Then I ran across this:
Quote:
Depression, Low Self-Esteem Worsen Schizophrenia Symptoms
British researchers studying 100 schizophrenic patients who had recently experienced a relapse into psychosis found that depression, low self-esteem and negative views about others contribute to more severe auditory and persecutory hallucinations.
Patients were assessed both for schizophrenic symptoms such as hallucinations and for signs of depression, low self-esteem and negative views of others. Researchers found that individuals with depression and low self-esteem had more severe auditory hallucinations featuring more intensely negative content. Where these symptoms were combined with negative views about others, individuals also experienced more severe and distressing persecutory delusions. Meanwhile, severe grandiose delusions were directly related to higher self-esteem and inversely related to depression.
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What do you all think? My son flips back and forth between depression and grandiosity. It doesn't seem to me that his self-image is shifting back and forth between too high and too low. It's more like he can't tolerate the depression and self-disgust, so he pushes himself into the grandiose place where he believes he's very, very important and people admire and envy him and want to be like him. It's more pleasant for him to be in the grandiose place than the depression place, but extremely low self-esteem seems to underlie both IMO.
I'd like to find a way to raise his self-esteem, but I don't want to flip him into the grandiose place. Unfortunately that's exactly what starts to happen when I offer reassurance that he's fine just the way he is. He doesn't think "I can accept myself - warts and all." He thinks "Mom says I'm fine, so I must be perfect." ["Perfect" is one of his favor words. He wants to be perfect and make no mistakes, but he's also afraid he'll be "too perfect."]
Any thoughts?