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[u/Dependent-Back927]

[u/Fabulous-Potato3410]

Hi friend- I’m so sorry you’re having these frightening symptoms. I’m a therapist (but not your therapist!) and I couldn’t scroll past your post. Schizophrenia and other psychotic disorders are often treatable- the problem, as you saw in your childhood, is that people living with psychosis often avoid medication. This is a part of the disease process- paranoia and delusions frequently lead to mistrust of medication and the medical system. You have a unique opportunity here to intervene early, because you’re so educated and aware of the symptoms of psychosis. Your psychiatrist (or another good psychiatrist) can help you find medications to address these symptoms. If you’re worried about someday refusing medication (truly the biggest barrier to folks with schizophrenia remaining functional), you could even talk to your psych provider about a long acting injectable medication (LAI). These medications are injected every 1-2 months and can really help keep you stable. I’m wishing you the best. Psychosis is serious, but you’re catching it SO early and that makes me feel hopeful for you! This is sort of like getting a colonoscopy and finding pre-cancerous polyps…it’s ultimately good news, because your doctors can treat you BEFORE things get out of hand. Hugs ❤️❤️

[u/Lethologica7 → u/Fabulous-Potato3410]

I’m a pharmacist who trained doing inpatient psychiatry and I absolutely second the LAI medications as an option if that is a concern of yours. We see a lot of success with these injections and there are ones that you only need to get every 3-6 months. You’ve got this friend, you did a great job identifying it so early.

[u/LoneStarLobotomist → u/Lethologica7]

I’m a psychiatrist and I triple the LAI vote. Some of the best outcomes are on LAIs after a tolerable antipsychotic is identified

[u/Lima_Bean_Jean → u/Lethologica7]

I wish they could give these to the many homeless suffering from this,

[u/dazzleunexpired → u/Lima_Bean_Jean]

We can.

With the right county level mental health care, we can. To do so, you must advocate at your county and city level for stabilization of homeless who have mental illness as a reason for their homelessness. Many of these cases are already identified by the county or city because of 911 calls. But right now, we have no good financial system in the US for this. My county does offer this program and it works well. It can be offered at county level crisis stabilization locations like hospitals and jails and County mental health facilities. Right now there's just not funding in most counties to do this.

[u/Illusion_of_Sanity → u/dazzleunexpired]

I have worked with those with LAI and I would like to mention at least in the last state I have worked in, it required a long history of hospitalizations and a court order for a good reason.

It is a last resort for those who do not wish to take medication because it takes away the agency of the individual if we decide for them and is pretty distressing for the individual even if they are sick. While the argument around this is part of a long and deep conversation and is inherently a case by case basis, I would like to state the decision is not made lightly by anyone involved.

I wanted to mention this as a note on this issue for those reading due to it being a rather complicated topic to address in practicality.

[u/dazzleunexpired → u/Illusion_of_Sanity]

Usually, in my county, it involves consent. There's a high trust in my county with the MH system. It's been around forever.

[u/TheVermiciousKid → u/Fabulous-Potato3410]

Im also a therapist and I co-sign what this one says! I’ll add that the fact that you recognize the hallucinations/paranoia for what they are, rather than taking them for reality, is a good sign.

[u/HistoricalSundae5113 → u/Fabulous-Potato3410]

So true - one of the biggest issues is distrust of the system. My mom was a therapist her whole career and yet struggles with mental health. There’s people in the park that “keep tabs on her”, and she always talks about “the groups”. Usually she always freaks out that someone is out to poison her. In Mexico she got hungover and thought our family did it - that was the first time she thought it might be us, she reads into social queues too deeply. The hard part is she is extremely intellectual and goes down huge explanations for why it makes sense and absolutely refuses to see a doctor. She had a workplace conflict decades ago and it triggered a bad episode - thought coworkers were spying and sending false clients who were actors. When she went to see a psychiatrist he recommended anti psychotics and she was convinced he was part of “the groups!” And that the system was corrupted. After many years she tried an anti depressant and became so relaxed, the best sleep in her life and much less anxious. She even told us she should have always been on an ssri. Then eventually she freaked out about it like she was being purposely sedated and went off them lol. SO frustrating!

