[Lee1029]

Im 30 about to turn 31 and in the past few months I have been showing signs of early schizophrenia. I have been diagnosed with a depersonalization disoder due to some things that happened to me as a child. I was wondering if its possible that that disorder could cause schizophrenia or if maybe the depersonalization is just getting worse for some reason. I feel like Im losing my mind and what makes it worse is that I have small children and Im afraid Im going to be unable to care for them. Right now my parents are taking care of them half the time because Im getting to where I cant function some days. I feel like a bad mom, but I cant help what is going on inside my head. Its like no matter how much I tell myself that what is happening my head isnt real, I cant seem to be convinced. I just need someone to talk to. Im about to start seeing a new therapist after being out of therapy for a couple of years and Im nervous about it. I just really need some support from people who know what its like. My family can only do so much. I mean they havent had to deal first hand with the things I have had to deal with, so they cant empathise with me.

[RunningEagleRuns]

Originally Posted by Lee1029

Im 30 about to turn 31 and in the past few months I have been showing signs of early schizophrenia. I have been diagnosed with a depersonalization disoder due to some things that happened to me as a child. I was wondering if its possible that that disorder could cause schizophrenia or if maybe the depersonalization is just getting worse for some reason. I feel like Im losing my mind and what makes it worse is that I have small children and Im afraid Im going to be unable to care for them. Right now my parents are taking care of them half the time because Im getting to where I cant function some days. I feel like a bad mom, but I cant help what is going on inside my head. Its like no matter how much I tell myself that what is happening my head isnt real, I cant seem to be convinced. I just need someone to talk to. Im about to start seeing a new therapist after being out of therapy for a couple of years and Im nervous about it. I just really need some support from people who know what its like. My family can only do so much. I mean they havent had to deal first hand with the things I have had to deal with, so they cant empathise with me.

Good luck :

[mgran]

Hey Lee, I'm sorry you have to go through this. I'm thirtynine, and for most of my son's childhood I was desperately fighting my "crazy" so that nobody would find out and take him off me. It finally got so bad that I had to go to the doctor and be honest about what whas happening... It was the single scariest thing I've ever had to do in my life.

Since divulging my problems to the doctor I've finally had a proper diagnoses, and the meds have cut the crazy dead in its tracks. All I can say is that I hope you have the same good fortune I did. You can't possibly get help unless you ask for it... don't make the mistake I made and wait decades to get help. My illness started when I was sixteen. You're lucky that yours is starting later, and that you have the maturity and self awareness to recognise it. If you get help now you have a very good prognosis indeed, and it will benefit your children.

Pop back in here and let us know what's happening. You're a Mom, and you're a good Mom, because you have the best wishes of your children at heart. Don't beat yourself up, and don't be afraid of help.

God bless.

[costello]

Hi Lee:

I don't know the answer to your question, but I really wanted to say I strongly agree with mgran that a mom who's thinking about her kids and making arrangements to keep them safe is a good mother in my book. Getting down on yourself about it won't help you. You're doing the best you can in a difficult situation.

[WikidPissah]

I'm gonna give the above posters a thumbs up...you are putting your kids welfare first...your a GOOD mom. I suffered throughout raising my children, thankfully I had a husband that was willing to take over at the end of every day. Medication helps A LOT. for me anyways...

Depersonalization disorder is different from schizophrenia. Even though you feel unreal and detached, it isn't psychosis because you keep the ability to tell the difference between reality and fantasy. If you're loosing touch, and people are thinking your beliefs and ideas aren't right, then you may be having a psychotic episode.

Your Therapist will help you distinguish it...good luck.

[milkblood]

the difference between dissociative d/o and psychosis is the persons ability to be aware of what is going on . i too suffer from a dissociative d/o that can often mimic psychosis in many ways.

[spiritual_emergency]

Lee1029: in the past few months I have been showing signs of early schizophrenia. I have been diagnosed with a depersonalization disoder due to some things that happened to me as a child. I was wondering if its possible that that disorder could cause schizophrenia or if maybe the depersonalization is just getting worse for some reason.

