Q. Am I suffering from schizophrenia?

Answered by
Dr. Ashok Kumar Choudhary
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 11, 2016 and last reviewed on: Apr 29, 2020

Hi doctor,

I am 25 years old. One night, when I tried to go off to sleep, I had racing thoughts that I had no control over. I did not hear any voices, just thoughts. I could not track them or process them. I was really scared as a result. This phenomenon has been happening whenever I try to go off to sleep or wake up from sleep. Now, very recently I moved abroad. I felt extremely depressed and stressed about this. I started having sleep problems all of a sudden. Being a hypochondriac, I thought this must be something fatal. This led me to be stressed, anxious and depressed. I have been searching on the internet obsessively for five months and I came across schizophrenia. I was terrified. Ever since then, I started searching for schizophrenia obsessively and my symptoms worsened.

I thought I started to hear voices after reading about them. But actually at most, they are silent thoughts that occasionally mock me. I have random words pop into my mind at odd occasions. After reading about paranoias, I seem to be developing them too. I get scared or threatened by people for no reason. I am more concerned about the fact that why am I getting scared of people, rather than actually scared of them. I feel extremely detached from reality like I am just going through the motions. I am extremely tired and sleepy throughout the day. My appetite has declined completely. I cannot do anything. I visited four doctors and all told me that I have extreme anxiety and depression. Can anxiety and depression cause these symptoms? Can being a hypochondriac lead to this?

When I talk to a friend on the phone, I have an engaging conversation, laugh and cheer up. And then I think, should I feel threatened by him? Am I losing control? I speak fluently and I go about my activities fine. Most of the symptoms that I have developed have been after I got to know about the symptoms on the internet and obsessed over them. I constantly cry about what has happened to my life and why did this happen to me. So, what is happening to me? Moreover, these symptoms come and go in 7-10 days.

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology
#

Hi,

Welcome to icliniq.com.

I read your query with keen interest and understand your concerns.

First of all, I must assure you that there is no evidence of disease called schizophrenia in your case.

Schizophrenia is often presented with different kind of prodromal symptoms and they do not match to your current symptoms.

Having said this, the symptoms are more indicative of anxiety disorder with added obsessive and compulsive behavior.

This is more likely as you are already suffering with hypochondriasis, which is again a disorder from same spectrum of psychiatric disorders like obsessive compulsive disorder.

I also like to inform you that stress, anxiety and depression can present with symptoms mentioned in the query and there is no doubt about that.

For your clarification worsening of symptoms and spontaneous remission of symptoms are indicative of obsession rather than psychosis such as schizophrenia.

In my opinion, it is time for you to engage in therapeutic process rather than moving from one doctor to another as constant approach will bring out the positive outcomes.

For further information consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist


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Hi doctor,

I had consulted you before. I am giving an update of my symptoms. I am still a major hypochondriac. I began to feel extraordinarily detached and disconnected from people and things around me. I started to feel extremely depressed too. Yet I could carry on the activities and go on with life. Around a year ago, I began to feel scared of random noises, including inanimate objects making noise. This went away, or rather, I began to ignore this in a month. I even rejoined work. However, for the past one week, I am feeling perplexed in my head almost as if I cannot think straight. Regular activities and normal things cause me to panic a lot. Whenever I see anything in the corner of my eye, I will misinterpret it as something else and get scared. For instance, shadows or random patterns or spots can scare me. I also feel afraid of any random noise.

I think anything I am seeing or hearing is a hallucination. But it is almost as if I have lost the capacity to see and hear normal things in a normal way. I get frightened by everything. I also feel incredibly depressed maybe due to the conviction that I have a mental illness. I also have sleep problems for two years. I wake up frequently, have vivid dreams, and I am exhausted and fatigued throughout the day. I am 27 years old. I also feel crazy in a sense, everything I do or think feels abnormal. And mostly, I cannot enjoy life anymore.

For an extended period, I could function. I even rejoined my job. But for the past few days, I feel extremely depressed and panicky. As far the visual experiences are concerned, I get scared when I see normal things from the corner of my eye. A circle will seem like an eye, and so on. It is more like a misperception rather than a hallucination. I will have mental images. A random pattern will look like a face. As far as auditory experiences are concerned, I sometimes mishear things. Apart from this, every perceptual phenomenon of normal things causes major panic for no reason. I must add that this is worse when I get the help of internet or obsess over my illness. I have not taken any medication till now. I feel extremely depressed, empty and joyless as a result. Is there a chance that my OCD has caused depression?

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology
#

Hi,

Welcome back to icliniq.com.

I am glad to know that after a span of time you decided to seek help which is extremely important.

First of all, I will request you to come out of stigma that you have a mental illness. You are not alone in this universe, and there are much more who have mental illness and thriving to excel in their life. If you go on statistics almost 30% of people are suffering from one or another mental disorder, and nearly 6% to 8% have a debilitating mental illness.

As suggested you, there is definite need of taking treatment either in the form of medications or psychotherapy.

In your condition, I feel cognitive behavioral therapy can wonder similar medications. Now regarding your question I like to inform you that OCD and hypochondriasis are linked and so depression. Almost half of the patients with OCD meet criteria for depression. This is not surprising as the biological mechanism between depression and OCD overlaps to a significant degree. We do not have much data about hypochondriasis and secondary depression, but it is estimated to occur in at least 25% to 30% of patients with hypochondriasis.

I like to re-emphasize again that it is essential to seek help as soon as possible. This is because untreated illness makes permanent scars and you may need a higher dose of medication if timely action not taken.

For further doubts consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist


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Thank you doctor,

What kind of medication will I be put on? I am really scared that this is psychosis or schizophrenia. Is my condition treatable only using therapy? Because, I do not want to take medication if therapy is an option. Is OCD along with depression a common one or can it progress to psychosis?

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology
#

Hi,

Welcome back to icliniq.com.

Most of my patients with depression and OCD respond to SSRI (selective serotonin reuptake inhibitors) group of medications. The options in this category include Sertraline, Escitalopram, Fluoxetine, Fluvoxamine and Paroxetine. These all six medications have similar efficacy and act similarly although side effect profile may differ. When you go to your doctor, he might discuss the best option suitable for you. In my own experience, I prefer fluoxetine as the first choice among all these possibilities.

Although therapy is an option, the therapist is limited across the world and I am afraid whether you can afford one. As stated above, cognitive behavior therapy is an option for your condition and may act in similar way alike medication. There are no side effects with therapy and that is a significant advantage.

Now regarding your disease, as per the available description, I do not think it is schizophrenia or psychosis. It is almost definite that the disorder belongs to obsessive-compulsive spectrum disorder and in most cases, it responds to medication as well as therapy.

For further information consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist


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