Personality disorder or Schizophrenia?

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I've heard voices for about twelve years now. There are three male voices which I hear as coming from outside of my head. They are always there although the content of what they say can be determined by my mood. If it's low they're critical and aggressive. If it's normal they will just comment on what I'm doing (a type of running commentary). I was diagnosed with schizophrenia about ten years ago and put on a variety of medications. Clozapine was the only one that stopped the voices completely but I found the side effects of it to be intolerable and so stopped taking it.

About five years ago I moved home and changed psychiatric care team. Since that time my diagnosis has been changed to avoidant and borderline personality disorder. This seems to be based on the fact I self harm a lot (although this is always when I become distressed by the voices) and am rather withdrawn. I do find being around people rather difficult but I've always put this down to the voices as they can make interacting difficult, if they're loud or if they're telling me people hate me or are plotting against me. I don't feel I'm emotionally unstable. In fact I seem to feel numb most of the time. I'm currently undergoing group therapy for personality disorder and today in the session I mentioned that the voices are constant and have responded to meds in the past after my therapist told me that the voices are not 'properly psychotic'. She seemed surprised by this.

My question is how do I tell the difference between schizophrenia and a personality disorder? Which diagnosis (if either) seems to be the correct one? I know that diagnosing someone is not an exact science (especially online!) but I wonder if the treatment I am being offered would differ with the diagnosis and if my current diagnosis is really correct.

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  • Posted

    hi there,

    i really feel for you..........my nephew is exactly the same,he's 20, hears voices, constantly and he has also become very withdrawn and doesn't hardly speak anymore, he finds it hard to have a conversation at all now because the voices just take over in his mind, he's been sectioned 3 times as has been diagnosed with Schizophrenia. it has been terrible for him, he's had 3 lots of ECT therapy whilst in hospital and this time has been the longest, nearly 7 months now. this was all brought on by cannabis smoking :-( although i'm 37 now and smoked cannabis regularly and been fine, although i suffer depression and anxiety, both medicated and i'm fine but he's worryingly getting worse and worse it seems. hope you find someone to help you :-) 

     

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  • Posted

    I couldn't begin to provide a diagnosis, but what does come through your post is that you have a high degree of insight - i.e. you seem to know your voices aren't real. This is comparatively rare in severe schizophrenia, but not unknown. I work with the mentally ill (as a volunteer) and we have just one client who fully understands that her voices have no independent reality. She has a diagnosis of schizo-affective disorder.

    I quite understand why you gave up on clozapine. I've seen some truly terrible side-effects, both at work and in the case of a dear friend, who was prescribed clozapine for vascular dementia. Clozapine, like all other neuroleptics, is not authorised for use in dementia but that doesn't prevent approximately 50% of dementia sufferers in the western world being put on this group of drugs. The whole time she was on clozapine, this poor soul suffered appalling athetotic movements - constant bobbing and weaving of her upper body, writhing movements of her hands and arms, tongue constantly going in and out. This went on for two months, during which time she almost starved to death because she could barely eat anything, even if I fed her. In the end, I was practically screaming at the doctors to stop it.

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    • Posted

      hi lily,

      you're post is very interesting to read, you probably saw my post above about my nephew, what happens in the case where they do believe the voices are real and are terrified of them to the point where they no longer interact and are affraid to go out etc??? i'm not sure what meds he's taking right now as they have recently changed them. i think that they are thinking of more ECT therapy for him. he goes into catatonic states also for hours and previously has been screaming with arms flared out at the sides almost like something is possessing him, sounds bizarre i know but this is what we have gone through as a family and we just see no hope for him of having a normal life the longer it goes on, this time has been over 6 months :-(

       

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    • Posted

      I'm afraid I can't help at all, gingemac. Drug taking - even cannabis - causes a lot of severe schizophrenia cases, especially if people start too young, before their brain is properly formed. It's as if it opens a door in the mind that they can never close again. Youngsters really need to be warned against cannabis. A lot of people get away with it, but a significant minority don't and the consequences for them and their families can be terrible.

      I'm really sorry to hear about your troubles.

