Have Mental Health Questions? Ask a Psychiatrist Online
Hello! Please remember that my response is for information only, we are not establishing a therapeutic relationship.
One of the hallmarks of schizophrenia is auditory hallucinations, (sometimes visual ones) --are you hearing voices?
hello, no I never see anything. But when I reflect on experiences, there a many cases of me being ridiculously paranoid inside at the time drawing ridiculous conclusions and feeling them plausible, then I look bakc and kind of laugh at what I thought
Do you hear any voices?
I hear just 2 voices, both mine, but they do seem distinct.. or it seems like two paradigms in my head, one analytical and correct/right choices, and one more focused on what I want and feel... guess that just sounds like a concscious though hah
Hearing your own voice is not schizophrenia. It sounds like what you are describing is obsessive thinking --which can be a symptom of a number of different problems.
with obsessive thinking, are your thoughts at all unified, or does this feel like you are arguing with yourself constanting over little details
Looks like our previous transcript got erased.
I'm not sure what you saw, and what didn't post --so I'll just repeat.
If you hear your own voice, it's not schizophrenia. Obessive thinking has several qualities to it --it pretty much does not reach a "resolution," or "conclusion," but can be focussed on 1) worry 2) irrational conversation 3) can at times be paranoid
Is your converation, thought process focused on one topic or many?
And, how long has it been going on?
Looks like you are not online. If you respond, I will respond back to you as soon as I can.
I'm sorry I thought you had left, I'm here if you are still online. It's usually many, like a tree, starts from an identifiable root and branches out into infinite detail.. what you said about it not resolving... that seems to be the key difference in my thinking over the last 6 months... I never land anywhere. It's mostly worries + irrational conversation like you said, but it does seem to revolve around some level of mistrust of others intentions, like if I'm not always on top of what's going on with myself and them, I could be taken advantage of or make mistakes or something. This happens a lot now too, I start writing, to no end. I used to write eloquently and clearly to an approachable point. I never seem to get there now.
I am here --give me a minute to read your last response.
So the obsessive thinking could have maybe resulted from having some interpersonal problems? When did you first notice it starting? And, how old are you?
How long were you in therapy and did the psychologist give you a diagnosis?
Are you still here?
well I'm not sure when I first noticed, I'm 24, I started feeling not so great after college when I moved to Detroit from Ann Arbor, but this type of thinking is not anything new really. I've thought like this forever. Just this year though seems to have increased to the point its counter productive... before I guess I just thought I was very thorough. I was in therapy for a few months, then I stopped, I thought I could just kind of mentally improve myself, was pretty convinced I was getting better and it would continue. I also wasn't as honest as I should have been with the therapist, I just spun things to make them sound one way to get a more predictive manageable response... I don't know what I do that, but I do it a lot
I'll turn the volume up, didn't mean to leave you hanging.
That's OK, sometimes the chat seems to malfunction. My best advice would be to try therapy again and this time be honest. It doesn't sound like a problem you can overcome by yourself for several reasons 1) the type of thinking has been long term 2) It's getting worse Not being completely honest with one's therapist is a common problem, it's often a sign that one is "not ready" for the process, although it can also be a sign that the match is not a good one as well.
It sounds like perhaps you weren't honest with yourself, either, which is also very common.
What do other people say about your ability to get along with them?
well, that's the biggest thing troubling me lately, is I don't feel like I know what 'honest with myself' is any more... like I don't trust my mind to explain things to me in a way that is more suitable or comfortable or tidy for me. Is that what you are saying about being ready for the process though, I know realize I can't trust my thinking on the matter. Even now I review what I write trying to be sure it's honesty and not explanations or covering my own real motives....
I have never really had any complaints about getting a long with people, never really hear about people talking about me, my perception is I'm pretty liked... but I also know I don't act very naturally en route to making that happen, it's kind of by design it feels like.
That might be the start of being honest --that you're so confused at this point you're willing to admit the confusion and just go into a session and not try to wrap things up in a nice package.
OK --if that's the case that you don't have trouble getting a long with people, perhaps the problem is anxiety based.
