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Schizoid, Schizotypal or Schizophrenia?

January 21st, 2024

Hi, firstly, english is not my native language, so forgive me if I make some grammatical mistakes.

I’ve been experiencing depersonalization and other symptoms since I was 14 (I’m 20 now). It all started kind of suddenly and made me become very reclusive during my adolescence. At the time when I first started having those feelings, I looked for psychological and psychiatric help but none of them worked (with the exception of clonazepam).

My social life got better, but I’m still very reserved, shy and introspective and found out that I tend to intellectualize my feelings in psychotherapy (which is a symptom of schizoid personality disorder), but I’m also depersonalized and rather paranoid and have problems to associate my thoughts sometimes (for example: I think “wall” and say “mall)- which is a symptom of schizotypal personality disorder.

To make things worse, I have a lot of relatives (none of them are of first-degree) with schizophrenia and I wonder if I’m displaying prodome symptoms of it throughout the years.

Am I going silently crazy?

It is difficult to know what disorder, if any, you may have. It is true that having a family history of schizophrenia may make it more likely that you would develop the disorder. Yes, it slightly increases your chances, but it does not mean that you are destined to develop schizophrenia.

You may not have any one particular disorder. You may be suffering from a number of various symptoms but nothing that is diagnosable at this time. I would suggest meeting with a mental health professional for a diagnostic evaluation.

I find it encouraging that over time your social life and presumably your social skills have improved. You do, however, continue to feel depersonalization as well as paranoia and those symptoms are concerning.

You asked about whether your symptoms are prodromal symptoms, presumably a sign that schizophrenia is imminent. It is difficult to answer that question. You have had symptoms since the age of 14. That would be an abnormally long prodromal phase. It is possible that what you are experiencing are prodromal symptoms but I cannot tell based on a short letter. The typical age for the onset of a schizophrenia episode among males is approximately 18 years old.

Because it may be possible that you are experiencing prodromal symptoms, I would strongly encourage that you be evaluated and that you consider treatment. If you are in fact experiencing the prodromal symptoms of schizophrenia then being in treatment could help to prevent a psychotic episode. When it comes to psychosis or schizophrenia early treatment is very important. Research has shown that early intervention is associated with a more favorable response to treatment and better outcomes.

I think it is wise to be concerned. It is also important to be proactive with treatment, especially when it comes to psychosis or schizophrenia. As I mentioned above I do not know if you are experiencing prodromal symptoms, but if you are then it would be advantageous to be in treatment with a mental health professional. Delays in treatment have been associated with less favorable outcomes.

If you’d like to search for mental health treatment in your community, please consult this directory.

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