No, the Dayton Shooter Was Not an “Antifa Shooter”

Right. The Dayton mass shooter was not the first “antifa mass shooter,” as the drooling, unhinged nutcase Andy Ngo insists. I don’t think this idiot deserved to get beat up by antifa, but he’s definitely a full-blown nutball.

Yes, Connor Betts was associated with the far left in the US and with the antifa portion of it with all of the behaviors that go along with that. He hated cops and fascists. His random shooting of nine innocent people outside of a bar in Dayton, Ohio had zero political overtones. “Antifa” does not advocate taking guns and killing innocent workers and other citizens. It advocates nothing of the kind.

Obviously mass shooters will often have a political ideology, especially in our ideologically blighted times. After all, they are adult Americans and nowadays most adult Americans have some sort of politics. In a nonpolitical shooting, a shooter may have any politics whatsoever from Far Left to Far Right and everything in between, and none of it matters one whit. That is because the shooting had nothing to do with politics, so the shooter’s politics is absolutely irrelevant.

By the way, the sex life of the shooter is also irrelevant. The Gilroy and El Paso shooters didn’t seem to do well with women, but neither was complaining about it, and there’s no evidence that misogyny or incel ideology had anything to do with the shooting. Believe it or not, any man can go on a mass shooting, from virgin to playboy. As long as the shooting has nothing to do with his sex life, obviously his sex life is utterly irrelevant.

The Dayton shooter did quite well with women, but he also had some serious anger towards them. Yet the shooting, which fired into a mixed crowd and killed more men than women in addition to killing his beloved best sister, was clearly not motivated by misogyny.

Instead, Connor Betts appears to have been suffering from sort of psychotic disorder, possibly Schizoaffective Disorder or Bipolar 1 Disorder. We know that he had been hearing external voices from an early age.

Politics in this country is getting seriously retarded with each passing day, and I blame both the Right and the Left for that because nowadays the Right and Left are equally deranged ideologically.

They don’t have much in common with each other except for a lack of connection with the real world and a tendency to lie, make stuff up, hallucinate, and engage in wild hyperbole and conspiracy mongering. Neither the Right nor the Left is as bad as the demonizers on the other side make them out to be.

Meth-induced Voices in Your Head Start with Pareidolia

Interesting article on meth-induced voices in the head deriving from long-term use of methamphetamine.

Eventually, and note that this happened with everyday use of crystal meth for a couple of years, there didn’t have to be any white noise to trigger the voices. Eventually I heard voices all the time, and they took on a different nature. They would sound just like real voices, coming from different directions and distance, so the sensation was enough to trick my brain into believing that I really heard the voices with my ears.
They became voices that mocked me, voices that ridiculed me, voices of imaginary observers to a mind that became increasingly paranoid and deluded. So it became much like a persecution complex, or paranoid schizophrenia.
At one stage I heard people talking about me at work, saying terrible things about me. I heard them through the walls. I heard them even when I was alone.

That sounds almost exactly like paranoid schizophrenia. I have heard that long-term meth use can lead to a permanent paranoid schizophrenia-type illness. Most of this data has come out of Japan where people have been injecting shabu or meth for many years. The cases involved subjects who had been injecting shabu every day for 10+ years. The illness was incurable.

Meth-induced voices in your head take you to a bad place, a real living hell on Earth. And many who go there don’t return. They end up permanently psychotic…
…I find this very interesting, in that it could mean that hearing voices is simply an expected side-effect of prolonged drug use. Further, I noticed many meth addicts who tended to believe in black magic and possession. Even when I was in rehab years ago, some residents there became convinced that a schizophrenic resident (who talked to himself and spoke in gibberish that they thought were “demonic tongues”) was possessed. No amount of attempting to reason with them would convince them otherwise.
So beware, voices in the head and apophenia leading to an irrational belief in the paranormal (as well as possibly in God in recovery) may well just be a side-effect of the high levels of dopamine as a result of frequent prolonged drug use. And it may be permanent.

This is interesting, implying that in some cases, the delusions never really go away. 
It’s interesting how the voices start up faster the longer they have been going on. For instance, if they have been going on a long time and you quit for a while, they will start up again full-blown after only a few days of meth use. This is a kindling effect and it is well known in cocaine use and bipolar disorder, especially manic episodes.
A heavy cocaine user will quit and then smoke cocaine one time. After only using it once, they are running around shutting all the drapes and talking about how the police outside can hear everyone so people need to quiet down.
In Bipolar Disorder, the more episodes you experience, the worse the illness until you get to the point where you are a somewhat manic all the time. Episodes come more often and healthy periods between episodes shorten. The episodes themselves become worse and last longer.

Meth-induced Voices in Your Head Start with Pareidolia

By Jerome

I’ve never written about this topic on this blog, although it was a frequent subject on my old blog. Maybe it’s time…
This subject is fascinating to me now, though it wasn’t always that way. In active addiction it was scary. It was something that I lived with for a few years, but what I find most interesting is how it started.
Firstly, you need to know what pareidoloia is. It’s defined as seeing patterns where none exist, and while that explains it technically, it doesn’t really make it clear what the psychological phenomenon actually is. Visual pareidolia is when we think we see shapes like faces in inanimate objects, like Jesus on a piece of toast, or a face on Mars.
But pareidolia is also when we think we hear voices or recognizable sounds through white noise. An example of the less well known auditory pareidolia is when you’re taking a shower or hear really loud rain falling on your roof, and you think you hear voices or your phone ringing through the noise. That was how my meth voices started. At first it was just ordinary pareidolia, where there was loud rain or wind and I thought I heard voices, but would realize immediately that it was my imagination.
But then something seemed to go wrong in my brain. Fragments of sound that sounded like voices evolved into much more. As months went by, it would happen more frequently, and any background noise, even noises that were not noticeable to most people, would trigger it. So what started out sounding vaguely like voices, after a few months became voices of people that I knew speaking unintelligible words. So it was like hearing a conversation from another room, one just out of earshot and not heard clearly. Then as time went by, it became actual words and sentences that I could make out.
Eventually, and note that this happened with everyday use of crystal meth for a couple of years, there didn’t have to be any white noise to trigger the voices. Eventually I heard voices all the time, and they took on a different nature. They would sound just like real voices, coming from different directions and distance, so the sensation was enough to trick my brain into believing that I really heard the voices with my ears.
They became voices that mocked me, voices that ridiculed me, voices of imaginary observers to a mind that became increasingly paranoid and deluded. So it became much like a persecution complex, or paranoid schizophrenia.
At one stage I heard people talking about me at work, saying terrible things about me. I heard them through the walls. I heard them even when I was alone. Eventually I isolated myself from the outside world and everything in my life was affected as I retreated into my own delusional world of suffering and pain.
Meth-induced voices in your head take you to a bad place, a real living hell on Earth. And many who go there don’t return. They end up permanently psychotic. I’ll probably revisit this topic and write about how it felt to live with those voices and the inevitable delusion, but today’s post is mostly about how they start.
I find it interesting to know that those voices do start with auditory pareidolia, which is something we all experience. Of course, if you’re a meth addict and you start to experience voices, it’s probably a great time to stop using. But you won’t, I know. Yet you need to recognize that when this happens, you can no longer try to convince yourself that you aren’t an addict.
When it reaches this point, you’re a long way past crossing a line from user to addict. You need to recognize that you have a serious problem, one that is affecting not only your life but those of all involved in it. Once the voices progress to the point where you hear them all the time, they don’t stop as long as you continue using. Even if you are clean for a long time and then relapse, the voices return in a few days, and then stick around as long as you use. At least that’s how it was for me.


Update: This article about apophenia (the spontaneous perception of connections and meaningfulness of unrelated phenomena), which is of course closely related to pareidolia, lists high levels of dopamine as a possible cause. Of course drugs like meth, and to a lesser extent cocaine and crack cocaine, cause tremendously high levels of dopamine, considerably higher than the levels that occur naturally. And all of those drugs cause voices in the heads of long-term users. Apparently high levels of dopamine might also cause belief in the paranormal, and EVP, among other things. (I’d considered mentioning EVP here anyway.)
I find this very interesting, in that it could mean that hearing voices is simply an expected side-effect of prolonged drug use. Further, I noticed many meth addicts who tended to believe in black magic and possession. Even when I was in rehab years ago, some residents there became convinced that a schizophrenic resident (who talked to himself and spoke in gibberish that they thought were “demonic tongues”) was possessed. No amount of attempting to reason with them would convince them otherwise.
So beware, voices in the head and apophenia leading to an irrational belief in the paranormal (as well as possibly in God in recovery) may well just be a side-effect of the high levels of dopamine as a result of frequent prolonged drug use. And it may be permanent.
Some of my most annoying Facebook “friends” are people I became acquainted with in rehab, who share Christian nonsense followed by “type Amen” all the time. I can’t bring myself to unfriend them somehow. The most annoying proponent of the sharing Jesus movement is a girl I remember from rehab who believed that she needed to eat sand. There was even a patch of sand set aside especially for her in the garden. (My greatest challenge in rehab was to refrain from pissing in her sand patch.) So ironically, some who hang on so desperately to Jesus in recovery may in my opinion do so simply because their brains are fried from all the drugs. Fortunately I’m not one of them. I guess I’m just lucky.

