Psychiatry & Psychology--General/Anxiety and mental illness

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QUESTION: Hi, I'm having anxiety about how my anxiety may not be an anxiety disorder, but could be a sign of a severe mental illness like schizophrenia or bipolar disorder. I know that all of this is extememly irrational and I tell myself that it is difinitely because of anxiety. I'm causing problems for my family because of this, and they're getting stressed out because of me. I started worrying about this problem when i was 13 years old ( I'm 16 years old now) when I started developing an interest in psychology. I read up on schizophrenia and I felt that it kind of resembled my personality. So I started thinking that I might be mentally ill to begin with.  I was pretty neurotic as a child, I remember asking someone multiple times if they want to play with me even thought they said yes the first time I asked. They even told me that I was annoying because I asked so many times. My parents also told me that I was an annoying neurotic child ever since I was little. Then starting at around grade four, I started feeling sad and a bit of self hatred after seeing how my test scores were so low. Grade four was the time when kids first start doing tests in the area where I live. I assumed that it was because it was my first time doing a test and failing it and seeing mom explode at me because of it made me feel discouraged and Ill adjusted to this new kind of learning environment. I felt worthless at age nine and later on, I began to feel pessimistic about everything. i started liking writing and began to create an imaginary world. I started living in my head from the on, expanding on my stories and drawing some scenes from them. That's when my goal as a novelist began. I also started criticizing society and pondering philosophical issues at this age. My parents said that the amount of interaction that I had with other kids of my age decreased at this time too. Other kids said that I was wierd as well. think i have a depressive personality that makes me vulnerable for issues such as anxiety or possibly depression. Many things I've read online said that early onset schizophrenia in teens is indistinguishable from anxiety disorders or depression. It also said that the depression or anxiety aren't usually severe enough to quality as major depressive disorder. In the past, I tried telling myself that this disorder is rare and it's much more probable for me to just have anxiety than to be suffering from a possible case of this illness. It worked and I was able to move on in life. But now things are getting more complicated in life and usually this is when schizophrenia starts. One day, the day before  school started, a song that I've been listening too began looping in my head nonstop for the whole night. It was an extememly distressful experience as it had never happened before for such a long extended period of time and everyone I've talked to about this issue said that it was perfectly normal, while some sites said that it was a sign of ocd or anxiety when I haven't been worrying about anything when it happened. But i started worrying if it was a sign of bipolar or schizophrenia and now I'm a nervous wreck, constantly waiting for the voices to start or something like that to happen, especially when the early onset symtpoms are technically inditinguishable from anxiety or depression in teens. I don't have any hallucinations right now, my grades are fine even though the anxiety is fierce, and I am having some memory issues lately, which I think is due to my anxiety and depression lately.  My thoughts are getting a little strange too and I'm zoning out more, but this could also be due to anxiety and preoccupation with schizophrenia. Because of the anxiety, I dropped all the hard courses that I signed up for in the beginning of the year and took easier ones instead. So I keep thinking that the reason my grades are fine is because they aren't that challenging and not because my brain is functioning properly to begin with. Please help me set my thoughts straight. Based on what I've said, this is all due to anxiety right? I'm a wierd person ever since I was a kid with some dark and depressing ideas for stories. I'm sorry if I appesr to be rambling, but I sometimes think I'm cursed for having this personality that makes it so easy for me to get these problems. Thank yoù so much for your time.

ANSWER: Hello Angela,

I was tempted to check the box that said "Question too long" but I began to read your post and thought I really wanted to answer this.  I want to get you on the path towards healing that part of yourself that learned the self-hatred you so obviously feel. Out of that self-hatred, frustration, and self-doubt grew an intense anxiety fueled mainly by suspicions that there must be something wrong with you (children feel that those close to them would not have acted the way they did unless something was terribly wrong. That line of thinking is defensive for the child but equally devastating).

First, I would like to acknowledge your suffering, brought on by misgivings in your mental status and those frightening thoughts that you are psychologically impaired with serious mental illness. I am not minimizing your troubles here but I would like to reassure you that I do not believe you are suffering from schizophrenia. I also do not, under any circumstances, believe that the issues troubling you are something you were born with. What I DO believe is that your depression and anxieties are issues of the mind caused by disruptive and hurtful relationships from your early childhood.

When you tell me you were pretty "neurotic as a child," I believe the trauma in the relationships with your parents had already taken its toll on your developing sense of self. Your obsession with repeatedly asking your friends if they really wanted to play with you illustrates a very fragile and doubtful sense of self which could only be created by interactions with your parents that might have made you that you were less than pleasing to be around. I am unsure how that actually went down in your family because you do not explain this. Given my professional experience, I am fairly convinced by your narrative that your parents were demanding and critical. You said...

"it was my first time doing a test and failing it and seeing mom explode at me because of it made me feel discouraged and Ill adjusted to this new kind of learning environment."

I am going to add that you felt ill-adjusted, not only to the new learning environment but to life in general. A mother who communicates that kind of rejection in the face of a child who is struggling tells me that she was mis-attuned to your needs. I am not saying she was doing this to purposely hurt you. Most often parents act toward their kids in the same way they were acted on by THEIR parents. This could be a case that your mom did not know any other way to behave.  

