Question:
From all that I have read on the subjects of SZ and MD I am left wondering
whether the diagnosis of "manic depressive psychosis" is a nice cosy way of
saying that I suffer from SZ and MD - or alternatively that the
psychiatrists are unable to decide whether I have SZ or MD. My father in
law has exactly the same symptoms and is now diagnosed "manic depressive
psychosis". However, he was originally diagnosed some 20 years ago as being
"paranoid SZ".
I would welcome opinons on this - do I have SZ or MD or both ?
Answer:
I have been diagnosed as having "manic depressive psychosis". I have
suffered with psychosis since the age of 3 and mood swings since the age of
13. I had my first major "manic" episode at the age of 18 and have had 4
major episodes since. I regularly suffer from "hypomania" and psychosis in
its mildest form is present almost every day. From time to time it becomes
very severe. I very rarely suffer from depression (only after a major "manic" episode).
I get psychosis with mania and with hypomania. I hear "voices", feel
"controlled", suffer from anxiety, paranoia, delusions and I get visual
hallucinations.
From all that I have read on the subjects of SZ and MD I am left wondering
whether the diagnosis of "manic depressive psychosis" is a nice cosy way of
saying that I suffer from SZ and MD - or alternatively that the
psychiatrists are unable to decide whether I have SZ or MD. My father in
law has exactly the same symptoms and is now diagnosed "manic depressive
psychosis". However, he was originally diagnosed some 20 years ago as being
"paranoid SZ".
I was diagnosed as Paranoid SZ at about the same time as your father. Maybe
in those days the manic depressive/mood swings bit was not as much to the
forefront in diagnoses. If you don't suffer the depressions then you are very lucky although I agree
that the manic aspects of the mood swings can be a problem.
You seem to have some of the symptoms of schizophrenia. There are people
more qualified than me who can quote complete theories on how and when
schizophrenia is actually diagnosed. I think the symptoms have to go on
long term rather than just during manic episodes.
Are you taking any drugs to control the situation? Do they work? Are you
functioning well in life? Are you a recluse or a social person? Do you
suffer anxiety and fear? Do the voices and other Sz symptoms leave you at
the end of a manic episode?
There are far too many questions.
If you are under the care of a psychiatrist then you should really clarify
this with him/her. It all depends on whether whatever they have given you
to cope with the situation actually works and whether you are to all intents
and purposes - "happy".
If you are having a bad time then you really need to speak to the person who
is looking after you and explain why and see if there is anything they can
do to help.
The psychosis is present pretty much all of the time, but I have now learnt
to live with it. I am totally intolerant of the side effects so only take
anti-psycotics when things get too bad to cope with.
The psychosis often remains once the mania has gone.
I alternate between being very sociable and being very reclusive. I suffer
anxiety and fear on quite regular basis, for varying lengths of time.
Thankfully I have a very wonderful and understanding wife who is very
supportive. This makes life much easier.
I am currently functioning very well, although sleep is a problem. Lack of
sleep leads to hypomania, but my wife simply "forces" me to take nitrazepam
for a few nights and the hypomania soon passes.
I do have a psychiatrist, but to be quite honest I have little faith in
their so called skills. Psychiatry seems to be based on pure speculation -
they don't have a clue
When all is said and done, I have accepted my mental illness and I am
learning to live with it. It doesn't really make any difference what
"label" I am given, but I have this inbuilt curiosity and will not simply
accept what I am told by a psychiatrist. My experience of my father in
law's problems has shown me that the psychiatrists know little more about
the illness that my wife does. She has spent many years researching manic
depression and psychosis and regularly finds gaps in the knowledge of my
psychiatrist and her father's psychiatrist. Indeed, my shrink has even
said that he wishes that she would consider taking up a career in mental
health.
Well there are few people at this chat room for BP people that I go to
often. I too am said to have schizoaffective disorder but I don't ever hear
things except during a crash which happens not so often. I've made it two
years with out one now. Before then ..I had my first one in 95 and then
again in 97...they only lasted like a month or so each. Sometimes I don't think the doc's know what to think.
Check out the site below if you care chat with other BP people...it's a real
laid back place but we often find ourselves talking bout docs and meds and
so forth.
http://home1.gte.net/longmand/bpcafe.htm
My understanding is that mania & SZ very often result in similar symptoms. I
think there was a time in the US when there was a significantly higher
proportion of SZ being diagnosed than in Europe. This was studied & it was
decided it was a matter of the diagnostic criteria rather than any difference in
actual illness present in the two areas. My understanding is that in bipolar
disorder, the psychotic symptoms go away when the mood returns to normal (either
through mood-control medication or in normal mood swings). In SZ, the paranoia
or other psychotic symptoms are not directly linked to mood. Is your mood sometimes normal? Do you experience paranoia at such times? From what I have gathered, and by no means am I a doc, but from trying to
understand my own DX by questioning my docs, and reading books:
Schizoaffective disorder, seems to be a sort of Schizophrenia-lite plus
Bipolar (MD). "(MD) Bipolar psychosis, is the presence of psychotic
symptoms (only) during the Manic phase of Bipolar Disorder. So if you are
only psychotic while you are Manic, then you probably have (during those
episodes) "Manic psychosis". If you have psychotic symptoms ALL or most of
the time, and have Manic episodes on top of that, you are probably
"Schizoaffective." If you have psychotic symptoms all or most of the time
and have NO Manic phase, then you are probably Schizophrenic. There are 3 classes of Schizophrenia, Paranoid, Catatonic, and Hebaphrenic.
If you are Paranoid Schizophrenic, a major component of your illness is
paranoia and delusions, though you may in other respects appear and speak
normally. If you are Catatonic Schizophrenic, you are withdrawn and
sometimes physically frozen. If you are Hebaphrenic Schizophrenic, you
often speak inappropriately, or with inappropriate emotion, and speak in
"word salad" and don't make much sense to others. Hebaphrenic, and
Catatonic are the most outwardly obvious forms of Schizophrenia, whereas a
paranoid Schizophrenic can speak clearly and act mostly normal, and is less
obvious to a casual observer.
