Why Anxiety is NOT related to schizophrenia

odisa said:

Odd post. Schizophrenia is often accompanied by anxiety. If you'd said "psychotophobia" is proof of not being psychotic, for the experiencing party is not ignorant to changes that occur with psychosis, but fears them, then perhaps it would make sense.

Click to expand...

This is just something I found while browsing, something else I found while browsing the web (which I personally relate to) is the following:

What Is Schiz OCD?

Repost from the old site.

Well, to be honest, it's nothing, officially anyway. It's just a colloquial name given to a certain type of OCD, or obsessive-compulsive disorder, this type being a pure-O type, or obsessions without compulsions*. I have recently discovered, after hanging out on some OCD boards, that schiz OCD is actually quite common, though it is a very disturbing type of OCD and is probably also often misdiagnosed.

The person with OCD starts out worrying that they either have schizophrenia or are going to get schizophrenia. They start to read all about schizophrenia, including all of the symptoms. Then they start to misinterpret stimuli in their environment as being due to hallucinations.

They hear noises in the environment and think that they are hearing voices or hallucinating. They see things out of the corner of their eye and start worrying that they are having visual hallucinations.

Keep in mind that it is considered normal to hallucinate for brief periods on rare occasions. It is not uncommon for normals to report hearing indistinct voices for 5-10 seconds a couple of times over a 5-10 year period - a person who experiences such an experience will likely say, "My mind is playing tricks on me." Transient hallucinations are not necessarily pathognomic of anything.

The real problem with schizophrenia is that the person is afflicted with frequent or continuous tormenting voices that the person insists are real.

Then they start worrying that they are going to get schizophrenic or psychotic delusions. Pretty soon, "delusions" or "psychotic thoughts" start popping into their minds. In more serious cases, the "delusions" or "psychotic thoughts" repeat endlessly in typical OCD style.

Some are reporting just about every schizophrenic and psychotic thought and delusion known to mankind (they are either getting them out of the books or making them up on their own). I am doing amateur therapy now with a man who has experienced hundreds of "psychotic delusions". It is clear that, at the moment anyway, he has OCD.

Some of these folks have committed themselves to mental hospitals, often repeatedly, insisting that they must have schizophrenia. At the hospitals, the doctors are not very nice to them, and the nurses make fun of them, saying that they have "medical student syndrome".

Some of them insist that they are delusional - their delusion being that they have schizophrenia. The "delusion that one has schizophrenia" is not an appropriate symptom for a diagnosis of a psychotic disorder.

People with schiz OCD are often in a great deal of pain, but they are not psychotic at all, and, in general, they are not dangerous in any way whatsoever. The "delusions" are simply obsessions that are often vigorously resisted. Sometimes the person spends a lot of time checking to make sure the "psychotic thoughts" are not true.

Some of the thoughts that they get are, "They are poisoning me," when being served food, "They are against me", about anyone, especially a loved one, "This is a message for me", if they see a piece of paper, etc.

The thought about being poisoned proved to be quite common, with many OCDers reporting it. They all said that they went ahead and ate the food anyway. I do not think someone who really thought they were being poisoned would go ahead and eat the food.

Proper diagnosis is essential in these cases, as a number of clinicians are diagnosing these folks as psychotic. They are not psychotic; they have OCD. It is very important to distinguish between obsession and delusion. The bizarre, psychotic-like nature of the obsession does not mean it is a delusion.

An obsession is defined as the following:

Obsessions as defined by (1), (2), (3), and (4):

1. recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress

2. the thoughts, impulses, or images are not simply excessive worries about real-life problems

3. the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action

4. the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)

B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.

If the "psychotic thought" or "delusion" has the qualities above, it is an obsession. A person with a true delusion simply accepts the thoughts as absolute fact, with a conviction so deep that you cannot change their minds even if you argue with them all day and night. They believe it the same way that you believe your name is whatever your name is. Furthermore, delusions are never resisted.