A Look at Cluster A Personality Disorders

Cluster A are the odd personality disorders. They’re not so much awful people as they are simply so odd and strange that you can’t have much of a human relationship with them. Their general theme is to drive people away from them in some way or another.
Schizoids are ok, but they are very annoying. It’s generally impossible to have any decent human relationship with someone like this because…well…they don’t do human relationships. I’ve talked to Schizoids but I have never really known one in real life. You are unlikely to run across a Schizoid in life because they are such extreme loners that they simply don’t get involved with other humans at all.
Schizotypals simply have a mild form of schizophrenia and are more or less impossible to deal with in ways that are similar to how schizophrenics can’t be dealt with but on a lesser scale. They are also quite suspicious and paranoid. They have awful social skills and conversations with them degenerate and start getting tangential and strange pretty quickly. They will give off a feeling of alienation and weirdness that would probably make you want to get away from them.
I had a girlfriend who had Schizotypal traits, but she was mostly just a Borderline. When she was off into her schizotypal strangeness, it was like talking to someone from another planet. She would be saying weird and odd things that didn’t make a lot of sense and the conversation had the creepy feel of someone who is way out there and is not really with the rest of us at all. I eventually broke up with her on the grounds that she was too crazy for me. It was like dating a Martian.
I’ve never met or talked to an actual full-blown Schizotypal, so I don’t know much about them. I don’t see how you can have a decent relationship with someone like this. They’re too crazy for that. You usually won’t meet schizotypals because they are extreme loners who don’t do human relationships. They are suspicious, withdrawn and don’t talk much. They give off vibes of trying to drive you away. When at home, they often get quite shut-in and don’t want to go outside.
Paranoids I do not understand very well, but I hear they are hard to deal with too. They can also often be angry. Their constant suspicion drives you crazy and relationships with these people must be hard to deal with. You often won’t meet Paranoids either because, well, they’re too paranoid! They shy away from most relationships too and even if you work with them, they probably won’t reveal much of their disorder. They also give off serious “get away from me” vibes.
None of these people are easy to get along with. It’s going to be hard to have a decent human relationship with any of these people.
Of course Cluster B’s are awful human beings. I’ve gone into them before on this site.
 
 

Schiz OCD Versus Psychosis: Differences and Interactions

Hassan Herrera: By saying “Anxiety processes can at times escalate all the way to psychosis.” You mean, for example a OCD’er getting through the fear of going psychotic can start experiencing psychotic symptoms coming out of the anxiety process? I catch sight of a post of you setting apart core process and where the symptoms come from. I hope i got myself across.

Never seen a case of Schiz OCD going all the way to psychosis, although I know a woman with schizophrenia and Schiz OCD in which the two sort of go together but not completely. She still has delusions that she does not doubt. She also hides symptoms a lot, which is very hard to figure out, though I can sometimes do it.
I don’t think the Schiz OCD went into the Schizophrenia, but the Schizophrenia dx obviously played into the Schiz OCD. It’s an extremely complex case. Never seen a case of Schiz OCD going all the way to psychosis, although I know a woman with schizophrenia and Schiz OCD in which the two sort of went together but not completely. She still has delusions that she does not doubt. She also hides symptoms a lot, which is very hard to figure out, though I can sometimes do it. I don’t think the Schiz OCD went into the Schizophrenia, but the Schizophrenia dx obviously played into the Schiz OCD. It’s an extremely complex case.
There is a Psychotic OCD but I have never seen a single case of it, and I have seen more OCD’ers than 95% of clinicians will ever see. I have seen cases that I worried were Psychotic OCD, but when you got it all untangled, they still had reality testing intact more or less, at least in terms of overvalued ideas. There is a sub-diagnosis of OCD with Overvalued Ideas.
The OCD symptoms in this case were extremely bizarre, and phenomenologically, they looked a lot like the sort of thing you see in Psychotic OCD. His symptoms appeared so psychotic that when I mentioned them to a retired clinician, she insisted that this person was psychotic and would not accept that they were not. Unfortunately I am not allowed to share the very interesting symptoms on here.
Psychotic OCD has a sort of a “look” to it along with typical delusions that are present in a lot of cases – it is a syndrome, in other words.
A classic case of Psychotic OCD would be a case where the obsessions have escalated into delusions. The people are typically not dangerous, as fear is a freezing agent, and OCD’ers tend to be shy or very shy, passive, introverted, and remarkably nonviolent. A classic case is a man sitting in a chair all day shaking like a leaf and going on about his obsessions, which have now reached delusional intensity. The old view was that Psychotic OCD’ers never got too far gone psychosis-wise, and it was quite easy to pull them out of the psychosis. A typical case might last three weeks.
However, we now have recent cases of Psychotic OCD going on for years that did not respond to treatment. Some responded to ERP oddly enough. Some of these people are so ill that they have become the homeless mentally ill like a lot of schizophrenics, carting their belongings around in a suitcase.
The main thing to note is that Psychotic OCD is rarely seen. However, when OCD is very bad, they can appear psychotic. Hence, OCD’ers are often misdiagnosed with psychosis of one form or another and put on antipsychotic drugs, which generally do not help them. I get clients all the time coming to me with a diagnosis of some form of psychosis. Once I figure out they are not psychotic and are usually instead Schiz OCD’ers with what I call fake delusions and fake hallucinations, I tell them to fire their psychiatrist and go doctor shopping until you find an MD who understands that you have OCD and not psychosis.
A lot of psychiatrists continue to misdiagnose OCD’ers with psychosis. The phenomenology of OCD is not understood well by many clinicians, and the fact that OCD when severe looks like psychosis but is not results in  a lot of misdiagnosis.
I think a Schiz OCD’er would be the last person to go psychotic, as the condition is predicated on continuous worry and doubt that they are going psychotic. If you have spent any time around psychotic people, that’s clearly not what’s going on. In psychosis the person never worries whether they are psychotic, nor are they are aware they are psychotic.
If you are worried about or are aware of being psychotic, then you cannot possibly be psychotic. That’s a rule out for psychosis right there. This is exactly what is going on in Schiz OCD, hence Schiz OCD is never psychotic by definition.

