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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Kari on August 10, 2002, at 7:19:53
Does anyone here suffer from this disorder? If so, what meds have you found helpful, and do you find that it is necessary to remain on them indefinitely?
Thanks,
Kari.
Posted by NikkiT2 on August 10, 2002, at 8:02:00
In reply to schizotypal personality disorder, posted by Kari on August 10, 2002, at 7:19:53
I was diagnosed with this by a Psychologist I saw just 3 times... But have since been diagnosed Borderline Personality Disorder, so who knows!!!
Anyway, I have found Zyprexa an absolute godsend... it hs helped enormous amounts.
I am thinking I will probably be on meds mostn of my life.. *sighs*
Nikki x
Posted by Dinah on August 10, 2002, at 9:39:40
In reply to schizotypal personality disorder, posted by Kari on August 10, 2002, at 7:19:53
My first two psychiatrists thought I was schizotypal (by input from my therapist, I assume). I think the reasons were blunted emotions, odd ways of expressing myself, and a family history of schizophrenia. The first psychiatrist made no attempt to treat it with medications. He just said it was the way I was, there was nothing that could be changed, and not to feel guilty for the symptoms because they weren't my fault.
The second pdoc (who had had my records transferred from the first) suggested atypical antipsychotics. But I was in the midst of a Wellbutrin induced hypomania when I saw him and fired him before we really talked about it. By the way, I'm so glad I fired him because he never recognized the hypomania, and my third pdoc put me on depakote immediately.
I didn't transfer my records to my third pdoc, who just thinks I'm a bit eccentric, not schizotypal. So I've never been treated medically for schizotypal personality disorder.
I think my therapist still thinks I have it. But I've come to think of myself as eccentric, with a lot of dissociative skills, and some Aspergerish traits. So I guess my diagnosis isn't by any means sure.
If you don't mind my asking, could you tell me more about your diagnosis and treatment? Since I'm still pretty sure my therapist still thinks I have schizotypal personality disorder, I always want to learn all I can. And the literature seems woefully inadequate. All it seems to do is repeat the DSM-IV criteria, without much in the way of examples. I even bought a big expensive textbook on it once, to find it was nothing but a lot of statitistics, no stories of what it was like at all.
Do you know of any good books on the subject?
Sorry to go on for so long, but it's not a subject that comes up very often. :)
Dinah
Posted by Kari on August 11, 2002, at 9:42:15
In reply to Re: schizotypal personality disorder, posted by NikkiT2 on August 10, 2002, at 8:02:00
Hi Nikki,
Glad to hear Zyprexa is helping you.
BTW, I've heard of many people not being certain what personality disorder they suffer from- schizotypal or borderline. It seems strange, as I thought these two disorders were so different.Take care,
Kari.
Posted by Kari on August 11, 2002, at 10:30:45
In reply to Re: schizotypal personality disorder » Kari, posted by Dinah on August 10, 2002, at 9:39:40
Hi Dinah,
The first thing I have to mention is that I always enjoy reading your posts and find it difficult to understand what you mean by "odd ways of expressing yourself", as you always express youself so clearly and to the point :)
Are you still on depakote? Do you find it helpful for symptoms such as blunted emotions?
In response to your question, I have never been diagnosed with SPD. My Pdocs have generally stated that they don't know what I suffer from, though in the past I have received mistaken diagnoses from both extreme ends of the schizo spectrum. The assumption that SPD is the proper diagnosis is mine, based on symptoms like blunted emotions, severe social anxiety and communication problems, living in an internal world, autistic tendencies and a tendency to lose the capability for reality testing during stress.
The only AP I ever tried was perphenazine, which even at a low dose was difficult to bear, though it had some effect on emotional blunting. Perhaps an atypical AP would yield better results but perphenazine has given me tardive dyskinesia, bouts of dystonia and parkinsonism every now and then (even years after going off the drug) and an intense fear of going anywhere near another neuroleptic. So all I can consider taking is celexa, which at the proper dose elminates all symptoms of anxiety and depression but leaves the negative symptoms of SPD unchanged.