I have known psychotic persons who had delusions and hallucinations; it is simply impossible to try to argue them out of their false ideas and sensory illusions. Typically, persons in the midst of a psychosis do not have the slightest clue that they are ill.

It is true that in the early stages of psychosis or even schizophrenia, the person often has some level of awareness and insight. This is especially true of more educated persons who know a lot about mental illness.

I recall a poignant case where a young man experienced the early stages of schizophrenia, went to the library and researched his symptoms and diagnosed himself with schizophrenia. However, soon afterwards, he became full-blown psychotic and all insight was lost.

The lack of awareness of being psychotic makes it difficult to get these persons to take medication. Often they have to be convinced to take medication via subterfuge.

It is also true that schizophrenics who are on anti-psychotics and are getting a good response sometimes have excellent insight.

I have lived with psychotic persons for months on end, have spent months befriending and socializing with a schizophrenic and have talked with other schizophrenics who were actively psychotic. I have never met a psychotic individual who had the slightest bit of insight into their condition.

All of my efforts to talk psychotic individuals out of their delusions or convince them of the false nature of their hallucinations have been fruitless. It is a mystery to me how anyone can claim to do psychotherapy with an actively psychotic person.

Persons with schiz OCD are being diagnosed psychotic or even schizophrenic. Let this post serve as a warning that differentiation between obsession and delusion is of profound importance, as proper diagnostics is an essential pillar of treatment. Incorrect diagnosis poses numerous risks to clients, including exposure to dangerous drugs, damage to self-esteem, confusion, etc.

Persons with schiz OCD often have a history of other forms of OCD, such as HOCD (obsession with being gay), POCD (obsession of being a pedophile), harm OCD (obsession of being a rapist or murderer), germ OCD (obsession about contamination), etc.

A man I know with schiz OCD just got back from a visit to a psychiatrist who diagnosed him as "a little bit psychotic" and tried to put him on anti-psychotics.

She gave the following reasons why he was psychotic: because harm OCD and schiz OCD were not "typical" forms of OCD, and, if he was worried about going psychotic, it must be because he is going psychotic. She also said that most psychotic people have insight into their illness - in fact, the very definition of psychosis precludes insight.

Nevertheless, although anxiety disorder does not lead to psychosis, and OCD in general does not progress to psychosis, sometimes OCD presents as the leading edge of schizophrenia, usually in a young person. In such cases, full-blown schizophrenia occurs within about two years after development of OCD. OCD and schizophrenia can also co-occur, strange as it may seem.

And some persons who seem to be suffering schiz OCD may be experiencing the onset of schizophrenia. In cases where a person with schiz OCD is regularly actually hearing things, further investigation is warranted.

However, it is likely that a person in the early stages of schizophrenia will experience their strange thoughts as ego-syntonic instead of ego-dystonic - that is, the thought will not be immediately marked as crazy and vigorously resisted, but will instead be embraced as verifiable reality.

Perspective is important. The main problem here is OCDers being diagnosed as psychotic, not the other way around.

Little has been written about the treatment of schiz OCD. A man I interviewed experienced an almost 100% loss of schiz OCD on Anafranil, one of the best anti-OCD drugs out there. He also told me that other SSRI's have been successful in preventing relapse. When schiz OCD is very bad, medication may be necessary. A successful response to SSRI's will typically vindicate the OCD diagnosis.

Little has been written on the cognitive-behavioral therapy (CBT) of schiz OCD. One sufferer told me that the strategy of accepting the thought and just letting it pass on through without debating it seems to be helpful. Resistance is often counterproductive, as it often just strengthens the obsession.

There is a serious dearth in the literature and understanding of schiz OCD. This post will hopefully spur more articles on this poorly-understand type of OCD.

Here and here are a couple of more articles on schiz OCD.

*Fred Penzel suggested to me that actual pure-O OCD is quite rare. He is correct. What he means is that most pure-O types engage in reassurance seeking, checking and mental compulsions. Sure they do.

