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This was getting interesting on the backup board in a thread about possible psychosis.

We were basically discussing self awareness in relation to paranoia and delusions.

In my own experience I am never aware that i am paranoid or delusional and other members of my family and people I have known who suffer sz have had the same. Generally for me the thoughts just go away when I get a med increase for something else like hallucinations but after the fact i never remember what I was delusional about.

For others I know who suffer sz both in rl and on other forums they often hold onto the old delusiona nd still beleive that the government WAS out to get them but they are no longer (if they are med compliant).

Having said that I also know someone who is bipolar and has some self awareness in regards to delusions that come and go with mood...I just wanted to carry ojn this thread, so in the words of VE: as you were...

Dan

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Well as I said before on the old thread (and this is a very interesting topic Dan, thanks for continuing it) the major feature of my illness is paranoid delusions about my thoughts being broadcasted to other people/over the television/radio/internet, issues of being able to psychically control other people or people are controlling me. If I am really ill I become convinced people are following/tracking me through cameras and trying to harm me in some way. I once became convinced that I was the psychic conduit for a war between Israel and Greece.

However, I deal with the delusions pretty well and exhibit a high degree of self-awareness - a fact that has probably led to me escaping an out and out diagnosis of schizophrenia. I have all the positive symptoms but no thought disorder and negative symptoms. In other words, I function too well to be a schizophrenic. In some ways, and this will sound totally insane to those of you living with schizophrenia, I wish I did have the diagnosis because then I could get clozaril which I believe is my best chance of leading a life without symptoms. Although I function very well, have an amazing degree of self-awareness and people would not know I had symptoms unless I told them, it doesnt mean that things don't get very difficult for me. I can at one level recognize the thoughts as paranoia but at another level I do believe in them. It's very confusing.

I don't mean for this post to sound like a one-woman pity party, and I'm sorry if it came across that way but this is a very interesting topic and I wanted to give you all an insight into what it is like to live with psychosis and concurrent insight. Any feedback and experiences is appreciated

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Well as I said before on the old thread (and this is a very interesting topic Dan, thanks for continuing it) the major feature of my illness is paranoid delusions about my thoughts being broadcasted to other people/over the television/radio/internet, issues of being able to psychically control other people or people are controlling me. If I am really ill I become convinced people are following/tracking me through cameras and trying to harm me in some way. I once became convinced that I was the psychic conduit for a war between Israel and Greece.

However, I deal with the delusions pretty well and exhibit a high degree of self-awareness - a fact that has probably led to me escaping an out and out diagnosis of schizophrenia.

Does anyone know if self awareness, or rather lack of is part of diagnosing sz as opposed to say psychotic disorder nos or delusional disorder? It seems this may be a key to our discussion.

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Just my 2 cents: many scientists consider schizophrenia a label/diagnosis that actually covers a (large?) number of really different "diseases". I'm using quotation marks here, because in medical terms schizophrenia is really a syndrome, possibly a disorder. I'm not sure whether disease and illness are considered two different things in medical science (long time ago since I studied that), but for convenience here I'll assume that they have the same meaning, and for something to be able to be called a "disease" both the cause of the "disease" must be known and the process of the "disease" must be well understood. This is not the case for schizophrenia, which is basically a label that refers to a combination of symptoms. "Schizophrenia" is considered by many scientists to be a label for "diseases" that may both differ in origin, symptoms, prognosis, development and other things.

So I'm having trouble with schizophrenia as a label, because it covers so many different disorders in mental functioning. And for as far as I know, lack of insight is considered more typical for a worse prognosis. But does awareness/insight mean you don't have schizophrenia ?

For as far as I can see, that's mostly a matter of playing with words.