Some information that may be helpful and reassuring for you Lee (and others)...

There are clearly complex and multiple relationships between trauma and psychosis. Psychosis can be a traumatic experience and have consequences for the individual that may be very similar to PTSD. It appears likely that, at least for some people, psychosis can be a reaction to traumatic experiences, given the prevalence of such experiences in people with psychosis, and the links in relation to form and content of psychotic experiences.

For example, a consistent finding in research studies is that childhood sexual abuse seems to be specifically associated with the development of critical or commanding voices in adulthood. It is also important to note that in almost every country where surveys have been conducted, the public understands the causes of psychosis in terms of adverse psycho-social events and circumstances more so than biogenetic factors. They have continued to do so for decades, despite numerous campaigns designed to teach them that schizophrenia, for instance, is ‘an illness like any other’.

Despite a recent increase in research devoted to this topic, there are relatively few studies that examine the mechanisms that may explain how trauma may increase vulnerability to psychosis. Recent psychological models of psychosis may help to explain the relationship between the experience of trauma and the development of psychotic experiences, and becoming a patient with a psychotic diagnosis. There may be several ways in which traumatic experiences may confer vulnerability to psychosis via cognitive and behavioural processes.

It is also possible that the cognitive and behavioural consequences of trauma may make people vulnerable to psychosis. Negative beliefs about self, world and others (such as ‘I am vulnerable’ and ‘Other people are dangerous’) have been shown to be associated with the development of psychotic experiences. A recent study published in this issue has also shown that such beliefs specifically formed as a result of trauma are related to psychotic experiences in patients. Positive beliefs about psychotic experiences (such as ‘paranoia is a helpful survival strategy’) may also be related to traumatic experience, and have shown to be associated with the development of psychosis.

It is likely that psychotic experiences are essentially normal phenomena that occur on a continuum in the general population. It would seem that the occurrence of trauma in the life history of a person experiencing such phenomena may represent the difference between patients and non-patients. It appears that catastrophic or negative appraisals of psychotic experiences result in the associated distress.

In this context, the study in this issue of Bak et al. is particularly welcome. Their large, prospective study of the general population found that there is a high prevalence of trauma in people who have psychotic experiences associated with distress whereas those without distress had a low prevalence of trauma. Therefore, consistent with predictions of cognitive models, trauma may predispose people to appraising their unusual experiences in a problematic way.

In addition, the study by Roy and Janal, also published in the present issue, suggests that childhood trauma also affects likelihood of suicide attempts, and increased severity of trauma is associated with younger age of first attempt . This is clearly of relevance to people with psychosis, given the high prevalence of trauma and their increased risk of suicide.

This research also highlights the need to ask service users about traumatic events in their life history. Currently, most child abuse cases, for example, remain undetected by mental heath services internationally.

Furthermore there is some evidence that this is especially the case for people with diagnoses indicative of psychosis, and that mental health staff with strong biogenetic causal beliefs are particularly unlikely to ask about childhood trauma. We would, therefore, agree with the conclusion of Bak and colleagues that failing to ask about trauma will ‘impede installation of appropriate treatment strategies’ and therefore, prolong distress unnecessarily.

Bleuler originally described ‘the schizophrenias’ as a group of distinct psychotic disorders with differing aetiologies and outcomes. More recently, there have been several suggestions that there is a subgroup of schizophrenia that is trauma-induced and characterized by a predominance of positive symptoms. For example, traumatic psychosis is described as an entity in which trauma has a distinct and specific role in terms of the onset and content of psychotic symptoms. Often, the underlying trauma has been a sexual or physical assault in childhood or in adult life but bullying has also emerged as a potent aetiological factor.

The typical presentation is of command, and critical hallucinations with linked somatic and visual hallucinations. These are often directly trauma congruent or linked to the negative schematic representations of childhood sexual or physical abuse. Other typical symptoms are fluctuating depression with suicidal ideation, delusions of persecution and substance misuse. These symptom profiles are consistent with the findings from the research studies outlined above.

