Schizophrenia/The Problem With Self-Diagnosis Part 1

I recently thought I might be schizophrenic.

I was reading a book about the disease out of personal interest, since I’ve toyed with the idea of focusing on it professionally once I have my degree. (It’s a fantastic book called The Complete Family Guide to Schizophrenia, and I’d highly recommend it to anyone looking for help.) But as I read through the first few chapters, which cover basic symptoms and diagnosis, academic fascination slowly turned to anxiety when I realized I almost completely relate to descriptions of schizophrenia.

To clarify, I don’t have schizophrenia, as I eventually confirmed with my doctor after reading the book. My diagnosis is borderline personality disorder (BPD), which used to be called borderline schizophrenia for a reason: the defining line between BPD and schizophrenia is thin. I’m not even totally comfortable describing it here, because I’m not a medical professional with the qualifications to understand the crucial nuances that separate the disorders.

However, I’ve read enough to know that in many cases, they present the same problems with emotions, thoughts, and behavior. For example, I wasn’t surprised to find out that people with schizophrenia commonly experience depression, anxiety, and sleep problems; the same problems are often present in BPD as well. 

However, the book soon got into the nitty-gritty of schizophrenic behaviors, which tend to be more specific to that disease in particular. Look at this checklist of schizophrenic symptoms I found at healthyplace.com:

Experiencing no feelings or motivation? Flat affect and diminished reactions? The three A’s? That’s unequivocally me. And not just sometimes, but frequently. It’s almost every day that I find myself unable to show emotion because I just don’t feel anything, and so I can’t even conceive of opening my mouth to say something when there’s nothing in me. It’s not just a fleeting mood or a funny idiosyncrasy. It’s a huge impairment for me, and one that often finds itself co-occurring with depression, which just strengthens my conviction that my experience of these symptoms isn’t normal.

And those are just some of the non-psychotic symptoms of schizophrenia that describe me. I also experience delusions (psychotic beliefs that are not realistic). Check this out:

Some of those symptoms haunted me more closely when I was in middle school and my illness was just developing, and I learned to manage them as I got older. However, the ghost of each of them still plagues me quietly. I often catch myself believing that other people can read my thoughts, or I can read theirs. The belief is so strong that I have an anxious physical reaction to it. In public I usually feel like I’m being menacingly followed or scrutinized unrealistically by complete strangers. And my relationships with fictional characters are so strong that I wouldn’t hesitate to qualify them as at least slightly delusional.

As I kept reading the book, I began to panic. If I’m schizophrenic, I thought, a lot of things are going to have to change for me RIGHT NOW, the biggest of them being my expectations for recovery. While it is perfectly possible for schizophrenic people to recover with the help of antipsychotic medications, their prognosis is still generally not as good as that of people who have BPD. BPD responds better to therapy and is not physically degenerative in the brain the way schizophrenia is.

In other words, depending on which diagnosis fits me, I can predict whether my symptoms will get better or worse over time.

That’s important.

The chapter I read about schizophrenic symptoms concluded with a chart of these issues summed up in 20 or so categories. It dawned on me that I fall squarely into about 17 of them. The only parts I’m missing for a full schizophrenic diagnosis are disorganized, incomprehensible speech, difficulty paying attention, and hallucinations (having a sensory experience, usually audible or visual, that isn’t triggered by an outside stimulus). If my doctor had missed the presence of schizophrenia in me, it wouldn’t be the first time a qualified psychiatrist had accidentally overlooked important clues as to the true nature of my condition. I spent ten years being told I was bipolar before someone realized I have BPD. Could my schizophrenic symptoms have slipped under the radar as well?

It was a close call, but a false alarm. After a conversation with my doctor, I was adequately convinced that the small handful of schizophrenic symptoms I don’t have – especially hallucinations – disqualifies me from the diagnosis.

I was relieved not to have to reframe my entire outlook on my condition, but it was a scary few days. In part 2 of this post, which will be published here tomorrow, 9/15, I’ll expound on the importance of letting a doctor diagnose mental health problems instead of doing it at home. Hopefully situations like this one, where I panicked because of symptoms I read in a book, can be avoided.