BPDRecovery.com: Forums

I saw my T this week and we were talking (again) about Schizotypal Personality Disorder. He had told me I have features of this. And one of them is psychosis. So he told me that when I was really depressed last year, he and my pdoc both agreed that I had exhibited psychotic features.

So I told him I didn't recall being that way. I asked him how do I know if/when I'm psychotic? He said I wouldn't know. So as I'm talking to him I can feel myself retreating, sort of dissociating. It was weird. I was there but I wasn't there. Nothing felt real. So afterwards I told him that I had been dissociating and he said that I was still able to talk to him while I was doing it. I said yeah.

It was such a weird experience. It's strange enough for your T to tell you that you've been psychotic, and then to retreat like that - my goodness!

I'm not really focusing on what he said, I'm just sharing what he said. The whole psychosis thing is a bit strange to me.

I can imagine that if my T told me I'd been psychotic I'd freak out and dissociate a little. (For me, mild dissociation is a way of coping with stress.)

Did your T explain why he thought you'd been psychotic and what symptoms you'd had? I think I'd want to know that.

I know when I was really severely depressed, I had some weird thoughts, like I became worried that I might not exist and I did various things to try and prove that I did. At one point I became convinced there was a loose connection in my head and that if I banged it on the fridge, it would sort it out. Unfortunately it didn't work, it just gave me a monster headache!

I think it's quite common with severe depression to have some psychotic symptoms, if that helps at all.

Thanks Echoes. I don't think he told me what the symptoms of the psychosis were. If he did, I might have tuned him out. I think when people tell me things that I can't quite believe I dissociate. Like I'm thinking "this didn't really happen, did it?"

I know when I had that situation with the student intern, I probably had faulty thinking there. No one could convince me otherwise that what I was thinking was not based in reality. But while I was going through it I was convinced that my thoughts were okay.

It's kind of scary when you think about it. That you can be so far gone but not realize it or believe it. And you have no way of knowing exactly that you're doing it.

I'm going to have to ask my T about when I was depressed and how I was acting and saying. I just don't remember. I know I was very depressed then, but I don't recall the details.

Well, this came from Wikipedia:

The whole page is actually pretty good.
The other thing to consider is that those are traits. They aren't absolute, they aren't all the time, they aren't always 100%. I have a lot of those traits, but not all of them all the time to the highest degree. If all I choose to look at are the most extreme examples, it's easy for me to say "well, I'm not like THAT" or "I can have this because I don't do that one thing". Having psychotic symptoms and "being psychotic" aren't the same thing. A lot of times, people use psychotic when it isn't really the correct word, so it's easy to get mired down in all the stigma.

Thanks Minx! Yes, he said that I exhibited psychotic traits and only for a certain amount of time. I'm not "psychotic." I think I still found it weird to realize I was acting in a certain way and I wasn't even aware of it. He never told me at the time that I was doing that. I'm so much more stable now.

I think people are just afraid of the word "psychotic" because of it's common place use. I have been told that when I have an extreme amount of stress upon me I have had "psychotic episodes".

You didn't explain in detail the reasoning behind this diagnosis, so I will explain a little bit of how I feel, or what has been referred to as an episode. I would think people were going to break in my house and hear a random noise like a pipe banging because of the radiator and assume that someone was in the house. Or I would believe that co-workers were conspiring against me at work, or my family was trying to control me etc... when this was not true. As for "reality", in the moment (hours or days) it was happening, it was my reality. I don't think you can stop yourself if you're having a psychotic episode by being mindful as well as you can with depression or anxiety for example.

"Person first" language helps the stigma, for example: "she's psycho" replaced with "she has Schizotypal Personality Disorder" or in the case of my work, "he has a developmental disability and cerebral palsy" sounds better than "he's a palsied retard".

Society needs to get a grip, not you or us here. Accept people for having all of the mind-frames and emotions they are going to experience. It's natural to clam up on the topic! Hang in there.

I have identified that I go into states of psychosis, slight mania, and hyper and hypo states of delirium under times of great emotional stress. Sometimes when my SO and I get into an argument, I will assume he is someone from the past and begin to assume his intentions and argue with him as if he is, but it doesn't make sense because it is not the same person I am arguing with. I believe that these are behaviors I learned in order to cope with extreme distress in childhood and into my adult life. I used to disassociate quite often and "zone out", I have cut these behaviors to a minimum, and now the "zone out" has been replaced by a state of hypo delirium, in which I can't focus, and my thinking is fast and disorganized. I believe that I did it when something someone said or did was too painful to face, as was set to be in early childhood. As time goes on, I am trying to minimize and get rid of these behaviors as much as possible. Something someone says or does can be interpreted by me through my filters (without me actually finding out what they did mean first), and can trigger a state of mind similar to a highly-emotional situation I experienced in my past.