Such patients are often treatment resistant to pharmacological interventions and case management but may respond well to CBT. Another postulated subgroup is that of drug-induced psychosis, and it is evident that drug use is often comorbid with both psychosis and PTSD and may be a response to trauma. The categorization of the psychoses needs to be reconsidered in the light of such findings, with the incorporation of trauma and its consequences.

There are several clinical implications of this approach to understand psychosis. Helping service users to identify any links between their traumatic experiences and current psychotic symptoms may help to normalize their experiences, reduce their distress and increase their perceived control. The use of voice diaries with coping strategies and rational responding to critical hallucinations can lead to an early success experience by reducing symptom burden and lessening depression.

From a broader perspective, the emerging literature demonstrating the causal role of adverse life events in psychosis would seem to imply that psychosis may be as preventable as other mental health difficulties, and that the mental health community has a responsibility to join others in lobbying for primary prevention programmes targeted at supporting families to care for and protect children in their early years. Similarly, we have a responsibility for reducing the potential for treatment experiences themselves, such as acute psychiatric admissions, to be traumatizing for service users.

The link between trauma and psychosis has a growing body of empirical support, and the implications for treatment should be fairly uncontroversial, and could benefit service users regardless of the aetiology of their mental health problems. It is clearly important to consider the possible role of trauma in the development and maintenance of distressing psychotic experiences and to ask about it. However, it is also important to remember that there are multiple pathways to psychosis, and while trauma is clearly involved for some people with psychosis, there are many others with no history of trauma. Even in such instances, it is possible that they are prone to exacerbation and maintenance of their psychotic experiences, through being traumatized by the subjective experience of psychosis or through subsequent victimization in the community.

Source: Trauma and psychosis: theoretical and clinical implications

Music of the Hour: Morcheeba: Big Calm ~ Love and Fear

[spiritual_emergency]

The following article excerpts also address the issue of trauma and psychosis...

Quotes from Judith Herman's book: Trauma and Recovery

The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma. When the truth is fully recognized, survivors can begin their recovery. But far too often, secrecy prevails and the story of the traumatic event surfaces not as a verbal narrative but as a symptom.

We need to understand the past in order to reclaim the present and the future. An understanding of psychological trauma begins with rediscovery of the past.

The fundamental stages of recovery are:
1. Establishing safety
2. Reconstructing the traumatic story
3. Restoring the connection between the survivor and his/her community.

Psychological trauma is an affliction of the powerless. At the moment of trauma, the victim is rendered helpless by overwhelming force. Traumatic events overwhelm the ordinary symptoms of care that give people a sense of control, connection, and meaning.

Certain experiences increase the likelihood of harm.
1. Being taken by surprise
2. Being trapped
3. Being at the point of exhaustion
4. Being physically violated or injured
5. Being exposed to physical violence
6. Witnessing grotesque deaths

Trauma occurs when action is of no avail--when neither resistance nor escape is possible. The traumatized individual may experience intense emotion but without clear memory of the event--or may remember everything in detail but without emotion. Traumatic symptoms have a tendency to become disconnected from their source and to take on a life of their own. (Dissociation)

Source: Trauma and Recovery

More...

Psychotic reactions should be seen as attempts to make sense of one's experience and to cope with experiences so difficult that it has not been possible to construct a rational spoken narrative about them. In subsequent stress situation, these experiences may be actualized and a way is found to utter them in the form of a metaphor (Karon, 1999; Penn, 1998; Van der Kolk, 1995). This is the prenarrative quality of psychotic experience (Holma & Aaltonen, 1997; Ricoeur, 1992).

Source: Open dialogues with good and poor outcomes for psychotic crises: Examples from families with violence

Carl Jung's approach...

Jung saw the individual as being made up of many selves, which are autonomous and therefore we cannot assume the unity of consciousness or the primacy of will. Jung relates complexes and psychosis, with a view of the latter as a type of waking dream:

Quote

“A person with a strong complex thinks in terms of the complex, he dreams with open eyes and no longer adapts psychologically to the environment” (Jung 1907).

