It’s impossible to provide a diagnosis over the Internet. That’s why it’s always best to visit a clinician, in-person, for a full evaluation and diagnosis. The interesting thing is, that you have done this and it did not quell your fears. Despite their objective review of your symptoms, the idea of having schizophrenia still dominates your thoughts. It’s possible that this is the result of an anxiety disorder, of which you have been diagnosed, among other things.
As I have mentioned many times in this column, people with anxiety inquiring about possibly having schizophrenia, is the most common question that I receive. It’s also very common for them to have used drugs, experienced depersonalization and or derealization, just as you have, which only serves to increase their fears. In some respects, it’s an understandable concern given your fear; however, you are opting not to believe in reality. You had an evaluation that indicated you do not have schizophrenia. The evaluator knew about all of your symptoms, had the opportunity to ask you many questions, and schizophrenia was not the diagnosis they gave you. That should reduce your fear of developing schizophrenia.
In addition, you mentioned that the voices you hear are not external and are instead internal, which is yet another sign that it is anxiety and not schizophrenia. The hypnagogic hallucinations are likely more characteristic of a potential sleep disorder or, as you mentioned, your heightened state of anxiety. It is important to believe in the truth, and to not let anxiety get the best of you. Understandably, this is easier said than done but it needs to be done nonetheless. It can be done if you focus, try harder and utilize the assistance of mental health professionals for guidance.
You stated that your mother has schizophrenia. You also indicated that you understand that there is a 13% chance of your developing schizophrenia because you have an immediate relative with the disorder. Clearly, you’ve done some research about schizophrenia.
The part you may have missed, and perhaps the most important part, is that illicit drug use increases the probability of developing schizophrenia. Given your concern about developing schizophrenia, and your increased likelihood of developing it, because of the family member connection, it’s surprising that you would put yourself in greater danger by using illicit drugs. Thankfully, it seems as though the aftereffects may have subsided but you may not be as lucky the next time around. It is wise to stop using drugs altogether and to protect your brain as much as possible. Using drugs is very risky and could lead to the potential development of a severe mental illness. Had you not used drugs, you may not have developed what ultimately was diagnosed as psychotic depression. Avoid illicit drug use at all cost. It’s a choice. Choose to say no.
You mentioned having a number of evaluations and diagnoses but what’s lacking in your letter is any indication of treatment. The problem may be that you are not getting the right treatment or you’re not getting any treatment at all. If you were undergoing treatment, you may not have any symptoms and thus your fears would be diminished or nonexistent.
Contact a mental health provider and ask for treatment. You would likely benefit from counseling to deal with the PTSD and anxiety that is causing you to fear the development of schizophrenia. Medication may also assist with your symptoms and potentially the hypnagogic hallucinations. Finally, stop using illicit drugs and make sure you never use them again. You only get one brain you need to protect it as much as possible. I hope that I have answered your question.
Don’t hesitate to write again if you have additional questions. Please take care.
Dr. Kristina Randle