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Worrying about Some Possible Symptoms

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So, a bit of context about me, I see a therapist about depression, social anxiety and self-harm. I’ve mentioned before to two different therapists about two instances separately where I had a very forceful and compulsive urge to do something. By something, I mean things like yell “fake” at a Remembrance Day service, even though I respect troops etc., jump off of a high ledge/cliff when I get close to the edge, punch my favourite aunt in the face out of nowhere. These would probably last for as long as I am in that situation, e.g. 15 min talking to said aunt.
I’ve tried ignoring these thoughts that come into my head, but it doesn’t tend to work. I argue with myself, but its like the thoughts will not go away, I keep interrupting myself and I don’t trust myself.
Lately I’ve been thinking about whether my arguing with myself isn’t actually with myself. The intrusive voice seems to sound like a mix between my own voice, my mother’s and my aunt’s. It’s a very sweet-toned feminine voice, but it’s very – forceful i think would be the right word?
I’m starting to question whether I have Schizophrenia. I have an uncle who has it, but I’ve never met him and *technically we are not related. However, long story short – via Ancestry, there is a good possibility that there is a bloodline connection.
I’d just like to know whether you would strongly recommend that I talk to my therapist.
I’m not confident in my current, family doctor mainly because she asked me if my self-harm was simply for attention. She looked at me quite strangely when I said my reason was that I felt like I needed to ‘punish’ myself. Also, my father’s & said uncle’s father whom I am close to is getting closer to passing away, and there is a bit of history between my uncle & grandfather, so I’d like to know whether it’s a seriously likely issue before I scare my family.
Regarding my depression and social anxiety, I struggle to deal in just about any social situation that is face to face, I mainly feel like people just know everything about me, like they can’t directly read my thoughts but they just know. I understand that this isn’t a diagnosis or anything, just don’t want to risk ridicule I guess.

Worrying about Some Possible Symptoms

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A.

You should tell your therapist about your strong urges. Your therapist needs to know about everything that’s going on, especially this particular symptom. It’s a symptom that is not necessarily consistent with depression, anxiety or self-harm. The more information they know about what may be wrong, the easier it will be to ensure that you are receiving the right treatment.

You also mentioned the possibility of hearing a voice that is not yours. Hearing voices is associated with psychotic disorders such as schizophrenia. The key to knowing if you are hearing voices or if it is your conscious mind (i.e. your inner voice) typically is if the voice sounds like it’s coming from outside of you. It would be an external voice, a voice that you do not recognize. In your situation, you recognize it is as partly your voice, in combination with your mothers’ and aunts’ voices. Those voices would be recognizable to you so it’s difficult to know if you are hearing voices in the clinical sense or if you are hearing the voice of your conscious mind. That is something that should be explored in therapy. This is yet another reason why it’s important for you to report all of your symptoms.

Relatedly, you also mentioned self-harm. People who engage in self-harm often have a very critical inner voice. Negative and critical internal dialogues are also among people with depression. Possibly, the voice you hear is a critical inner voice as opposed to an external voice. Again, this is something that should be explored in therapy.

You are now beginning to question whether or not you have schizophrenia. There is a family connection. Research indicates that having family members with the disorder increases the possibility of other family members getting it too. It is hereditary, at least in part. However, environmental factors are thought to be contributors as well.

Environmental factors often include abuse and drug use, among others. A thorough mental health evaluation could help to determine if schizophrenia is present.

Regarding your family doctor, she obviously wasn’t familiar with the research about self-harm. You mentioned having engaged in self-harm to punish yourself. That is common reason why some people engage in self-harm. Unfortunately, your doctor seemed ill-informed about the reasons why some people engage in self-harm. Not all doctors would react in the way that she did. In fact, most would never have responded in the manner that she did. They would have been more supportive, open-minded and likely more knowledgeable about self-harm. Perhaps you need a different family doctor.

I understand your fear about being ridiculed, especially after the incident with your family doctor. However, I doubt you would have that same experience with a therapist. Therapists are knowledgeable about these kinds of issues and will not judge. Consider therapy a no judgment zone. If on the off chance your therapist did have an inappropriate reaction, then you can always find a new therapist. Not all therapists are the same. Some are better than others. It’s always best to find one you like and who makes you feel a little bit better after every session. Good luck with your efforts. Please take care.

Dr. Kristina Randle

Worrying about Some Possible Symptoms

Kristina Randle, Ph.D., LCSW

Kristina Randle, Ph.D., LCSW is a licensed psychotherapist and Assistant Professor of Social Work and Forensics with extensive experience in the field of mental health. She works in private practice with adults, adolescents and families. Kristina has worked in a large array of settings including community mental health, college counseling and university research centers.

APA Reference
Randle, K. (2019). Worrying about Some Possible Symptoms. Psych Central. Retrieved on December 5, 2019, from https://psychcentral.com/ask-the-therapist/2019/11/20/worrying-about-some-possible-symptoms/
Scientifically Reviewed
Last updated: 18 Nov 2019 (Originally: 20 Nov 2019)
Last reviewed: By a member of our scientific advisory board on 18 Nov 2019
Published on Psych Central.com. All rights reserved.