“...in schizophrenia the complexes have become disconnected and autonomous fragments, which either do not reintegrate back to the psychic totality, or, in the case of a remission, are unexpectedly joined together again as if nothing happened” (1939).

Source: A Jungian Approach to Psychosis

Music of the Hour:

[spiritual_emergency]

The following is an excerpt from my own experience -- part of a much larger experience that I wrote down as it was occurring. Incidentally, the following is also consistent with Stan Grof's definition of a spiritual emergency, in that, it contained autobiographical elements...

Give Us This Day, Our Daily Bread

This is a story . . .

According to my mother I was the product of my father's rape. In spite of this she says I smiled when I was born.

"It's just gas, dear," said the nurse. But my mother had given birth to three children and she knew a smile when she saw one. She says she knew then I'd never give her much cause to worry. And I didn't. Not really.

I don't know where my father was when I was born. He might have been away at the base camp or perhaps he'd checked himself into the hospital again. He did that from time to time. My mother never knew when he'd leave or when he'd return. His presence in our lives, like his fits of violent behavior, was erratic and unpredictable. When he was home, her life was hell. When he was gone, she happily busied herself mothering her children and caring for her home.

Like the third daughter in every fairy tale, I was the fortunate one. I don't remember that life at all. My eldest sister does though; she remembers crouching under the kitchen table as our father laid his boots and obscenities into our mother who lay, curled into a ball on the floor. And my sister Colleen must have remembered things too, but not me. I was only two months old when she left. Three dress ties fashioned into miniature hangman's nooses and placed carefully around each of her sleeping daughters' necks prompted her frantic, middle-of-the-night departure.

She ran first to the church, but the doors were locked tight. From that moment forward, she never again willingly entered a Catholic church. The comfort of the church denied her, she ran to her family. They'd surely known, but why they never did anything about it, I don't know. Why she never fought back, I don't know either. I guess she feared he'd kill us if she did.

She stayed with her family for a short time and then found a low-rental flat. We were poor then, desperately poor. At first, my sisters and I slept on pillow cases stuffed with newspapers, I don't know what my mother slept on. We lived on social assistance but it wasn't enough. In those first few months my mother lost 40 pounds, there simply wasn't enough food to go around. She couldn't live in that kind of desperation so she found a job as a telephone operator and thereafter left her three young daughters to the care of babysitters -- some of them good and some of them very, very, very bad. All three of us received our sexual introductions through those babysitters but for some reason, we never told our mother of those events. I'm not sure why. Maybe it was enough to know that she'd have protected us if she had known. Maybe we were trying to protect her.

Meanwhile, even though she left and then divorced our father, he still managed to inflict terror over her. She moved numerous times in those early days to avoid him but he would always find her. He'd never confront her. He'd just leave a sign that he'd been there: his shoes appearing on the front steps in the morning, his body vanished. She'd move again and he'd find her once more, oftentimes tipped off by her own family members who thought that a father should be able to see his children. (It's mind boggling, don't you think?)

And then, my father came along -- or rather, the man I consider my father.

He was sixteen years older than my mother. Over six feet tall with shoulders like a buffalo, he had once played professional football -- a veritable mountain of a man. I think it was Colleen who fell in love with him first. By then she'd been diagnosed with some form of autism. If anyone other than our grandmother came to the house she'd quickly retire to a closet where she'd whimper to herself until they left. She didn't speak. She didn't laugh. She didn't cry. But the day that my father walked into our home for the first time, Colleen crawled into his lap. I suspect that was when my mother, not to mention my grandmother, fell in love with him.

Of the three of us, Colleen manifested the damage of her early childhood the most. My mother couldn't take her out of the house -- she'd leap from a moving vehicle. At home, she kept to herself. She'd rock: back and forth, back and forth, back and forth. She wouldn't play. But my dad thought that was nonsense. "Children have to play!" he declared. So he'd take Colleen to the park, place her tenderly on the swing and then lie on the ground beneath, her tiny feet on his chest. He'd swing her gently, gently, gently: back and forth, back and forth, back and forth. When we drove in the car, the expected ritual was that Colleen would sit on his lap. She never jumped out when he held her. Colleen began to heal. She began to play, to talk, to laugh. Within a span of a very short time she was just like every other child. It's amazing what love can do.