Do you think that possibly when someone like your t says something that is difficult to face, that your automatic reaction may be to use a defense mechanism like denial in order to create beliefs that will automatically deny these things that could be too horrible to face, or that you could enter a state of mind similar to one in the past and be acting-out the same episode, but it doesn't necessarily apply to the present situation? This could also explain the disassociation - that the fact that you could have psychotic episodes may be difficult to face and the fear is so overwhelming, that it causes an automatic reaction of disassociation and/or a psychotic episode including some sort of belief set in place to deny the existence of it or anything that is threatening to the point where no other information is let in that could cause any hurt within you. If I don't allow any new information in (or even consider another viewpoint), I don't have to allow the existence of anything that may hurt me. I was in this boat, for a long, long time. My mother has been in this boat all her life. If I tell her something about herself, she will just pretend it doesn't exist, but also that could be done within by simply "disagreeing" and thinking the other person is stupid or ignorant for thinking what they do, and that the other person can't possibly be right about anything. These are all defense mechanisms set in order to protect the self from pain. And I have done all of them at one time or another. I am slowly finding my way out. It's wonderful that you are getting to the point where you are accepting that you have psychotic episodes, now I think identifying the thoughts that are unrealistic in regards to the present situation (using denial heavily as a defense mechanism, which is no longer needed because you are in control of yourself and your own situation), and trying to find your way out of these states of mind once you enter them, are needed.

When you know you are safe, you can allow more to enter your mind as a possibility, while knowing that you cannot be harmed by a thought, yours or any other's.

Yes, Aqua, you are absolutely correct! I have used dissociation when I felt unsafe. The weird thing is, when I dissociate, I actually feel LESS SAFE! I feel out-of-control. I used to think that outside forces were invading my body. When I began having dissociate attacks, I didn't know what caused them. I went to a counselor, but they never explained it to me. Later on, when I was a teenager, I read "I Never Promised You a Rose Garden." I believed that outside forces were invading my body whenever I had a dissociative attack. I couldn't believe that it was something happening Inside Of Me.

And yes, when I receive information that I believe can be harmful or is scary to me, I retreat into myself. I just can't believe that what the person is telling me is real/true. And often, I also believe that I am "making up the symptoms." That's sort of how I feel about the Narcolepsy diagnosis. It's so strange that I can't believe I really have it. I have this idea that I'm making it up to gain attention from my doctors. Even with tests and all, I still have trouble accepting it.

So when my T tells me I had a psychotic episode, I was in complete denial. It was too weird to contemplate. I need more information from him to process it. I don't know how I was acting when it happened. I don't remember how I felt or what I did.

I wonder now if that whole episode with the student intern was a psychotic episode? I had these paranoid ideas and was convinced that she was watching me, reading my files, etc. No matter what anyone said, I was convinced she was doing these things. It lasted for quite a while too.

What you said about feeling harmed is true too. I retreat in my mind when things seem dangerous to me. My T telling me I had a psychotic episode seemed dangerous and something beyond me.

I don't know how to feel safe. I have never trusted myself. I need other people to take care of me. I need my H and my T. I depend on friends to feel safe too. I latch onto people to feel safe. I'm 57 years old and feel I can't take care of myself. I can take care of myself, but only for short periods of time. I've never been alone and don't know what it's like. If something ever happened to my H, I don't know what I'd do. I need him to take care of me.

I need to talk to my T about this. Thanks for bringing this up Aqua. I feel like I'm going to cry. You really helped me! Thank you!!!!

I have such a hard time talking about my dissociative symptoms that I tend to dissociate whenever the topic comes up in therapy! LOL In order to "normalize" the dissociation, I tend to describe it more often as "not paying attention" rather than "freaking out" because I don't like being a freak. This may be a means of "minimizing" (something I am told I do) but I find it easier to talk about certain things in certain terms and not in other terms that trigger me. Some psychological terms have such negative connotations that it is hard to admit that we are so messed up.

