Schizophrenia

I’ve lived in social reclusion over the last few years, and since I gave up my studies at the university, I’ve had no clear plans for the future. I’d been writing ever since, in an attempt to find solace in fantasy. At that time, I felt very melancholy, and often considered suicide.
When the only friend I had fell in love with me, I felt forced yet unable to requite her feelings. Yet, while I was not in love, I displayed the same obsessive-compulsive behavior characteristic of it. Her love consoled me for a while, especially because I had long felt the need for a soulmate. At the same time, however, that I could not requite her feelings made me feel miserable. During that period, I sometimes cut myself weekly, every time rubbing salt in the wounds or pouring eucalyptol on them. This was more frequent than ever before, yet I didn’t realize what this experience was doing to me, even when I once got a splitting headache after seeing her. Around this time, I begun to experience emotional flattening, which I attributed to summer (I suffer from ‘reverse’ seasonal affective disorder, also known as summer depression).
Over the last few months, I’ve spiralled into clinical depression when she abandoned me, and it appeared that we had both confused friendship with romantic love. I’ve felt increasingly empty over the last few months, experiencing ever increasing blunted affect. I can no longer enjoy almost anything. I appear to suffer from anhedonia: lack of pleasure in food, nature, social contact, etc. I’ve also been an ascetic for over a year because of its hormonal benefits (lowered prolactin and increased testosterone levels) and to sublimate my libido into creativity. I now find myself completely unable to find pleasure in it, at least not consummatory (appetitive pleasure is present but only very slightly, and it easily suppressed).
I tended to be quite creative until the onset of my clinical depression. I’ve always been extremely absent-minded and have been diagnosed (falsely) with ADHD, for which I’ve used Ritalin for three years. Obviously, I have a low “latent inhibition,” which is associated with both creativity as psychosis. (Latent inhibition blocks seemingly redundant information, in this way increasing alertness and reducing creativity.) I am gifted, though I don’t know my IQ and don’t care to know it. My IQ test score varies (110-140) and is ultimately unreliable in my case. I’ve had atichyphobic panic attacks whenever I had to do some cognitive test, be it a simple game such as chess, an IQ test, or an exam (for the latter, I’ve used Lorazepam over the last years). Being an unworldly person, I also have a lack of basic knowledge while having more extensive knowledge in more advanced areas. I suffer from PDDNOS (pervasive developmental disorder not otherwise specified), which has recently been alleviated through visual and motoric training. As a result of my PDD, I’ve had poor social, motoric, and perceptual skills. PDD has been shown to be associated with childhood-onset schizophrenia (COS).
I’ve tried a dozen medicines, and now use tyrosine and melatonine. They appear to work slightly, but not much. Very, very rarely, I can function normally again for a few days, only to relapse shortly afterward for many more weeks. Usually, I have no motivation at all, and almost no will to do anything (avolition). I’ve mostly been searching for psychiatric information to find out what the hell is wrong with me.
I first suspected that I was clinically depressed at the beginning of this May, when, on one of the rare occasions I saw my assumed soulmate, I felt listless, lethargic, apathetic. I felt nothing at our first kiss. That same day, I’d been lying in bed staring at the ceiling half the day. This wasn’t the first time this had happened to me, as the first time I’d been in such state of stupor was at the end of March. It had never been so severe, however, and by the evening I called my father telling him that I wanted to see a psychologist.
The psychologist my father had in mind was currently unavailable, however, so we instead saw a psychiatrist. I spoke him a few days later. At that time, I was very upset about not being in love with someone I nonetheless so loved, as I had been on and off for the past two months. It felt as if I could feel absolutely nothing, and this terrified me. I was so confused about this that I wanted to find out what was wrong as quickly as possible, and I was determined to pay the bill relieved and with a greater understanding of my own psychological situation. But the way he spoke to me, beginning by plainly asking what was wrong and patiently waiting for a response, intimidated me. I had to force myself to disclose my feelings, and yet I wished to explain everything as quickly as possible, so that as a result I talked a lot of gibberish. My psychiatrist apparently interpreted this as thought disorder, although I’d never talked in such a confused manner to anyone else. Worse, he had completely misconstrued many of my words, and when I tried to explain them, he didn’t want to listen. After fifteen to thirty minutes, he told me I was schizophrenic. Because he was clearly jumping to conclusions, I didn’t want to believe him. I was also scared of psychiatry, and had I known beforehand that I was speaking with a psychiatrist, not a psychologist, I’d have been more cautious. I was terrified that he’d force me to be hospitalized, and drug me against my will to control me. I’d never had a high opinion of psychiatry, and this conversation didn’t improve it much. I left with fears of being followed by an ambulance, which I realized was rather paranoid.
Ironically, this conversation made me feel better for a few weeks, as though I’d just been subject to electroconvulsive therapy. The coming weeks, I was very hyperactive, doing anything in order not to relapse. I spent my time writing like mad, sometimes writing up to five pages per hour. What I wrote was not incoherent, however, as my father read and fully understood it.
