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Just Can’t Bring Up Schizoaffective Disorder in Person

I have been seeing a psychiatrist and a therapist since I was hospitalized in 2012 for a suicide threat. I’ve been treated for depression and anxiety since then and, because nothing has come up since about 2011, I have not opened up about other issues. But lately I can feel something coming on again. Every few months I would go through a few weeks to months of delusions, hallucinations and mood swings usually resulting in me sequestering myself from church, school, friends or whatever else I was involved in. I had a recurring experience of a demonic familiar, visiting other dimensions, and shadow people that seemed to stop when I got a custom tattoo on my back that is an alchemical symbol for demon warding. But it’s starting to slip back. I’m distracted, hear and see things that startle me, and recently put myself in the hospital again when I got so agitated that I cut myself deep enough to damage a tendon. My problem is I just can’t open up in person about exactly what is going on; I feel it coming back like someone following me down a sidewalk, like drowning placidly. I guess what worries me is that I know I’m going somewhere that will harm me but it is familiar and in many ways more real as if it replaces my daily life. Have you ever passed out when really drunk and just before you do you feel like you’re falling into a deep hole that will certainly kill you? It’s like that. I just can’t get myself to talk about it. In the past few weeks I have seen both of my doctors and didn’t feel like wasting their time with this. How can I open up before I no longer feel that it is necessary? It’s been more than ten years; it needs to end.

A. Even if it’s difficult to ask for help, you should do it. Early treatment can prevent psychosis. You want to do everything in your power to prevent the development of psychosis. Let me explain.

With each psychotic episode, it can be more difficult to return to your baseline. In other words, it might take more time and more treatment and medicine to recover from every psychotic episode. For some people, it seems that each psychotic episode is worse than the last.

There also is evidence to suggest that psychotic episodes cause brain damage. Theoretically, more psychotic episodes equates to more damage. The sooner you report your symptoms, the sooner you can begin treatment and prevent a full-blown psychotic episode.

I’m wondering why your symptoms are returning. Are you actively in treatment? Are you taking medications as prescribed? It is common for people with serious mental illnesses to stop their medications when they feel better. They don’t realize that stopping medications can trigger psychosis. Being off your medicine is risky. I wouldn’t recommend it.

Finally, if you are having difficulty speaking about what’s wrong, then try writing a letter. You can bring them the letter that you wrote to me. Sometimes people feel more comfortable writing than they do speaking. You might also ask a family member for help. That family member could speak to your doctor for you. Do whatever is necessary to protect yourself from slipping further into psychosis. Please take care.

Dr. Kristina Randle

from Ask the Therapist


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