Sorry I don't know of any books on the subject. There doesn't seem to be much about it on the internet, either, except for the repetition of DSM criteria, as you have already seen :)
Do you suffer from symptoms such as odd sensations or perceptions, social anxiety and being "trapped" in your own world? Most schizotypals seem to. Have you considered asking your therapist for more information and an explanation of the condition she suspects you suffer from? In any case, regardless of your diagnosis, I hope you find your therapy helpful and that you are able to work on the issues which you feel need to be worked on.
Sorry I couldn't be of any more help, but if you have any further questions, please let me know.
Take care,
Kari.
Posted by Dinah on August 11, 2002, at 14:22:17
In reply to Re: schizotypal personality disorder » Dinah, posted by Kari on August 11, 2002, at 10:30:45
> Hi Dinah,
>
> The first thing I have to mention is that I always enjoy reading your posts and find it difficult to understand what you mean by "odd ways of expressing yourself", as you always express youself so clearly and to the point :)Thank you, Kari. :) I guess the sort of thing my therapist would show as examples is like right now I'm experiencing some lightheadedness and grogginess from Effexor withdrawal (I hope). But my natural way of saying that would be to say that it felt my brain had been replaced by a viscous fluid that was sloshing about when I moved. I prefer to think of it as imaginative, (grin) but my therapist often has difficulty following me. I'll say I'm "whooshing" when I mean I'm experiencing derealization, or that "the wind is hurting my arms" when I'm feeling agitated. That sort of thing.
>
> Are you still on depakote? Do you find it helpful for symptoms such as blunted emotions?
>
Depakote neither hurts nor helps. I've gradually come to believe the blunted emotions are a combination of strong dissociative skills and some Aspergerish qualities. But given my family history, I don't completely rule out schizotypal personality disorder either.> In response to your question, I have never been diagnosed with SPD. My Pdocs have generally stated that they don't know what I suffer from, though in the past I have received mistaken diagnoses from both extreme ends of the schizo spectrum. The assumption that SPD is the proper diagnosis is mine, based on symptoms like blunted emotions, severe social anxiety and communication problems, living in an internal world, autistic tendencies and a tendency to lose the capability for reality testing during stress.
>
Hmm. A lot of that does describe me. Although I don't really have social anxiety. I am withdrawn (off board) but I like it that way. Have you looked into Asperger's? I understand that there is some diagnosis overlap. I tend to think Aspergerish for myself because I have a lot of the neurological signs, like toe walking and having to motor through things.> The only AP I ever tried was perphenazine, which even at a low dose was difficult to bear, though it had some effect on emotional blunting. Perhaps an atypical AP would yield better results but perphenazine has given me tardive dyskinesia, bouts of dystonia and parkinsonism every now and then (even years after going off the drug) and an intense fear of going anywhere near another neuroleptic. So all I can consider taking is celexa, which at the proper dose elminates all symptoms of anxiety and depression but leaves the negative symptoms of SPD unchanged.
>
I've got to say, SSRI's can cause the negative symptoms in just about anyone. And can certainly exacerbate them in vulnerable people. I always say (and this would be one of the schizotypal things according to my therapist) that SSRI's work by increasing the tension and distance between your feeling self and your thinking self, and since I already have a high degree of tension between the two, that SSRI's cause me to overshoot the desired distance. I don't know if that makes any sense.> Sorry I don't know of any books on the subject. There doesn't seem to be much about it on the internet, either, except for the repetition of DSM criteria, as you have already seen :)
>
Yeah, it makes it tough to decide if you have it or not when you can't find much info on it. If I just read the DSM criteria for most any personality disorder, I can convince myself I have it. I did have elevated scores on scales 2,7,&8 on the MMPI which would be consistent with schizotypal personality disorder, but that isn't adequate to diagnose it.> Do you suffer from symptoms such as odd sensations or perceptions, social anxiety and being "trapped" in your own world? Most schizotypals seem to. Have you considered asking your therapist for more information and an explanation of the condition she suspects you suffer from? In any case, regardless of your diagnosis, I hope you find your therapy helpful and that you are able to work on the issues which you feel need to be worked on.