You say you acted weird. Kids who become so fearful of their own worthlessness have little other alternatives but to act weird. Actually, the mechanism that is going on here is pretty simple. When a child encounters hurtful and disappointing treatment at the hands of parents, they can respond in several ways. What I think has happened to you is that, as a child, it is impossible to believe your parents are defective or at fault. It puts you in too vulnerable a position and it feels unsafe. Speaking in general terms, what children do is they blame themselves. THEY feel defective. This way it liberates the parents from responsibility (which actually makes the child feel safer in the family environment() and puts all the responsibility on the child (which actually gives the child some illusion of power..."If I change and be better than mom and dad will like me.") This is a kind of false hope that helps keep the child connected and not feeling totally isolated. Now...it is possible you may not agree with my understanding of the situation. And you may be right. I can only help you as far as I understand and interpret what you have explained to me. There may be other things going on that I do not know of. But my best professional interpretation is what I have written to you. What I have written to you here is a lot to take in and it may be difficult to believe or understand. However, do not be discouraged by what I have told you. It actually gives you much hope that you can 'change your mind' in therapy with a well-trained therapist. You can begin to understand why you feel like you are crazy when really it might be the relational environment that encouraged you to feel that way. Your parents may not have wanted to have that impact on you but that is what happened.

So...to make a long story short...from your narrative I do not believe you are schizophrenic. However I do believe you are suffering from incredibly low self-esteem, some depression and much anxiety. If you can, I would speak to a trusted school counselor. If you do not have one, I highly recommend that you talk to your parents about finding a therapist who specializes in child and adolescent therapy. Look on the internet. See if there are any therapists who are psychoanalysts (the field I am trained in) who could help you. There are paths to achieving a more true and satisfying sense of yourself and sense of the world. Your relational experiences have taught you not to expect anything from yourself and, instead, to believe that you are unlovable and worthless. A child comes to see herself and believe in herself only in the ways she has been seen by her parents and through what she is taught to believe.

I wish you all the best.

---------- FOLLOW-UP ----------

QUESTION: I'm sorry if I'm asking too much, but I'm sure I'll get over this once and for all if I say this. As a child I've been so introverted, and I remmeber feeling a bit of resistance when my parents tell me to go socialize with others. This was when I was 6 or 7. Really young and I barely remember having as much self hatred or depression as I have now. I read that this could be a sign of schizohrenia. I know that I'm probably wrong but can you tell me what I should be looking for if i really do have the illness? Some websites say that it isn't genetic and it's common. Other sites say that the depression in schizphrenia aint caused by anything external.  Is this true?

Answer
Angela...

I fear I could try to reassure you that you do not have schizophrenia until I drop from exhaustion and you would still not be convinced. The next day you would develop yet some other symptom that would convince you that you are severely mentally ill. I think that this is an easier conclusion than the one that I think better explains your issues.

Re-read my previous answer to you. You confirmed in your first sentence that I was on the right track in my previous answer. My understanding still holds firm. I believe you are suffering from some relational trauma as relates to your early childhood and your relationship with your parents. You were not born introverted. You were not born anxious. I cannot say for sure because you are not my patient and this is only an online advice center. But I will say that from all indications of your narrative, and from all my professional experience, you do not strike me as someone suffering from schizophrenia. It is just difficult for you to consider that perhaps all your suffering from early childhood onward was caused by some neglect, some rejection, or repeated misattunements from your parents.

Talk to them. Show them these posts if you think that would be helpful. I seriously believe your best help, in order to work through these feelings you were taught to feel about yourself, is professional analytic therapy. I will advise, once again, to look on the internet. Check out International Psychoanalytic Association, which is the international psychoanalytic website. They will list institutes and professionals who might be able to help you in your geographic area.

I wish you all the best. If you want someone to diagnose you with schizophrenia or suggest that that is your problem based on your narrative, you will have to look somewhere else other than to me. I do not believe that is your problem...at all.

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Jacquelynn Cunliffe

Expertise

I would like to answer under the category of Psychiatry and Psychology. However, I would like to see a separate category for Psychotherapy/Psychoanalysis. I do not answer questions about medications as I do not prescribe. My expertise is in psychotherapeutic treatment.

Experience

I am a psychotherapist and psychoanalyst who specializes in the treatment of mental health issues caused by childhood trauma, domestic abuse, eating disorders, relationship difficulties, and a wide variety of psychological disorders. The kind of therapy I do is often referred to as deep therapy, talk therapy, or psychoanalytic therapy. Please note that I am not against medications and when managed well, medication can be an adjunct to psychotherapy intervention. I think it is important for the public to realize that psychodynamic or psychoanalytic psychotherapy DOESmake changes not only in people's minds but those changes can also be detected in their brain structure. Psychotherapy and psychoanalysis are powerful interventions to help people change their lives from the inside out.

Organizations
American Psychoanalytic Association American Psychiatric Nurse Association Member of Psychoanalytic Center of Philadelphia Member of National Eating Disorder Association

Education/Credentials
Ph.D.-University of Pennsylvania, Psychology and Education, Division of Human Development M.S.N. and R.N.-B.C. Board Certified Nurse in Psychiatric and Mental Health Nursing. 2-Year Adult Psychotherapy Program graduate 2-Year Child Psychotherapy Graduate Current: Candidate in Psychoanalytic Training at the Psychoanalytic Center of Philadelphia

Past/Present Clients
I have worked with clients who have experienced significant childhood traumas. These patients come with a variety of mental health issues, including anxiety, depression, suicidal ideations, relationship difficulties and diagnoses such as Personality Disorders, Adjustment Disorders, and, though rarely, Dissociative Identity Disorder (formerly multiple Personality Disorder)

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