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Family History

Schizoid, Schizotypal or Schizophrenia?

by Kristina Randle, Ph.D., LCSW January 21, 2024

written by Kristina Randle, Ph.D., LCSW

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.

January 21, 2024 0 comments

My Boyfriend May Have a Personality Disorder

by Kristina Randle, Ph.D., LCSW November 8, 2022

written by Kristina Randle, Ph.D., LCSW

I recently began dating a male who I believe may have a certain type of personality disorder. I’ve done as much research as I can and think it may be something along the lines of Pathological Lying or Pseudologia Fantastica. I also believe that Facitious Disorder may also be a possible diagnosis. He is currently 27 years old.

As far as family history goes, this individual had a mother who was a heroin Addict and was diagnosed as a Sociopath. As a child, he was exposed to drugs, pills, watched his own mother do heroin, was taken to crack houses by his father and was physically abused by his father. His mother abandoned his family at an early age. He claims to have had dyslexia as a child but says his father refused to recognize it. He has a poor relationship with his father now. He claims to hardly “feel pain” and that pain killers “don’t work for him.” His medical history seems to be extremely lengthy. Claiming to have split his head open twice and broken and fractured multiple limbs. He was diagnosed with depression at one point and was prescribed the drug Trazodone. He says he does not like doctors and seems to be extremely knowledgeable when it comes to medical information. He does not like doctors and seems to enjoy proving them wrong. He has a history of sleep walking/irregular sleeping patterns and says he was discharged from the military for it. He also claimed to have had an irregular heartbeat but no diagnosis of an actual disorder or disease has ever been mentioned. He has the tendency to repeat certain stories.
All this aside, he is still extremely intelligent, polite and quite put together. He is very rational and kind.

It wasn’t until recently that I began feeling as though something wasn’t making sense. Am I wrong? How should I approach him? Is there a way to help him?

You suspect that he may be lying or that he has a psychological disorder but nothing you have written would indicate that either of these are true. Do you suspect that what he has told you is not true? What aspects of his behavior make you think that he has a factitious disorder?

You stated that you and he have only recently begun dating. If you believe that he has serious psychological problems and is a pathological liar, then it would be in your best interest to end this relationship immediately. If an individual is unwell, then it will be difficult for them to maintain a healthy, functional relationship.

Also, it would be inadvisable to approach him about these issues, especially if you hardly know him. It’s difficult to anticipate his reaction. He might be angry or offended. You don’t want to put yourself in danger. Nor do you want to hurt his feelings.

Without more information about why you believe these things to be true about your partner, it is difficult to give you advice. If you would like to write back and provide more information I may be able to give you a more complete answer. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

November 8, 2022 0 comments

Urge For Suicide And Suicidal Images And Thoughts

by Kristina Randle, Ph.D., LCSW August 29, 2011

written by Kristina Randle, Ph.D., LCSW

I I am from Korea, Seoul and I have been on medication for my psychological reasons. I tried to suicide less than twice and I have been always the one who has a lot of suicidal tendencies. However, my only brother did it last year. Sometimes when I think about past with him, I can’t help myself from the urge to kill myself. Even now, the only reason I am alive is because of rest of my family. my sister and mom saw him and I saw only pictures from detective office. It looked painful and I can’t forget his purple fists.

I gotta live only for my family because I don’t want to give the pain as we got from my brother. I got diagnosed to have Bipolar I, depression, ADHD, anxiety disorder. and recently I think I might have border line of schizophrenia due to my thought, images, and also the way how I understand whatever other people say.

I really need your help so that I can be alive for my rest of family. is there any way for you to give me any advice?

I am sorry for the loss of your brother. I can imagine how difficult this time in your life has been for you. The fact that you have attempted suicide, are currently considering it and have a family history of suicide, is concerning. Those variables put you at risk for suicide.

You stated that you are taking medication for psychological reasons but you did not mention counseling. Medication alone is often not enough to treat psychological problems. Counseling is an important aspect of treatment. Counseling could also greatly assist you in appropriately grieving the loss of your brother.

Studies of suicide survivors have shown that the decision to end their lives was not well-planned. Those decisions were often made impulsively. If you feel that you might harm yourself, it is imperative that you go to a hospital. The hospital can protect you from making an impulsive decision.

Suicide survivor research also has shown that the majority of individuals who had survived their suicide attempt, never truly wanted to die. They were thankful to have survived. Those individuals were suffering and they often lacked the necessary coping skills to deal with difficult life situations. I believe, at least in part, this is the case with you.

It is important that you talk to your parents about getting into counseling. You should also consider joining a suicide survivors support group. Go by yourself, attend group meetings with your family or do both. Survivor groups can be tremendously helpful. Here is a link to a website where you can find a list of support groups in your community. Here is an additional link to a resource page where you can find related websites.

It is imperative that you speak to your parents or to your prescribing physician about your suicidal thoughts. If you feel that you can’t protect yourself, then you must go to the hospital or call 911. The phone number to the suicide helpline is 800-273-8255. Do not hesitate to call if you are feeling overwhelmed.

Help is available. Please be willing to accept it. If not for yourself, do it in honor of your brother and for the sake of your family who would be immensely devastated by the loss of another beloved family member. Please take care.