Paranoia, Aggression, Victimhood, and Assimilation: The Dilemma of the Jews

If you want to find out if someone is an anti-Semite, the last person you should ask is a Jew. This is because Jews see probably 10X more antisemites than actually exist. In other words, they’re paranoid.
One wonders why one would want to think that people who like you actually hate you or go about worrying all the time that many people in your day to day life surreptitiously hate you. If you go to a therapist with symptoms like that, you get diagnosed with a mental disorder. It’s called paranoia. When it gets very bad, it becomes Paranoid Personality Disorder and it gets even worse in a lot of psychoses, especially Paranoid Schizophrenia, Manic Psychosis, and Delusional Disorder.
If paranoia is a mental illness, does that mean that most Jews are nuts? Maybe. I’d much rather call Jews crazy than evil. Besides, it’s a lot more accurate.
But one wonders why the need for the paranoia? It’s simple. The Jews are a tribe, a human tribe. Judaism and Jewishness is simple a manifestation of human ethnocentrism found in every tribe. All tribes are paranoid about all the other tribes and have an extremely elevated view of themselves that implies that they are either the best people on Earth, the only people on Earth, or the first people on Earth. Paranoia tends to go hand in hand with grandiosity. After all, if you are a measly nothing of a man, why would all of these powerful entities be plotting against you all the time. The only way you could have all these people out to get you is if you were pretty damned important!
People with low self-esteem are not usually paranoid. They assume people don’t like them, often correctly. At any rate “people don’t like me” is an anxiety process related to low self-self esteem, anxiety, guilt and high inhibition. The classic process is Social Phobia. Social phobics often feel that people don’t like them because they are inferior. But that’s not paranoia!
Paranoids, instead, go far beyond the notion that people don’t like them. It’s so much worse than that. Paranoids believe that the people who don’t like you are actual enemies and they are plotting against you! And it’s associated with high self-esteem, not low self-esteem, and low levels of anxiety as opposed to high levels. Instead of anxiety and depression, the paranoid feels grandiosity and anger.
Now here we tie into the Jews.
Look a the description I just wrote of how paranoids act and feel and tell me that doesn’t sound exactly like some of the negative stereotypes of Jews.
Why be paranoid?
The Jews are paranoid because paranoia is the only thing that keeps them going. In the Middle Ages, they actually built some of those ghettos themselves in order to keep their people away from the Gentiles. In 1800, a proper Orthodox Jew would not only not dine with a Gentile. He would not even take tea with one! The Yemeni Jews are like this to this very day.
For centuries in the ghetto, the rabbis preached how the Gentiles hated them and how the Jews had to keep away from the Gentiles. In Medieval Spain, if a Jewish woman had sex with a Gentile, her community would punish her by cutting off her nose!
The Jews are remarkably inbred. They have existed for 2,000 years in the Diaspora and they are still remarkably pure. A good way to keep your tribe pure is to preach that all of the outsiders are evil people who hate you. Of course you don’t want to mingle with them, much less have sex with them.
So the Jews actually owe their very existence to centuries of paranoia along with all the attendant emotions that go along with it – grandiosity towards themselves, anger and hostility (not anxiety) towards non- Jews and basically aggressive, belligerent, chip on the shoulder mindset, which clinical paranoids also have.
All paranoids are victims. Not only that, but they are innocent victims. Innocent victimhood is a necessary state for the paranoia to develop in the first place. The Jews also are perennial victims. They are supposedly victims of centuries of oppression everywhere they  have gone and the future only holds the same if not worse. And of course the Jews are always innocent. They got thrown out of all those countries through no fault of their own. They dindu nuffin. Those Gentiles were just being irrational or insane and downright evil. Pure evil. Pure evil for no reason at all, the worst sort of evil of them all.
Hence it follows that Jews have a need to be victims. Hang around Jews long enough and it will become apparent that they actually desire and cherish their victimhood. In fact, in my opinion, victimhood is the most precious thing a Jew has. One thing you don’t do is take away a Jews sense of victimhood. It seems they will almost kill to keep that.
So what happens if you take away the paranoia and sense of victimhood from the Jews? Simple. The Jews go extinct. The only reason they persisted all this time was due to their hatred for non-Jews. The day the Jews stop hating non-Jews and seeing themselves as victims of all-encompassing anti-Semitism is the day the Jews start going out. Because once that happens, the Jews will have no reason not to assimilate and marry non-Jews.
And this is the Catch-22 of Jewish assimilation. And in fact some of these very arguments have been used by Jews themselves in the centuries-old debate about assimilation.

Are Schizophrenic People Smart?

Although of course schizophrenics vary in IQ, the research shows that lower IQ is associated with schizophrenia. Typically the lower IQ was present before the schizophrenia hit. Whether these people already had pre-schizophrenia and the low IQ was a signal of that or whether lower IQ is an independent risk factor is not known. I suggest the former.
I am not sure if schizophrenia itself, once it hits, causes an IQ decline, but it would not surprise me. The process of developing schizophrenia involves considerable damage to the brain. It makes sense that this brain damage, in addition to causing the disorder, also lowered your IQ.
In summary, people with schizophrenia tend to have lower IQ’s than normals on average, but the difference may not be large. I think it was only ~3 points.

How Can I Tell If I Have Paranoid Schizophrenia or Schizotypal Personality Disorder?

Answered on Quora.
Simple. If you had either one, you would probably not be asking this question right now.
If you had paranoid schizophrenia, you would not be asking this question because people with this illness do not recognize that they are ill, typically refuse to seek help, and also refuse to take medication. If you tell them they are ill, they will not agree.
If you had Schizotypal Personality Disorder (really mild schizophrenia) you would probably not be asking this either. These people probably do not believe there is anything wrong with themselves either, and they are typically too paranoid to go in for treatment. There is a forum for Schizotypals on the Net, and many of them are on there saying that they are too paranoid and distrustful to go to therapy.

Borderlands: Obsession, Delusion and Their Differential Diagnosis

The Borderland between Obsession and Delusion

Anxiety processes can at times escalate all the way to psychosis. I have had some OCD clients who I had a very hard time figuring out if they were psychotic or not. With one, I told a retired therapist of their symptoms, and the therapist immediately said, “Well, they’re psychotic. That’s a delusion.” The things that they believed or almost believed did look like psychotic delusions. However, they did not entirely believe them. OCD with Overvalued Ideas was probably a better diagnosis. There are a few cases of Psychotic OCD. I have never seen one though, although this case was getting close.
When OCD gets very bad, they appear psychotic. However, they generally are not, and in 95% of cases, I can figure out that they are not psychotic. That is because Severe OCD That Looks Psychotic has this particular look, feel, or vibe (gestalt) about it where the cases all give off this particular vibe. It’s like they are all reading off the same script in a sense.

The Problem of Psychotic People Hiding Symptoms

You get a different look, feel, or vibe (gestalt) with an actively psychotic individual, but they can be hard to figure out too because sometimes they lie about their delusions.
I have caught them hiding symptoms from me.
Some people with psychoses learn to hide symptoms because they figure out that every time they say “The FBI is after me,” someone grabs them and hauls them off to the hospital. So they continue to believe the FBI is after them, but they learn to shut up about it.
You look at what the person is doing in reaction to the thoughts. They thought the neighbors were hacking into their computer so they disconnected their computer from the Internet? Delusion. A person who just had the fear or obsession that the neighbors were hacking in would not disconnect the computer, and their description of the fear would be full of all of these strange doubts and uncertainties.

The Difficulty of Differentiating between Thoughts and Voices

Psychotic people sometimes refer to thoughts as voices. I had one client who referred to thoughts telling him to do bad things, in this case, to kill animals. He had recently killed five puppies in response to these thoughts ordering him to kill these animals. I suspected these were more than thoughts, so I had him describe them, and he said, “It’s a thought, you know. You hear it like someone standing next to you and talking.” Ok if you hear it outside your body like that, it’s not a thought, it’s a voice.
Some people with schizophrenia hear their thoughts spoken out loud in the environment, and they fear or believe that others can hear their thoughts being broadcast out there. However, if you corner them on it, some will try to deny it by saying that they just have very loud thoughts in their heads, and the thoughts are so loud that they worry or fear that maybe others can hear them. That’s not quite precisely a delusion, and it’s not a hallucination like the thought broadcasting. It’s off into the obsession/delusion borderland.

Schiz OCD – OCD with the Fear of Psychosis Theme

There is a type of OCD where the person fears that they are going psychotic. OCD’ers have made up a term called Schiz OCD for this illness, which is really OCD with the Fear of Psychosis as the theme. Some clinicians have complained to me about these “hokey names” for the different OCD types and accused me of making them up. I didn’t make up any of them.
The sufferers make up these names for the different themes that they have. I feel that the sufferers have a right to own their symptoms and illnesses and call them whatever they want to call them. That’s their right as sufferers.
Who are we to tell them that their name for their symptoms is the wrong name? Do we have a better name? Of course not. “We” are just arrogant clinicians who think we know these illnesses better than the sufferers themselves know them. I realize Schiz OCD is a confusing name, but it’s the name they picked, and we don’t have a better one, so let’s go with it.
They develop all sorts of “psychotic” symptoms, including fake delusions, fake hallucinations, and even perceptual disturbances. Once again the Schiz OCD symptoms have a completely different quality – look, feel, vibe or gestalt – than you get with someone who has actual delusions and real hallucinations. In addition, all of the Schiz OCD symptoms have a very similar quality across many different people – once again, it’s like they are all reading off the same script.

The Problem of Misdiagnosis in Schiz OCD

I have now seen more people like this than I can count, and I’m an expert on this illness. But I still get people with this type of OCD coming to me all the time with diagnoses of various types of psychoses, schizophrenia, psychotic depression, etc. They received these diagnoses from qualified clinicians such as psychiatrists and clinical psychologists. They were misdiagnosed in 95% of cases, so you see even skilled clinicians can’t tell this OCD type from a psychosis in a lot of cases.

Are People on the Schizophrenic Spectrum Less Intelligent?

