called me a psychopath. She said that I legit act like one. I shared some of the thoughts that I have that scare me with her and she think’s I am insane.
I want to kill myself, but I stay for my mom.
I get really depressed and then very energetic randomly, and in fazes.
I do act normal sometimes and have control of myself and my mind.
I am a very sexual person, also. I am turned on pretty much 98% of the time.
I don’t know what else to say, except that I am scared.

A. I am sorry that this is happening to you. I can understand why you are frightened.

Your symptoms may be indicative of bipolar disorder with psychotic features. I can’t know that with certainty because only an in-person evaluation by a mental health professional could determine a diagnosis.

What is clear from your letter is that your symptoms are causing you a great deal of distress. At this point, you’re unable to control your symptoms. For those reasons, you should be evaluated by a mental health professional. A mental health professional could gather a detailed psychosocial history and determine what may be wrong and begin treatment immediately.

Your symptoms are frightening but they are treatable. In your case, a mental health professional is likely going to recommend both medication and psychotherapy. A low dose of medication might decrease many of your symptoms, especially the paranoia and anxiety. Medication can also stabilize your mood.

I hope you will consider my advice. It is especially concerning that you have contemplated suicide. Thankfully you stated that you will not end your life because of your mother but the fact that you were considering it is indicative of how much you are suffering. Please don’t hesitate to get the help that you need and deserve. There is no reason to suffer when excellent treatments are available that can decrease or possibly even eliminate your symptoms. Please take care.

Dr. Kristina Randle

First of all I want to apologize if my English is bad. I developed extensive fear of having/being on the onset of schizophrenia (and psychosis in general) after I read medical articles on the internet about symptoms of schizophrenia. I noticed that I sometimes hear “voices” in my head, more precisely in my mind, usually when I’m lying in the bed and waiting to fall asleep. Now I know of hypnagogic states and hallucinations and visions in half-sleep state, but my “voices” (which I do not actually hear, as if someone talk to me, but like inner speech in my mind) and closed-eye visualizations of vivid images sometimes occur when I’m aware that I’m still awake, sometimes even during the day, usually but not exclusively when I’m tired. I can describe my “voices” as thoughts of random (often nonsensical) short sentences or words that are usually non-related to the topic I think of at that moment. They come unexpectedly, I feel like I’m not choosing what is going to be “said”, but I know they are just thoughts and that they are produced by certain processes in my brain, even if I don’t understand how and why, and is having this condition sign of loss of mental health. I don’t believe that someone is controlling my mind, or that someone is putting those thoughts in my mind, or that I’m reading other people’s minds etc. I do not talk to these voices because I do not consider them to be entities which you can talk to. One of other problems I consider potential symptom of psychosis is that I often have very random and nonsensical inner speech, which I stop as soon I realize I’m having it. I am also occasionally paranoid, more precisely I get very anxious if there is any possibilities for something bad to happen to me, and I just can’t put those catastrophic thoughts out of my head, even being aware that they have low chances of happening. I have lot of irrational thoughts which I recognize as irrational. I was diagnosed OCD several years ago after I was being frightened for a months of possibility that I am bisexual (I could not explain to myself whether certain emotions I feel toward men were homosexual impulses or not, or whether I like these feelings and impulses or not). Now other therapist agrees that I have OCD but says that I also have borderline personality disorder. I occasionally doubt in my diagnosis and seek reassurance. I also sometimes doubt that maybe I did not exposed my problem to therapist on appropriate way, or that my therapist do not want to tell me my accurate diagnosis because I could be frightened of the fact I’m having/developing psychosis. The problem and anxiety is bigger if I more often think about “developing schizophrenia” ad vice-versa. I can feel ok for long periods of time, but suddenly one of those “voices” just appear in my head and I get really upset and I get anxious for days.

I know that there are lot of differences in between “my case” and typical schizophrenic/psychotic case, and I’m aware of my history of (predominantly obsessive) OCD, but I just can’t help myself to overcome this problem and live without these unusual worries. My therapist has prescribed me Rissar – 2mg; Rivotril – 2mg; and Cipralex – 10mg for dialy use .Thanks in advance.

A. You have been thoroughly evaluated by mental health professionals who believe that your symptoms are characteristic of obsessive-compulsive disorder (OCD). Though I do not have all of the details of your case, it seems that their diagnosis of OCD, rather than schizophrenia, is accurate.

Individuals with certain types of OCD are overly concerned with the possibility that they have a serious health or mental health disorder. Individuals with that type of OCD often focus on what they consider to be the “worst” health or mental health disorders. Schizophrenia would fall into that category.

If you have not done so already, I would recommend speaking to your therapist about your fear of developing schizophrenia. In all likelihood, it’s a symptom of OCD. It is important that your therapist knows about how strongly you fear developing schizophrenia.

OCD tricks the mind into believing things that are not true. In that way, it can be an insidious disorder because it significantly disrupts one’s ability to see reality clearly. Thankfully you are participating in treatment. I wish you well. Please take care.

Dr. Kristina Randle