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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Deneb on October 23, 2009, at 1:27:49
With my lack of motivation and declining functioning I am worried I am developing a serious illness.
I sleep a lot and recently I wake up and don't even bother to brush my teeth or wash my face. Sometimes I go to bed without a shower in the evening too and I always take a shower. I used to wear makeup and get dressed for school in high school. These days I just wear sweat pants and a sweater. I just have a lack of regard for my appearance most days.
Academically I am doing awful. I skipped class and pretended I was going to class. The worse thing is that I don't care! I used to get straight A's in high school. I got the medal for having an above 90% average. Now I am just looking to pass.
I'm worrying I am in some kind of prodrome state or something. I always thought I was too old to develop anything like schizophrenia, but guess what I discovered? The average age of onset for females is 25!
What if I become psychotic like my grandmother?
I hope I am just being a hypochondriac about this, but regardless I have major problems. :-(
Posted by 10derHeart on October 23, 2009, at 3:36:00
In reply to I hope I am just being a hypochondriac, posted by Deneb on October 23, 2009, at 1:27:49
You sound depressed. A lot of apathy there. All those things I did exactly like you when I was smack in the middle of depression. I often didn't realize it *was* the depression, either. Took a while to learn to recognize it. Maybe "just" (ha! "just" yeah, right ...{sarcasm, of course} depression symptoms? Does not have to be schizophrenia.
I hope you describe this stuff to your pdoc. She knows you really well.Sometimes, it's all a vicious cycle...meds aren't right (our brains change - all the time) ...we feel like crap, we exhibit behaviors, we are upset at ourselves about the behaviors, thinking of that fuels additional depressive thinking...and so on...you get the pic....? Perhaps a talk with pdoc and/or med adjustment can help.
It'll be okay. There are ways to help, things can be done. Try not to catastrophize (< fake word CBT T's made up?)your feelings, though I know it's easy to do. I have been there, done that.
Keep posting about it, if that helps, as I suspect it might.
Oh yeah, have you have a thorough physical lately, at least within the past year? You know to r/o all that thyroid, anemia, etc. stuff that could make you exhausted?? Always a good idea to start with the basics. But, you probably already thought of that... :-)
Posted by Deneb on October 23, 2009, at 3:45:50
In reply to Re: I hope I am just being a hypochondriac » Deneb, posted by 10derHeart on October 23, 2009, at 3:36:00
Thanks 10derHeart,
I didn't think it is depression because I don't want to kill myself. In the past that was the big sign of something being wrong. Now I am just in a state of apathy. Maybe you are right now. I guess depression is more likely than schizophrenia at this point.
I haven't had a check up in about 2 years, but I have an appointment for end of Nov. I think I will get copies of test results this time. I want to see where I'm really at in terms of health.
I really hope there is a simple fix for this, but I doubt it.
Posted by Deneb on October 23, 2009, at 6:12:55
In reply to Re: I hope I am just being a hypochondriac » 10derHeart, posted by Deneb on October 23, 2009, at 3:45:50
I just sent this question to AllExperts. I hope I get a useful response.
Worried I am in a prodromal state
Hello
Thanks for answering my question in advance. I am wondering if I need to worry if if I am just being a hypochondriac.
As a child I was very anxious and had frequent panic attacks. I was not treated for this. In high school I did extremely well academically but had awful social anxiety. Then my last year of high school things got very bad. I started getting very depressed and moody. I was constantly thinking of suicide, and got anxious to the point of paranoia. I was thinking all the teachers were talking about me behind my back and I would actively avoid them in the hallways. I self harmed and my grades slipped a bit, but not much. Finally the guidance counselor contacted my parents when I told her I had experimented with hanging myself.
Then I saw my first psychiatrist. I acted very bizzarely with him because I was just really scared. I didn't respond to him at all and then he asked me all these questions like did I know where I was, and to count backwards by 7 and stuff. I must have given OK answers because he then diagnosed me with social anxiety disorder and said I could decide to see him or not. I chose not to. I saw my GP and was put on Zoloft. I being extremely moody, something getting very happy, like elated and thinking I could do anything and other times suicidally depressed. Sometimes I was happy but wanted to die at the same time. It was very strange time.
I forget what happened exactly but eventually I stopped the Zoloft. Then came my first year of university. I was OK the first semester, but then I got suicidally depressed again. I sought counseling. I saw the counselor for a while before she referred me to a psychiatrist. I was put back on the Zoloft.
My grades started slipping. I have now been in university part time for almost 9 years and I still do not have my bachelors of science. I started this semester positively but now I am skipping classes and midterms. There was a period where I took a full courseload and got 3 A's and 2 B's. I was unmedicated then. But then next semester my anxiety got bad and I actually took a medically serious OD. I was put on a 72 hour hold in the psychiatric ward. They diagnosed me with an adjustment disorder.
My psychiatrist has diagnosed me with borderline personality, social phobia and depression. Currently I am not depressed, but my functioning has declined over the years. I used to wear make up and dress up in high school. Now I don't care about my appearance at all. Recently I didn't even bother to brush my teeth or wash my face after I got up. I wear sweatpants and sweatshirts now.