As for my biological father, he stopped coming around once my adoptive father was on the scene. Like most bullies, he was easily intimidated. A few years later he signed adoption papers and we three girls were legally adopted by my father.

It's a matter of odd coincidence that both my biological father and adoptive father were born sixteen years apart in the same hospital. It's a further matter of coincidence they were placed for adoption through the same ward. But it's not coincidental at all that my father was an alcoholic -- not the vicious kind though. He was the gentle, jovial kind. He played with us. He'd wake us at midnight just to look at the stars or present us with a gift of chocolate. He never struck his children. We adored him. Trailing his godlike presence we became quail children, our heads bobbing as we followed wherever he led.

In our early years he once became deathly ill with cirrhosis of the liver. The doctors gave him only a few months to live and amazingly, my father's liver regenerated. After 25 years of exceptionally heavy drinking, he quit cold. There's that power of love thing for you again.

We were still poor then, mostly because our father couldn't hold down a job for very long. Fortunately, he was an accomplished thief. He'd take us into the grocery store and pick up some day-old bread -- you could buy it by the box in those days. Then, as his brood of children charmed the people around him, he'd lift the top loaves, squish down the bottom ones, and sandwich our daily necessities in between. They never caught him and we always ate well. You can't buy day-old bread in boxes anymore. Ha! It's probably my father's fault.

Thus began the good years of my childhood.

Music of the Hour:

My own experience of psychosis began when my mother died. I knew to expect sadness and grief. I didn't know to expect terror. Within days of her passing I encountered a male who must have reminded me on some unconscious level of my birth father. From that point forward, unconscious content -- in Jungian terms, contents from my personal shadow -- began to leak forth in the form of dreams, fears, terrors, and finally... an extended bout of what would be considered a very intense, very florid bout of psychosis.

By the time it was done, I understood why I had been so frightened when my mother died -- it meant she was no longer present in my life to protect the terrifified child I had been; a child who was still alive, still well, and still terrified, locked deep within me. Thereafter, began the work of assimilating and coming to terms with the trauma of my early childhood and slowly, putting myself back together again.

Best of luck to you Lee, milkblood and others.

~ Namaste

[spiritual_emergency]

This is a very good article as well...

PTSD and psychotic symptoms can co-occur. In clinical terms, PTSD is described as consisting of three clusters of symptoms: re-experiencing symptoms, avoidance symptoms, and hyperarousal symptoms. However, some mental health professionals believe that the experience of psychotic symptoms should be considered as an addition to that list, given that they commonly occur among people with PTSD.
Psychotic Symptoms

Before the relationship between PTSD and psychotic symptoms is discussed, it is first important to describe what would be considered a psychotic symptom. Psychotic symptoms can be divided into two groups: positive symptoms and negative symptoms.

Positive symptoms are characterized by the presence of unusual feelings, thoughts, or behaviors. Positive symptoms include such experiences as hallucinations or delusions. A hallucination could be hearing voices that no one else can hear, or seeing things that are not really there. Delusions are ideas that a person believes are true despite the fact that they may be unlikely or odd. For example, people with delusions may believe that the CIA is spying on them, or that aliens are controlling their behaviors or thoughts.

Negative symptoms are characterized by the absence of experience. For example, a person with negative symptoms may not be emotionally expressive. She may have difficulty speaking, may not say anything for days on end, or be unable to persist at simple tasks or activities, such as getting dressed in the morning.

These positive and negative symptoms are often associated with the diagnosis of schizophrenia; however, they are also seen in other disorders, such as PTSD.

Psychotic Symptoms in PTSD

Researchers at the University of Manitoba, Columbia University, and the University of Regina examined the data on 5,877 people from across the United States in order to determine the rates with which people with PTSD experience different psychotic symptoms.

