I have been diagnosed with schizophrenia (as is obvious if you are reading my blog) and with that disease/illness comes a wide range of possible symptoms.
According to the revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), to be diagnosed with schizophrenia, three diagnostic criteria must be met:
- Characteristic symptoms: Two or more of the following, each present for much of the time during a one-month period (or less, if symptoms remitted with treatment).
- Disorganized speech, which is a manifestation of formal thought disorder
- Grossly disorganized behavior (e.g. dressing inappropriately, crying frequently) or catatonic behavior
- Negative symptoms: Blunted affect (lack or decline in emotional response), alogia (lack or decline in speech), or avolition (lack or decline in motivation)
If the delusions are judged to be bizarre, or hallucinations consist of hearing one voice participating in a running commentary of the patient’s actions or of hearing two or more voices conversing with each other, only that symptom is required above. The speech disorganization criterion is only met if it is severe enough to substantially impair communication.
- Social or occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care, are markedly below the level achieved prior to the onset.
- Significant duration: Continuous signs of the disturbance persist for at least six months. This six-month period must include at least one month of symptoms (or less, if symptoms remitted with treatment).
I have several symptoms, at least I did before the current regiment of medications (they are not completely gone, just significantly dulled). I believe I have delusions and what I mean by ‘I believe’ is delusions are defined in many ways. I do have delusions of grandeur and that falls under, in some cases, the definition of delusion. Hallucinations are something that I am very familiar with as I have had them most of my life. Hallucinations are not solely a characteristic of schizophrenia. Hallucinations can be the result of drug use or many other illnesses including sub-types of bi-polar disorder. I have had and still do in extreme anxiety situations (meeting someone new, etc.) extremely disorganized speech and my thoughts have never been linear or organized in anyway (including now – it is better than it has need however). Just those three symptoms are enough for a diagnosis, but they are not the only symptoms I have had and still have.
I had little to no emotions and had not cried since I was a small child until very recently (weeks). The rush of emotions is too much at times and I cry at the most inconvenient of times (standing in line at the grocery). So I definitely suffered from blunted affect. Alogia, a verbal expression decline, is not something I had an issue with. I stutter started and had issues getting words out, but I always talked – people said too much at times. The big problem was that it would take me two minutes to greet someone, not because I used so many words, but because the four words that I did use took that long to get out. If I was meeting someone new and was not under the influence of narcotics I would not speak at all, run away (literally), or, if forced, shake, sweat, and it would sound like I was either in severe pain or ecstasy trying to release the H from my throat. I, like so many, also had a severe lack of motivation – none at times, lying in bed or on the couch not moving for days (voiding and defecating on myself and the furniture holding me). Not all of these symptoms occurred after I was diagnosed with schizophrenia. Prior to that time my diagnosis was bi-polar disorder and because they are so closely related I am not sure if it was a misdiagnosis or if the schizophrenia just reared it head after my breakdown in late 2007.
So I have established that I have the disease/illness and that I have multiple symptoms, but I only really want to focus on the one symptom that, to me, is misconceived the most. Hallucinations.
Prior to 2007
In my youth I had been diagnosed with PTSD, ADD and then Bipolar Disorder in my late teens/early twenties (my mother tells me there were others, but her memory is worse than mine). I was medicinally treated the entire time except for a period of four years where I heavily self-medicated; I self-medicated while being medicated, but during that period my part was the only part and it was more than drastic (I nearly died more times than I can count and I lived more times than I should have).
When I was young I had a friend that only I could see and hear, my imaginary friend. That was not a hallucination associated with an illness by with an overactive imagination, bored and with a need to be loved and to garner more attention than I was getting.
I started using LSD at a very young age and contrary to popular belief there are very few incidents of hallucinations regarding what popular belief of them are associated with it. Primarily there is a sense of altered reality. Meaning nothing new appears; what is already present is altered. Tracers, fisheye effect, ‘melting’ or the running of surfaces and more. I can only think of one time that I believe LSD was contributing factor (but not the only one) to a hallucination that created something entirely new. It was the beginning of a significant amount of hallucinations and at the end of my LSD use. Some say it was a result of the residual LSD in my system, others think it was associated with the bipolar disorder and then others believe it is a mixture of the two. I am prone to believe it is the later of the three.
I was about twenty years old and was in the car with a friend coming home from a party when I heard a voice come from the back seat, shouting over the blaring sound of Depeche Mode coming through the speakers of his Ford Probe.
What the fuck are you doing asshat?