I am now on Prozac, Celexa and Risperdal. I find the Risperdal helps me a lot. It helps calm me when I am in crisis.
Anyways, I am doing terribly in school and have no motivation in general. I sleep over 12 hours a day most days and stay up all night. A few weeks ago I heard my Mom calling my name while I was brushing my teeth. It was loud. She wasn't even in the house. Then just a few days ago I heard my Mom yelling at me while I was in the shower. I read up about this and realize these are illusions and not hallucinations, but I am still a bit concerned.
I also find I cannot do work that is anything but the simplest of tasks. My room is a complete mess. I don't do any chores around the house (I live with my parents). I don't cook, I just buy food or my Mom cooks.
The thought of something serious like schizophrenia has not crossed my mind. I always though I was too old to develop it. I am 27 now. But, I just discovered the average age of onset for females is 25 and now I am worried as I read about the prodrome state and a lot of that fits me. The lack of motivation, lack of social life (I am pretty much isolated), the decline academically, the decline in functioning and lack of caring about appearances....I have all that.
My immediate family does not have schizophrenia. I don't think anyone else does either. I am not sure about my grandmother though and it is hush hush, but my Mom said my grandmother used to think my Mom was poisoning her and my grandmother had been hospitalized in a psych ward before.
Now the question is, should I be worried about this and what can I do to get my life together?
I have seen my psychiatrist for about 7 years now. She is also my therapist. I have seen her weekly for therapy for 2 years and recently am seeing her every 2 weeks because I have made a lot of progress with the borderline traits. I now no longer feel suicidal or want to OD.
I am doing very poorly in life, all of my peers have surpassed me. I used to have a lot of potential in high school. I am losing hope. Please give me some advice.
Thanks you so much
Posted by Deneb on October 23, 2009, at 19:18:04
In reply to Re: I hope I am just being a hypochondriac, posted by Deneb on October 23, 2009, at 6:12:55
I sent my question to 4 different "Experts". Let me know which one you think is right. Here are 3 of them:
---------------------------
What a life to have had at such a young age.
As an authority only in a field rather remote from mental health, and as someone who has not met, interviewed/tested, or treated you, I am hardly in a position to second-guess those who have. So let me talk in general terms rather than about you as an individual.
It seems that in some people, some neurochemicals (which we are only starting to understand) are abnormal, and the purpose of various psychoactive medications is merely to regulate these brain microchemicals. The choice, dosage, and duration in using these drugs is somewhat trial-and-error, so the best results are associated with people who are younger, self-aware, and articulate. That's why these people should continue seeing a trusted, competent, and cooperative psychiatrist, especially to focus on the drug response.
But there is a second string to add to the bow. Progress is generally better through the additional help of the right kind of clinical psychologist. Where the client is intelligently verbal, motivated, and introspective, the best would be one trained in cognitive behaviour therapy. Here the emphasis would be on understanding and coping with maladaptive thoughts and actions.
Whether the services of a psychologist would be covered by the Canada Health Plan might depend on the province, whether it was prescribed by an MD, and whether the clinician works within a hospital or similar facility, but in any case, the psychologist should certainly integrate with the psychiatrist.
Finally, it is often the case that there is no real change in the person, right from childhood. The symptoms tend to present differently across life stages, and may be given different names, but it's only the same disorder.
Even though I'm not a practicing clinician, I'm glad you asked, in hopes that those generalities will be of some interest to you. I would say that compared with those of your peers who have the same biological handicap, you have excelled, and you show considerable promise in being able to overcome it.
Wishing the best to you,
Alan
---------------------------------------Thanks so much for writing and asking your question. It sounds like you have had a really rough go at it for many years now. I am happy to hear that you feel you are making progress with your therapist and that you do not feel suicidal and don't want to over dose. I also have to say that your writing is very good and clear. That, I'm sure, can really be an asset for you in school.
In regard to your question:
When diagnosis a problem, sometimes it is best to look the most obvious explanations to explain what's going on. Though I'm not in a position to make a formal diagnosis, without having talked to you, there are some indications from what you wrote that we can take a look at.It seems like the original symptoms that you have dealt with in your life has been anxiety. As stated, you suffered from panic attacks and social anxiety beginning when you were young. So, when thinking about your question, I'll need to keep that in mind. Your primary issue is anxiety. You also state that you have suffered from depression. Depression and anxiety almost always come together to some degree and it really makes sense in your situation; you were anxious as a kid, had panic attacks and experienced social anxiety. It was probably hard to make friends or go places out of fear of having more panic attacks. These symptoms would make anyone depressed. I'm sure you felt isolated, scarred and lonely. . . anyone would. Depression can be a very nasty cycle because when someone is depressed, they usually do depressing type things that only make them more depressed. For instance: someone might become depressed because they feel a lack of connection with others. . . they might feel they have no friends or that no one understands them. So what do they do. . . they isolate. In isolating themselves, they feel even more alone, disconnected and misunderstood. Depression begets more depression. To me, it really makes sense why you would have felt depressed.
So how does this relate to your question?