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    • Posted

      thanks for your reply lily, yes he is a mere shadow of his former self, in appearance and in personality, like a totally different person in a pale and skinny body, paranoid and without a doubt,  a prisoner to his own thoughts, so sad, we will just have to keep helping him and hope that the door closes for him at sometime in the future :-) thanks for your kind words.

       

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    • Posted

      I'm not promotIng drug use, quIte the opposIte, consIderIng the problems drug use does actually cause, but the theory that pot causes schIzophrenIa was long ago debunked. 

      AccordIng to recent research at Harvard MedIcal school: 

      'The researchers concluded that the results of the current study, “both when analyzed using morbid risk and family frequency calculations, suggest that having an increased familial risk for schizophrenia is the underlying basis for schizophrenia in these samples — not the cannabis use.'

      There Is, however, some evIdence to suggest that people wIth a genetIc predIsposItIon for schIzophrenIa may have a greater tendency to use marIjuana.

      The poInt beIng, If pot actually dId cause schIzophrenIa, we would have seen an enormous Increase In the dIsorder resultIng from the enormous Increase In pot use, and that has not been the case.

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    • Posted

      Mary, I'm amazed you can say that. It is true that the cannabis/schizophrenia link was initially debunked, but there is now ample evidence that the use of stronger, skunk-type products has caused a big increase in schizophrenia. I can't post a link here or the moderators will cut me off, but there was an article on the BBC website on 16/02/2015. Here's the first sentence: "Smoking potent (my italics) cannabis was linked to 24% of new psychosis cases analysed in a study by King's College London." This is only one of many reports that are all over the web.

      Most of the studies have indicated that it isn't bog-standard weed that's causing the problem, it's the stronger products that have been taking over the market in recent years. In some areas, these are all that is available, and young people may be smoking skunk without realising it. I'm a former nurse, now volunteering in a mental health centre, and I hear the same story from clients on a regular basis: they had their first psychotic episode after smoking a few joints of skunk, particularly when that happened in their early teens.

      Of course it's not a simple equation - you smoke a single joint of skunk, you automatically get schizophrenia. That's nonsense. The problem is that many of us have a genetic disposition to schizo-affective disorders without realising it. I suspect I do, btw, as several members of my mother's family were clearly on that spectrum, though they lived at a time when mental illness was often not diagnosed. My mother escaped the family curse, suffering only from crippling anxiety and anger management problems. During a long period of depression in my mid-20s I heard some very disturbing inner voices and often misread neon advertising signs as having personal messages for me during my endless walks through night-time London. I didn't become schizophrenic, but I suspect I might have been at risk had I smoked skunk, which wasn't readily available when I was on the scene.

      This isn't about adults smoking the odd recreational joint. It's about very young people inadvertently smoking the much stronger products that are available on today's streets.

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    • Posted

      You wrote:

      '"Smoking potent (my italics) cannabis was linked to 24% of new psychosis cases analysed in a study by King's College London." This is only one of many reports that are all over the web.'

      I have not read the report; I do, however, know a thIng or two about statIstIcs, the most Important beIng:

      **Correlation does not imply causation** 

      "a phrase used in science and statistics to emphasize that a correlation between two variables does not necessarily imply that one causes the other", (quoted from WIkIpedIa, but basIc to any scIentIfIc dIscIplIne).

      In other words, what I saId In my fIrst answer. Where Is the huge Increase In schIzophrenIa (In the general populatIon, not just In one study of exIstIng schIzophrenIcs), that should follow the huge Increase In drug use?

      I agree, If you have an exIstIng mental Illness, or a predIsposItIon to mental Illness, It would be a good Idea to avoId strong mInd-alterIng drugs.

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    • Posted

      i totally agree lily and also, these days they say it's "skunk" but is it ?? these street drugs are laced with all sorts of anphetamines to get that extra high, my nephew used to take allsorts to get a more intense "buzz". some of the names were just as crazy as what they have made him now. he was smoking these potent concoctions from the age of 13, i strongly believe that this has caused his schizophrenic state and damaged his young developing brain beyond repair. 

       

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