Answered on Quora: 
Indeed, repeated studies have shown that schizophrenia is associated with a somewhat lower IQ – possibly 5–10 points. These studies showed that schizophrenics had lower IQ even before the schizophrenia developed.
Why schizophrenia is associated with lower IQ is not known, but schizophrenia is a disease of the brain, and it seems that whatever is causing the schizophrenia is also lowering the IQ.

Schizophrenia and Autism: Similarities and Differences

JohnnyHG writes: There is evidence schizophrenia is developmental like Autism. I would exclude the cases of diagnosis of someone with a history of drug use or brief psychotic hallucinations from environment. The fuck up just gets delayed – it’s latent, which is why it happens in one’s teens/early 20s rather than toddlerhood. But there are signs lasting years leading up to it if I am correct, prodromal? It doesn’t happen overnight.
Experts have watched videos of children who later went on to develop the condition and could pick them out after a while. Often poorer school grades, abnormal movements, and irritable behavior could be found. Plus the negative and cognitive symptoms overlap heavily with Asperger’s/ASD or just Autism Disorder. I believe they bundled it all up because there is too much heterogeneity, hence the distinction between AS and Autism was a bit artificial.
Some things seem to be opposites: clumsiness in autism vs. stupor/stiffness in SCZ, repetitive literal speech or no speech in autism vs alogia or garbled speech in SCZ, obsessiveness with one topic in autism vs apathy in SCZ, but stereotypies are shared and so are bizarre habits. However, there is a different flavor to them, hard to describe.
Do you believe it is neurodevelopmental or stick with the old belief it’s degenerative?

Thanks for the excellent comment. I share your views. I have long believed that schizophrenia is developmental. Really they are born with it or born with the tendency. With enough stress or genetic loading, they get schizophrenia, and if they have little stress or low genetic loading, they either get schizotypal personality disorder (really just mild schizophrenia) or they may get schizophrenia with a later onset.
There really are two things they are seeing in the early symptoms.
The first are the early symptoms – clumsiness, oddness, poor grades, irritability, etc. Those are childhood symptoms.
Then there is the prodrome which hits in adolescence at some point. This causes a slow deterioration over a few years’ period leading to the classic onset from 16-24. I was best friends with a man with paranoid schizophrenia for a year. I hung out with him every day that year. It was a most interesting experience!
At the time, he was 27 years old and he was in the prodromal phase of paranoid schizophrenia. It had been going on maybe since age ~22, so five years. A long slow prodrome is common in paranoid schizophrenia. He was hearing voices the whole time, but his charming personality was quite intact. He was half-Black, very good-looking, and very charming, and he attracted White women everywhere we went together. He later got slowly worse and worse, and after a while, he was not even talking much. I haven’t heard much about him since, as my relatives are telling me to avoid him.

Do Therapists Ever Think Their Clients are Unfixable?

Question from Quora:
Some people are utterly unfixable or even improvable, but they are quite rare.
There are clients who are just too far gone, and they cannot be helped at all. It is as if the person were a ceramic bowl that was dropped on a hard floor. The bowl is now in 100 pieces, and the person who dropped it is on the ground looking at the pieces and throwing up their hands. “Where do I start?” he asks in exasperation.
All sociopaths and psychopaths are unfixable by their very nature. We can’t cure the sociopathy and psychopathy because they don’t want to get better. They enjoy being antisocial, and they do not wish to change. However, we can get them to change their behavior. For instance, a homicidal sociopath may show up in the office. A good therapist may be able to convince this sociopath that acting on their homicidal fantasies would be one of the stupidest things that they could ever do. This sociopath may then be able to go through life without killing an innocent person. So we can’t fix sociopaths, but we can change their behavior somewhat, tone it down, or reduce the amount of damage they do to society.
All paraphilias are unfixable by their very nature. The paraphilia quite literally will not and cannot go away. It’s etched in stone.
Schizophrenia is largely unfixable. They need a great deal of medication, and even then in most cases, they are repeatedly hospitalized. A few can go on to lead somewhat normal or even successful lives, but these people still need continuous medication and regular psychotherapy. In addition, they need frequent interventions to stay out of the hospital.
Many illnesses such as OCD, Bipolar Disorder and Chronic Major Depression are unfixable by psychotherapy. Most of these people will need medication for the rest of their lives. However, psychotherapy can improve their conditions a lot at least in the first and last cases.
Long-term suicidality is very hard to fix. It tends to become chronic with repeated attempts over the years. The suicidal person is typically defiant and is furious with you for challenging their suicidality. You are expected to sympathize with their condition, which is actually a very bad idea. Most suicidal people are what I would call “defiantly suicidal.”
Personality disorders are generally incurable. Theoretically, they could be fixed, but these people almost never present for therapy, and when they do, it is often at the behest of others, and they do not really wish to be there or get anything done. People with personality disorders, like sociopaths, literally do not want to get better. They like their personality disorder, and they are incredibly resistant to change. There are some case reports of cures of personality disorders, but in general the prognosis is grave.
I have never been able to fix long term low self esteem, and I have tried with a few people. There is something about that condition that hammers itself into the brain as if into concrete. I do not know why, but long-term low self-esteem seems to be one of the hardest psychological problems to fix. Why this is, I have no idea. Perhaps someone else can offer some ideas.
In many cases, long-term mental disorders simply cannot be fixed or cured. However, with psychotherapy and drugs, people can often get much better than they were before. We need to stop thinking in terms of cures and start thinking in terms of amelioration.
I realize that many clinicians insist that most people can be fixed or cured of long-term conditions, but I think they are lying. They are probably trying to drum up business. Many clinicians fear that if word got out that a lot of long-term mentally ill people cannot be fixed or cured, people would stop coming in for therapy. There goes their paycheck. Therapists are a lot more money-oriented than most people believe, and don’t let anyone tell you otherwise. I know this field very well.
Clinicians have nothing to worry about. Even if a lot of conditions could only be ameliorated and not fixed, I am sure a lot of folks would show up to try to get some improvement. Some mental disorders are so painful that any improvement feels like a miracle cure to the client. A lot of people have given up on being cured anyway, just want to at least get better and are quite happy to do so.

The Untreatable Borderline Personality Disorder Client: A Therapeutic Nightmare

Borderline Personality Disorder (BPD)is one of the hardest disorders of all to treat. It can be improved with some therapies, but the road is long and hard. Many seem to go on for years or decades with little or no improvement. There are reports of cures, and I am familiar with a woman whose BPD cleared up at age 55 after having come on in childhood. That’s probably a typical cure. Decades of nasty illness followed by a lifting of the illness in middle age.
Many mental disorders improve in middle age, and even many personality disorders improve during this age period.
Schizophrenia often ‘burns out” in middle age, and florid positive symptoms are replaced by more negative symptoms.
Many anxiety disorders attentuate in middle age.
Even psychopaths often get better or at least less destructive in middle age, as many of them also burn out in a similar fashion as schizophrenics. A number of highly antisocial psychopathic men get better in middle age as the antisocial behavior attentuates. It is often replaced by depression, heavy drinking and a pessimistic, cynical, imbittered and misanthropic person who nonetheless does little damage to society anymore.
It should be noted the clients with BPD vary widely in their symptom pathology.  Some are much more functional than others. Quite a few can even function well at their jobs all day, but when they come home from work, they fall apart and shift into full BPD pathology.
However, some people with BPD are so ill that they seem nearly untreatable. It is these people who will be the subject of this post, not BPD’s in general. These people seem so far gone and broken that one wonders how anyone could ever even begin to put them back together again. I suppose some progress could be made, but the damage is so severe that I have a hard time seeing how even the best therapist could possibly fix these people in any significant way.
A typical case might be a young woman who, only in her late 20’s to early 30’s, already has 8 -13 suicide attempts and many hospitalizations behind her. She goes into the hospital on a regular basis. Therapy seems to do nothing but feed her pathology as she manipulates gullible new therapists to believe her lies, nonsense, and projections as the new therapist confuses symptom pathology with the truth. Drugs do almost nothing.
Diagnosis itself is often difficult because the BPD is so severe that the person often appears psychotic/delusional. One wonders what are delusions and what are not. Even the delusions do not seem to last for long, as they are dropped, changed around, added to or substituted in a wildly chaotic fashion.
Usually there is a lot of combativeness and involvement with the court system, as the extreme rage leads a litigious person.
Splitting is severe and textbook.
Self-image is so unstable that the person almost literally adopts the full personality and even persona of whomever is on their radar at the moment. The clinician needs to be prepared that this person will so identify with the clinician that they will adopt the therapist’s image and persona as their own. Boundaries nearly do not exist for these people, and they often fall in love with their therapists, try to seduce them, or on the other hand become furious at them to where sessions became rage attacks at the therapist, and the therapists is at odds of how to respond without violating ethics.
The client can become overtly suicidal even during sessions, and infatuation with the therapist can quickly split to where the therapist is the source of all evil. Homicidal threats and homicidal-suicidal threats against the therapist may now appear. The client then hospitalizes themselves due the “horrible trauma from the evil,  incompetent therapist” and soon finds sympathetic new therapist, typically a feminist woman, to unload her story on. The new female therapist forms an alliance with the client against the “evil male” former therapist and accuses him of damaging the client.
Commonly, the therapist gets angry and tells off the client. This leads to abandonment and a vengeance agenda against the therapist, who has now “irreparably damaged” the BPD and “caused them to spiral out of control.” Be prepared to get accused of abandonment, causing severe trauma in the client and making them dramatically worse. The client may become hospitalized due to allegations of damage from an incompetent therapist.
These people are so difficult and chaotic that many clinicians refuse to see Borderline patients. Some are on the record as saying that when they say a Borderline client coming their way, they hide under their desk until they go away. For a lot of therapists, these clients are nothing but trouble, and endless parade of drama and chaos. Therapy itself is chaotic, mercurial, and wild with severe splitting and often extreme idealization of the therapist for good or ill or both, interrupted by fairly regular hospitalizations. The therapist begins to wonder what’s in it for them and thinks you could not pay them enough to suffer through such clients. These clients make an excellent argument that therapeutic abandonment is the proper choice with some clients.

