Hello. I believe I can be of help to you with this issue.
At age 52, it would be well known if your sister had schizophrenia
, because the onset of this disorder is nearly always before around age 35 and certainly before age 45. Your sister would be well past the age of initial onset for this particular disorder. However, your sister clearly has considerable anxiety
management problems, possibly an anxiety disorder. She likely has absolutely no true, trusted confidants---people she can really relax and be herself with; no one to really talk about her thoughts and beliefs. (I presume this woman is not married and has not long-term partners). As you suggest, she uses her medical degree and career as the primary sign of her self-worth and it serves to protect her from the challenges and threats of intimacy.
Can you please go into more detail about what she says or does when you observe her to be 'phased out'? For example, do you ever get the sense she is hallucinating? Any indication that she might be abusing prescription drugs? Alcohol?
It isn't terribly unusual for people to talk to themselves or talk aloud in the privacy of their home, when they think no one else is listening. Typically, this happens when people don't have genuine, trusted social outlets. If she had someone to really talk to, whom she trusted, she might not talk aloud like this. Having someone to regularly talk to can also help correct and shape paranoid thinking----talking and hearing others respond helps provide a reality check on one's thinking. It doesn't sound as if your sister has many quality 'reality checks' on her thoughts.
I will await your reaction to what I've written here, and your answers to the questions I've posed. Thanks.
Edited by DoctorMichael on 1/1/2011 at 9:38 PM EST