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I was always under the impression the delusions were born of excess/misdirected emotion. I can clearly remember every time I went off meds and slid into paranoia. It would start with social phobia about which I was able to rationalise quite clearly - just the feeling I'd rather not meet my friends today because maybe I'm not welcome. That "maybe" was a sign of still being quite lucid - I avoided social contact simply by inclination. Then it al spiralled from there - my emotions are telling be to be suspicious of them so I am, and I'll look for signs that validate the paranoia, coincidences, "ideas of reference" etc. simply because my mind has somehow chosen the paranoia, however that works.

However I was always able, when I wanted to, to fake being normal, so I did have a sense of "sane" reality, and I never had one particular theory about paranoia - I tried to make sense of it every day in a million different ways. I remain convinced that we have the ability to tap into a subconcious world of meanings and correspondances in everyday details that can precipate "delusion" through not interpreting the signs right or focusing on negative aspects. Hmmm, delusions of grandeur perhaps, but I'd like to think that schizophrenia does not automatically = idiocy, like a lot of pdocs seem to think.

I'm not a big fan, but some of what the "magician" Derren Brown does on TV is quite interesting in this respect.

Still, I'm not sure how much I want to know - consiousness can be quite scary and a proper in-depth discussion of schizophrenia involves religion, the subconcious, "magic" and a load of heavy stuff that is perhaps never meant to be understood, perhaps for good reason.

I'm rambling. I'm going to have a sane normal cup of tea.

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Whilst it is probably more common to have limited insight into one's problems with schiozphrenia, this is a common feature of all types of mental illness. It is common, in the early phases of treatment at least, to havea lack of insight as to what the problems and symptoms are.

Often over time a diagnosis shapes and changes as a result of increased insight by the patient which helps the dr treat the condition better.

I am a classic example - my diagnosis changed from panic disorder & depression, to major depression with a mixed anxiety state, to OCD, to schizophrenia over a period of about 2 years. In retrospect my symptoms and condition havent changed much, but the way I perceive it has. This has helped my p-doc to treat me better.

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However I was always able, when I wanted to, to fake being normal, so I did have a sense of "sane" reality, and I never had one particular theory about paranoia - I tried to make sense of it every day in a million different ways. I remain convinced that we have the ability to tap into a subconcious world of meanings and correspondances in everyday details that can precipate "delusion" through not interpreting the signs right or focusing on negative aspects. Hmmm, delusions of grandeur perhaps, but I'd like to think that schizophrenia does not automatically = idiocy, like a lot of pdocs seem to think.

I agree 100% with you. I can maintain my own vision of a 'sane' reality and keep my mouth shut about my paranoid thoughts. It upsets my family if I talk about what's going on with me so I just keep schtum.

I also agree with being able to tap into a subconscious/subliminal world of meanings and correspondences.

Olanzapine here I come! ;)

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Greetings all!

I believe the thread this was carried on from was my enquiry about psychosis (the GP having told me that may be where I was/am heading). Everything everyone has said is really interesting - and nice to hear other people can be aware of their paranoia too, and that this doesn't make it anything 'less' (I have problems convincing myself the doctors don't think I'm a fraud).

Cheers for all the ongoing input/support xx

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did someone say 'NHS'.....????

and to add my bit....my paranoia is actually hyper-vigilance of PTSD in addition to some classic paranoid-schizoid position from my early life trauma (read Klein and Winnicott)...I have plenty self awareness, but in the midst of a panic attack/flashback/dissociation I know its not happening now, but am powerless to reach myself....as it were....

in my case...they really WERE after me...

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Just my 2 cents: many scientists consider schizophrenia a label/diagnosis that actually covers a (large?) number of really different "diseases". I'm using quotation marks here, because in medical terms schizophrenia is really a syndrome, possibly a disorder. I'm not sure whether disease and illness are considered two different things in medical science (long time ago since I studied that), but for convenience here I'll assume that they have the same meaning, and for something to be able to be called a "disease" both the cause of the "disease" must be known and the process of the "disease" must be well understood. This is not the case for schizophrenia, which is basically a label that refers to a combination of symptoms. "Schizophrenia" is considered by many scientists to be a label for "diseases" that may both differ in origin, symptoms, prognosis, development and other things.

