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The Ultimate Guide to Schizophrenia.

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#1 SolomonOrlando

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Posted 02 September 2014 - 01:52 AM

The Ultimate Guide to Schizophrenia.

 

More times than not, I'm greeted with this familiar phrase trickling it's way into the site: "I fear that I have Schizophrenia," followed with a discussion of scared individuals trying to work their brains around the idea of Schizophrenia, the fear of getting it and the urge to try and WebMD themselves with Psychosis. After seeing this happen way too often, I am taking the time to write this Ultimate Guide. I will be adding to this, with sources, so if you would like something to be stated inside of here and would like a better explanation to something, please comment and I'll shed some light on whatever it is you would like. As the preface, I will outline some of the things that I will be talking about, though:

  • Understanding Schizophrenia.

  • Knowing the difference between Schizophrenia and Dissociation.

  • Realizing that Dissociation can not lead into Schizophrenia.

  • Symptom differences between the two.

I will be posting this once in this blog and once in the forums so as to really raise awareness to this issue. I feel that people really need to understand what Schizophrenia or Psychosis is and I feel that people also need to realize that Schizophrenia is quite serious, but while serious, dissociation does not lead in Schizophrenia. I want people to understand that, just because you have this detachment from yourself or the world, does not mean that you have Schizophrenia or are slipping into Psychosis.

 

Understanding Schizophrenia.

 

Schizophrenia is a brain disorder that affects the way a person acts, thinks, and sees the world. People with Schizophrenia have an altered perception of reality, often a significant loss of contact with reality. They may see or hear things that do not exist, speak in a strange or confusing way, believe that others are trying to harm them or feel like they are being constantly watched. Some of you may be thinking to yourself, "Oh my.. I think oddly, I sometimes have delusional thoughts, I must be Schizophrenic!" - no, not exactly.

 

In nearly 100% of cases, people who have Schizophrenia have no idea that they have it. First, because it's a disease that first attacks your ability to recognize that you have it - social cues are the first sign, and they are very dramatic. Some of what is affected is your ability to respond to your name or having no regard for other people's personal space and/or property. You see, there needs to be extreme cases of multiple symptoms for someone to have Schizophrenia or be developing such disorder. Let's move on to the causes, just to back up what I previously said.

 

The causes of Schizophrenia are prominently genetic, coupled with environmental factors. Schizophrenia has a strong hereditary component to which individuals with a first-degree relative (parents of sibling) who has Schizophrenia have a 10 percent chance of developing the disorder, as opposed to the one percent chance of the general population. The environmental factors are all based around extreme levels of stress, which someone can be more prone too if:

  • They have prenatal exposure to a viral infection.

  • They have low oxygen levels during birth (prolonged labor or premature birth.

  • Exposed to a virus during infancy.

  • Experienced loss of early parental loss or separation.

  • Physical or sexual abuse in a childhood is prominent.

Even if you did have a family member with Schizophrenia and were involved in environmental factors, the percentage of you getting Schizophrenia is a near fraction of 1%. Especially if you are expressing your concern of getting it or already having it - like I said previously in this part of the guide, Schizophrenia first attacks your ability to recognize that you have it, then more dramatic symptoms become prominent in your life. Expressing concern and fear for getting Schizophrenia most likely means you don't have Schizophrenia.

 

Knowing the Difference Between Schizophrenia and Dissociation.

 

We've covered most of the things we needed to cover above to really understand Schizophrenia, how it works and how people get Schizophrenia, but let's take it one step further. Let's examine dissociation (Derealization and Depersonalization) and really back up the idea that you don't have Schizophrenia.

 

Depersonalization and Derealization are often interchangeable because they're so strikingly similar to each-other. Depersonalization is an anomaly of self-awareness. It consists of a feeling of being "robot-like", a "pair-of-eyes" or watching oneself act whilst having no control over the situation that oneself is inside of. Derealization, on the other hand, can experience the same thing, but is more inclined to believing that the external and immediate world around is dream-like, fake or sometimes even completely made up. People with dissociation have nearly the same symptoms - one way or another, things may not feel particularly real.

 

Dissociation, as the term used for grouping both disorders together, is often then confused with Schizophrenia due to their likenesses in symptoms:

  • Feeling unreal.

