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Psychiatric Evaluation

Extreme Jealousy Could Indicate Delusional Disorder

by Kristina Randle, Ph.D., LCSW June 28th, 2022

My boyfriend has periods when he gets insecure and jealous that he becomes very different and thinks there is a secret among the rest of the world that he isn’t included in regarding hooking up. He also sees words as code. He’ll look at my email spam and for instance if the word is Float, he thinks each letter stands for another word.

It all relates to dating, love and cheating. His wife cheated on him alot. He will be up for days talking to me and he’ll think that what I’m saying means something else and that I really am like everyone else and he just doesn’t know the right code to be “in” on the secret world. During these episodes, he can also rationalize that he’s probably being crazy and that he’s sorry. He’s calm and quiet during these times. He says he sees the codes in words/letters all the time, not just when he’s “trippin” as he calls it.

I’m worried about him and our family. He’s a happy person otherwise. This usually happens when we have an arguement and he leaves, he thinks I’m with someone else while he’s gone or that I purposefully started an arguement so I could be with someone else. He knows I’m completely faithful. I’ve even had him video call me while he’s gone and I cooperate fully…but he thinks whoever I’m with is in on it and hiding…etc. I am wondering where to even begin researching what this could be and how to help. I talk and talk to him and eventually he decides that maybe there isn’t a secret world…if I am telling him there isn’t.

It is possible that your boyfriend may be experiencing delusional disorder but only an in-person, psychiatric evaluation could confirm that diagnosis. Two possible signs of the disorder include his belief that words, as “codes”, have a hidden meaning and his paranoia with regard to you cheating. The fact that he had an ex-wife who cheated may make him hypersensitive to the possibility of cheating but his intense focus on your alleged infidelity is unusual.

Delusional disorder is a type of mental illness that involves psychosis. Psychosis is a break with reality. Psychosis involves the inability to distinguish what is real from what is not real. A delusion is the belief that something is real, despite evidence to the contrary.

Individuals with delusional disorders experience “non-bizarre delusions.” An example of a non-bizarre delusion is the belief that someone is being poisoned, followed, conspired against, or admired from a distance. There are six main types of delusions associated with delusional disorders. Jealous is one of them. Individuals experiencing a jealous type of delusion believe that their partner or spouse is cheating in the absence of evidence to support their belief.

If your partner is willing, he should undergo a psychiatric evaluation by a mental health professional. With regard to psychotic disorders, treatment is particularly important because generally, delusions do not go away on their own. They can become worse in frequency and in intensity. Medication could reduce or eliminate his delusions. It may not be easy to convince him to see a mental health professional but it would be in his best interest.

Please take care.

Dr. Kristina Randle

June 28, 2022 0 comment

Unsure What Is Wrong

by Kristina Randle, Ph.D., LCSW February 5th, 2019

written by Kristina Randle, Ph.D., LCSW

Hello, I am unsure if I may have something wrong with me. All my life I have had difficulty dealing with people. I am going to be turning 29 next month, and I have never had a girlfriend.

When I was in school it was torture, most of the years I was in school I had no friends. I would basically just set off by myself and watch the other kids. Around the 10th grade I did get a few friends, but after I got out of school, I got to where I couldn’t even stand being around them, and I would park my car behind the back of the house hoping they wouldn’t see that I was home to avoid them. In fact I ended up quitting school, and just going to get my GED because I hated school so much.

When I was younger, around 14-15 I had uncontrollable thoughts. Thoughts I would call “bets” I would make stupid bets in my head, like “If I cant do A before B happens, then C will happen” I was able to gain some control over these thoughts, but even to this day, I find myself wanting to start doing stuff like that again.

I find myself getting overly angry at things. Things I know I shouldn’t get mad about. I get depressed a lot. I worry that I may have some form of Schizophrenia, because my uncle is schizophrenic. I don’t believe I have ever seen anything that wasn’t really there, but I just worry that I may have some form of it that may be a lower level of it.

Maybe it is just stupid of me to worry about it. I just wish I was able to deal with people better. I feel embarrassed to go talk to a doctor about my problems, but sometimes I think maybe I should.

I believe it would be advantageous to have a psychiatric evaluation. This would be the most efficient way to determine if a psychiatric diagnosis is possible. In addition, it seems as though you are struggling with a variety of on-going symptoms. These should be treated.

