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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by JaclinHyde on March 25, 2006, at 2:18:41
During my hypochondriac heydey I was positive I was psychotic. I had no reason to believe this though; I never heard voices etc. But the idea still scared me. To put that in perspective a stomach ache was DEFINITELY stomach cancer.
Anyway I had a doctor straighten me out one day with some very brilliant words. I told him that sometimes my left arm didn't feel like it was attached to me. He said "Look at your left arm. Do you see it?" I said well...yes. He said "That makes you neurotic. You get the feeling it isn't there but you still see it. A person with a psychosis will get that same feeling, look at his left arm and NOT see it."
I have never forgotten that. So for all of you who are afraid you are going crazy remember what he told me.
Hope this helps someone.
JH
Posted by Tony P on March 25, 2006, at 2:26:55
In reply to Are you psychotic or neurotic? How to tell...., posted by JaclinHyde on March 25, 2006, at 2:18:41
My mother the doctor used to say: A psychotic says black is white. A neurotic says, I know black is black ... and I can't _stand_ it!
Posted by special_k on March 25, 2006, at 4:02:24
In reply to Re: Are you psychotic or neurotic? How to tell...., posted by Tony P on March 25, 2006, at 2:26:55
Reality testing (present in neurosis absent in psychosis) and level of functioning (higher in neurosis lower in psychosis) were meant to be the main differences.
Though the distinction doesn't appear in the DSM.
I think... Because it was thought to be not very useful...
Though it is still a distinction that is employed by some clinicians.
Posted by JaclinHyde on March 25, 2006, at 8:32:12
In reply to Re: Are you psychotic or neurotic? How to tell...., posted by Tony P on March 25, 2006, at 2:26:55
> My mother the doctor used to say: A psychotic says black is white. A neurotic says, I know black is black ... and I can't _stand_ it!
LOL, I love it!!
JH
Posted by Caedmon on March 25, 2006, at 13:51:23
In reply to Are you psychotic or neurotic? How to tell...., posted by JaclinHyde on March 25, 2006, at 2:18:41
Unfortunately the distinction is not always that simple.
I recall a study in which doctors, blinded to prior diagnostic history, were given schizophrenic patients to evaluate. The blinded evaluations were not very consistent. (Often they were mistakenly Dx'ed as depressed or anxious.) So, even in the more clear-cut cases of psychosis, it may not be so clear-cut.
I subscribe to the "spectrum" model of psychosis in which one can exhibit a certain degree of psychotic Sx without being truly psychotic. I don't think these conditions are black and white.
- C
Posted by med_empowered on March 25, 2006, at 16:59:56
In reply to Are you psychotic or neurotic? How to tell...., posted by JaclinHyde on March 25, 2006, at 2:18:41
There are shades of grey between the two--at one point, a doc told me my super-high anxiety levels were due to a "subtle though disorder" which was dx'd as psychotic disorder nos--basically, the idea was that I had a low-level psychosis and still managed to function reasonably well (luckily for me, those problems have since ended). ANYWAY...point is: even seemingly "normal" people can have psychotic symptoms and even seemingly "crazed" people can have pretty good insight and ability to distinguish reality from fiction. The BIG question is about the level of functional impairment, which is determined more by the interplay of symptoms with surrounding than by either factor alone. Example: Some people who hear voices hear nice voices, which apparently enriches their lives. Assuming they can handle these hallucinations, they might be better off without treatment. ON the other hand...someone who isn't psychotic could be dealing with such severe anxiety or OCD or depression that they're effectively crippled in their day-to-day life. In that case, treatment might be desirable, even though there isn't any "psychosis".
Posted by Racer on March 25, 2006, at 19:13:03
In reply to psychosis vs. neurosis, posted by med_empowered on March 25, 2006, at 16:59:56
The English poet William Cowper -- pronounced 'Cooper' -- was locked up in a mental institution, because he heard the Devil speaking to him. After some time there, though, he was released.
At that point, the Devil had stopped speaking to him. Now the voice he heard speaking to him was that of God. Therefore, he was well enough to be released.
When I think of that, I'm very glad to be living today, despite all the problems we all have with meds...
Posted by Phillipa on March 25, 2006, at 20:11:21
In reply to psychosis vs. neurosis, posted by med_empowered on March 25, 2006, at 16:59:56
Gee thanks med I know I have high levels of anxiety so since they interfer with the functionsing of my life and I'm afraid of my shadow and afraid to go anywhere I'm psychotic? Love Jan
Posted by special_k on March 25, 2006, at 21:51:14
In reply to Re: Are you psychotic or neurotic? How to tell...., posted by special_k on March 25, 2006, at 4:02:24
yeah. the distinction isn't part of official nosology (is that the word? official terminology) because... of the difficulty in the distinction.
it is like bizzare / non bizzare delusions.
that one isn't part of official usage either.
but clinician's (typically old school ones) persist in using the terms...
though to be fair. just because there isn't a hard and fast line to differentiate doesn't mean the distinction isn't worth it.
i mean... when does a hill become a mountain? there might well be an indeterminate bit in the middle where there is no fact of the matter but that doesn't mean the distinction is completely worthless...
Posted by TylerJ on March 27, 2006, at 13:40:32
In reply to Are you psychotic or neurotic? How to tell...., posted by JaclinHyde on March 25, 2006, at 2:18:41
> During my hypochondriac heydey I was positive I was psychotic. I had no reason to believe this though; I never heard voices etc. But the idea still scared me. To put that in perspective a stomach ache was DEFINITELY stomach cancer.
>
> Anyway I had a doctor straighten me out one day with some very brilliant words. I told him that sometimes my left arm didn't feel like it was attached to me. He said "Look at your left arm. Do you see it?" I said well...yes. He said "That makes you neurotic. You get the feeling it isn't there but you still see it. A person with a psychosis will get that same feeling, look at his left arm and NOT see it."
>
> I have never forgotten that. So for all of you who are afraid you are going crazy remember what he told me.
>
> Hope this helps someone.
>
> JH
Great job by your doc...we neurotics need to hear things like that. I remember when i first started experiencing probs with dep/ocd/anxiety i was also afraid that i was really going off the deep end. Information similar to what you mentioned above finally convinced me that i was not psychotic and i was very relieved...still miserable, but relieved. :) My ocd consisted of really bothersome thoughts, no rituals, just repetitive thoughts that I tried and tried to stop...when i learned to just accept them and not fight them they lessoned greatly. Today with Parnate and hundreds of hours of CBT my ocd is non-existant.Tyler
Posted by spriggy on March 29, 2006, at 0:02:39
In reply to Re: Are you psychotic or neurotic? How to tell.... » JaclinHyde, posted by TylerJ on March 27, 2006, at 13:40:32
My thoughts on psychosis is that if I am questioning if I am psychotic, most likely I am not.
My dr. told me once, " If you wonder and are concerned if you are crazy, you aren't. the people I have to give that diagnosis too are clueless that they are."
This is the end of the thread.
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