>
We've discussed it ad nauseum, when it first came up. I really didn't know what a personality disorder was when my pdoc first suggested I had one, and my feelings were really hurt. They really ought to change that classification name.I do have what some people may consider odd perceptions I guess. I am extremely aware of what is happening in my body, and I might experience anxiety or anger, for example as being broken into isolated physical effects, rather than saying I'm angry or I'm anxious. And I firmly believe I pick up the emotional energy of other people. My perceptions are usually quite accurate however, so I'm not sure that they are odd at all. I think I just have extra sensitive antennae for that sort of thing. But what other people would think is what would matter in schizotypal I suppose. I can't imagine why my therapist would consider it an odd belief though, when I repeatedly show in therapy that I really can read his moods. Maybe it's just the way I express it.
> Sorry I couldn't be of any more help, but if you have any further questions, please let me know.
>
Oh no, it's of enormous help just to find someone I can discuss this with. I'd love to hear your reactions to what I described.
> Take care,
> Kari.You too,
Dinah
>
>
Posted by Kari on August 12, 2002, at 7:43:22
In reply to Re: schizotypal personality disorder » Kari, posted by Dinah on August 11, 2002, at 14:22:17
Hi Dinah,
>I've gradually come to believe the blunted emotions are a combination of strong dissociative skills and some Aspergerish qualities. >
Does anyone else in your family have similar dissociative skills or Aspergerish traits?
>Have you looked into Asperger's? I understand that there is some diagnosis overlap. >
Thanks for the tip. I looked at some information now and some of it seems to fit.
> I've got to say, SSRI's can cause the negative symptoms in just about anyone. And can certainly exacerbate them in vulnerable people. I always say (and this would be one of the schizotypal things according to my therapist) that SSRI's work by increasing the tension and distance between your feeling self and your thinking self, and since I already have a high degree of tension between the two, that SSRI's cause me to overshoot the desired distance. I don't know if that makes any sense.>
It makes a lot of sense. I don't however, experience a worsening of negative symptoms on SSRIs. They simply have no great effect on them besides making everything so much easier due to the absence of depression and anxiety. On a high dose all I can feel is an unconditional sense of satisfaction and well being. This is not so disturbing as I don't have access to a full range of emotions anyway. Do you find that SSRIs increase the severity of your dissociative tendencies?
> They really ought to change that classification name.>
Definitely.
>I do have what some people may consider odd perceptions I guess. I am extremely aware of what is happening in my body, and I might experience anxiety or anger, for example as being broken into isolated physical effects, rather than saying I'm angry or I'm anxious. And I firmly believe I pick up the emotional energy of other people. My perceptions are usually quite accurate however, so I'm not sure that they are odd at all. >
Me, too :) After many years of being overwhelmed by such intense feelings such as anger and depression, I lost the ability to feel. Now all emotions appear to be physical sensations-extreme physical tension and feeling on the verge of explosion instead of anger, for instance. I can describe feeling that "nothing in my body works anymore" instead of recognizing this as depression. As difficult as this is, the alternative was far worse.
I also pick up on people's moods, even when they themselves aren't aware of it. It is obvious to me, for instance, when a family member is on the verge of a depressive crisis.
Your perceptions don't seem to be strange. Perhaps your therapist is uneasy about the fact that he can't hide his moods around you :)
By the way, do you also feel that you sometimes project your feelings or their intensity onto other people?>Oh no, it's of enormous help just to find someone I can discuss this with>
I feel the same way :)
All the best,
Kari.
Posted by Dinah on August 12, 2002, at 10:07:43
In reply to Re: schizotypal personality disorder » Dinah, posted by Kari on August 12, 2002, at 7:43:22
> Hi Dinah,
>
> >I've gradually come to believe the blunted emotions are a combination of strong dissociative skills and some Aspergerish qualities. >
>
> Does anyone else in your family have similar dissociative skills or Aspergerish traits?I can see some Asperger's traits in my family. No full blown Asperger's. Dissociative skills I don't think I'd be able to see, and it's more of a learned coping mechanism. But as I learn more about myself, I realize that it isn't necessarily that my feelings aren't there, but more that I'm separated from them. I am very good at dissociation.
>
> >Have you looked into Asperger's? I understand that there is some diagnosis overlap. >
>
> Thanks for the tip. I looked at some information now and some of it seems to fit.