Do Psychologists Make Their Patients Aware of the Diagnosis of Narcissistic Personality Disorder or Sociopathy?

I recently answered this question on Quora.

Do Psychologists Make their Patients Aware of the Diagnosis of Narcissistic Personality Disorder or Sociopathy?

These personality disorders seem to carry a lot of social stigma, therefore are patients made aware of their diagnosis or does the therapist just continue behavioral therapy to treat the symptoms rather than informing them of the diagnosis?

I am not a psychologist. I am a counselor. I only work with one disorder, OCD, and I can quite accurately diagnose that condition, I assure you. Nevertheless, I am not allowed to give out legal DSM diagnoses. However, I can obviously give out my opinion on a diagnosis. I can also tell the person my opinion on what they do not have. For instance, I have gotten many clients with OCD who have been misdiagnosed with some sort of psychosis. I am an expert at telling the two apart. I simply tell them that in my opinion, they are not psychotic. Then I tell them to fire your clinician and go get a new one that will recognize the difference between OCD and psychosis (many clinicians are very poor at telling these apart).
Other than OCD/psychosis, I also have to make differential dx on OCD/sociopathy, violent thoughts, etc., OCD/pedophilia, pedophilic thoughts, etc. and OCD/homosexuality. In a limited number of cases, I told clients that in my opinion, they did not have OCD but instead had some psychotic disorder, or sociopathic traits, or pedophilia, or that they were homosexuals. Most of this differential dx is pretty straightforward.
I have never had any narcissistic clients, God forbid clients with NPD. One thing nice about working with OCD clients is that they are usually very nice people. Not all of them, mind you. But if they are not nice, there is often some other reason, for instance, Borderline Personality Disorder in an OCD client could possibly make them impossibly vicious, cruel, unstable, not to mention extremely crazy, far crazier than any OCD sufferer ever gets.
OCD by its very nature strikes nice people. The fact that they are so nice, meek and kind is actually one of the main reasons that they have the disorder in the first place! For the most part, only nice people get it, and the nicer you are, the more likely you are to get it. I will leave it at that for the moment and give you a chance to think of why that might be. I know why but it goes beyond the scope of this post at the moment.
But in general, I never even give my opinion on other anxiety disorders or on any mood disorders or personality disorders. I only rarely see clients who have psychotic disorders, and the two that I have seen were already diagnosed. I also very rarely see people with personality disorders, and the few that I have seen were all females with Borderline PD diagnoses. I did see one woman for two sessions with obvious Borderline Personality Disorder, but I had not figured it out yet in the first session, and by the second session, I declined to diagnose her. She has already been diagnosed by a psychiatrist from afar anyway. So apparently I am guilty of failing to dx a Borderline PD client.
The session was about her OCD, not her BPD and she was very nice through the whole session. It would have ruined the whole thing if I told her she had BPD, and I doubt if she would have accepted it anyway. At any rate, I am not allowed to give legal dx’s anyway, so it’s apparently proper for me not to diagnose someone!
That only comes up if there is differential diagnosis. I simply say that I not only can I not legally give these out but that I am not qualified to work with any condition other than OCD, which I can actually work very well with. If they want me to work on their depression or whatever, I tell them that I have no expertise or training in that area so I can guarantee nothing and it would be similar to talking to a friend or family member.
If I were able to give out diagnoses, I think I would simply give them out in most every case. Possibly if it might make a suicidal patient go over the edge, I might decline to give one out. But I will disagree with the clinicians below. In my opinion, physicians and other medical professionals in addition to all licensed clinicians should give out whatever diagnosis is appropriate. I feel it is a moral matter. The patient or client is simply owed a diagnosis on the part of the clinician or MD and I feel it would be remiss of the clinician or MD not to tell the patient what is wrong with them, and I mean everything that is wrong with them.
This is just my personal opinion and I believe there no ethical rules on the subject. Also I respect the clinicians below for not giving out diagnoses in cases where it would not be helpful. I simply feel that this is a case were morals or even the categorical imperative trumps pragmatics or even common sense.

False Memories in OCD

False memories are quite common when OCD gets bad. I have dealt with a number of people who were going round and round about false memories. They are not an extremely common symptom, but you do see them sometimes when the illness is bad. It’s generally a sign of a bad illness.
Ms. Z was periodically convinced that she killed people. She would have a conversation with someone for 5-10 minutes, then walk away ,and then suddenly think that she had killed them somehow during the conversation. Perhaps she had suddenly swung her fist out and beat them to death? Perhaps she had pulled out a knife and hacked them to death? Perhaps she had shot them with a gun? She would have all sorts of false memories of how she killed these people.
In the course of these false memories, she would become 100% certain that she had killed that person she was talking to in that store that day. In the next few days, she would ask around to people she knew if anyone got murdered or if she killed someone in the store that day. Of course she would always be told no. I’m sure her friends must have tired of answering these weird questions. As soon as she was told that no murder had occurred, immediately the firmly held belief that she had killed that person would vanish, and she would never think about it again. Until a little while later when she would be talking to someone again and then walk away and once again become convinced that she had killed that person…
Another woman, Ms. S., was a young college student. She was at a large California university that had a lot of long, winding trails with undergrowth. There were deep gullies on the sides of the paths that were overgrown with foliage. Ms. S. would be walking down the paths and as she walked, she passed all sorts of people coming her way. At some point, she would suddenly get an idea that she had grabbed one of the people coming her way and thrown them down into one of the gullies.
She had a pretty clear memory of who the person was she threw down there and exactly how she had done it. She would be overwhelmed with guilt, and she would take off down into the gully searching for the “body” of the person she had thrown down into the gulch. She did this on a pretty regular basis, and eventually the university wondered what she was doing floundering around in the gullies, and they sent the university police down there to see what she was up to. After a while, it become clear that she needed to go to the university counseling center.
In both cases, the women received a diagnosis of schizoaffective disorder in addition to OCD. This was an incorrect diagnosis, and it was based on the fact that for a short while after Ms. S  was clamboring around in the gullies or after Ms. Z became convinced that she had somehow killed someone she was talking to, that both women were absolutely convinced that they had either thrown someone down into the gully or had killed the person they were talking to in the store.
The diagnosis was incorrect because as soon as the women were told that there was no one in the gully or that they had not killed the person in the store, the “delusion” completely vanished and they didn’t think of it again until next time. Delusions just don’t go away like that. It’s not a very strongly held conviction if can vanish with a mere word of reassurance.
We look at the whole process in a holistic sense. What is the nature of the process? Is this a characterological process (personality disorder), a mood process (mood disorder like Bipolar Disorder or Depression), an anxiety process (OCD, PTSD, GAD, Panic Disorder) or a psychotic process (schizophrenia, manic psychosis, psychotic depression, schizoaffective disorder)? It is important to look at things in an intuitive sense and get the “smell” or “feel” of what the basic process is that you are dealing with.
In the case above, this is an anxiety process, specifically an OCD process. It’s not a psychotic process, despite the fact that it superficially resembles a psychosis.
Some of these folks with false memories actually go to the police station and turn themselves in for crimes that they did not commit.
“Hi, I am here to report a murder.”
“Ok, what happened?”
“Well I think I killed someone last night.”
“You think you killed someone?”
“Yes.”
“Well, where did this happen?”
“I am not sure. I think maybe the bridge over the river.”
“What time did this happen?”
“I’m not sure. Maybe midnight?”
“Who was the victim?”
“I’m not sure. I think it was a man, maybe.”
“What weapon was used?”
“I am not completely sure. I think it was a knife maybe.”
After a while the police started to get the message. He was not there to report a murder at all. He was there to find out whether or not he was a murderer!
As the conversation degenerated, the man started repeating, “How do you know if you killed someone or not?”
The police did not know what to say to that. After he left, the police were talking among themselves. “That’s so weird,” one of them said. “What does he mean, ‘How do I know if I killed someone or not?’ How could you not know something like that? That’s so weird.” The cops were shaking their heads.
 