I am aware of this research and find it fascinating but I'll save that for another thread.

So I'm having trouble with schizophrenia as a label, because it covers so many different disorders in mental functioning. And for as far as I know, lack of insight is considered more typical for a worse prognosis. But does awareness/insight mean you don't have schizophrenia ?

For as far as I can see, that's mostly a matter of playing with words.

This had also occured to me: degree of insight relating to prognosis.

However I was always able, when I wanted to, to fake being normal, so I did have a sense of "sane" reality, and I never had one particular theory about paranoia - I tried to make sense of it every day in a million different ways. I remain convinced that we have the ability to tap into a subconcious world of meanings and correspondances in everyday details that can precipate "delusion" through not interpreting the signs right or focusing on negative aspects. Hmmm, delusions of grandeur perhaps, but I'd like to think that schizophrenia does not automatically = idiocy, like a lot of pdocs seem to think.

I agree 100% with you. I can maintain my own vision of a 'sane' reality and keep my mouth shut about my paranoid thoughts. It upsets my family if I talk about what's going on with me so I just keep schtum.

Does that mean that while you are spending time with your family you know nobody is watching you etc or that you know it's the wrong context to talk aboout being watched (in the same way you wouldn't tell your great grandmother dirty jokes)?

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Does that mean that while you are spending time with your family you know nobody is watching you etc or that you know it's the wrong context to talk aboout being watched (in the same way you wouldn't tell your great grandmother dirty jokes)?

That's precisely it. I know 99% of other people don't get thoughts about mind control and being stalked psychically by Palestinian terrorists so I keep my mouth shut. My family have suffered enough of my bollocks, the least I can do is just shut up rather than ranting in a paranoid fashion. It's hurtful to them and I am grateful that I have the self-control and insight to stop doing this. Thank fuck for insight or Id never leave the house at all! ;)

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Yes, it IS an interesting topic all right. Thanks, Dan.

And one thing I apologize for forgetting to add to my previous posts (temp Board) is that upon reflection, I think there ARE different kinds of paranoia - with different levels of insight built in (GREAT article, Blackbird!). Maybe they're related to the diagnostic framework the person is coming from and maybe not (It's a big assumption, of course, that the diagnosis is always correct and consensual. In actuality, there is huge variability between locales, doctors - even cultures).

However, having said as much, I know one person with sz who most definitely DOES have periods when she is well aware she is "becoming paranoid" . However, when she's full into it, she can't be convinced her delusions aren't accurate.

Especially given the present legal/economic situation in the US regarding treatment of MI, one of the great challenges (hate that buzzword. Please imagine puke emoticon) of sz is how to help the pt ACT on that awareness while it's still there. Pt might, for example, ask for an upping of meds for the duration. If that weren't possible, maybe there could be an agreed upon custodian (one the pt. agreed to while "sane") - able to act on informed observation of the pt.

Said person would be empowered to adjust dosage levels independent of pt consent, even by depot injection if needs be. (Kind of picturing Ullsyses arranging in advance to be bound, when he knew his ship was going to pass near the Sirens).

Then it would be possible for more people to do with much lower levels of meds, most of the time. Effectively, they would be adjusted PRN.

That's my great hope for my son , for instance - but it doesn't look likely as things stand. He's just as entitled to make decisions about his medications when he's WAY out of it as when he's stable and self-aware. Makes me so sad.

I'd love to see him able to get by with less medications - especially given the current state of the Art regarding what's out there to prescribe. All those cognitive side effects and increase of negative symptoms . Then of course, there are also the many that are puely medical: obesity, diabetes proneness, liver enzymes and the whole raft coming with Clozaril (they just found some new ones there, did you know?).