  • Delusions.

  • Hearing/Seeing things that aren't there.

  • Lack of Emotional Expressions.

Schizophrenia and Dissociation do share some similar attributes, but there is one huge difference between the two: people with dissociation are aware. Schizophrenics experience a loss of reality, but create a new one entirely - they have no awareness that the world they have created is fake or made up in their mind, they simply believe it to be true. The fact that dissociates are completely aware that they are "distant" is justification that they are, in fact, experiencing reality and not any form of Schizophrenia.

 

Many people with dissociation fear that they have Schizophrenia for some very common reasons: Obsessions over delusions, hearing things, visual snow, brain fog, etc.. All of these things are simply revolving around anxiety - which Depersonalization and Derealization are; they are based off of anxiety disorders and stress. I would check yourself out for Obsessive-Compulsive Disorder before chalking something up to be Schizophrenia, there's more a chance of you just have a form of OCD than having actual Psychosis.

 

Derealization and Depersonalization cannot "slip you into Psychosis or Schizophrenia", it is based off of anxiety and that's all. If you had Schizophrenia, Derealization/Depersonalization would be a symptom among the many other extreme symptoms of Schizophrenia or Psychosis - just because you're dissociated from reality does not mean that you are going to Schizophrenia from dissociation itself.

 

 

 

 

Sources:

Schizophrenia: Signs, Types and Causes.



#2 <AGENT>teh345

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Posted 02 September 2014 - 09:48 AM

Thanks for bringing this one back.

#3 SolomonOrlando

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Posted 02 September 2014 - 12:08 PM

Thanks for bringing this one back.

 

You're welcome!



#4 asdfyoyoyo

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Posted 06 September 2014 - 03:54 AM

People who had serious psychotic breakouts and then get medication know they are/were schizo, but in their first psychotic episode, they will not notice. It is MUCH more likely that your environment will see you acting crazy instead of you recognizing what you are doing is crazy. They usually (most cases) fear not their symptoms, but the things, that become real for them. They do not fear "omg pls i dont wanna think thats an agent that follows and murders me" but "oh god this guy will kill me". The selfreflection of schizos is extremely low. And, to be honest, most schizos i know, live a pretty normal life, if they take medication and dont do drugs.

Another interesting thing, a psychiatrist told me: usually schizos dont want to talk about their shit, if they are aware, they usually hide it and pretend everything is alright.

#5 trey

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Posted 04 March 2015 - 04:57 PM

i feel alot better after reading this , thank you very much!!



#6 *Dreamer*

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Posted 04 March 2015 - 05:10 PM

It's good to post this, but I have to make two remarks.  Someone who HAS schizoprhenia or a psychotic disorder isn't "schizo" ... I despise that word.  I work with people on a daily basis ... volunteer for NAMI ... who have all sorts of mental illness.  Not one has the same experience.  And when seriously ill -- true, someone in the middle of a psychotic episode loses insight, but if treated well, such an individual can even recall what occurred during that episode.  Such an individual can also tell if they are getting worse.

And also, true, you cannot always tell if someone has schizoprhenia.  Sometimes it is VERY obvious.

And the follow, is not true save for #1.
 

Dissociation, as the term used for grouping both disorders together, is often then confused with Schizophrenia due to their likenesses in symptoms:

  • Feeling unreal.

  • Delusions.

  • Hearing/Seeing things that aren't there.

  • Lack of Emotional Expressions.

 

Those of us who have a dissociative disorder -- specifically the perceptual distorition of DP/DR (and are NOT having this as a result of psychosis) -- yes, either feel AS IF parts of their body are distorted/not attached, etc. DP, or that the world is 2D, flat, dark DR.  Feel AS IF they are dreaming, AS IF they are dead.

We do not have delusions, we do not hear or see things that aren't there.  And if we have any lack of an emotional expression it may be from sadness or exhaustion.  Not a completely "flat affect."

But definitely it is good to repeat that DP/DR IS NOT IN ANY WAY RELATED TO PSYCHOSIS.  One can have psychosis AND experience DP/DR, anxiety, OCD, depression,etc. BUT if your PRIMARY diagnosis is DP/DR, you do NOT have schizophrenia or any type of psychosis.