As you can see, false memories are quite common in OCD when it gets very bad.
I dealt with them myself at one point in 1985 or 1986. I have to admit it was a pretty nutty way of thinking. I was so ashamed of my false memories (which I temporarily convinced myself were true) that I never told anyone except for a couple of therapists. I have not dealt with any false memory nonsense in over 30 years, and I hope I never have to deal with that again. It’s truly a crazy way to think.

Psychopathology of Serial Murderers

The primary problem with almost all serial killers is simply ASPD, Antisocial Personality Disorder, derived sociopathy or primary psychopathy. It is present in almost 100% of such cases. Most everything else is rather secondary to this primary character disorder, which is the most prominent symptom.
Very rare is the serial killer without this disorder, although there have been a few. I remember a long-distance trucker who turned himself when he walked into a Northern California police station with a woman’s breast in his top shirt pocket. He had camped out in forests while trucking and had picked up women and killed them. He kept the body of one in the truck for three or four days and drove around with it.
Experts said he was quite unusual in that they said he actually felt bad about what he had done. I wonder how bad he really felt though. You could not get me to drive around in a truck with a dead woman in the back for very long. I would go into severe panic pretty fast, would stop the truck, get out and start walking or probably running away. I would not be able to walk around with a woman’s breast in my shirt for long either. I would completely panic almost right away, take the shirt off, throw it on the ground and start running. But then I am a pretty guilty type person with a strong conscience.
Based on that, while I am sure he may have felt some guilt for his killings, the fact that he was able to drive around in a truck with a dead woman in the  back for 3-4 days shows without completely flipping out shows to me that he didn’t feel that much guilt, certainly not on the level that most of us would. And the fact that he could rather calmly walk into a police station with a cut off breast in his pocket without flying into total panic shows to me that he didn’t feel that bad about it. So guilt, even when it is present, is not as strong as in most of us, otherwise they would not have even done such horrible things in the first place.
Sexual sadism is also often present, and I have heard that Sadistic Personality Disorder is very common. Juvenile delinquency, voyeurism, exhibitionism, burglary, prowling, petty thievery, etc. typically precede the serial killings. When the serial killer starts killing, he usually has a fairly long rap sheet of more minor offenses. The murders are best seen as an escalation of a chronic criminal character type.
The ones who kill children are typically though not always preferential or fixated pedophiles. Certainly the ones who kill only children are preferential pedophiles. There is a type of pedophile called a mysoped, which is a sadistic pedophile. They are not very common. I doubt if 5% of pedophiles are like this, but these people are very dangerous. Probably almost all serial child killers are mysopeds and these crimes often have a sexual basis.
95% of rapists are the type that rarely if ever go serial, but the sadistic rapist, composed of no more than 5% of rapists, is very dangerous. Most if not all rapist serial killers are sadistic rapists.
The rage rapist is dangerous, but he generally does not intend to kill his victim although he assault her. If she fights back or gets difficult, he can fly into a rage and beat her so badly that she dies but again he usually does not intend to kill. I doubt if these types go serial much if at all. Serial killers intend to kill; rage rapists do not.
Malignant narcissism, the disorder, believe it or not, of our wonderful President, is also present sometimes. Ted Bundy was a malignant narcissist. Yes, our wonderful President has the same mental illness as Ted Bundy! Comforting thought.
A few have Schizoid Personality Disorder, and some of the more disturbed ones have Borderline Personality Disorder.
Schizotypal, Paranoid and Narcissistic Personality Disorders are rare if ever seen in serial killers. Schizotypals are probably too disorganized and decompensated and just out and out strange to commit such crimes. The serial killer must blend in, and schizotypals do not do that. A few schizotypals have committed mass murders. James Holmes the Aurora Batman Theater Shooter, was a notable case. But note that he was caught immediately.
Paranoid PD is rarely if ever seen. These people tend to be rather retiring and like to hide away from a hostile world. They also do not like to call attention to themselves from a hostile world. They are suspicious and distrustful by nature and this makes it hard for them to blend in well with ordinary society as serial killers often do.
Narcissists are usually too self-centered to kill. While narcissists are often very mean, the disorder is usually well-controlled in that the rage rarely escalates to homicide. There have been a few cases of NPD’s committing mass murder, usually of their families.
The case of Jeffrey MacDonald, the mass murdering physician of Fatal Vision, seems to be such a case. This is a superb true crime case by the way.
Also narcissists think that if they kill, they will get caught, and if they are in prison or jail they will not be able to live this wonderful life they are supposed to be killing. They are “too cool to kill.” Killing would mess up all their wonderful plans to exploit others and hold them up to contempt by millions of people, which the narcissist would have a hard time taking. The narcissist is “too good for prison.” Prison would be such a crushing blow to their self-image that it would very hard to take.
However, malignant narcissists can be very dangerous because this is a combination of psychopathy, sadism, Paranoid PD and Narcissistic PD. When you weaponize NPD with paranoia, sadism and particularly psychopathy, you create a dangerous illness.
Cluster C Personality Disorders like Passive-Aggressive Personality Disorder, Self-Defeating Personality Disorder, Dependent Personality Disorder and Obsessive Compulsive Personality Disorder are rarely if ever present in these types. These are PD’s where aggression is mostly displayed passively, and serial killers display aggression actively, not passively.
Mood disorders do not seem to be common. Bipolar Disorder is not common, and serial killers are rarely if ever depressed. They displace guilt and loathing outwards instead of pushing it inside of themselves as depressives do. Depressives are passive, and depression acts as sort of a freezing agent in that it tends to immobilize people by its nature. Men in general tend to either experience less depression than women or mask it with other things such as anger and rage, drinking, drugs, gambling, promiscuity or even workaholism. It is simply not acceptable as a man to be depressed, so depressed men simply channel their depression into other things and say they are not depressed, they are just drunks or workaholics, for instance.
Substance and alcohol abuse issues are quite common with serial killers, but the better ones are more sober, as drinkers and dopers tend to be scattered and unreliable and serial killers must be on the ball  24-7.
Only a few are psychotic. 2% of serial killers are psychotic. Psychotic people can barely organize a trip to the bathroom. How are they going to plot out elaborate and professional serial homicides?
They are motivated by many things, but your typical rape-murders of murders of attractive young women almost always have a sexual component. I would call these serial killings lust murders. The Germans coined the term. Even among the lust-murders, there are a number of different types. Some are motivated by purely sexual desires, others get off specifically on killing and the power gained from it, others are hunter types who get pleasure from the hunt and chase as if they were hunting an animal, which they are of course, but when we refer to hunters, we are always talking about hunters of non-human animals.

A Bit About Paranoid Schizophrenia, with a Real Life Example

If you were going psychotic and hearing voices, you would not even know they were voices. When you first heard them, if you were in your home, you would go around looking for the person hiding in your house because it would sound exactly like a person talking in your home. You would search everywhere, under the bed, behind the couch, everywhere someone could hide.

I spent a year hanging out with a paranoid schizophrenic every day. He heard voices all the time, but he was convinced they were coming form the radio or the vents or wherever. For instance, he kept demanding that we take apart the radio in my car to find the recorder in there that was putting out the recordings.

When he first came over to my house, he said he heard someone down in the cellar, so we went down there to look, and there was no one there. I thought it was pretty weird at the time, and I did not know what to think of it, as I had just met the guy, and I did not know he had schizophrenia.

After I hung around with him a while, I started to put two and two together and realized that he was slowly developing paranoid schizophrenia. I figured this out because I had been studying mental illness for 25 years. I had never dealt with a paranoid schizophrenic up close and personal like that before, but he seemed to be a textbook case based on everything that I had read.