On the other hand, OCD'ers seem to want to distinguish between the more ruminative types who do not have overt rituals (no one who knows me would think I have OCD because I do not wash my hands all day or turn lights off and on 20 times). Furthermore, clinicians also seem to want to make this distinction. I was told I was a "classic obsessive" - implying rumination and lack of overt rituals.

http://robertlindsay.wordpress.com/2011/10/12/what-is-schiz-ocd/

Here are a few more links to share, this is one on intrusive thoughts (such as my experience of imagining people were demons during a high anxiety attack, even though I knew they were not it was a thought that popped in my head when I was obsessing over possibly being schizo which made me freak out thinking they were demons)

-------------------------------------------------------------

These past three days have been horrible ive been having this fear of losing control of reality and ill start thinking crazy thoughts that support this fear I don't really won't to talk about this too much because ill start to have a panic attack but the thoughts are extremely bizarre and it makes me start to think that I'm going crazy because I start to think that they are way to bizarre to be intrusive thoughts like I can't stress this enough about how bizarre these thoughts are and its really starting to scare me.

http://www.addthis.com/bookmark.php?v=250&pubid=anxietyzonehttp://www.addthis.com/bookmark.php?v=250&pubid=anxietyzone

« Reply #1 on: November 17, 2010, 12:18:01 AM »

There is no limit to how far intrusive thoughts can go. The content of the thought and how intrusive it is does not matter, all intrusive thoughts come from the same place, anxiety. How ever far your mind can think is how intrusive a thought can get. Try to realize that these thoughts are just a manifestation of anxiety, and that they don't mean anything. If they are really bothering you,I would recommend seeing a therapist. A therapist can put things into perspective for you and give you the tools you need to deal with these thoughts. Know that you are not the only one with these type of thoughts, many, many, many people have them and they can be managed.

------------------------------------------------------------------------------------

Another link may help us who obsess and fear schizophrenia:

FEAR OF SCHIZOPHRENIA

This problem can be viewed as an illness phobia and many of the difficulties and recovery techniques described in that website article will apply here. However, from those coming to Anxiety Care with the problem, there is usually a very strong obsessional thinking element to this particular fear and the booklet 'obsessional thinking' might also be a useful read in conjunction with this article.

What is schizophrenia?

What it is NOT is multiple personality disorder, which is a completely separate and rare problem. Many people believe this is the 'typical' schizophrenic: someone who is host to numerous totally different personalities that 'take over' the body at different times: some of them invariably dangerous. Schizophrenia, in fact, has a number of different symptoms that interfere with the sufferer's ability to think clearly, make rational decisions, relate to other people and cope with emotions. In the latter case a schizophrenic may display inappropriate emotions in some situations.

The 'thought' aspect can include difficulty in concentrating that makes work or study very hard or even impossible. Here thoughts may seem to wander from one subject to another where the original thought is quickly lost and the process may feel as if these thoughts are becoming indistinct or hazy. Someone with this problem may find it difficult to make him- or herself understood in conversation and may use inappropriate groups of words or nonsense words.

The more extreme thought problems and the ones most lay people are familiar with; are what is commonly referred to as 'hearing voices'. In this situation a sufferer may feel that someone else's thoughts are in their mind or that they are hearing some outsider speak to them when there is nobody present, probably urging them to do things, even dangerous things that they may feel powerless to resist. This can seem so real that the sufferer finds it difficult to believe that other people cannot hear these voices and does not understand that it is the brain mistaking personal thoughts for real experiences. People with severe depression may also hear voices that talk directly to them, however the voices heard by a schizophrenic may also seem to talk to each other.

When it feels as if some powerful presence is controlling one's body and mind it will often seem necessary to find an explanation and people suffering in this way may believe that they are the subject of radio or TV 'waves', lasers or even aliens. Some people with thought problems may also believe that the TV or radio is discussing their personal and private lives or giving information that is specific to them alone and may find it difficult or impossible to believe that other people exposed to these programmes have not picked up the same information. When these delusions focus on this person feeling harassed or persecuted by some outside force or a particular person or group of people, these are known as paranoid delusions. Research suggests that up to 75% of schizophrenics will hear voices at some time during their illness.

