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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Zanzibar_inJanuary on May 11, 2005, at 2:52:29
not so bad? Or are they indicators of a predisposition to psychosis?
Many things here, bare with me---This is for anyone with knowlade, first hand or otherwize, of psychosis/schizophrenia/pathological anxiety
1) Does anyone with mild psychotic symptoms, ie auditory hallucinations (not conversing,) and bouts of derealization, depression and anxiety, fail to respond to atypical antipsychotics? If so, what is your diagnosis? Do older antipsychotics work for you? What about benzodiazapines? Have you had to learn to simply *cope* with the psychotic symptoms?
2) If you have actually been diagnosed with Schizophrenia, or have developed psychosis, did you have any precipitating symptoms like those described above?
I don't have a Schizophrenia dx because I've never had bizzare delusions, and the hallucinations are mild, and are usually precipitated by stress. (Possibly caused by anxiety?)
I don't *feel* like I could ever be delusional, I always have much insight and am reasonable even whilst hearing things and being agitated and depressed..But I'm young- according to all I've read,younger than the average age of initial psychotic breaks. Are these "sub-syndromal"? symptoms? Could they someday develop into fullblown psychosis?
I worry at times that something horrible will happen in my life (like losing a loved one) I could not cope with something like that. Maybe I have a diathesis for developing Schizophrenia?My aunt was diagnosed with paranoid schizophrenia, she committed suicide at 22; but she had her first psychotic break when she was in her mid-teens, and she always denied that anything was wrong with her.
I've read some other posts on this subject on this board, and over and over again people say "if you are objective and have insight, are aware your hallucinations arent real, then you aren't schizophrenic".
Yes, I'm absolutely aware the voices arent real, and I never lose myself completely when I dissociate. But who knows how fine the line is that I'm walking?
All of these problems started durring very stressful circumstances in high school- I don't know what came first, the depression or the anxiety, but the hallucinations started seemingly out of the blue last summer.If youve made it this far- I commend you. you may have already responded to my other thread, but if not, please share any thoughts.
Posted by xbunny on May 11, 2005, at 8:48:31
In reply to Voices in the Head/ maybe not so bad?, posted by Zanzibar_inJanuary on May 11, 2005, at 2:52:29
Hi there,
> not so bad? Or are they indicators of a predisposition to psychosis?
> 1) Does anyone with mild psychotic symptoms, ie auditory hallucinations (not conversing,) and bouts of derealization, depression and anxiety, fail to respond to atypical antipsychotics?when Im not over the top psychotic I have symptoms like this. They are pretty resistant to antipsychotics. Given a scale from say 0 to 10, for me antipsychotics reduce symptoms to a 3 or 2 on a good day.
> If so, what is your diagnosis?
My dx is schizophrenia so I guess Im not the target audience for your post I just though I would post anyways.
> Do older antipsychotics work for you?
Yes, better than the atypicals.
> What about benzodiazapines?
no affect.
> Have you had to learn to simply *cope* with the psychotic symptoms?
Yes. I did this CBT for psychosis thing last year which dealt all about coping with and managing psychosis.
> 2) If you have actually been diagnosed with Schizophrenia, or have developed psychosis, did you have any precipitating symptoms like those described above?
Yes. For me when Im not actively psychotic, and I havent been for some time, I straddle the symptomology of Paranoid, Schizoid and Schizotypal Personality Disorder, I was that way from way before my first break. Often these disorders can be a precipate of proper schizophrenia. However not every one with these disorders will develop sz. The term for the symptoms that occur before one develops an illness proper is prodromal. In fact there used to be a subtype of sz whereby you only ever had prodromal symptoms, cant remember what its called.
> I don't have a Schizophrenia dx because I've never had bizzare delusions, and the hallucinations are mild, and are usually precipitated by stress. (Possibly caused by anxiety?)
> I don't *feel* like I could ever be delusional, I always have much insight and am reasonable even whilst hearing things and being agitated and depressed..are your hallucinations in theme with your depression? or just random?
>
> But I'm young- according to all I've read,younger than the average age of initial psychotic breaks. Are these "sub-syndromal"? symptoms? Could they someday develop into fullblown psychosis?They could, but they dont sound like prodromal symptoms to me. To my knowledge sz prodromal symptoms are usually sz like, ie paranoia, off the wall ideas, strange but brief hallucinations etc. Theres an overview of prodromal psychosis here if you like:
http://www.mentalhealth.com/mag1/scz/sb-prod.html> Yes, I'm absolutely aware the voices arent real, and I never lose myself completely when I dissociate. But who knows how fine the line is that I'm walking?
my advice would be not worry about this label or that label. If your hallucinations are bothersome see about treating them, same for the depression and anxiety. Since you have good insight feel blessed about it, keep an eye on yourself, be proactive if you think things are changing for the worse seek further help.
> If youve made it this far- I commend you.no, YOU have made it this far I commend YOU!
Regards Bunny
Posted by DanielJ on May 11, 2005, at 11:23:48
In reply to Re: Voices in the Head/ maybe not so bad?, posted by xbunny on May 11, 2005, at 8:48:31
From the Dad of a Lad whose dx = schiz.
As parents we were shocked and frightened to find our son might have it. Luckily he started meds less than a week after his first episode at 15 yrs. old. The learning process contiued with us resolving to do home stabilization.
He was given Abilify first, it = no sleep, true paranoia (which he hadn't yet experience and yes he had delusions of grandeur, the same one from day to day).
Within a month he left home one night at 2:00 am and wound up at a friends house. They let him stay till he got on their nerves. Back to the Pdoc in a week and on Zyprexa. It helped right away, he slept and so did we. His routine continued but a little better each day till one violent outburst brought the police and they brought him to a crisis center. The Pdoc there dumped the Klonopin he was taking and added Zoloft and doubled his Zyprexa. 10 days later he forgave us for sending him there and he was home at last.