He was 28 years old, and the symptoms seem to have started when he was about 23 and at college. There is often a long slow prodrome with paranoid schizophrenia. So while it does have a later onset often in the late 20’s and early 30’s, there has often been a long slow prodrome going on characterized by slow deterioration for even up to five or ten years.

Paranoid schizophrenics do seem to function somewhat better than the rest of schizophrenics, possibly due to this later onset. Some of them have even married, had children, started on careers or opened businesses when the disease hits, so they have had some illness-free years in which to develop their personalities. Hence the personality is more intact in paranoid schizophrenia than with the other forms.

Later I would be over at his place, and he would hear the voices coming out of the vents. He lived with his Mom, and he insisted that his Mom put a recorder in there to harass him, and he wanted me to help him take the vent apart to “look for the tape recorder.” He had a lot of arguments with his Mom about her “putting the recorder in the vent.”

It was very difficult to deal with the guy because he heard the voices, and they were so loud and clear that he would whip around and say, “You hear that?” and he would point to the car radio or the vent or wherever. I always said no, and it was making him mad because the sound to him was clear as a bell, and it was absurd that I could not hear it. So he was always accusing me of being a liar and saying I did not hear the voices when really I did.

After a while, I started making excuses and saying things like I had a problem with my hearing.

The problem is do not want to agree with the person when they say they hear voices because you are just reinforcing their craziness, and pretty soon you will be working with the person to take your car radio apart to “find the microphone.”

Furthermore, it’s best not to reinforce their delusions either because you will just strengthen the craziness.

Actually it probably would not hurt to say you hear the voices too or agree with their delusions, but I always worried that it might make them worse.

For instance, a schizophrenic says someone is persecuting them. Well, you can either agree or not agree. If you agree, you run the risk of reinforcing their belief, and they might get so reinforced, convinced and angry that they assault the person.

Another problem is that I would take him places with me sometimes, say to my doctors appointments, while we were running about trying to get him an apartment. While there, say as we were leaving, he would insist that someone in the waiting room had said some particular insult to him. Actually no one had said anything to him, much less the insult that he heard. He would want to go back in the waiting room and challenge the person over the insult, and it would be rather difficult to convince him not to do that.

He had done very well in college and was a great basketball player but not such a good student. At one point, he had moved into an apartment with other people, but that all ended when he accused them of messing with him through the walls of the apartment. He also accused people of breaking into his car. He would go out to his car, and it would seem like someone had broken into it or messed with stuff inside. He eventually had to move out due to this, and he moved back home to live with his Mom.

I kept trying to get him into an apartment down in Fresno, but things kept falling apart. He would get into the new place, and it would have the damn recorders in it too, and he would accuse the guy was rented it to him of putting the recorders in there. I met one of the men who rented to him, and he was dumbfounded, shaking his head, and could not make sense out of my friend at all. His attitude was “Good God, what the Hell is the matter with this guy!?”

My friend was a mulatto, and he had a very charming personality along with being very goodlooking. Everywhere we went, he would walk up to young White women and chat them up in his usual engaging manner, and they would usually be very interested in him. He was quite a charmer and could really talk to the girls. It was insulting as the girls would always rather talk to the insane guy than to me who was not nuts, although I was in my 40’s at the time I must admit.

If you were out in public with him, and he was chatting up women or whatever, he would typically not seem crazy at all. Instead he would seem to be a perfectly normal, charming, extroverted guy.

I was never afraid of him. Everyone kept telling me he was dangerous, and they were all trying to get me to get rid of him as a friend. He didn’t seem violent to me, and I can read people pretty well. He did yell a lot but not usually at me – more at the folks who were “persecuting him.” The whole time I was with him, I would be looking at him and trying to read his mind (I am a very good mindreader) to figure out if he was going to do something violent. I never got any vibes off of him that he was going to be dangerous, so I wasn’t really worried about him.

However, people close to me eventually convinced me to ditch him, which was not easy. I saw him a few times later around town and gave him a couple of rides. Later he had somehow gotten a job at the local supermarket, but by that time, he was deteriorating even more, and he had become very quiet and would almost ever talk.

I later heard that he was down in my city roaming around on the streets and hanging out at the mentally ill drop-in place.

My friend would never admit to being even slightly mentally ill, and after a while I stopped confronting him about it. But I did try to get him to see a psychiatrist I knew under the guise of giving him some pills for his nerves to calm him down along with some other phony excuses. She was good at dealing with psychotic people who would not admit they were ill, and she would often succeed in surreptitiously giving them some antipsychotics under the guise of calming their nerves or other phony excuses. You have to be a bit sneaky with these people when they will not admit they are ill. I have known people who had psychotic or seriously mentally ill relatives who they were considering dosing with antipsychotics in their orange juice or coffee. I actually think that would be a morally proper act.

The problem in psychosis is that the person typically has no idea that they are ill. Whether they do not want to admit for psychological reasons such as stigma or whether they can’t realize they are ill because psychosis blinds the person to the fact that they are ill, I am not sure. I suspect some of both. Some people are episodically mentally ill, and when they get better, they will often not admit that they had been ill due to stigma or ego reasons.

The problem in psychosis is that the part of the body that is needed to recognize that you are ill is itself sick. The person can’t figure that they are ill because in order to do that, you usually have to be at least somewhat sane. In fact the presence of insight is an excellent diagnostic feature in mental illness, and the greater the insight, the better the prognosis.

Insight is also a very serious problem in Bipolar Disorder, even in the milder phase known as Hypomania.

OCD and Homicidal Thoughts

Homicidal thoughts or harming thoughts are quite common in a type of OCD called “Harm OCD.” It can get pretty bad. As a counselor and a sufferer, I have dealt with many people who had this particular type of OCD. In fact, they come to me all the time! I typically do some sort of differential diagnosis with them to make sure it’s OCD and not something more serious.
Below are some cases of obvious OCD or OCD-like thinking:

1. OK so one day me and my sister were just talking and all of a sudden I get this weird urge to choke her. I would never do that to her. I can’t even kill a bug and I’m not bi polar. This has happened again recently with my other sister, the thought just randomly occurs. If it helps I have been diagnosed with panic disorder. Please don’t be mean and say I’m a psychopath or I’m crazy. I need to know if any one else has experienced this to. Please help!
2. I do too sometimes. Sometimes while I’m driving I feel the urge to swerve into traffic. Sometimes for no reason I get the urge to choke my dog or hit her to death. (Of course I’d never do it.) It feels like you have no control over yourself. It feels like your actually about to do it but you don’t.
3. Believe it or not I’ve been through the exact same thing I had violent and sexual urges that I couldn’t control but I never hurt anyone I just always felt like I would, some specific urges I had were to drown my sister in the pool , every time I was someplace high up I would have a strong urge to jump off. I had these urges from age 10-15 and I was scared to be around people but I found out it is OCD look up OCD violent urges online.
I finally talked to somebody about it and said I was worried I would hurt somebody and they said the reason the urges don’t make me a violent dangerous person is because I’m worried about it were somebody dangerous would either not care or enjoy it.
4. i think everyone thinks these thoughts, not because you want to do them, but because your brain can think it. Its just putting yourself into a scenario, kinda like a daydream. Ive thought that way…”what if i just punched her…what if i slipped and fell and hit my head….what if i swerve into traffic??” tons of things will cross your brain…you’re human and its curiosity. I think you’re just fine. Unless you start getting the urge to actually follow through with it, or attempt it. Don’t sweat it.
5. Guys… I have that too. Sometimes ill sit and watch tv and suddenly ill have a random thought of killing my mom or hurting my dogs. Anyone in my house hold. I’m completely fine when these thoughts occur. I’m not mad, nor upset. And my family never did anything wrong to make me think such things…I would NEVER hurt anyone…
And it scared me. Sometimes i avoid certain objects i could hurt people with and i stopped watching my favorite crime shows. It all freaks me out now.. Ive asked a friend, and he has it too but not as extreme. More of a “what if” thing. He says im fine and he thinks everyone has these thoughts at one point.

Some of these folks may not even have OCD, but at any rate, all of these thoughts have an OCD-ish feel to them. It’s quite common for non-OCD’ers to get thoughts like this once in a while.
This case is more difficult:

Hello. This isn’t very easy for me to let go into the world, but I would like people’s opinions. I am on the other end of a 1.5 year bout with OCD and being terrified that I am going to indulge in homicide. Things are much better now, but yesterday at work, I got all my issues worked up in my head and at one point I genuinely wanted to indulge in homicide. I actually wanted to do it.
During that I had slight panic attacks running and of course it worries me that the curiosity of doing such an act is attractive. Now, I have read many posts here on how to self help your OCD, but this is the first time I have ever been genuinely attracted to the horrible thing I’ve been afraid of for such a long time, and that’s the difference between being afraid of intrusive thoughts and being attracted to them. Is that normal psychology for an OCD sufferer, do you think my thoughts got twisted in knots and then I deceived myself into thinking I wanted to do it, or do you think I should seek some help?