Also, I believe DP/DR should be in a category by itself.
Dissociative Amnesia/Fugue and DID, as well as DD NOS are different.  All include amnesia for events.
Those with DP/DR do NOT have amnesia for events.

 

Also, DID has been linked more recently to BPD.

Please don't make it "US" vs. "THEM" -- t here are people I know who have bipolar with mania and controlled schizoprhenia who can accomplish more than I can in a day.  And I hate to say this, but to me, the word "schitzo" is equivalent to the word "n***ger.

 

Someone isn't schizophrenic ... they HAVE schizophrenia.


Edited by *Dreamer*, 04 March 2015 - 05:12 PM.


#7 *Dreamer*

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Posted 04 March 2015 - 05:19 PM

  • Paranoia
  • Auditory hallucinations
  • Hearing voices
  • Abnormal thinking
  • Severe paranoid reaction

    These are the definition of true delusions.  We with a DP/DR diagnosis do not have these.  For example I am yakking at myself in my head all the time.  That is NOT the same as hearing a voice telling you to kill yourself.  That you can actully hear speaking to you.  Or the TV speaking to you, etc.

    Sorry, edit again.  Not all individuals who have schizoprhenia even know what I am talking about when I describe DP/DR.

Edited by *Dreamer*, 04 March 2015 - 05:22 PM.


#8 *Dreamer*

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Posted 04 March 2015 - 05:33 PM

http://www.nami.org/...s/Schizophrenia

 

This is a more accurate guide to schizophrenia.  From The National Alliance on Mental Illness

 



#9 SolomonOrlando

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Posted 04 March 2015 - 08:01 PM

 

  • Paranoia
  • Auditory hallucinations
  • Hearing voices
  • Abnormal thinking
  • Severe paranoid reaction

    These are the definition of true delusions.  We with a DP/DR diagnosis do not have these.  For example I am yakking at myself in my head all the time.  That is NOT the same as hearing a voice telling you to kill yourself.  That you can actully hear speaking to you.  Or the TV speaking to you, etc.

    Sorry, edit again.  Not all individuals who have schizoprhenia even know what I am talking about when I describe DP/DR.

 

 

I'm going to respectfully disagree. 

 

These delusions can, and sometimes are, present with individuals suffering from Depersonalization or Derealization. Paranoia and abnormal thinking, especially, as I can attest to having those thought processes before. As for auditory hallucinations, I'm not sure it's so far out of the realm of possibilities to see that people suffering from Depersonalization or Derealization could experience this. In fact, there are many people on this forum that have experienced this. So, in my opinion, I think that most of the things you've listed can be seen in people with Depersonalization. 



#10 *Dreamer*

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Posted 04 March 2015 - 09:59 PM

I'm going to respectfully disagree. 

 

These delusions can, and sometimes are, present with individuals suffering from Depersonalization or Derealization. Paranoia and abnormal thinking, especially, as I can attest to having those thought processes before. As for auditory hallucinations, I'm not sure it's so far out of the realm of possibilities to see that people suffering from Depersonalization or Derealization could experience this. In fact, there are many people on this forum that have experienced this. So, in my opinion, I think that most of the things you've listed can be seen in people with Depersonalization. 

I appreciate that.  I just have to go back to the most reliable diagnostic criteria that exist for DP/DR including the work of Mauricio Sierra and the IoP.  Also, Marlene Steinberg, Abugel, etc. 

I refer to DP/DR as a very specific syndrome ... that is the perceptual distortions we have -- essentially "feeling unreal" or rather we feel AS IF we are unreal.  These symptoms  can be short-lived or chronic.  They can go into remission and then return.  They may be accompanied by anxiety, accompanied by panic ... or one comes before the other -- I've given up on figuring that out.

My diagnosis for example has been for years Depersonalization Disorder.  I also have comorbid anxiety (of a billion types) and clinical depression.  Never once in my entire life has any therapist, psychiatrist or member of a support group heard my describe hallucinations, delusions, paranoia, etc.  I don't experience these things as individuals who have these specific symptoms -- individuals I know who have psychotic disorders.  And as noted, many of them do not understand what I mean by DP and DR. They do not have those specific symptoms.