Yeah Denim. I can relate to that. Sometimes I am quite amazed that I am in therapy and taking psychiatric drugs, etc. etc. But I always "knew" something was wrong with me, even when I was young. So I'm not surprised that this is where I've ended up. I know I can change things, but not too much. I am who I am. I'm not 23 anymore. So I have to accept things and learn how to deal with them.

I don't think you're a freak Denim. I think that's a label you put on yourself. We all have issues and have to learn to accept them. Labeling yourself a freak can't help you at all. Once you can be kinder to yourself and not put these labels on yourself, it will be easier to deal with them. One of the DBT exercises is to not be so judgmental.

I think for me, I just have to accept what is happening and realize that it is real.

Hi Border Girl

what you are describing, and even more so what echo was describing I have had many many times before.

I was then, probably 7 years ago, diagnosed with Depersonalisation disorder. When I then later read angry heart, I realised lots of things. Anyway, from what I can understand, this is a common psychiatric symptom, with depression, and anxiety etc. It is also sometimes classed as a protective mechanism.

When echo describes the feelings of wanting to prove you exist, and worries of loose conections in the brain - I had this for years, and feeling unreal etc.

Dont fear it, it does not harm you, and it probably served at one time, as protection from what was going on in your life.

Thanks Jake. Yes, it was a protective mechanism. But now when it happens it scares me as I feel totally disconnected from my body. I find myself pinching myself to make sure "I'm here." When I type, I can't feel the keys under my fingers. It's so weird! I don't understand how something that was supposed to "protect" you can make you feel so scared and out-of-control.

Plus my T explained to me what happened when I had the psychotic symptoms. It was when I was very very depressed. I couldn't reason anything, make sense out of anything, he said I was "inconsolable" and was extremely paranoid. To me, that's also being out-of-control. It scares me. I have a big issue with control and it scares me that I can be this way and not know it and not be able to prevent it. The best I can do is try to remain as stress-free as possible, which would prevent me from becoming depressed and more likely to go into one of these episodes again. So I guess there IS something I can do to prevent it.

BG - would it help to come up with some sort of "advance directive" for if you get psychotic symptoms again? You could let your family and friends know what symptoms to watch out for and what you'd like them to do if it happens. You could also discuss what you'd want with your T and pdoc. That's a way of retaining some control, because even if you're not in control when it's happening, you'll have already put things in place for what you want and need.

Jake - that's really interesting that you've had such a similar experience to me. I feel less weird now. Thanks for sharing.

I know milder dissociation does protect me in a way. I reach a point in nerve-racking situations where I can't take the intense anxiety any more, so I go numb. Unfortunately, it also makes it hard for me to take action in any way. It doesn't bother me so much now that I know what it is and have learned some strategies for dealing with it.

Thanks Echoes - that's a good idea. My T did tell me that he would "watch" me for these signs. I need to talk to my H about it. I'm a bit scared and embarrassed to bring it up with him, but I know I have to. What bothers me is that sometimes when my H thinks I'm doing something "crazy" he'll say "you're acting BPD again." So I'm a bit nervous about bringing it up with him, but I know I need to.

I'm going to see my pdoc the first week in June and I'll bring it up with him too. I don't see him that often but since I do see my T every week so I know he'd be aware of any symptoms I may display.

I guess I have to realize that the only way I can have control is to give up control - over to my T and pdoc. That's a hard concept for me to swallow but I guess I have no choice.

Echoes, can you tell me what your strategy is for dealing with the mild dissociation? I get that too and it is so difficult to manage. Thanks so much for your help!!!!

Yeah, it's hard to give up control to another person. I struggle with that too. Does your H know you don't like it when he says you're "acting BPD"?

What helps with my mild dissociation is mainly just being aware of it and understanding what it is and what triggers it. For me it's usually triggered by anxiety, so if I have to do something that scares me, I try to do it straight away before the dissociation kicks in. Also, if I do dissociate and can't do whatever it is, at least I know why, and I can try again. Before I knew what I was experiencing was dissociation, I felt like a failure because I "couldn't" do things that everyone else could. I thought I was a coward. Now I know as long as I don't put it off too much, I'll be OK.

The other thing that helps is if I find myself dissociating, take a break from the situation to regroup. I usually just go to the bathroom. No one thinks anything of that, and it seems to "reset" me to some extent, and makes it easier to participate when I get back. I don't have any problems getting up and leaving when I'm dissociating - it's participating socially that I find really hard. It's like there's a thick pane of glass between me and everyone else. The anxiety I mentioned above is mainly social anxiety, in case that wasn't obvious!