I have a real bad feeling about what's going to happen once he turns eighteen as I know he wants off the meds entirely. Does not seem to be aware of how his mind goes kablooey when he does stop taking them (he experiments right now. He's confided that in me - as if I couldn't tell!). Of course, he could legally refuse them already but does not seem fully aware of this - that's it's not related to his being a minor (or a "major"?)

Bad thing is his Alter Ego or whatever, COMMANDS him not to take them - and the more he's off them, the stronger that force becomes both in persuasive power and in actual control. (He's got that "Control phenomenon" business).

I can easily see his being the sort that could hurt somebody someday too. Wish the mental health system here were like in Denmark (which I consider the best in the world): Free high quallity care, top notch residences integrated into the community - and as needed, forced medication.

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Does that mean that while you are spending time with your family you know nobody is watching you etc or that you know it's the wrong context to talk aboout being watched (in the same way you wouldn't tell your great grandmother dirty jokes)?

That's precisely it. I know 99% of other people don't get thoughts about mind control and being stalked psychically by Palestinian terrorists so I keep my mouth shut. My family have suffered enough of my bollocks, the least I can do is just shut up rather than ranting in a paranoid fashion. It's hurtful to them and I am grateful that I have the self-control and insight to stop doing this. Thank fuck for insight or Id never leave the house at all! ;)

I'm jealous! Even when people tell me constantly "your delusional! Get some help!" it doesn't register that they're serious. Who was that comic that summed up positive, negative and disorganised symptoms of sz? Or was it paranoid sz, undif sz and hebe sz? Anyway I tend to fall into the evrything is laughable category that half not there giggle at reallly serious times.

I sometimmes remember litttle bits of my delusions. I know Steven Hawking and Albert Einstein were a source of paranoia (we all know how threatening someone with motor neuron disease is,particularly when they live half way across the globe; and someone else who's dead).

However, having said as much, I know one person with sz who most definitely DOES have periods when she is well aware she is "becoming paranoid" . However, when she's full into it, she can't be convinced her delusions aren't accurate.

Yes, and the more people try to convince otherwise the more one becomes convinced that 99.99999999...% of the world populace has been brainwashed.

Especially given the present legal/economic situation in the US regarding treatment of MI, one of the great challenges (hate that buzzword. Please imagine puke emoticon) of sz is how to help the pt ACT on that awareness while it's still there. Pt might, for example, ask for an upping of meds for the duration. If that weren't possible, maybe there could be an agreed upon custodian (one the pt. agreed to while "sane") - able to act on informed observation of the pt.

Said person would be empowered to adjust dosage levels independent of pt consent, even by depot injection if needs be. (Kind of picturing Ullsyses arranging in advance to be bound, when he knew his ship was going to pass near the Sirens).

Then it would be possible for more people to do with much lower levels of meds, most of the time. Effectively, they would be adjusted PRN.

That's my great hope for my son , for instance - but it doesn't look likely as things stand. He's just as entitled to make decisions about his medications when he's WAY out of it as when he's stable and self-aware. Makes me so sad.

I'd love to see him able to get by with less medications - especially given the current state of the Art regarding what's out there to prescribe. All those cognitive side effects and increase of negative symptoms . Then of course, there are also the many that are puely medical: obesity, diabetes proneness, liver enzymes and the whole raft coming with Clozaril (they just found some new ones there, did you know?).

I have a real bad feeling about what's going to happen once he turns eighteen as I know he wants off the meds entirely. Does not seem to be aware of how his mind goes kablooey when he does stop taking them (he experiments right now. He's confided that in me - as if I couldn't tell!). Of course, he could legally refuse them already but does not seem fully aware of this - that's it's not related to his being a minor (or a "major"?)

Bad thing is his Alter Ego or whatever, COMMANDS him not to take them - and the more he's off them, the stronger that force becomes both in persuasive power and in actual control. (He's got that "Control phenomenon" business).