Unfortunately, I failed, however, and after a few weeks relapsed into my former state of apathy, this time for several months. I’d recover a few more times, although this usually lasted only a few hours to a day. I once felt much better for four days, following an intense religious experience I felt when walking by the coastline on a rainy day at sunset.
Following my breakup, my behavior became erratic. I often found the need to take my aggression (toward myself, my life, and the world) out on objects, such as by smashing sticks. Once, I vented my hatred in screaming. I started having murderous thoughts, though at no-one in particular. At the worst point, I pretended to stab someone, imagining them to stand before me. I started to hate everything in the world, often visualizing to destroy everything in my environment in various ways. My suicidal urges came to a head at the beginning of June, when I lay in bed for nearly an entire day preparing myself to kill myself. All that time, I still didn’t feel anything, and the emotion I had was often inappropriate. I hadn’t shed a single tear that day, yet later that evening I laughed, genuinely. At that time, I was very fatigued, and in the afternoon often slept for hours. Again, I attributed this to my summer depression. I’m very sensitive to light, and feel much better in murky weather (photosensitivity is a symptom of pyroluria, which occurs in 20% of cases of schizophrenia and appears to be one of its causes). My exhaustion got better after a month or so as days shortened again. To allay my sleep disorders, I also used Dynatonic, a tonic containing an assortment of vitamins of the vitamin B complex, as well as magnesium.
I’d suffered from irritable bowel syndrome since February, which may have been due to chronic use of valerian (which for some time I also thought in part responsible for my feelings of emptiness). In June, this came so severe that for some time I thought I suffered from acute appendicitis. I was diagnosed with gastritis and intestinal cramps, which a specialist later said to be psychosomatic.
At that time, I began to abuse anxiolytics whenever I felt like it, on one occasion using 4 mg of Lorazepam (Temesta, Ativan), twice the maximum dose, along with a glass of whisky. It was my intention to kill myself, but I reconsidered before I’d overdosed the Temesta. I dozed the whole day and vomited the only meal I had that day. I considered using hallucinogens, but reconsidered out of fear for HPPD. (Although the causal relationship is unclear, schizophrenia is associated with substance abuse.)
I’ve had a few cases of catatonia, though I’m aware that it also occurs in clinical depression. March the 31st, I lay in bed for hours thinking of nothing and feeling nothing but emptiness. Eventually, I made an enormous effort to carry on and even managed to write for some time. When my computer crashed before it was saved, so that hours of work had come to nothing, I freaked out, smashed a chair against the wall, and started screaming and sobbing. Then, I slumped into my chair in an unusual posture. I made repetitive utterances and movements characteristic of catatonic stereotypy. I hadn’t lost touch with reality, however, although I’ve heard that my brother (now 37) has once become totally mute while clinically depressed.
Although my father, appart from being gifted, is normal psychologically, my mother seems to suffer from mood disorders (slight bipolar disorder), which I may share. (Bipolar personality disorder and schizophrenia appear to be pleiotropically linked, meaning that they have common genetic risk factors.) She’s possible schizotypal, which is manifested primarily in highly eccentric behavior. I myself have always been legendary for my eccentricity, and on an Internet test scored 90% for schizotypy. I also appear to be schizoid, satisfying most of the criteria of the Akhtar phenomenological profile (http://en.wikipedia.org/wiki/Schizoid_per sonality_disorder#Akhtar_phenomenological_ profile), except for the “Covert Love and Sexuality” and “Covert Ethics, Standards and Ideals” features. I’m not afraid of intimacy, and I also don’t satisfy most of the Guntrip criteria (http://en.wikipedia.org/wiki/Schizoid_per sonality_disorder#Guntrip_criteria). I don’t think I suffer from narcissism or sense of superiority (I scored only 14% for narcissism on the mentioned test) and I don’t think I suffer from depersonalization or regression, either.
My mother was 45 when I was born. There was a complication during pregnancy, namely a placental hemorrhage. My father told me this was harmless, although, as the placenta was my first body, I’m not sure about this. Because my brother died during pregnancy, I suffer from general and social anxiety disorder, and consequently have been exposed to much stress in my life. I was born in late spring, the first of June. All my life I’ve been living five days per week in the city, in rather poor housing conditions. I’ve been persecuted in early childhood and have had social problems all my life, which came to a head when I was forced to repeat a grade. School has been a torment to me until I studied at home, especially during pubescence.
I’ve had many paranoid ideas in the past, including that people would plot against me or that I’m being watched by others. I still have the latter, though this may as well be because of my sociophobia. However, toward one person I’ve had fears which are clearly irrational. I speak of a highly idiosyncratic private teacher I’ve seen a few times. His appearance frightened me immediately when I saw him, and his presence made me feel intensely uncomfortable. During my first lesson, I almost feared that he’d rob, kidnap or rape me, and deliberately took the chair closest to the exit. When I later accidentally sent him a mail, and he replied, I didn’t dare to read it. When someone rang the doorbell of the building the next morning, I locked the door and fled into my closet, having trouble controlling my breathing when I heard knocking. These few panic attacks of acute paranoia have never occurred to me since then, and this was months ago (April?).
