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Old 08-16-2008, 03:52 PM   #1
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Question If psychiatrists cant be sure btw anxiety disorders or schizophrenia. what do you do?

I posted this on an ocd forum and have copied slightly altered it and pasted it here.... Can anyone give some insight to this?
I will try to make this as short as possible, although i know this will be longer than most want to read through (sorry)...I am a friend and provide one to one support to a 30yr old man who has been diagnosed with GAD and a question mark with the diagnosis about a year ago (my friend admits he never told all in detail that was happening to him in fear of being locked up for having these thoughts and compulsions to act on them). Over the past 11years he suffered from anxiety/panic and depression and possibly ocd such as constant repeitive perfectionist thoughts, self absorption about having grand ideas of his perfectionist daily life as a lawyer (brought upto be and expect the best, high flying family with ocd tendancies and depression, and he was really good at everything, but a sensitive guy who depended alot on his families decisions for him). He has battled with depression and self reflection and self absorption for a long time, gave up his work as a solicitor 3 years ago. Since this time he went into hospital for observation and was treated with ECT for depression. Since this treatment he developed depersonalisation/DR and racing thoughts. It was never explained to him or he did not accept his diagnosis and therefore did not respond to early advice none very clear, back then. He became housebound due to symptoms and dependent on his father for more than two years now. Over time the lack of explanation/convincing by medical professionals about his condition, has led him to suicide attempts and admission into a psychiatric hospital twice. His DP/DR and violent thoughts convinced him that he was from another dimension and that he did not belong in his body. His racing thoughts became more sinister and constant and has misled him to believe he had been taken over by an evil force or the very least of his worries that he has schizophrenia.

I met him six months ago, i worked with him in doing a lot of research into GAD...sadly the medical sites have little if no info for severe GAD, but also fortunately I have found some of the forums and sites such as anxietynomore.co.uk and panic away programme and the Dr Weekes books and audio files and this site were the best place to get an understanding and idea of the best way forward. My friend Pete has made a lot of progress in his life (not so much his symptoms, yet) as he no longer is AS agoraphobic/social phobic and is less frequently in a speechless (catatonic) state has less panic attacks and now sorts his own finances, makes more decisions on his own uses knives in the kitchen goes to the pub occasionally, shops etc.. sometimes on his own, usually with someone he can trust. He is by far the man he was or yet to return to, but also more capable than he has been in two years. He still finds daily activities very stressful due to his accumulated symptoms, this in turn increases his anxiety which then exacerbates his symptoms further and fills him with such despair which exhausts him constantly to the point he does not want to live like this anymore, but is also afraid to die (thank god).

I am trying to help him recognise how he responds mentally to this fear he experiences due to the symptoms as being crucial and how to accept his experiences for what they are, to reduce and hopefully in time eliminating the symptoms. This must be a very difficult process to attempt as he makes slow progress, but i believe he does his best under the circumstances! He has as we all do in our daily lives, dealing with some emotionally stressful situations recently and his symptoms have exploded tenfold ....He says that his every action is questioned before and after everything.. it is a voice/thought of a devil along with the images of a devil always with him. He thinks the devil is a part of him maybe his inner self. The irrational tricking dialogue of his every action or thought is so distressing to him he cannot concentrate and is obviously fixated on the content of this internal conversation..he says how else can he not as it is with him for every thing he does or does not do, taking hold of his entire conscience making him very confused and would like to just sit and ruminate. He is at the same time suffering with other OCD thoughts/images violent and sexual in nature all the time and making him believe that he will or has become a psychopath/ serial killer etc..as he has long ago lost the feeling of his emotions and says he has a desire or urge to act on these thoughts (He is a lovely honest,caring guy!) as he has so much built up rage and anger inside him ( i only see and hear frustration and anger, but he assures me it is a fraction of what he feels inside). He is very guilty and very distressed that these thoughts happen to him all the time. The theme or person he has the images/thoughts about include everyone, but usually one or another person every so often who may have had some emotional impact on him at the time i.e. a neighbour who has been suffering with cancer or myself or his father.... the violent things happening to this persons body, internal organs, rape etc.. every unimaginable and distasteful thing that could happen is happening in his mind, this so distresses him...

We are trying together to keep active doing tasks to help distract him from ruminating and in addition provide him with situations that are uncomfortable for him to become less housebound and accustomed to the effects that people and the environment has with his mind, by exposure and correcting the response to it. I believe as he gets better at his responses, this does help him feel more capable at being out, although he does not agree as he says his symptoms get worse during and after these activities (shops, pub etc).