You had mentioned that you have looked at some of the symptoms of schizophrenia and have related them to yourself. "The lack of motivation, lack of social life. . . the decline academically, the decline in functioning and lack of caring about appearances. . . " These are all symptoms of schizophrenia. . . but they are also all symptoms of depression. Depression is what you have, so that is the most likely explanation. Sure, what you described can be symptoms of schizophrenia, but they are not the main symptoms of schizophrenia, so you cannot use these alone to diagnose yourself. So how about the voices? I think you were correct in your conclusion, that they were an illusion, not a hallucination. But what is a mind prone to anxiety going to do. . . worry that the "voices" they heard are indications of schizophrenia! Everybody hears voices from time to time. Just last week I was out camping in the woods by myself. What do you think I heard when I was alone in the woods at night? Voices! I was convinced I heard people talking, or yelling in the distance. Think of that situation though. I was alone so I was a little afraid. . . so I had heightened anxiety, so any noise that I heard my brain interpreted that it was a voice. . . and that someone was going to jump out of the trees and get me! But in reality it was all just anxiety. Similarly to the most likely explanation of your situation. Your anxiety is already heightened, you've read some about schizophrenia, so you are prone to second guess normal occurrences and interpret them as abnormal. There is no need to worry about thinking you may have heard a voice. You should worry if you constantly hear clear, prolonged, audible people talking to you incessantly, when there is no person there. The key is that they would be clearly audible. . . not something you thought you heard or are pretty sure you heard. They would be unmistakably there. . . loud, audible and present for long periods of time. Also, if you did have schizophrenia, you wouldn't likely be worried about having schizophrenia. The fact that you are worried about it is a strong indication of not having it.So what can you do?
I think it's positive that you are making progress with your therapist. It's going to be really important for you to make continual progress and to really focus on the diagnosis of anxiety and depression. In my opinion, cognitive behavioral therapy is the best kind of therapy for anxiety and depression. The best resource I have ever found has been a book call "When Panic Attacks" by David Burns. In this book, he explains that there is real and tangible hope for people with any kind of anxiety. He also explains hundreds of methods for getting rid of anxiety that actually work. For someone to find relief, they must be willing to really work and put concentrated and deliberate effort into the healing process. So the best advice I could give to you is, follow the instructions of your therapist. Ask him/her for exercises to do at home. Get a good book on cognitive therapy (like the one I mentioned) and study it inside and out. Do the exercises it explains and don't give up. Also, of course, seek immediate help if you feel like hurting yourself again.I hope this helps,
I hope my explanation was at least almost as clear as your question! (You should really capitalize on your skill)
Let me know if I can answer anything else or clarify something for you.
Good luck, Rich
-------------------------------------Sounds like you have been suffering severely with forms of mood disorders. Also, check with your doctor about being bi-polar too. For people who suffer with bi-polar disorders - lithium is good. Ask your doctor about that. You may need a new medication - ask her also what she thinks about Effexor.
It sounds like you need the right mix of meds to get you stable. To help educate yourself:
Dr. Ivan Goldberg is a New York Psychiatrist who has developed an excellent website. Take a look at his site and scroll down to the depression inventory, and also a self-inventory for anxiety, because the person suffering from depression can also be suffering from anxiety. His web site is:
http://www.psycom.net/depression.central.html
Take the self-inventory(s) and make a copy for the clinical counselor/therapist you will be seeing.It is hard to function in life when your brain chemistry has gone awry. Dr. Goldberg's website also talks about people whose brain chemistry is resistant to medications - you may want to read that section.
Your education is important, so keep working at it when you can and see if you can take online courses to in order to gain college credit.
I hope these ideas help you out. If you like your doctor/therapist stick with him/her; but if you feel you want to change, then look for another psychiatrist that specializes in mood disorders.
- Show quoted text -
Posted by 10derHeart on October 23, 2009, at 20:13:51
In reply to the responses, posted by Deneb on October 23, 2009, at 19:18:04
Parts of all of them.
But who cares what I/we think, really.
What do you think?
What does your pdoc think?
Why not show this to her? It should lead to a great discussion!
Posted by Tabitha on October 24, 2009, at 5:08:25
In reply to the responses, posted by Deneb on October 23, 2009, at 19:18:04
I didn't understand the 1st guy's point, he seemed so hesitant to offer an opinion. The 2nd guy seems wise and kind. The 3rd one perhaps didn't read very carefully. He seems to have totally missed the fact that you're already in treatment and on meds.
Is that expert site free? It seems like it could be a good source of entertainment. I'd like to ask fake questions that are just bizarre enough to make them wonder, yet not bizarre enough to get outright rejected.
Posted by Deneb on October 24, 2009, at 13:50:18
In reply to Re: the responses, posted by Tabitha on October 24, 2009, at 5:08:25
Yeah, the site is totally free. Just search for AllExperts.
Posted by Phillipa on October 25, 2009, at 0:27:11
In reply to Re: the responses » Tabitha, posted by Deneb on October 24, 2009, at 13:50:18
I felt the second opinion seemed to cover all the bases. Phillipa
This is the end of the thread.
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