>
The thing (other than neurological signs) that really seems to fit me is the inability to read social cues. I'm excellent at reading emotions, but lousy at conversational rhythm, jokes, all sorts of social things. I have to fake it a lot, which makes face to face socializing a strain, although I'm not a teensy bit shy or phobic about socializing. I just find it difficult.>
> >I do have what some people may consider odd perceptions I guess. I am extremely aware of what is happening in my body, and I might experience anxiety or anger, for example as being broken into isolated physical effects, rather than saying I'm angry or I'm anxious. And I firmly believe I pick up the emotional energy of other people. My perceptions are usually quite accurate however, so I'm not sure that they are odd at all. >
>
> Me, too :) After many years of being overwhelmed by such intense feelings such as anger and depression, I lost the ability to feel. Now all emotions appear to be physical sensations-extreme physical tension and feeling on the verge of explosion instead of anger, for instance. I can describe feeling that "nothing in my body works anymore" instead of recognizing this as depression. As difficult as this is, the alternative was far worse.
> I also pick up on people's moods, even when they themselves aren't aware of it. It is obvious to me, for instance, when a family member is on the verge of a depressive crisis.
> Your perceptions don't seem to be strange. Perhaps your therapist is uneasy about the fact that he can't hide his moods around you :)Definitely true. It's kind of funny to watch him now trying to be perfectly honest while framing his honesty in the most positive way possible. So I do think he's uneasy at my accurate perceptions. You should have seen him blush when I told him exactly how long a period of time he really dreaded seeing me in his office, before he became more comfortable, or various times he was angry with me. I think it makes him especially uncomfortable that I can read him better than he can read me, when it would be more useful in therapy for the reverse to be true.
> By the way, do you also feel that you sometimes project your feelings or their intensity onto other people?
>
Oddly enough, no. There are times when I can practically see my psychic energy (for want of a better word) snapping and crackling with anxiety or agitation. I almost expect people to jump back when they touch me, or at the very least be as aware of my moods as I am of theirs. But no. I am actually quite flat in my expressions and people have a harder time reading me than they do most people. I have gone through two week agitated depressions with my husband being largely unaware of them. And my therapist as well has trouble reading me. Much less anyone else. It's odd to me, as I see the ability to pick up on these things as essential as seeing or hearing. But I did grow up in a volatile home and may have developed my sensitivity to reading emotions as a way to emotionally survive.
What other sort of things make you feel like you might have schizotypal personality disorder?Thanks,
Dinah
Posted by Kari on August 13, 2002, at 13:12:31
In reply to Re: schizotypal personality disorder » Kari, posted by Dinah on August 12, 2002, at 10:07:43
>The thing (other than neurological signs) that really seems to fit me is the inability to read social cues. I'm excellent at reading emotions, but lousy at conversational rhythm, jokes, all sorts of social things. I have to fake it a lot, which makes face to face socializing a strain, although I'm not a teensy bit shy or phobic about socializing. I just find it difficult.>
I am extremely lousy at conversations. I never know the right thing to say and it takes so much effort to fake it through and to pretend I have the same abilities, feelings and perceptions as do others.
>I think it makes him especially uncomfortable that I can read him better than he can read me, when it would be more useful in therapy for the reverse to be true.>
Yes, this is a problem. Do you find that, despite the fact that he lacks your skills, you are able to trust him enough to discuss most of what you would like to?
>I am actually quite flat in my expressions and people have a harder time reading me than they do most people.>
This complicates things further, since people who feel different as we do usually long to be understood but lack the communication skills and confidence to bring about this understanding.
>What other sort of things make you feel like you might have schizotypal personality disorder?>
Inappropriate and constricted affect, tendency to feel as though people can see through me (or perhaps that's just wishful thinking), great difficulty finding the proper way to describe things or to phrase sentences, faulty sense of identity and sensing that my inner feelings are an indication of what is going to happen to others, to name but a few :)
Best wishes,
Kari.
Posted by Dinah on August 13, 2002, at 20:06:58
In reply to Re: schizotypal personality disorder » Dinah, posted by Kari on August 13, 2002, at 13:12:31
I actually do trust my therapist very deeply, after only seven years of therapy. Actually I learned to trust him after only five. Part of what helps me trust him is seeing him try so very hard to be honest with me. No blank slate there.