I understand that this is a horrendous cycle and to break it is to move through it ..hell or high waters, as i never want to see him return back to the state he was in when i met him... like a fetus in an invisible cage.

I asked him to write down something for others to respond to some while back for other forums where he had little response to and no one that could entirely relate to this accumulation of symptoms at once. I have posted his letter in this post at the end...

I HOPE AND PLEAD that someone out there experiencing the whole severe anxiety/ocd thought 24/7 package that can relate to loosing themselves to years of depression/DP/DR, anxiety/panic, including dark violent sexual ocd thoughts/ internal rage/ nightly sleep terrors etc will respond!!.... He takes 2 lorazapam am/pm and 40mg mirtazapine (AD)at night to aid sleep ..he is fearful to try antipsychotics again but is thinking on seroquel as a last resort...i would like to see him manage without, but it is his decision ultimately!

Pete's letter..........
A friend told me to write on here but Im pretty sure people will be horrified about what Ive got to say and run for the hills.

I dont only have dark, violent, sexual thoughts, I have this violent rage and hatred that accompanies them. My mind also change everything I do, see, hear, smell, eat into something horrifying, foul, disgusting, sexual etc in my brain. I shout abuse and threats to people in my head. I imagine the devil following me around and speaking in my head, and I count down days and activities until I will be locked up. Ive been ill for 11 years and somewhere deep inside I appear to have given up, and I seem to be doing this whole process to myself through some self-destructive compulsion. Sometimes I think Im enjoying it.

Floating past my thoughts doesnt work because they are my whole existence. Im sure you will agree Im a pretty evil thing and need to be locked up. Im not sure why Im writing on here as I know no-one will have anything to say and that will send me even further down. Im also pretty certain most of the time that Im not of this world and my existence is some sort of aberration.

Sorry and thanks.

My question as a close friend.... could this be shizophrenia??? I know that you out there are not doctors but have valuable experience that may contribute to this post. The stress of going through the mental health system once again will pose as a great anxiety problem again exacerbating these symptoms that he could do without at all costs

 
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Old 08-16-2008, 04:11 PM   #2
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MSD607 HB User
Re: If psychiatrists cant be sure btw anxiety disorders or schizophrenia. what do you

It could be schizophrenia, especially how he thinks he is from another dimension. It seems really serious...he needs help. He seems to be very sick. It's good he is able to trust you- you sound like a great friend. Try to get him the help he needs, and keep being his friend.

 
Old 08-17-2008, 12:26 AM   #3
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Peters friend HB User
Re: If psychiatrists cant be sure btw anxiety disorders or schizophrenia. what do you

Quote:
Originally Posted by MSD607 View Post
It could be schizophrenia, especially how he thinks he is from another dimension. It seems really serious...he needs help. He seems to be very sick. It's good he is able to trust you- you sound like a great friend. Try to get him the help he needs, and keep being his friend.
When he says he is from another dimension he is relating to his depersonalisation and derealisation the fog btw him and the world. He is mostly convinced and very afraid and fearful that he has been taken over with evil, because of the horrific violent thoughts and images that are constant in his mind. At the same time he knows that he is experiencing this which is not him, but happening to him. Does that make more sense?

 
Old 08-17-2008, 08:30 AM   #4
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Re: If psychiatrists cant be sure btw anxiety disorders or schizophrenia. what do you

That's interesting, because he actually understands that this is an illness...most people are not able to tell that they have the illness. I really don't know what is wrong, but he obviously needs help. What are some of his other symptoms? Is he paranoid? Does he hear voices? Misinterpret things? etc...

 
Old 08-17-2008, 01:40 PM   #5
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Re: If psychiatrists cant be sure btw anxiety disorders or schizophrenia. what do you