Thankfully, I haven't had the more severe stuff that I described in my first post in years. I think it was either a symptom of my depression, or a side effect of the AD I was on at the time.

Oh... I also find when I've been through a lot emotionally, I tend to feel numb, and go into "coping mode". That's not exactly dissociation, but it's related. It can be a good thing for a short period of time (for example, when my cat went missing, I would never have been able to put posters up and contact shelters etc if I hadn't gone into coping mode). But if I get stuck there for too long, it helps to deliberately do things that will make me feel emotional - listening to certain kinds of music, etc. Also to make myself slow down, not accomplish so much, focus on what I'm thinking and feeling, and journal about it.

I hope that helps.

Thanks Echoes. I tend to dissociate in my T's office, like when he tells me things I find hard to process. Like with this psychosis thing. I just sat there and listened and it felt like there was a film between me and him. I sort of retreat. I did tell him but by that time the session was over.

I don't get social anxiety but it happens a lot when I'm driving. I have to use DBT skills, like Distraction or Observing and Describing skills, to get through it. Turning on the air conditioner on high also helps me.

I think I tend to dissociate when things don't seem real to me, like when people tell me things I can't deal with. Sometimes I go into coping mode, like when my mother was sick and dying. I never dissociated when I went through that. But other times I will. It all depends.

I can't take a break from my T session, but I suppose I can tell my T right away if I'm dissociating. That would be better than waiting till the end of the session.

Where did that come from?
Why not take responsibility for yourself? Learn to manage and control yourself?

I understand that psychotic episodes can be hard to pin down. When we're on the inside, it all makes sense because it's all coming through our unreality filter. But that doesn't mean that we have NO control. It only means that it could be difficult at first to identify what's going on and that we will need time and practice to minimize our episodes. Remember when you first come on board here and you used to have tantrums at your T's office? Then you began to see that you were doing it, then you began to learn how to sit still (even if you didn't want to), then you started being able to talk yourself through them? I really don't think this is THAT much different.

I do think that it's a good idea to discuss this with your pdoc and your T and your H. But I don't believe that you have to "give them control". By discussing this, you can be TAKING control (in a way). You have the opportunity to tell them what YOU want done if you can't decide for yourself, and I believe you should use it. This is about what YOU need to be healthy, and you DO have a voice. You may also have more control within the episodes than you think.

Think about how you felt and what you were thinking during the episode that your T has told you about. Did you feel completely normal or out of sorts? Did you feel balanced or did you feel extreme? These thing can be clues for us that our reality is getting skewed. If the important people in your life are clued to start seeing the symptom, they can help you get whatever it is you might need. But if YOU start feeling off-balance and extreme, you can start doing your own reality checks (just keep in mind that you might not believe them). There are ways to help stabilize us before a full-blown episode comes on IF we act early in the progression.

Remember that there is no black and white, absolute solution. Stop looking for any definitive answer. looking for something that doesn't exist can drive the sanest person to despair. You HAVE lived with this for some time - it didn't just pop up last week. I understand that it can be scary, but it's not the end of the world. If it was, My world would have ended back in 1970Something...
You are not hopeless. You are not helpless. You have issues (don't we all?) but you can be just fine. I believe in you.

I know that it may seem that I'm picking at your words...We've talked before about the power and meaning of words. What you say colors your impression and unhealthy, unbalanced, negative speaking can really make you feel things are worse than you really are. When I say "I'm hopeless, I can't, I'll never" I set myself up for failure and misery. When I say "I can, I will, I am" I set the stage for me to be strong and capable. It's not 100% and it's not magic but it DOES make a difference.

Thanks Minx. I think the reason I said "give up control" is because I misread what Echoes wrote. I understand now what she meant. So far it's been difficult for me to know when I'm having one of these episodes. But of course at the time no one told me they were psychotic episodes. I just found out last week I had them. But you're right - now that I know about them I can be more aware of my behavior and if I think I'm going into one, I can ask my T if he sees that happening. Then I can take steps to make things better.

I don't want to give up control to other people. I want to know what is going on and how I can take steps to control it myself. I suppose I just need to get on with my life and not let this bother me. Thanks for your pep talk!!!!!