One symptom that seems to be consistent throughout your life is your difficulty interacting with others. It frightens you, so you avoid it. This is a typical though unhealthy reaction. It might be indicative of a social anxiety disorder.

Another possibility exists as well. Your long-running lack of social interaction could be a sign of schizotypal personality disorder. Schizotypal personality disorder is characterized by a lack of social interaction and extreme anxiety in social situations. Individuals with this disorder tend to keep to themselves. They don’t have many or any close friends. They are very shy and have difficulty interacting with other people. They sometimes think that they have special or magical powers. The “bets” that you made with yourself may be an example of magical thinking.

An alternative explanation for the “bets” is that they are a symptom associated with obsessive-compulsive disorder (OCD). Individuals with OCD engage in rituals. Rituals are thoughts and behaviors designed for the purpose of attempting to gain control. The feeling that one has control can provide a temporary decrease in anxiety.

Schizotypal personality disorder is closely linked to schizophrenia. It is considered to be a milder form of schizophrenia. I mention it as a possibility because of your family history of schizophrenia and due to your concern that you might have a “lower level of it.”

Please bear in mind that I could never know, based on a short letter, if you have schizotypal personality disorder or any other psychiatric disorder. That is why I suggested that you undergo a psychiatric evaluation because it will be the most accurate way to determine if you have a disorder.

The depression and anger you have described may be related to the fact that you have difficulty interacting with others. You also wrote that you feel as though you should be at a different place in your life (i.e. 29 without a girlfriend). In the context of these frustrations, your depression and anger is understandable.

It is never “stupid” to be concerned about your mental health. In fact, it’s very wise. If you continue to be concerned about your mental health, then I would strongly recommend a psychiatric evaluation. If you are frightened to speak with a mental health professional, try not to be. It is their job to help. They are very compassionate and are trained to deal with all variations of mental health problems. Untreated symptoms will likely continue to degrade the quality of your life. In addition, fear is very limiting and it will hold you back from achieving your full potential. The find help tab at the top of this page can help you locate a mental health professional in your community. I wish you best of luck. Please take care.

Dr. Kristina Randle

June 13, 2011 0 comment

Confused About What’s Wrong in My Life

by Kristina Randle, Ph.D., LCSW April 20th, 2019

written by Kristina Randle, Ph.D., LCSW

As of a few months ago (2 or 3) i’ve been feeling really bad. actually it’s been a really long time since i felt not so good about life, but it got worse around this time. i decided to take to googleing my possible problems when my friends started saying they think i’m bipolar, because i have periods of extreme niceness and other occasions of being really mean or down in the dumps… sometimes i feel like everyone thinks i’m ugly and dumb and other things, and other times i feel like i’m totally awesome.

i told my mom that my friends think i’m bipolar and she said “yeah right” and just blew it off. she’s bipolar by the way. i also asked my dad and he said i’m kinda acting depressed more than bipolar, but niether of them really know what’s going through my head. sometimes i have totally random mood swings that i don’t tell anyone about, so that’s probably an important thing to say. another thing is that sometimes i feel like life really sucks and is pointless (not suicidal tho), and other times i feel happy and loved. it’s kind of 50-50 on which one of those i feel like though.

Bipolar disorder may be a possibility but only a psychiatric evaluation could determine this for certain. Sometimes individuals experience problems but don’t have a diagnosable mental health disorder.

You are having difficulty regulating and understanding your emotions. Many people can relate to this especially if they have never received proper emotional guidance from parents or mentors. Managing and understanding emotions are skills that can be learned. If an individual lacks a healthy model for dealing with their emotions effectively, then maladaptive reactions may develop. This may in part be the cause of your current difficulties.

A major problem is that when you experience “random” mood swings you do not let others know. You keep it to yourself. Perhaps this is due to fear. You may not want others knowing how you feel. Sharing that type information can make an individual feel vulnerable. Another possibility is you want to talk but you believe that others are not interested in what you have to say. Your mother did not take you seriously when you expressed the possibility of having bipolar disorder. If you feel shunned by your family, then your reluctance would be understandable.