I think more concisely, I get along with every one, but often it feels like its at my personal expense somehow... like I'm guiding the relationship to a happy place, but I may not even want to be in it, may not like this person at all really. I don't really realize that until later when the friendship is developing, and I'm ignoring the calls and what not. Probably anxiety based, I've known for a long time I feel more pressure than my peers all other things equal in social situation. I've never had a problem until recently with keeping up with people, and getting out now and then whether I want to or not. I guess I'm afraid maybe what I thought was 'coping' with this for years, could have really been avoidance and kind of damaged my ability to tell people what I am thinking. Do you have some time for this, I'm happy to pay your rate to talk a bit longer.
I need to step out for about an hour (maybe a little less) and then I can return and talk longer. Would that be OK with you?
Sure, appreciate it.
OK --when I return, I will make a comment so you'll know I am back.
Thanks for your patience, I am back.
Yes, it does sound like you have some avoidance going on in relationships.
What are the most difficult emotions for you to experience?
that's tough to answer. I think probably sadness, because I almost view it as a flaw in my life... like if I could do better, and not be sad somehow - studying buddhism helped me some with this though and relaxing my mind in general. I think also anger, because I view it as kind of a wasted emotion I guess... and so that's like a defective emotion to me as well... also frustration, and feeling small or inferior... because I think again, these signify in my mind places I could improve or like emotions I shouldn't have.
Guess that's all emotions really, I have no problem expressing them if I feel they are 'ok', but I think I have some pretty rigid guidelines or something... because most of mine feel like undesired responses, like I want to correct the way I feel about things
OK --emotions that are pushed away can result in anxiety, which can lead to obsessive thinking. To be psychologically healthy means to be able to experience a full range of emotions --and to not judge them.
Of course, this is not the easiest place to get to --but the people who do best are the ones who have the emotion, experience it, and then it moves on ---
Feelings just "are," they are not right or wrong.
We call "intellectualizing," a "defense" against feeling undesirable emotions.
I assign value and make connections to the emotions I think, way way way too many. So if I'm paying too much attention to thoughts and feelings, to that extent I'm kind of making them something that will affect the way I act I feel like? How can start helping my mind differentiate between what's important and what's not or I guess reduce attachment to the ones that are supposed to be fleeting?
True, it would be helpful to let "fleeting," thoughts go --sometimes people get really stuck on these and make them much bigger than they need to be. If you could give less value to the emotions (i.e. sometimes we just feel something for no important reason --such as being tired, hungry, or just Tuesday). But, it sounds like you go the other way too --have an emotion, start judging it, and get caught up in the thoughts that way too.
Yes, behaviors result from our thoughts and feelings -
As well as physiological responses --although you didn't mention that.
there's some interference there, I have crohn's disease and take TNF blockers for that, sometimes I'm not sure whether I've got physical problems, mental problems, or imaginery problems because I don't seem to act abnormally to the people around me... but I first started seeing a therapist because I just completely had no desire to do anything any more, I knew what stuff "I liked" but nothing mobilized me any more. I was either staying up for 30 hours, or sleeping for 12.. real irregular, lots of couch time and eating, not doing much of what I did a lot of before like golf/tennis/movies/work/etc.... and this has continued and gotten worse to the point I'm just not mobilizing to do ANYTHING for the past few weeks, yet I don't necessarily seemed sapped of ambition... I just never do anything... this is the most proactive and productive thing I've done in a few weeks really
It sounds like it's been a really rough time. Crohn's disease sounds like it's horrible --so I'm sure it's been an adjustment to manage that. Did the Psychologist give you a diagnosis, by the way?
What you just described above, that you are experiencing right now, sounds like some form of depression.