I can easily see his being the sort that could hurt somebody someday too. Wish the mental health system here were like in Denmark (which I consider the best in the world): Free high quallity care, top notch residences integrated into the community - and as needed, forced medication.

Here in Aus forced treatment occurs when a patient is deemed dangerous to themselves or others. Do they have that in Other countries?

Oh and yes thank you for the article Blackbird

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Over here they can 'section' people (i.e. detain them against their will) and enforce medical treatment upon them if they are a 'danger to themselves and others'. One guy in the local nut house has been forcibly detained there for the past 18 months.

realitytest, it is very unfortunate that the people who most seem to need medicine are the ones reluctant to take it. Your son is in my thoughts.

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Guest Guestxyz

Wish the mental health system here were like in Denmark (which I consider the best in the world): Free high quallity care, top notch residences integrated into the community - and as needed, forced medication.

Hi. I won't get into the main message of your post, but I'd like to put the above statements into perspective. I really don't know much about Denmark's health care system. I presume that it's mostly state organized or controlled. Perhaps with a few private hospitals, that are almost certainly (if they exist!) not covered by any insurance. Maybe the average Danish hospital is better than the average USA Hospital (although I doubt it). I presume the Danish system is more a "equality for all" type of system, guaranteeing basic healthcare for everyone. But not providing the superior healthcare of the USA, at least for those who can afford it. Also, speaking for Europe in general, many medications that are registered and available in the USA are not registered in Europe. And doctors in the USA are, for as far as I know, more willing to experiment and to apply a combination of medications, instead of the British monotherapy approach. And about that forced medication issue: I can understand your point of view. But morally, I think that forced medication is reprehensible. Although a variation of this, confining people to mental hospitals against their will, without giving them treatment, is not exactly great either. A more practical disadvantage of forced medication: (potential) patients learn that that is an option, and may be even more reluctant to seek medical help. Also, if the patient is unwilling to take the medication, forcing the patient to take the medication can become a struggle between doctors and nurses on one side, and the patient on the other side. Hurting other kinds of treatment, and if the patient is unwilling to cooperate it can be hard to know how a med affects a patient. And then there is the issue of side effects. And the issue of long term compliance. So, I am in principle against forced medication, perhaps with an exception for those who have lost all or nearly all grasp of reality for a considerable amount of time.

Ok, coming off the high horse ...

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Just a quick update for those who are interested (afraid I'm currently completely incapable of reading the long posts - my concentration has snuck off for a sneaky fag of late). The GP started me on Zyprexa last Thursday (was previously med-less) and we upped it to 10mg as of this evening. And reality came back properly today! Yay! Hate being back on meds, but if the choice is drugs or spiralling delusions.... *shrugs*..... that's not really a choice!

Blackbird - go team UK! ;)

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Even medicated and stable, I have certain beliefs which other people tell me are "wrong." I disagree with them, and get very upset if they try to argue me out of those beliefs. But those are pretty few and far between. Most of the time I can realize I'm hallucinating or whatever, which honestly scares me more than if I didn't know. It's like "oh fuck I'm hallucinating I'm losing my mind again what the fuck do I do OMG MAJOR FREAKOUT--"

So... yeah. Depends a lot on how far gone I am, but there are always exceptions.

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Even medicated and stable, I have certain beliefs which other people tell me are "wrong." I disagree with them, and get very upset if they try to argue me out of those beliefs. But those are pretty few and far between. Most of the time I can realize I'm hallucinating or whatever, which honestly scares me more than if I didn't know. It's like "oh fuck I'm hallucinating I'm losing my mind again what the fuck do I do OMG MAJOR FREAKOUT--"

So... yeah. Depends a lot on how far gone I am, but there are always exceptions.

What sort of false beliefs are you referring to? It might be interesting for us all to discuss this.

With my type of schiophrenia, i often get delusions of physical illness which isnt there, not in a hypochondria sort of way but in a confused mental torture sort of way.

Delusions arent really my major problem - voices in my head are my big bad symptom.

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