I would suggest having another discussion with your mother. Inform her that you wrote to Psych Central. It may help to underscore the seriousness of your concerns. You should also discuss with her the possibility of seeing a therapist. If she has had positive experiences with the mental health system, then she may be open to you seeing a mental health professional. In the meantime, here are some suggestions that you might want to utilize when trying to regulate your emotions:

• Keep a journal. Journaling can help release pent-up emotions. It also serves as a record of your feelings. After a week or two of continuous journaling a clear pattern may emerge. For instance, if you notice that you feel anger after interacting with a particular relative then it may explain the source of your feelings. Analyze what happened just before a particular feeling emerged.

• Label your emotions. Journaling can help with this. When you feel a particular way write down precisely what is happening and try to give it a name. This might help you further clarify your emotions.

• If you’re feeling overly emotional leave the situation if possible and allow yourself at least 10 minutes of quiet time. During this time alone, try to relax. Breathe deeply and attempt to emotionally stabilize. Try to answer the question “What just happened?” This would be a great time to record your feelings in your journal.

• Attempt to maintain an even emotional keel at all times. It is not healthy to allow yourself to be overly happy or overly sad. Don’t react impulsively without taking time to think through a response. When we feel emotional we may say or do things that are not rational or that we may later regret.

I hope this answer helps. I wish you the best and please consider writing back and letting us know how you are doing. Please take care.

Dr. Kristina Randle

March 10, 2011 0 comment

Schizophrenia At My Age?

by Kristina Randle, Ph.D., LCSW November 27th, 2019

written by Kristina Randle, Ph.D., LCSW

I realize that around my age and older is when symptoms of schizophrenia begin to show. I am extremely concerned that I may have it. I hear voices and see things all the time. The voices in my head introduce themselves to me, and sometimes speak in different languages. I have a friend that has Schizophrenia and she said it is usually obvious, and that it looks as if I am showing early signs. I feel as if I can read other people’s minds. The voices in my head tell me things. Sometimes good, more often bad. It’s affecting my school work because they will shout things at me in Italian. I have done extensive research on schizophrenia, and I have many of the symptoms. Such as delusions and disorganized speech. So far I’ve counted 29 voices in my head. Do I need to check in to a mental hospital? Or do I not even have Schizophrenia. Please help.

I do not believe that you have to “check in” to a psychiatric hospital at this point but you should have a psychiatric evaluation. You can do this several ways. One way is to go to the hospital and request a psychiatric evaluation. Generally, an individual would utilize this option if he or she is experiencing significant or severe distress or there is an emergency. Typically, an individual would be admitted to the hospital if the evaluators suspect that they are a danger to themselves or to others.

Another way to have a psychiatric evaluation is to make an appointment with a psychiatrist. You would choose this option if there was no immediate psychiatric emergency. Your parents can call the local community mental health center and schedule an appointment with a psychiatrist. Your parents can also speak to your primary care physician who may be able to recommend a psychiatrist. Another option, if you have health insurance, is to call the telephone number on the back of your insurance card. The insurance company typically has a list of mental health professionals they recommend and who are “in network.”

As I mentioned above, it is imperative that you are evaluated as soon as possible. Auditory hallucinations are not a common occurrence. It is a symptom that should be investigated very thoroughly. Hallucinations, both visual and auditory, are associated with schizophrenia but they can also be brought on by drug use, fever, organic brain disorders, dementia, and on rare occasions, parasitic infection.

Please speak with your parents immediately about having a psychiatric evaluation. It is best not to assume that you have schizophrenia or any other condition. You will not know what, if any, disorder you have until you have been thoroughly screened by medical and mental health professionals. In the meantime, it is important to remain calm. To the best of your ability, try to engage in activities that are stress-free and that you find relaxing. If the voices are worse during certain times, for instance when you are alone, try to distract yourself either by watching television, listening to music or by being in the presence of others. Other stress reducing activities include physical exercise, deep breathing, meditation, and yoga. I am not suggesting that you engage in these activities as a way to treat a possible diagnosis of schizophrenia. I am simply recommending that you reduce your stress levels as much as possible because increased levels of stress might exacerbate your symptoms.

The next step for you is to speak your parents and to be evaluated. I know it may be difficult but please try not to worry. Worrying increases stress and at this point, you want to focus on stress reduction. Effective treatments exist for virtually every mental health condition. Please do not hesitate to write again if you have any additional questions. I wish you the best of luck.

Dr. Kristina Randle

January 16, 2011 0 comment