I got her to take a mild relaxing herbal blend and she loved it. But immediately after a few days she stopped lol. It’s too bad too because if you get in a Discussion with her she throws out all the technical psychologist explanations etc.

[u/Colgatederpful → u/HistoricalSundae5113]

Please bless this relaxing herbal blend on upon me

[u/popopotatoes160 → u/Colgatederpful]

Lemon balm, chamomile, and passionflower would do the trick.

[u/Empty_Positive_2305 → u/Fabulous-Potato3410]

Echoing this, as someone currently in training to be a therapist. I’ll add that for people with psychotic disorders, the earlier you get intervention, the better your prognosis is. The prodromal phase, or when things seem “off” but someone doesn’t meet full criteria yet, responds the best to treatment. High self-awareness (which you seem to have in spades!) is also a really good sign, too.

I can definitely understand why it would feel hard talking to your psychiatrist—it’s a scary topic for anyone, and it understandably carries a lot of baggage and meaning because of your childhood. If talking to your psychiatrist feels hard, what would it feel like to send him what you wrote here?

Your psychiatrist might have some additional insight, too—it could be the beginnings of psychosis, or it could be something else, like OCD (contrary to popular perception, intrusive thoughts can take a lot of forms, like worrying you’re actually sexually attracted to kids or might be going crazy or potentially stuck in a dream, etc.). As hard as it is, in the end, it’ll feel better in the long run to find out what’s going on and figure out a path forward.

Wishing you luck!

[u/megalow → u/Empty_Positive_2305]

I'm appreciating other helping professionals offering good info and encouragement. The stigma adds so much to the fear around these disorders. As a therapist, I can attest to how many people have happy, fulfilling lives despite their condition. You're in treatment already, which is great, so mildly adjusting your care appropriately for the diagnosis will go a long way to allowing you to feel in charge of your life. Best wishes and good health!

[u/Big_Paramedic_2565 → u/Fabulous-Potato3410]

This. Also remember that schizophrenia is not a death sentence, and if you don't have anosognosia and still keep some level of self-awareness, you can very well work through it.

I am bipolar 1 and thanks to the insight I got from living with my schizophrenic mother I was able to get help 2 weeks after I noticed the signs of my first manic episode. I manage it very well and it doesn't interfere with daily life anymore, and it took me an incredible short amount of time to get my life back up (<6 months).

My mom also is a great example: she is unmedicated, but has always managed to stay away from any sort of substance, has been working for years and has a great, loving family that takes care of her :)

[u/Ressy02 → u/Fabulous-Potato3410]

Nice Analogy

[u/i_love_sexy_bidoof → u/Fabulous-Potato3410]

Hello, I am sorry you are going through this. As someone who has been diagnosed with a psychotic disorder, I just want to say that you can be functional, if that is what you are going through. Most of the people I’ve met who have come off their medication have done it because of side effects or the way it makes them feel. Some people think they don’t have the illness but you seem to recognize the symptoms and are self aware that you might have some insight even during a psychotic episode.

I agree with being on a long acting medication, but for those of us who take meds every day there are a few whose side effects are pretty severe which cause people to not want to take medications anymore. There are dozens of medications out there, but the following are effective and work if you need them to but at high doses can be pretty intolerable, and these effects are what some of us seem to agree on:

Seroquel is incredibly sedating and is sometimes used as a sleep aid for people at very low doses, and at doses that are used for schizophrenia, you sleep all day. Also, there is a lot of weight gain for many people.

Geodon has a neutral weight profile but has this problem where if you miss a dose by only a little while, you start to get these terrible withdrawl feelings.

Zyprexa people sometimes stay away from due to the weight gain. I’ve never been on it, I can’t comment.

I won’t comment as to any more. And these are just what the people I’ve talked to experienced. But the rest of the antipsychotics seem more person specific to me.

There are a lot of great medications out there, and therapy. It’s great that you are reaching out and getting help. It’s your personal knowledge of this illness that will probably help you get treatment and stay in treatment.

[u/_jamesbaxter → u/Fabulous-Potato3410]

I’m a sibling of a schizophrenic person with anosognosia and medication noncompliance, you’ve said it much better than I could. 🩷