And it's great, in that even though he thinks I'm odd, he's trying to make me see that being just a bit different in the way I experience things can be a positive thing, not only to me but to others too. He tells me it's a gift. I ask him if I can trade it for the gift of easy relationships. (grin)
Do you have a great therapist who can help you see your differences as positives? And also to help with practicing the more technical social skills?> Inappropriate and constricted affect, tendency to feel as though people can see through me (or perhaps that's just wishful thinking), great difficulty finding the proper way to describe things or to phrase sentences, faulty sense of identity and sensing that my inner feelings are an indication of what is going to happen to others, to name but a few :)
>
Hmm. Yes. That sounds familiar. But my pdoc says that diagnosis is a matter of degree. He sees me as just a plain garden-variety eccentric, while my last pdoc saw me as having schizotypal personality disorder. I REALLY wish I could find more information on the disorder. There is a sad lack there. So I guess I'll never have a firm answer. And I do so love firm answers. :)
Posted by Kari on August 14, 2002, at 13:04:47
In reply to Re: schizotypal personality disorder » Kari, posted by Dinah on August 13, 2002, at 20:06:58
It's good that you can trust your therapist and that he is trying to make you see the advantages of being different. I haven't been able to stay in therapy due to lack of trust and inability to communicate. In any case, considering the way I feel and the direction my life is headed, no one would be able to convince me there's a bright side to being schizotypal :)
It is possible that on a low dose of AP medication things might be different, including the ability to learn social skills, but with the way I have been feeling physically - low blood pressure, symptoms of parkinsonism and everything slowed down, I would have to be a fool to consider taking something like that :) so it comes down to settling for being "different".
It isn't right for your pdoc to label you "eccentric". He could have found a more fitting word. A person who can express herself in writing and support others the way you do on this board is anything but "eccentric" :)
It is true that there is little information about this disorder available. I found something through a search today - not a lot of information though...www.geocities.com/ptypes/schizotypalpd.html
Posted by Dinah on August 14, 2002, at 17:02:17
In reply to Re: schizotypal personality disorder » Dinah, posted by Kari on August 14, 2002, at 13:04:47
Thanks for the compliment, Kari. I don't really mind eccentric though. It makes me feel like British aristocracy.
I was thinking about you today. I've really gotten a lot out of this board as a way to reach out to others who are more likely than most to be accepting of differences. And I think it's really done me some good in terms of self acceptance. (I do have some down moments though. See my post on Social. :) )
Why don't you come join us on Psycho-Social Babble, and one day maybe in Open chat. :) You'll get some social practice, meet a lot of great folks, and have some fun.
And there is no huge risk to it either. We're all anonymous here, and I find that enormously soothing.
Oh, and I'll check out that website. Thanks!
Posted by Dinah on August 14, 2002, at 17:05:29
In reply to Re: schizotypal personality disorder » Dinah, posted by Kari on August 14, 2002, at 13:04:47
I think you express yourself enormously well. Are you like me in that your difficulties are less in type and greater in person?
That would be another reason to socialize here on the board. I somehow have much greater access to my emotions when I'm writing than I do in person. I really wish sometimes I could be Dinah in real life the way I am here...
Posted by Dinah on August 14, 2002, at 17:11:46
In reply to Re: schizotypal personality disorder » Dinah, posted by Kari on August 14, 2002, at 13:04:47
I forgot to mention that I mentioned this thread to my therapist today and told him that I said that even though my pdoc thinks I'm merely eccentric, that I thought he still thinks I have schizotypal personality disorder.
He admitted that he did, but said that he wouldn't lose sleep over what to call it. If I preferred my pdoc's explanation that was ok with him. :) So I read him right again. (He had never actually come out and said he thought my prior pdoc was right and my new one was wrong. I had just inferred his opinion.)
Posted by Kari on August 15, 2002, at 13:12:26
In reply to Re: Another P.S. » Kari, posted by Dinah on August 14, 2002, at 17:11:46
You really do seem to have a talent for reading people. It must be a challenge for your therapist, who probably notices your abilities, to try to cover up certain thoughts and feelings :)
>I think you express yourself enormously well. Are you like me in that your difficulties are less in type and greater in person?>
Thanks. I really am different on the board, as I find converstaion, even with family members, extremely difficult.
>I really wish sometimes I could be Dinah in real life the way I am here... >
Perhaps with practice on the board things will eventually get easier in real life, whatever that is :)
I'll take your advice and visit Psycho-Social Babble.
Take care,
Kari.
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