I whipped around and there was no one there. I asked my friend if he heard anything and I got laughter in response. We pulled up to my house and there was someone sitting on the front porch swing. My chest tightened because I was extremely intoxicated and it was three in the morning so whoever it was must have been waiting on me for some unknown reason. I sat in the car for a few moments until my buddy asked me if I was going to sit in his car all night or get out any any point. I said my goodbye’s and reluctantly got out of the car, never taking my eyes off the swing. I walked up the driveway and turned to glimpse at my cohort driving toward the stop sign at the head of the street. When I turned back I hit the ground from surprise. My dead uncle was standing in front of me, fake leg, cane and all. He was murdered several years prior and I was extremely close to him. He stood over me and put his can in the middle of my chest. I could feel the weight of it getting heavier and heavier.
What are you doing with your life that you are coming home at 3:00 am smelling like weed, with blown pupils and walking erratically? You are better than this dickhead. You need to clean up. You are seriously disappointing me. You realize I can see everything you do, right?
I stuttered and had issues breathing, from the pressure of the cane and the shock of the situation.
I … I … I … I … I don’t want to change right now. I … I li … li … li … like living like I ammmm right now.
Then do it little at a time – for me. No more acid. No more drinking.
I nodded. Somehow I knew that I would never trip again. I knew I would never get drunk again (I was wrong, but I didn’t know that at the time – it wasn’t often though). My dead uncle removed his can and helped me up. He was as solid as I was. He lead me up to the porch where we sat and talked on the swing until my little sister woke me up in the morning. I will never forget that and yet I have never told the story before. I always felt it was something that was just for me.
That’s when the voices started. They were not familiar in any way and they did not tell me what to do. They gave me a running commentary of my life, like I was living in a book and they were reading it out loud. I did see things, but I don’t know how much as I was always afraid to ask if someone else saw what I did after being told that I was crazy several times, by family and friends.
That stayed the same until the breakdown in late 2007. It wasn’t my first or last breakdown, but it was the most significant.
I was married and my wife and me were living at her parents to save money. I was between jobs and on the mend from major back surgery – okay, I thought it was major. I was interested in getting back into photography as I did some work in my early twenties and was interested in doing something creative again that was not writing.
I had sold all of my camera equipment not long after I started to pay rent and buy marijuana so I needed new equipment. We had little to no money and what we did have we were trying hard to save and failing. I went into a high manic state and decided I needed to do absolutely anything to get that equipment. I thought about stealing it, but I knew I would easily be caught so I struck that. After removing quite a few ideas from my list I cam to credit card theft. I looked in trash cans for info and found nothing. I finally found information on my sister-in-law’s husband who was a marine fighting in Iraq at the time. I applied for a card online in his name and got a significant amount of credit. I ordered the equipment from a store that I knew had a blind pickup system and had it shipped there. Avoiding their cameras I picked up the equipment and returned home. I got rid of all the boxes and such and even scuffed it up a bit to make it look old. When everyone came home I told them that a friend gave it to me to get it out of his apartment because his wife was tired of looking at it. They all bought it as they had no reason not to trust me because they had no idea that I had been lying to them since I met them about every little thing (I lied just to lie at times).
I was in the clear for four months when my father-in-law called me out and showed me statements that he had been receiving. I denied it at first, but it was obvious I was to blame. I broke down and cried. They kicked me out and my wife came with me (there is no one that can compare to her). I cried for three days. It was the only time I had cried since I was very young until just recently.
My mother took us in and I was not charged with anything as my brother-in-law knew the police and a judge. He was nice enough to get it wiped and somehow transferred the debt to my name. I started seeing a new psychiatrist days after we moved into my mother’s basement.
Several psychiatrists and a barrage of medications later brings me to the present, but what about the hallucinations during that time.
They continuously got worse until I had people following me around convincing me that everyone was watching me and they were all trying to steal my identity. I was convinced people were trying to kill me as I had been shot at several times (hallucinations). I spent a lot of time on the ground in a corner curled up in the fetal position – but no crying, just shaking and rocking. I thought I was going to end up in a home or something for the rest of my life. I didn’t know what to do. I tried to push everyone in my life away from me, but my wife stood by me. She gave me strength to figure out that the cat that I thought I owned was not real and the birds that constantly chased me around were also not actually there. She helped me get to where I am now. Without her I would have ended up in a mental health facility long before I did and I would have stayed there instead only visiting for a couple of weeks. She is my savior.
I hear whispers. I see flashes and glimpses. The paranoia is strong at times. The anxiety is uncontrollable. I am better. I know it doesn’t sound like it, but I would not be writing this if I were not.
- Coping With Schizophrenic Hallucinations and Delusions (everydayhealth.com)
- Understanding Schizoaffective Disorder (everydayhealth.com)
- Bipolar Disorder and Anosognosia (everydayhealth.com)
- Bipolar Disorder (education.com)
- Dr. Andrew Moskowitz on DID, PTSD, Psychosis, Schizophrenia (ptsdcreativewriting.wordpress.com)
- Schizophrenia (neumannpsychology.wordpress.com)
- Borderline Personality Disorder- Criteria and Me (bipolarmuse.com)