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SZA Symptom Expertise Needed Please


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Ok, I am diagnosed BPI, but I think I may be SZA instead. I have all the mood stuff, but with additional symptoms. I am not sure if they are all attributable to BP or not. I know they treat symptoms, not diagnosis, so it doesn't really matter. But it matters to me to understand the nature of my "illness". I have to know about stuff, if I can understand it then maybe I won't feel so bad about myself. Like maybe I won't feel like I just suck at life. I might ask my pdoc, but want to know if totally crazy in thinking it's anything other than BP before I bring it up.

So here's my additional not mood related symptoms. I definitely get the mania and depression, but they are both stable right now on my two mood stabilizers.

1. Paranoia – was so paranoid about ? being watched I guess at work that I couldn’t leave my office to go to the bathroom. Admitted to the hospital after that.

2. Delusions – was convinced the church was going to kick me out & everyone knew it, hated me & wanted me gone. Left for months, recently returned to a warm welcome, thanks to meds. I always think I have some special insight or really good intuition for seeing other peoples motives, which I usually think are bad, and I come up with all these paranoid ideas to back them up and do not understand why my partner won’t agree when I know I’m right. Occasionally think I’m mildly psychic because it seems like I always knew something was going to happen or I thought about it and it did happen.

3. Extreme irritability/agitation – no amount of meds have been able to help this yet.

4. Flight of Ideas – my partner gets very annoyed with this when she cannot follow or understand

5. Executive function – pretty sure mine is completely broken

6. Sleep disturbances – have had 3 sleep studies, they don’t know why I can’t stay asleep

7. Speech problems – long pauses in talking, get lost in conversation, have a hard time often coming up with the answer to how are you? even. Made up words come out of my mouth. Word finding problems, more than is normal, even small words.

8. Hallucinations – stopped my Abilify Friday and my smell problem came back (smell a horrible odor that no one else does) and also keep thinking a pile of laundry is a person and it scares the crap out of me till I look again. I get that kind of visual disturbance a lot. Feel stuff on my skin that isn’t there. There is the one spot on the side of my nose that always feels like it has a piece of hair tickling it, but it doesn’t go away no matter what. And little tornado swirly feeling things on my arms, hands or wrists. And weird feelings on my shins that make me scratch my legs till they practically bleed. Always hearing my phone text go off, or blackberry message me. And especially almost seeing something in the way while driving, and have a brief freak out like oh no what did I do? But I didn’t do anything wrong. Do those count as hallucinations?

9. Negative symptoms – blunted affect, alogia (just learned what that was & could explain my total inability to make small talk!), anhedonia (HUGE yes), asociality (only relationship is with my partner & if that ended today I wouldn’t care that much), LACK OF MOTIVATION

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I'm not asking for a diagnosis, that's what my pdoc is for. I'm asking whether my symptoms resonate with anyone else's experience. I don't want to bring it up to her and her think I'm an idiot. And I had to read about it to know what it was. I feel like I have a lot of symptoms not explained by my current diagnosis. Just wondering if my understanding of the symptoms and how they relate to me is the same as anyone who is sza, that's all.

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The main difference between BPI and SZA is whether psychosis occurs outside of a mood state. If this isn't the case, it ain't SZA. Everything else could be either illness depending on mood or recovery of mood or nature of bipolar or possibly the severity of bipolar.

Ask to go over all your symptoms. That's better than throwing a diagnosis out there which will only make her think that you've been reading the Internet. She's not going to think you are an idiot.

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A lot of your symptoms sound like extreme anxiety coupled with your bipolar to me. As always, talk to your pdoc. I get that smell thing when I run out of carbamazepine. I always thought I had mold in my house until I noticed that it coincides with running out of carbamazepine. I'm pretty sure that I don't have SZA.

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Guest Vapourware

Teasing out the difference between sza and bipolar can be difficult because you have to work out where the window of the psychosis stands. Sometimes it's not very clear-cut. I also recommend that you speak with your pdoc about this if you are wondering where you stand.

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I think its dangerous to self diagnose too much.

You have some psychotic symptoms as well as bipolar symptoms. You could well have schizoaffective disorder, but in the end does it really matter which label you wear? Its the symptoms that need to be treated.

My p-doc changed my dx over time from OCD to Schizophrenia. My symptoms didnt really change, they were just categorised differently.

I was already on atpypical anti-psychotic medication (seroquel at the time) as well as an anti depressant and benzos.

In my case, the differentiation of intrusive thoughts verses hallucinations was crossed over. I also had a great deal of confusion, negative symptoms which mimicked depression as well as panic attacks.

I would definitely recommend taking your list to your p-doc for further analysis. Remember that it is very difficult to self analyse due to a lack of insight. I hope this helps you. Keep posting :)

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I know my Dx was important to me because then I could look at books and other information to help me understand and cope with myself and my illness more so I think its very worth going over with your Dr. I did not know much about Schizophrenia until I finally ended up with the diagnosis again this last year. The first few times I totally refused to believe that I could have this illness. Though I know its not the same but you are in a better position than I was just questioning this.

For me, although it was the Dx that Mayo Clinic gave me, the bipolar diagnosis never rang true with me. The only manic episodes I have had were medication and drug induced, yet I stuck with it out of denial. I did not learn anything about myself or how to cope with my life going off the bipolar dx, either. I also could not see my own thoughts as being wrong the way you do with some of yours. I totally believed them - even after the fact - and still have trouble catching myself a lot of times when things happen to me. Sometimes I'm not certain what has happened to me.

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Wow you guys have offered a lot of good information and opinions. I suppose I hadn't even considered BP with psychosis. I know it doesn't matter per se, as I'd be taking the same meds as I'm taking now. But it'd make me feel better about myself. I just identify so strongly when reading about people's experiences with negative symptoms and how bad it sucks. And when I think about things I do that are not normal it makes me feel better, like I'm not horrible, when I'm able to separate from it by telling myself it's part of my disorder, if that makes sense. And because I love reading books to help understand myself because that helps me get better.

I just haven't read anything else that seems to fit these symptoms like this one. And I know self diagnosing can be bad, but can be helpful to give the dr. something to go on. Got my first script for ADD meds that way, and then a few years later, my first mood stabilizer. I think I have good insight sometimes. I guess I will talk to my pdoc about it. It is just so hard for some reason. I always get white coat anxiety or something and say I'm fine. Most things I don't share because I don't want to take up too much of their time, sound like a hypo chondriac, or have them think I'm crazy....lol.

So thanks for your replies. You've given me a lot to think about, and some confidence to bring it up to the doctor.

P.S. Glad to hear someone else has the smell thing, I've never known anyone and it sucks that other people don't understand how back it sucks to smell the awful odor all day till it gives you a headache. But I'm sorry you have it too.

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Does anyone know if negative symptoms are part of BP? If they are that'll really answer my question. Though I have figured out the paranoid delusions & olfactory hallucinations occur not in a mood state. Also wondering if BP can change into SZA bc I was dx BP abt 7 years ago but all these symptoms that really bother me just came on about a year ago, especially the hating being around people.

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