The staying up for 30 hours, though is not a symptom of depression.
no, we didn't really get a lot of results I see in hindsight, but just talking made me feel so much better I thought I was cured I guess. crohn's can be terrible, it rarely is for me though, pretty lucky - but the medicine makes me feel pretty bad about 3 days every 2 weeks (injections)... more than the crohn's did in the first place. in my mind I don't consider myself depressed, but I see that my activity and the way I think is so indicative of depression. Do you know what it's like for very depressed people? Can they explain the change in behavior.. like do they say 'I'm depressed' or is it like me... the change happens, and you come to that realization later?
the thing about being up 30 hours, is it'd still be nothing, just me hanging out not really doing much and killing time for a very long time until I could fall asleep easy... that confused me, and how I began sleepy in the day and working/exercising/groceries doing everything at night... and I felt better, like kind of lonely, but a lot more peaceful
Not all people who are depressed know that they are -- and there are a few different forms of it. Dysthymia is more of a "mild" depression --I use the analogy of a person's walking around but dragging a big ball and chain behind them, not even realizing it's there, necessarily. Everything is harder to accomplish, motivation is low, mood is generally flat or kind of down.
A major depressive episode is different in that generally a person is not doing much at all --lots of sleeping, overeating or not eating, not accomplishing anything, feelings of hopelessness, sometimes a lot of guilt.
OK...I got the part about the 30 hours...sounds like just up/awake, but not necessarily doing a lot.
both types of depression are characterized by low energy --sometimes feelings of worthlessness, not enjoying previously enjoyed activities.
So --i'd say the latter ---the change happens, and then either people realize it or someone points it out to them.
that may be happening right now. I just stopped all my work and doing pretty much everything but forcing myself to exercise (something I used to just love) a few times a week and look for houses. and I keep trying to explain it, fix it, correct it but I don't know I don't know what's stopping me for doing. I think a lot about what I want to do in the future because I feel in such turmoil right now it makes me question what I actually enjoy doing and what I believe in... and I really see no reason to be unearthing everything I ever believed but now it all seems under question and scrutiny... I really have a lot of options with what to do with my time... and I feel like I just keep choosing nothing.
How do you feel about taking antidepressants?
They can help a lot --and more quickly than therapy, although I would recommend that as well.
A non-drug option would be neurofeedback (www.eeginfo.com) which is more time intensive (about 30-40 sessions, generally).
how impactful are anti-depressants on the rest of the body? I am a little hesitant to meds, I have had some bad experiences already and some reservations about long term effects
Some people experience some very unpleasant side effects initially, including gastroinestinal side effects. They tend to go away, but if you've been having a rough time, I can certainly understand not wanting to go through that. Some psychiatrists will prescribe via a compounding pharmacy so that people can start on an extremely low dose, as a way to avoid the side effects (by building up very very gradually).
also, if the depression is derivative of OCPD or something, which it feels like to me, is there treatment strategies for that in specific are do you work from symptoms?
There's no drug treatments for personality disorders (which is what OCPD is) per se, that does not mean, though that people with OCPD do not suffer from depression that can benefit from drug treatment.
Personality disorder treatment tends to be long term psychotherapy.
I'm not opposed to really any amount of hassle to find a way back to 'normal', worth it just looking for the best option I guess. Do people become dependent on anti-depressants ever? Does dependence wain if therapy is successful? As you might conclude, I'm pretty prone to stuck on things if I identify it as 'good' or 'helpful' to me.
No, antidepressants are not addictive or habit forming. The theory is that the brain is not making enough of certain chemicals on its' own, and the drug helps with that --and that eventually the brain makes it's own chemicals (kind of like jump starting a car battery). The theory behind neurofeedback is that you are training your brain waves to function the way that they are supposed to function.
Many people don't stay on the antidepressants long enough (a year or two generally).
neurofeedback sounds interesting I'll read about it. Could be hubris, but if I see a way out and beleive in it (therapy) I won't need the anti-depressants, the excitement of escaping this far outweighs. This feels like a good point to stop, almost feel like some of the noise has stopped already just knowing not to pay attention. I don't really know how this site works, are we able to continue this in the future or is it question > answer > done.
You can rate my answer at this time --anything in the positive range gives me credit for the answer. If you would like to speak to me in particular in the future, then you need to put my name in the subject line and the other Experts will leave the question for me. There are a number of people who continue to request the person that they've worked with previously. Of course you don't have to do that, but it means most likely you'll be working with someone else.
I'm glad that the noise has gotten a bit quieter!
Appreciate your help, ty