It is not uncommon for individuals with panic disorder to fear that they may be “going crazy” or losing control. These are common fears. You mentioned at the end of your letter that you are afraid of losing control and losing contact with reality. These fears are consistent with the symptoms of panic disorder.
You discussed the specific possibility of developing psychosis or schizophrenia based on two specific irrational thoughts: what if your mother would harm you and wondering whether others are “on something.”
You describe being upset about your thoughts. I am not certain if this is because the presence of new irrational thoughts is fueling your fear of a developing psychosis or schizophrenia, or if you are concerned because you believe them to be true.
What is the subtle but key distinction? Whether you can determine the difference between reality and non-reality. My question to you would be: Do you believe that your irrational thoughts are true?
If you believe that your mother might actually harm you and there is no basis for this belief (i.e. she never threatened to harm you, she’s never harmed anyone, there’s no reason to believe that she may harm you, and so forth), this would be considered a paranoid ideation or a delusion.
If you believed that people around you were “on something” and because of this belief you no longer associated with them, despite evidence to the contrary, then I would be concerned about the possible development of a psychosis-based disorder.
Having irrational thoughts does not necessarily indicate psychosis or schizophrenia. The real concern is if you believe that your thoughts are true despite there being no proof, no evidence to support your beliefs or in the face of evidence to the contrary. By definition, a delusion is an erroneous belief held even when there is evidence to the contrary. Delusions and paranoia are characteristics of psychotic-based disorders.
You are correct to be concerned about these symptoms. Unfortunately, I cannot definitively answer your question unless I am able to interview you in person. I believe you should be evaluated by a mental health professional. He or she can determine if your symptoms are related to panic disorder or they are indicative of a possible psychotic disorder.
It is also important to note that you wrote a very logical and well-prepared letter. This shows that you are thinking clearly. Thought disorganization is a sign of schizophrenia and other psychotic-based disorders. There’s no evidence in this letter of that particular symptom. Also encouraging is the fact that you are very self-aware of your symptoms. Self-awareness is often an essential ingredient in the successful treatment of mental health disorders.
One final thought, you mentioned that you have utilized a specific form of yoga to help decrease your panic symptoms. It is very good that you are utilizing yoga to decrease your symptoms. I would encourage you to continue yoga classes but I would also recommend medication and psychotherapy. Medication and counseling, in addition to yoga, could be a very efficient way to cure the symptoms that are degrading your life.
If you choose to explore medication as a form of treatment, it is recommended that you see a psychiatrist. Primary care physicians can and do prescribe their patients psychotropic medications. Many are very good and highly qualified but a psychiatrist has years of additional training in the field of mental health treatments and disorders.
Psychology Today has a listing of mental health professionals. By typing in your ZIP code, you may be able to find one in your community.
Without treatment, your symptoms may become worse. With treatment, the quality of your life can be significantly improved. Do not let fear and anxiety continue to degrade your life. I hope that you will consider professional mental health treatment. It can benefit you but only if you are willing to try. Thank you for your question.
This article has been updated from the original version, which was originally published here on May 4, 2010.