Other symptoms that may seem to take away the quality of life rather than add another dimension to it as described above, can be a general reduction in energy, emotion and interest in life. A person with these negative symptoms may avoid other people, stay in bed and not bother with washing themselves or keeping their clothes clean. Such broad based symptoms can obviously be part of other problems such as depression and many parents may feel that their teenage children often fill these criteria.

Causes and onset

The cause of schizophrenia is not known but it is believed that it is most likely to be due to abnormalities of brain chemistry and/or brain structure. However, a physical test such as a brain scan would not be able to prove a person was or was not, schizophrenic; such a test could only rule out other physical reasons for certain behaviour. There are probably genetic elements involved in developing schizophrenia, and stress can be a factor but as a 'last straw effect' not a cause in itself. There is also research that suggests that illegal drugs such as marijuana, ecstasy and LSD can aggravate a present tendency into the full disorder. Amphetamines tend to generate schizophrenia-like symptoms, which cease when the person stops taking the drug.

About 1% of the population will suffer from this illness at some time in their lives and those with a parent who has the problem may be ten times as likely to contract schizophrenia: but this is still a 90% chance of not contracting it. Age of onset is rarely before age fifteen and women tend to contract it later than men: in the late twenties or thirties. The disorder appears equally in men and women.

Anxiety and obsession

Many people contacting Anxiety Care have used marijuana in the recent past and have experienced mental symptoms such as panic, confusion or paranoia that, even if minor and very temporary, have stayed with them in the form of a growing anxiety that they have, in some way, generated schizophrenia within themselves. If they, or in fact anyone have a tendency towards obsessional thinking, these fears might focus on intense monitoring of all thoughts and emotions that could conceivably 'prove' that they have this illness. Once this is done, the job becomes a life's work unless help is obtained. That is because our thoughts tend to be random and very reactive: we encounter a situation and our minds throw up a range of thoughts and memories that relate to our past experience of this situation, some of them odd and barely relevant. If there is a good deal of emotion involved, the thoughts will be more intense and possibly broader in scope and even less relevant. If our minds are set to fear certain emotions, the thoughts that touch on these are likely to seem very powerful and relevant, simply through the anxiety they cause.

In this way, perfectly 'normally-weird' thoughts are easily grasped as 'proof' that this person is becoming schizophrenic. Our thoughts can be as random as the endless pages thrown up by an online search engine when we ask it about something: probably more so as our thoughts will leap on from one area to another as described in the obsessional thinking article. For example, thinking about one's car might go to trips out, happy family days, the children, what they are doing now…etc. It could equally go to busy roads, being late, stress and unhappiness; or crashes; or high insurance. The list is almost endless. When a person's mind is set to worry and suspicion, the thought process will tend to go that way almost automatically. That is, with the car; the end thought is more likely to involve fear of accidents or stress than happy days by the sea.

Violence

Another area of fear is that of violence. Many obsessional people mistake normal anger, even a temporary urge to strike someone, as a sign that they are becoming homicidal maniacs. They ignore the fact that most of us will experience this level of emotion at some time. A quick 'straw poll' among charity users and volunteers showed that many, when asked to think about it, had felt like hitting someone in the previous week. They had simply acknowledged the urge and let it go. However, someone keyed to be frightened by his or her violent or aggressive feelings would probably become very distressed by such thoughts. As the brain throws up similar past situations when we think about something, a person experiencing such an urge would then remember many other times he/she had felt that way and could easily be persuaded that he/she is dangerous. This can be particularly worrying if the urge is against a loved one. Many people with obsessional thinking problems seem to find it difficult to acknowledge that they can be angry with, and have aggressive thoughts against, people they love. This is very common when an infant has driven its mother to distraction and she suddenly feels like smacking it hard. Most mothers feel a little guilty at this point and then put the thought aside. The mother afraid of her violence does not. This can work equally when the person generating these feelings is a spouse, parent or older child.