They found that, among people with PTSD, the experience of positive psychotic symptoms was most common. Approximately 52% of people who reported having PTSD at some point in their lifetime also reported experiencing a positive psychotic symptom. The most common positive symptoms were:

• Believing that other people were spying on or following them (27.5%)
  
  
• Seeing something that others could not see (19.8%)
  
  
• Having unusual feelings inside or outside of their bodies, such as feeling as though they were being touched when no one was really there (16.8%)
  
  
• Believing that they could hear what someone else was thinking (12.4%)
  
  
• Being bothered by strange smells that no one else could smell (10.3%)
  
  
• Believing that their behaviors and thoughts were bring controlled by some power or force (10%)

The researchers also found evidence that the more PTSD symptoms a person was experiencing, the greater the likelihood that they would also experience positive psychotic symptoms.

To take their study a step further, the researchers also looked at what traumatic events were most commonly related to the experience of psychotic symptoms. They found the following to be most strongly connected:

• Being involved in a fire, flood, or natural disaster
  
  
• Seeing someone get seriously injured or killed
  
  
• Experiencing tremendous shock as a result of a traumatic event that happened to a close relative, friend, or significant other

What This All Means

The experience of psychotic symptoms may tell the story of just how severe a person's case of PTSD is and how well he or she is coping with the condition. It may also raise red flags about the likelihood of potentially dangerous behaviors.

It has been suggested that the experience of psychotic symptoms in those with PTSD may be connected to the experience of dissociation. Frequent dissociation may increase the risk for the development of psychotic symptoms. And studies have shown that people with PTSD who experience psychotic symptoms, as compared to those who do not, may be at greater risk for a number of problems, such as suicidal thoughts, suicide attempts, and greater overall distress.

If a loved one has PTSD and is experiencing psychotic symptoms, it is very important that they seek out treatment. Positive psychotic symptoms can be effectively managed through medication. Addressing PTSD symptoms in treatment may also result in a reduction in psychotic symptoms. A number of different resources are available for people seeking help for their PTSD.

Source: Psychosis and PTSD

See also: Psychosis, PTSD and Story as a Vehicle of Healing

[The Saint]

I also have to commend you for thinking and taking care of your children first. I think Depersonalization disorder can be a phase of a lot of different psychological disorders. I have schizophrenia but psychosis is very rare for me.I've been dealing with this disease for about 10 yrs now and had only minor stuff after onset.Depersonalization for me starts with questioning myself for to long.I sometimes don't react as quickly to things as I should because of questioning my self to often.I try to deal with things one piece at a time then try to put them together as larger pieces and finally put the larger pieces together as one complete picture.I think to much and in doing so I feel like I lose out on a lot of joyful things and lose out a lot on the big picture.I believe that without the joyful experiences we lose a part of ourselves and this starts the withdraw and depersonalization.I wish you the very best ! PEACE BE WITH YOU !

[5thGeneration]

Originally Posted by Lee1029

Im 30 about to turn 31 and in the past few months I have been showing signs of early schizophrenia. I have been diagnosed with a depersonalization disoder due to some things that happened to me as a child. I was wondering if its possible that that disorder could cause schizophrenia or if maybe the depersonalization is just getting worse for some reason. I feel like Im losing my mind and what makes it worse is that I have small children and Im afraid Im going to be unable to care for them. Right now my parents are taking care of them half the time because Im getting to where I cant function some days. I feel like a bad mom, but I cant help what is going on inside my head. Its like no matter how much I tell myself that what is happening my head isnt real, I cant seem to be convinced. I just need someone to talk to. Im about to start seeing a new therapist after being out of therapy for a couple of years and Im nervous about it. I just really need some support from people who know what its like. My family can only do so much. I mean they havent had to deal first hand with the things I have had to deal with, so they cant empathise with me.

A "good" mother makes sure someone else is caring for her kids when she is not able to do so. You sound like a good mother to me. That being said, it is time to take good care of yourself. If you can get to doctor and find some relief in what a proper diagnosis and medicine has to offer then do eveything you can do to get there as soon as possible. You sound really overwhelmed and you deserve to feel a lot better. Make the calls you need to make, asap. Look forward to hearing more from you.