After that another 5 months adjusting the Zoloft dose and healing the episode. Then back to High School. A year later and he's an Honor student in HS looking forward to his senior year and graduation.
Summary and my opinion Zyprexa is the best AP but doseage is the key to all medications. He was on 20mg for 1 year, now is taking 15 mg. Zoloft (or a suitable AD)is necessary for anxiety that is part of the syndrome. Take it every day. If after several weeks you feel dopey you probably have an overmedication problem. I Believe from experience that a substantial AP mg and a moderate AD will do the trick for most people with this illness. My son says now he can just ignore visual hallucinations he had occasionally (he used to see words in block letters). He claims that he hasn't heard voices in over a year. He is happily anticipating summer vacation.
Posted by Phillipa on May 11, 2005, at 20:17:24
In reply to Re: Voices in the Head/ maybe not so bad?, posted by DanielJ on May 11, 2005, at 11:23:48
That's wonderful Daniel. I'm so happy for you and your family. I too have been told that a lot of people just have to ignore the voices and never act on them if they tell you to harm yourself or someone else. A horrible disease. Fondly, Phillipa
Posted by DanielJ on May 12, 2005, at 11:20:05
In reply to Re: Voices in the Head/ maybe not so bad? » DanielJ, posted by Phillipa on May 11, 2005, at 20:17:24
I think it can be bad illness if not treated properly but with correct meds and good therapy and support it becomes more of an inconvenience like diabetes. My son is an undifferentiated schiz. He has had most of the symptoms of all types but after stabilization regained all his memory, intelligence and sense of humor. Flat personality is also part of this syndrome caused by a chemical imbalance in the brain. A good AD helps bring this back to a normal outlook.
The main thing is to keep moving in a positive direction and don't give up until you are there. Avoid doomsayers and negative influences if you can't get away from them then ignore them until you can.
Posted by xjs7 on May 12, 2005, at 12:23:40
In reply to Re: Voices in the Head/ maybe not so bad?, posted by DanielJ on May 12, 2005, at 11:20:05
Your son's illness might be an inconvenience, but psychosis is much more than that for most people. Your son is in the 30% of people who recover fully. Do you understand how lucky he is? 70% have lifelong disability. This is with medication. Some people live in institutions, still. How many people with schizophrenia do you know? What qualifies you to make sweeping generalizations about the illness?
Posted by Phillipa on May 12, 2005, at 18:22:43
In reply to Re: Voices in the Head/ maybe not so bad? » DanielJ, posted by xjs7 on May 12, 2005, at 12:23:40
I really feel it depends on the individual and how compliant they are with their meds. Of course some really don't have success. Most of the schizophrenics I took care of in the hospital lived some semblance of a heppy life. Some schizophrenics had a schizo spouse or lover. A lot did very well when Clozaril came out. I remember one pt I had named Billy. He used to come in all the time when he was noncompliant and actually dumped the garbage can on the diningroom table so the "horses" could eat it. His mother was schizophrenic and her disease was controlled so well you would not have known. Billy eventually went on Clozaril and did remarkedly well. Of course that was years ago. I know there are a lot new meds available now. But most of the schizophrenics are not institutionalized even if they are unable to work. There just aren't enough hospitals. Fondly, Phillipa
Posted by ghost on May 14, 2005, at 8:58:40
In reply to Voices in the Head/ maybe not so bad?, posted by Zanzibar_inJanuary on May 11, 2005, at 2:52:29
you've pretty much described my symptoms to a "T" (no pun intended). my pdoc thinks it's possible that all of these are secondary to a head injury i sustaned when i was 3 (many years ago)-- i was hit by a car and blacked out for a little while. seemed insignificant at the time-- i recovered fully, or so i thought. she's said that it sounds like i hit the part of my head responsible for hearing and sight, which would explain many of my hallucinations. anyhow, consequently, she's said that i need to be extra careful with medication, and lower doses probably work on me far better than the higher doses prescribed to a primary mental illness. i may have some issues unrelated to the head injury, but it did explain a lot of my schitzo-like problems.
do you have any history of head trauma in your past?
Posted by bimini on May 14, 2005, at 17:24:21
In reply to Voices in the Head/ maybe not so bad?, posted by Zanzibar_inJanuary on May 11, 2005, at 2:52:29
I have visual hallucination in form of distortion of shape and color, color blotch floaters, sparks, flashing. I perceive thought as image or previously viewed stuff superimpose. I know real from improbable when this is obvious, don't know about the everyday things but stopped questioning reliability.
I don't hear voices but sometimes notice absence of sound. I do have gaps I lose connection further and cannot respond, lose motorcontrol. When I am walking at the moment this may mean I keep on walking staight until something gets in the way or I come out of it.
I was dx'ed with affective everything. Schizophrenia because of the visual symptoms, but don't fit into any category neatly.
bimini
Posted by DanielJ on May 15, 2005, at 7:48:10
In reply to Re: Voices in the Head/ maybe not so bad?, posted by bimini on May 14, 2005, at 17:24:21
My son did fall off his bike a few times maybe 2 times on his head. At that time there wasn't any indication of damage. He was a daredevil when it came to that. He has always been a little different though.
One of the problems with this disease is not getting treatment soon enough. It is thought that many "episodes" can cause irreparable damage and it is thought that early onset can cause brain tissue loss (if not treated at that time) There was even a kind of "shuffle" and posture he exhibited but over the last year that has improved too. Plenty of family support helps too plus monitoring of medication intake. We take this as seriously and try to never slip up.
This is the end of the thread.
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