Testing for schizophrenia

Many people with a fear of schizophrenia go for psychiatric testing, and although seeking reassurance is not a good way to deal with such a problem as it simply generates a reliance on this form of help and rarely lasts, this can be an option. When this is done, the person involved must try to accept the verdict. However, the mind tends to start looking for exceptions to any absolute 'yes' or 'no', particularly when there is heavy emotion involved. So it is not at all unusual for a person fearing psychotic illness to begin to doubt a diagnosis very quickly. This is usually on the grounds that the specialist: misheard, was trying to make the person feel better, was incompetent, missed something, that the symptoms got worse after the test, that new symptoms unknown to the tester are involved, etc., etc. The latter beliefs will then send the sufferer plunging into his or her mind in search of that item of 'proof' that was missed.

Tortured logic

Many people fearing psychotic illness involve extremely tortured logic to maintain the disorder. One person used his knowledge that he wasn't schizophrenic to prove that he was. That is, having been diagnosed as free of psychosis, he viewed his overpowering belief that he was schizophrenic, as delusional: which can be a schizophrenic symptom. Then, as a delusional person, this proved to him that he was schizophrenic. In this case, the fact that up to 10% of normal people are more delusion than some severe psychotics and that his belief was obsessional rather than delusional, had no effect.

Obsession/delusion

This, 'delusional or obsessional'? problem often occurs with OCD and with some people suffering with severe illness phobias (see HC in the 'Obsessional Thinking' article). And there probably isn't a single answer. Whether a belief is simply very strong but open to negotiation, or whether it is totally believed regardless of proof to the contrary may well depend on how deeply involved in the problem the sufferer is at any specific time. That it, the beliefs may be on a continuum of certainty from 'probably' to 'absolute', depending on the mix of fear, depression or outside influences involved from day to day. This is, naturally viewed by some sufferers as proof that their schizophrenia waxes and wanes, rather than accepting the more rational belief that they have a severe anxiety disorder. And, of course, when pointed out, this choice of irrational over rational will prove to some people that they are psychotic as in the case above.

　

　

Doberg said:

With symptoms like auditory hallucinations (hearing things that aren't there), derealization (feeling like you've lost touch with reality), and depersonalization (feeling as though you're on the outside, watching yourself), it's no wonder that so many people fear they're becoming schizophrenic. Rest assured, anxiety is not schizophrenia, and they are in no way related to the same disorder.

Click to expand...

When I read this, I wondered why do you (and most people) assume these are symptoms of an illness? I'm not being factitious here. I just look at this differently.

If you ask me, all those 'symptoms' you've mentioned are natural occurrences.

1/ To hear voices shouldn't automatically be regarded as hallucinations or a form of psychosis b/c that's not necessarily the case. Often it's just normal internal chatter or thoughts.

2/ DR and DP (or any dissociative 'disorders' for that matter) are natural functions of the mind to protect itself.

3/ Anxiety.. Natural function of the brain.

Why then do we assume if we experience any of these conditions, 'there must be something wrong'? Is it wrong for our bodies to react in this natural, organic way? I don't think so. I believe it's working within it's capabilities quite well. However, if we get told differently enough times we'll start to believe it. And we do get told over and over how 'ill' we are, from everyone, from your best mate to your family doctor. Seems misinformed more than anything.

We don't need to be stuck with these experiences either. Personally I don't want to be stuck with any of these conditions and I know they can all be reduced back to their generally acceptable levels with the right therapy and lifestyle changes. Sometimes it just takes a little longer than we wish.

I agree some of these experiences and feelings are disturbing and distressing at first... b/c we don't understand what's happening. Why don't we understand? Is it b/c we're not taught what these experiences and feelings are? Yes. More than likely that's the case. We don't even seem to get much assurance or support from the so called 'experts', the psychiatrists and the psychologists. Why not? What's the big deal about getting a good solid working database of information up for helping people with overwhelming dissociative stuff? What's the big problem??

Instead we get told how sick we are and pumped full of drugs that generally don't work or make us worse.

Stay strong!