At that moment I first suspected that my psychiatrist was right. Both my father and psychotherapist think I am not, however, although they know of most of the things I’ve written here. My psychologist claims that I do feel, and that my emptiness is merely an illusion (my emotions would be converted into meta-emotions). Usually, however, the only thing I can still feel is fear, no matter what happens.
I sometimes think that I’ll stumble upon him, or other people I know (notably the last friend I’ve had, and her parents) when I look at passersby who resemble them. Quite often, when I see a passerby I think I’m seeing an acquaintance for a few seconds, until I realize I’m mistaken.
As far as I know, I have no delusions aside from my slight paranoia: all of my ideas have a logical or philosophical foundation. However, it cannot be denied that many of these ideas are nonetheless unusual, especially my spiritual ideas. I am preoccupied with the occult, and, in the rare cases I feel any positive emotion at all, it is almost always of religious nature. I then feel a deep connectedness with the Universe, which makes me distracted. These intense spiritual experiences may last for hours or for days.
Until very recently, I did not believe in God. And although the philosophy which underlay my faith developed very gradually, the religious feelings came very rapidly. The shift from atheist/agnost happened almost overnight, which can certainly be said to be a significant change in personality.
As far as I know, I’ve had no hallucinations yet, although I begin to be suspicious about what is real and what is not. I could hardly have imagined talking to people, as there was always someone else, such as my father, who had also seen them.
While the dopaminergic medicines have allayed my apathy, avolition, and anhedonia (which could be the negative symptomatology of schizophrenia), I’ve been seeing “patterns” everywhere since I use them. I see faces and other things almost wherever I look (floor tiles, for instance), which can be very realistic. Recently, I’ve also become more aware of my phosphene, an optic “background noise”. Phosphene is an entoptic phenomenon arising from the retinal photoreceptors themselves rather than exogenous light, particularly visible when you tightly shut your eyes for a few seconds. I sometimes see patterns in it, although they’re only very slightly visible, and very transient. I also appear to be having very slight, infrequent and brief olfactory hallucinations, which very rarely occur when I listen to music. I don’t think I’m synesthetic, however.
I’m not actually worried about positive symptomatology. I’m not afraid to live in a dream, even in a nightmare. But if hallucinations or delusions would occur, it probably wouldn’t be severe or chronic: if I suffer from schizophrenia, I think it’s probably “simple schizophrenia,” meaning that I have negative symptoms, but no psychosis. The only thing I fear is emptiness. I value emotion, any emotion at all, immensely, and I can’t cope with loss of affect.
I experienced blunted affect for the first time when I started using supplementation of omega-3, which stimulates the production of serotonin, and has a mood-stabilizing effect similar to that of lithium valproate or carbonate. For some time, I’ve exceeded the prescribed dose, yet I already ate more fish than meat. As omega-3 and omega-6 will “compete” to be absorbed, an excess of omega-3 will be associated with a deficit of omega-6, which according to orthomolecular psychiatry is one of the causes of schizophrenia.
I’ve recently had a PET-scan in the university’s hospital of Ghent, and I’ll know the results monday. If my brain shows the deformations characteristic of schizophrenia (enlarged ventricle, shrunken hippocampus, reduced prefrontal cortex activity), I’ll let myself be hospitalized… but if not, I’m not sure what to do. It’s possible to be schizophrenic without obvious anomalies in the brain function or structure. Could anyone help? I don’t want to be hospitalized just for clinical depression, because I don’t think they can help me. It’s known that psychiatry often only makes things worse, and I’m already following mindfulness training, which I think is reasonably effective. But how likely am I to be schizophrenic?
Let’s make a list of the symptoms:
- apathy
- blunted / inappropriate effect
- avolition
- very infrequent catatonia
- infrequent olfactory hallucinations
- inactivity, preceded by period of hyperactivity
- poor concentration
- infrequent paranoid fears
- bizarre ideas and fantasies
- frequent reveries
- stilted language
- infrequent odd language structures
- infrequent derailment
- delayed response in direct speech
- intermittent alogia
- lack of body language
- lack of dream recall
- inability to weep
- anxiety
- schizotypy
- obsessive-compulsive behavior
- slight decline of body hygiene
- basic shift of personality
- preoccupation with the supernatural / religion
- mild substance abuse
- reclusion
- photosensitivity
- depression
- tension
- fatigue
- stress avoidance
- dependency
- period of obsessive-compulsive behavior
- period of sleep disorder
- suicidal urges
- sensitivity to noise
If we now scratch all symptoms which occur not only in schizophrenia but also in clinical depression, what’s left is this:
- blunted / inappropriate effect
- infrequent olfactory hallucinations
- periods of hyperactivity
- infrequent paranoid fears
- bizarre ideas and fantasies
- frequent reveries
- stilted language
- infrequent odd language structures
- infrequent derailment
- delayed response in direct speech
- intermittent alogia
- lack of body language
- lack of dream recall
- inability to weep
- schizotypy
- obsessive-compulsive behavior
- basic shift of personality
- preoccupation with the supernatural / religion
- mild substance abuse
- photosensitivity
- stress avoidance
- dependency
- period of obsessive-compulsive behavior