Perhaps there is some splitting of hairs or a confusion of definitions.  But for instance static in one's vision isn't a hallucination -- it is a disruption in the way the brain is interpreting incoming stimuli -- or as with floaters, they ARE there, we simply are overly conscous of them.  If you read Oliver Sacks' book titled Hallucinations, a true hallucination would literally be seeing something that is not there -- such as tiny people dancing around on the floor in front of you.  And there can be hallucinations that are totally harmless such as that in elderly blind people.  Or for example someone in an isolation tank in total darkness for some time may see faces, hear phones ringing, etc.  Thoses are hallucinations caused by stiumulus deprivation.

Could you give me an example of paranoia you have experienced?
Could ou give me an example of "abnormal thinking" -- I'm not sure what that means.
And auditory hallucinations are simply not in the diagnostic criteria for DP/DR. If someone is truly having a real auditory hallucination then they are experiencing another disorder that could have many sources.  THINKING one hears something and worrying about it, is not the same as literally hearing something -- and with psychiatric disorders it is generally something sinister.

I'm not attacking you.  Everything I have read about a diagnosis of DP/DR (most likely withanxiety -- which most folks have here) would not have paranoia, hallucinations as part of that diagnosis.  Now one could see "the walls breathing" as I've heard here -- but that sounds like a symptom of HPPD for example, from drugs. HPPD is not psychosis.

I hope I am making sense.  Perhaps I'm not.
Let me find the definition again in the Merck Manual.

I just like things to be clear.  I think that DP/DR can be horrifying, and someone might think they are "going crazy" ... we know they are not.  But if someone literally has DP/DR AND is truly hallucinating or has paranoia than the problem is something MORE than DP/DR alone.  I guess that is my main point.



#11 *Dreamer*

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Posted 04 March 2015 - 10:08 PM

I guess I just like to be precise in what we are talking about, and have to depend solely on the best sources.  Sierra (my best source, and the work at the IoP), and Steinberg. 

http://www.merckmanu...disorder&alt=sh

 

Symptoms and Signs
Patients feel detached from their body, mind, feelings, or sensations. Most patients also say they feel unreal (derealization), like an automaton, or as if they were in a dream or in some other way detached from the world. Some patients cannot recognize or describe their emotions (alexithymia). Patients may describe themselves as the "walking dead." Symptoms are almost always distressing and, when severe, profoundly intolerable. Anxiety and depression are common.
Symptoms are often chronic; about one third of patients have recurrent episodes, and two thirds have continuous symptoms. Episodic symptoms sometimes become continuous.
Patients often have great difficulty describing their symptoms and may fear or believe they are going crazy. They always retain the knowledge that their unreal experiences are not real but rather are just the way that they feel. This awareness differentiates depersonalizationdisorder from a psychotic disorder, in which such insight is always lacking.

 

That's it.  If hallucinations or paranoia were a SYMPTOM of DP/DR, they would be mentioned here and they aren't.  Thinking one has these symptoms is not the same as having the symptoms.

And also, I have to respectfully clarify.  And I think it is very important to make this clear to board members here.

Someone had the IoP definition up here.  I'll find that.  No mention of paranoia, hallucinations, etc.  And no disrespect.  Could you give me examples of your experience of what you would call paranoia, hallucations others have mentioned, etc.
Peace.

D


Edited by *Dreamer*, 04 March 2015 - 10:10 PM.


#12 SolomonOrlando

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Posted 04 March 2015 - 10:20 PM

I think we're having a split in communication here. 

 

You seem to be saying something that I've already said in my original post, that people who experience these "symptoms" are still aware that they're detached. Which would be the opposite of someone who suffers from Schizophrenia, who creates another reality to justify those symptoms. Where you quoted the bullet points about "symptoms", the text below those points read: 

 

 

Schizophrenia and Dissociation do share some similar attributes, but there is one huge difference between the two: people with dissociation are aware. Schizophrenics don't experience a loss of reality, but create a new one entirely - they have no awareness that the world they have created is fake or made up in their mind, they simply believe it to be true. 

 

The bold and underlined part is what you're trying to say in your posts, correct? I agree with you, unless I'm reading your posts wrong entirely.







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