Rituals

Very Frightened. I am a 21 year old Female. I developed major panic attacks when I was 16 after making poor choices with cannabis. Over the years I developed techniques to cope with the anxiety that was occasionally crippling ( ie breathing, finding distractions, going for walks, talking it through).

Unfortunately I became concerned with being poisoned. Anytime a panic attack hit I became concerned I had been drugged as part of a prank or accident and that was why I felt so dizzy and scaared( ie. waiters thinking its funny, or another drugged person not thinking clearly, ect.). For a year I became so paranoid I would avoid eating out. Eventually I learned to push these thoughts aside depite the worry( telling myself no one would do that, other people would also be sick, no one has any reason to that to me). But for a solid year I needed other people to taste my food as well so when they did not become sick I knew I was ok.

After my mother died I developed severe rituals and obsessive thoughts. Fears that I would go crazy and hurt other people or myself. I would count, rearrange and recheck many things, and had a hard time throwing items away. I finally got a hold of this as well by forcing myself to do the things I was afraid would trigger some horrible event or bad karma.

This last summer I felt almost one hundred percent normal. The rituals were almost gone, no panic attacks, and little to no concern with being drugged. Until recent health problems caused many to resurface.

A thyroid disorder and difficulties with the medication caused a great deal of stress. I went through a week of absolute apathy. I felt nothing but mildly sad, including tward my fiance. He was the first to point out my behavior. Now I’ve become perversly obsessed that maybe the paranoia and anxiety is stemming from developing schizophrenia. I know it isn’t normal to worry my fiance or someone else accidently or intentionally drugs me. I do not know if this stems from a phobia, schizophrenia, or the bad experience with drugs mentioned before. The lapses into apathetic states scrares me as well. No one has noticed anything besides the short depression (3-5 days) and obvious anxiety now and then. I like to think if it was schizophrenia I would know by now considering the paranoia and anxiety started over 4 years ago.
I’ve gone through phases of being convinced I was dying (brain tumors, heart failure, aneurisms), and I’m hoping this is another phase related to anxiety, but either way it doesn’t feel normal. So far I keep up well with my schoolwork and job, my fianc seems happy with me, but I worry about these paranoias every second of my day. Please help me. This isn’t a healthy way to live.

Without interviewing you in person I cannot offer a reliable diagnosis. You believe that you may have schizophrenia but the more likely possibility is obsessive compulsive disorder (OCD). A psychiatric evaluation would assist you with the proper diagnosis.

What you have described with regard to being paranoid is not the typical type of paranoia that an individual with schizophrenia experiences. Individuals with schizophrenia and related psychotic disorders who experience paranoia typically become preoccupied with fears such as the belief that others are following or watching them or that their thoughts are being extracted from their mind, etc.

To be diagnosed with schizophrenia, additional symptoms would need to be present including delusions, hallucinations, improper expression of emotion, poor social functioning and disorganized thinking, among others.

Schizophrenia is a thought disorder whereas OCD is an anxiety disorder. Your letter was written in a very logical manner which adds support to my assertion that schizophrenia is an unlikely diagnosis. In addition, your fears are health-specific which, in the absence of other schizophrenia symptoms, is more characteristic of OCD than schizophrenia.

My advice is to have a psychiatric evaluation for a mental health diagnosis. An evaluation could quickly rule out schizophrenia. With regard to anxiety disorders, delaying treatment is not recommended. The primary reason is because without treatment, anxiety disorders tend to become progressively worse over time. The most effective treatments for anxiety disorders include cognitive behavioral therapy, antidepressant and anti-anxiety medication and for OCD, exposure and response prevention therapy. I hope this answers your question. Please take care.

Dr. Kristina Randle