Quote:
Originally Posted by MSD607 View Post
That's interesting, because he actually understands that this is an illness...most people are not able to tell that they have the illness. I really don't know what is wrong, but he obviously needs help. What are some of his other symptoms? Is he paranoid? Does he hear voices? Misinterpret things? etc...
Hi. Thanks for replying...He can be paranoid, but i would say as much as I am, especially when a person feels so low and negative. He does feel that he is being followed and assumes it is the imaginative devil he knows is in his imagination. He does feel distrusting to some extent of the people around him, but also knows that he is probably being paranoid. He hears thoughts and cant be sure if it is his voice or not. He can misinterpret things but again no more than i can at times. He is usually very sensitive and accurate in interpreting a change in a persons body or facial gesture and mostly correct at his interpretation just at times understandably sensitive. He is suffering from depression no doubt who would not under the circumstances and becomes very gloomy and sorry for himself, which does not help matters as he then would be inclined to do nothing and if left will choose to go to bed to dwell in pity over his active destructive imagination he clearly hates but cant stop it. He says that every thing around him changes form and it is always disgusting and foul and bloody and sexual. His brain mutilates his body parts and other peoples body parts. This distresses him and sends him into despair. He reports to feeling so removed from the real world which he says is the depersonalisation/Dereality and the fact that he cant function as he would like to with good health because of the activity in his mind. He is extremely negative and has a tiny speck of hope that he gets from others around him and hangs onto from time to time. He says all he feels is rage and hate and cannot feel love or a care for others, however I see him express other positive emotions from time to time but he does not recognise this as a feeling. I believe anyone suffering like he is will no doubt have rage and hatred for the world...he just wants the agony of the warped activity in his brain to stop! A walk is not a walk in his brain everything unimaginable is happening. Eating is not just eating again everything unimaginable. Everything he looks at, hears or smells turns his brain into a playground of hell. He is intelligent and has not lost his cognitive abilities, only much slower to preform tasks, due to the constant activity he has to put up with whilst doing something. He finds making decisions difficult because he has no feeling to go with his own idea of what he thinks he would decide and these ideas are challenged by this internal commentary constantly, telling him this or that. All this confuses him, he reports he is not aware if he has any of his own thoughts or cannot recognise if it is his own thought or the destructive commentary that changes everything in his mind. I notice though that he does or can make decisions of his own if at a moments chance during a conversation or when an immediate action is necessary without him having time in pondering or giving his brain a chance to mess with his decision. He says that his nights are filled with terror during sleep and his dreams are hell. This may or is likely to be night panic attacks related to the day events imagined or real? It takes him hours in the morning to begin to communicate with us and this is due to taking a lorazapam slowing down his anxiety alot and activity in his brain slightly. If he does not take this pill his anxiety is high and he reports that the activity is not as sinister and he feels more comfortable in a high state of anxiety, however i can promise you he functions less and is more like he is in a primitive state (panic). His symptoms have got worse over the past several weeks to be like I have described, but as usual as in the past relating to stressful events, he has had some highly emotional stress going on and this usually results in his symptoms becoming increasingly worse for some time. Usually it takes several weeks or more of calm before his symptoms slowly decreases ever so slightly but enough for him to have more energy and resources of his own to cope a bit better... for instance the image of the devil and commentary is much less frequent, but the other violent/sexual stuff remains. He is a constant worrier. Always asking for reassurance. He says he has always worried and been introspective of his life and always made plans and remade plans over and over to be better and better with high expectations in his personal life and work, but yet they never seemed to match the reality of his high performances anyway! (His entire family are this way inclined twd him and themselves). He appears to have traits of that of 'dependent personality disorder' in the past and a social anxiety disorder due to the parental and intellectual pressures put on him. The process he says started at 19yrs when he suffered a major panic attack and became ill with glandular fever. Depression and worry took hold of him over many years. His mother says he was always fairly anxious as a child, but then he was always on show for his performances being very talented and away at boarding school since he was seven. His father is critical and internally perfectionist twd his children's lives if not to replace their own expectations that is in hope that that will be the answer to happiness!! All done out of love, but a lack of personal boundaries is very evident till this day. I hope i am being clear in describing this on his behalf. I appreciate your input!! My concern was or is or could this be prodromal psychosis or prodromal schizophrenia? slowly developing where a person is still aware of what is happening?? Not sure if anyone can describe their development of schizophrenia if any can at all..over years prior?

Last edited by Peters friend; 08-18-2008 at 12:04 PM. Reason: adding info

 
Old 08-17-2008, 03:56 PM   #6
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Re: If psychiatrists cant be sure btw anxiety disorders or schizophrenia. what do you

It sounds like he is truly suffering. It could be schizophrenia, but I am obviously not a doctor. He really needs some help from a mental health professional before it gets worse (because it will get worse). It is a good sign that he recognizes this is not normal- it gives him more hope to get better. I hope this helps.

 
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