Dr. Kristina Randle

August 29, 2011 0 comments

Voices a Sign of Schizophrenia?

by Kristina Randle, Ph.D., LCSW June 26, 2011

written by Kristina Randle, Ph.D., LCSW

I am a 22 year old woman who has dealt with mental health problems for most of her life. I was diagnosed with depression at a young age and still get depressed from time to time. My question though, is about recently problems. I have been having internal auditory hallucinations for a long time. They are like real loud thoughts, but each has its on unique sounding “voice”. Sometimes these voices are silly or give commentary on things, but sometimes they can criticize me or repeat words like “freak” or “your stupid”. I also have had these strange fears at night. For example, I kept thinking about the singer Kurt Cobain one night. I started to get worried that he would be mad at me and that I would see him in my room. I am always worried that i will see dead bodies or that ghost will come after me. I know that these fears are irrational most of the time. I have a family history of mental illness and psychosis. When I told my psychiatrist about it he said it sounded like anxiety or OCD. I see a therapist regularly and have been prescribed celexa, and seroquel to help with depression and the voices. My worry is that, since there is a family history of psychosis, that my symptoms will develop into a severe illness like schizophrenia. Do my symptoms sound like the beginning of schizophrenia, or do you agree with my doctor that this is a form of anxiety or OCD. Thank you so much for taking the time to read this I know you must be very busy. Your advice is greatly appreciated !

This is a difficult question to answer. Many people describe having an “inner voice” that they hear on a regular basis. It is quite normal. On the basis of a short letter, it is difficult to distinguish that inner voice from the voices associated with psychosis.

Individuals with schizophrenia (or other psychotic disorders) who hear voices often describe them as being external. In other words, the voices they hear are not their own. They seem to be the voices of others. They also tend to be derogatory in nature. The voices you hear are sometimes derogatory and critical. The latter would be consistent with the types of voices heard by individuals with schizophrenia or other psychotic disorders.

Having said that, you are presently being treated for depression and other symptoms. Anxiety commonly occurs with depression and OCD. Low self-esteem is also related to depression, anxiety and OCD. The derogatory nature of the voices could be related to depression, anxiety or OCD.

Having family members with serious mental illness can increase the likelihood of your also developing one but generally speaking the risk is slight. Whether or not you will develop a mental illness can depend on many factors, such as biology, drug use, traumatic experiences, environmental conditions, and so forth.

In summary, it is possible that the voices you hear are a sign of schizophrenia or other psychotic illnesses. Your treating professionals (who are familiar with your case) do not think so. They do not believe that you are developing a psychotic disorder and I find this to be good news.

I would encourage you to read more about the experiences of individuals with anxiety, OCD, depression, and psychotic disorders. It might help to answer your remaining questions. I hope this helps. Please take care.

Dr. Kristina Randle

June 26, 2011 0 comments

I don’t know what to think or how to feel

by Dr. Marie Hartwell-Walker March 28, 2011

written by Dr. Marie Hartwell-Walker

I really need some advice…I am in love with and involved with a married woman…she initiated the relationship…are first date was supposed to be harmless then one thing led to another and we slept together…we both have very strong feelings for each other and as time goes on we become very close friends and share everything with each other and her 3 kids adore me and I them…she says that she is no longer in love with her marriage but still has feeling for her husband in spite of all his wrong doings…she also tells me that i am amazing and super sweet and do a lot of things so much better then him..like being there for her and her kids and giving her emotional support and being a great listener…

so i asked if thats the case why am I on the outside looking in? she said cause its very hard to start over after 10 years and even though she believes every word i say and promise i make it will take time because not only does she have a hard time trusting men but she keeps focusing on the fact that i am 25 and she 37…

recently i had a death in my family that had a big impact on me and due to that and all my other stress i had to go to the er for high blood pressure…i takes meds for it and have a family history of it…she thought it was her fault and was gonna leave me thinking it was to much on me and she also feels guilty in spite of her husbands actions for cheating on him…we talked it out and she decided to stay…

however since then she doesnt call me her young love anymore or other terms of affection like she did in the beginning. When i ask her why she simply says she is tired or just not in the mood…i dont get that but ok..she calls and txt me everyday except on weekends cause thats when the husband is off and when i dont hear from her i worry and over analyze everything 🙁 and because of our work schedules and her kids and trying to get away from the husband we are spending less and less time together over the last couple weeks…i dont know if this means im losing her or what..

and just to be clear not only am i very much in love with her i want to spend the rest of my life with her and grow old with her and in doing so i will have to sacrifice my chance to have children of my own and possibly make my family mad…but i dont care aside from the poems i send her its like the 2 songs we listen to together go everything i do i do it for you by bryan adams and amazed by lonestar…she is my world my everything..what i need to find out is am i losing her and if not what can i do to show her that i want to be with her and will always be here and how do i cope or get through the waiting process without driving myself crazy all the time wondering what does this mean and what does that mean and why havent i heard from her today and why wont she say how she feels ?

I’m so sorry for your pain. There must be something very sweet about this woman for you to be so head over heels in love with her. But I have to tell you this: You aren’t losing her. You can’t lose what you never had. She’s married. She’s not being honest with her husband and she’s not being honest with you. She’s trying to have it both ways: A husband who supports her and their family and a young, romantic lover. She’s beginning to come to her senses but you’re not letting her leave easily. She seems to understand that what for her was a fun affair is much more serious for you. Her efforts to leave gracefully due to your illness are being thwarted by your unwillingness to let her go. However much in love you may be, it’s unwise to let your heart rule your head. She’s nowhere near as invested in a future together as you are. And remember this: A woman who will cheat with you will probably end up doing it to you.

Grieve this relationship, learn from it, and make yourself available to women your own age who are looking for someone just like you. There are women out there who would give anything to find a guy who is loving, loyal, and willing to commit himself utterly to the person he loves. Give yourself the chance to find someone who is going to love you back in the same way.

I wish you well.
Dr. Marie

March 28, 2011 0 comments