The thread goes on and on, and some folks are are telling him to go to the ER and check himself in. The guy who posted this is worried that he felt like he really wanted to do it. However, many of the OCD’ers I have dealt with have told me that they feel like they want to act on these thoughts. In every case, they were given a diagnosis of OCD by multiple clinicians. The thing is that OCD itself can make you feel like you want to do these things. It can also make you feel like you might or would enjoy them. All of this causes more panic, anxiety and attempts at thought suppression.
So if someone comes to me with classic Harm OCD stuff and then tells me that they feel like they want to act on these thoughts, I am not particularly worried. It’s probably more the OCD convincing you that you want to act on the thoughts or that you might enjoy them more than anything else.
This case is much more disturbing.

Hello, My name is Ryan. I’m 17 years old. I’m posting this here today because for quite some time i have been obsessed with murder, blood, torture, and rape. When I see someone walking down the road, my mind unconsciously comes up with random ways of torture I could try on them, I’ve been doing this since I was around 15, but now something’s changed – I feel its getting harder and harder to control, I’ve had to start journaling and drawing what I would like to do to my victims.
I feel I could take countless human lives and not stress about it. Will someone please tell me what’s wrong with the way I think? My parents told me its a stage, but I know it’s more. Just someone please try to give me insight on why this is happening.

I am honestly not sure what is going on with this guy, but one thing it is not is OCD. No way does a Harm OCD’er journal and draw pictures about torture, rape and murder. Forget that. The OCD’er would be terrified of having the thoughts in the first place, would not enjoy them at all, and would most likely viciously fight them from the first time they showed up until they went away, if they ever did.
The OCD’er doesn’t want those thoughts or feelings in his head for even one second. He would never just indulge in them for pleasure or write journals and draw pictures that delight in murder, torture and rape.
Truth is most Harm OCD’ers are so scared of their thoughts, etc. that they start avoiding all situations that might set them off, including any TV shows, movies or writing that has to do with murder, rape, torture, etc. If they watch or read something along those lines, they will feel serious anxiety and nearly have a panic attack.
In the thread, a few of them ask him questions to see if this is OCD. He says he enjoys the thoughts and feelings very much. That doesn’t sound like OCD one bit. However, he does say that he tries to resist them at times, but he can’t. Now that is very odd. But there may be occasional resistance with non-OCD stuff.
The fact that he feels like he could kill countless people without a single worry in the world is also disturbing. No way would an OCD’er feel that way.
It is interesting that a number of other commenters said that they had similar thoughts and feelings, especially when they were teenagers, and at some point, they just went away. That is very hopeful. I had assumed that once you get to the point where you are fantasizing about rape, murder and torture all the time, even to the point of doodling and journaling about your fantasies, you are pretty much gone. But apparently this is not so, and people can easily move out of this kind of thinking. That is a very good thing indeed.
The following are some cases of homicidal thinking in schizophrenia:

1. Yes but not intentional homicidal thoughts more like random ones that come in my head like if I see a bus pass by me sometimes I would have thoughts of breaking the windows with a baseball bat and screaming at the passenger or punching someone randomly passing by me but not of anger I barely get angry anymore just random thoughts.
2. Hi, I’m new here to this board. I was just curious if anyone feels these symptoms. I feel this way all the time. Whenever someone looks at me wrong. All I want to do is hurt or kill that person. I was recently hospitalized a couple months ago. I’m always scared to death. All I wanna do is crawl in to a dark room and cry. Sometimes when I’m driving I think what if I just turn the wheel and kill that jogger running.
Seriously I see a pdoc and have seen the same doc since I was a little kid. My pdoc says it’s just delusions. But it’s so real!!! I was diagnosed with paranoid sz. about 3 years ago. Does anyone feel this way? Please anyone I would love to know that I’m not alone here.
3. Hello Weenska, you most certainly are not alone. I get homicidal thoughts too. The scary thing is that they are all about killing children. You see, I work in a children’s’ hospital, and for some reason my mind is set on hurting the patients there. I get so nervous when I have to go clean a room with a patient sleeping in there.
The nurses are outside of the room sitting at the nurse’s station, and I’m alone in the room with the patient. While I’m cleaning I get evil thoughts of how I could swiftly kill the child without anyone seeing. My mind comes up with so many ways on how I could get away with it too. It’s like I’m constantly fantasizing about being a secret, mysterious child killer. Isn’t that awful?
4. I know I’m not a bad person and could never harm anyone. You’re not a bad person either. Why we get these kinds of thoughts flowing through our head is beyond me. I want you to know that whatever filthy person our minds may try and persuade us to be, that its not who we really are. 🙂
5. Princess is right, you’re definitely not alone! I have homicidal thoughts about my hubby. I don’t sleep well at night so a lot of the times I am just sitting in bed watching my hubby sleep. I would think about what it would be like to actually commit a murder. I can picture myself smashing his head in with a baseball bat, or poisoning his food, I even can see my self sneaking up on him and stabbing him in the back.
I’ve told him and at first he thought it was kinda funny, but now I can tell he’s sometimes a little edgy around me. I love him so much and I don’t want to lose him…To me, this is so much more than some kind of delusion. Its like the devil himself is tempting me. I hate feeling so sick and twisted inside. Anywho, yes I can relate. I know I’m not bad, and I will fight these thoughts off as hard as I can for as long as it takes!
6. I’ve always been a real docile person, but when I got sick I had some homicidal thoughts.
7. In 1980, I had a lot of violence in my head and I was afraid for about a week that I would get violent. It scared me and made me feel bad, but I managed to control it.
8. I get these thoughts of hurting people sometimes too. I haven’t acted on them so far.
9. I used to get terrible homicidal thoughts. There were command voices, and there were the videos/images that played in my head about terrible crimes I was committing. I have been hospitalized over 20 times, and many of these were for homicidal ideation. I would be taken to the inpatient unit and put in isolation because I could not control myself.
But after the fact when I would get re-stabilized on meds, my T told me that she did not think I had it in me to hurt another person. I have never hurt another person. I am generally very kind and calm. She wanted me in the hospital because she was afraid I would hurt myself. After I had the homicidal thoughts I would feel SO guilty about having the thoughts that I wanted to kill myself because I was such a “bad” person. But, I am not a bad person. Now I have been stable on Clozaril for 6 years, and I no longer have homicidal thoughts… ever.
10. From my perspective, It might b “normal” 2 have homicidal thoughts about some 1 I don’t like or doesn’t like me. But I have homicidal about the ppl i LUV the most! It’s like the thought pops up in my head then I got a whole bunch of cause n effect scenarios.
It could b like if i c a hammer on the table, I could bash my loved one in the head. Or it could b some insecticide, n I could add a dash of death 2 a meal. I mean yea, I been thru some bad shit, but this is just fucked up! After i realize what I just wuz thinking, then I start feeling all bad, then the potential bad endings, n it bothers me. I mean, I’m ain’t necessarily a bad dude, but damn that shit ain’t cool, feel me?
11. I get homicidal thoughts when I am deeply disturbed. I make up shit in my head on how I could kill someone and get away with it. I have really good self control, and I’m a good person, and it bothers me deeply. Most of my homicidal thoughts are about my brother though because he is clearly the Antichrist. I talked to God when I was actually planning on killing him and he stopped me. He’s a crackhead and pill popper big time and only uses my disabled mother for more crack money.
Luckily he has found a place to live so he doesn’t bang on our doors at 530 or call my phone anymore. He threatens a lot towards our family, but I can do so much more harm than he could. My father passed away in January and he was the only person who could keep him in line. The constant family feuds we’ve been having has at times caused me to the point of pure insanity. I talk about killing him openly with my family and how he just needs to die.
Of course, they’re very freaked out. I’ve always had homicidal thoughts even before schizophrenia. But they have just been getting worse about my brother. I think about killing other people sometimes, but it’s mostly my brother because he’s a piece of shit. This morning he came by again and I couldn’t sleep. I haven’t heard voices in over a week, they come and go, but this morning voices were telling me to murder someone.
12. When I read this post, I immediately remembered my early teen years, when my illness really started getting bad. I had my first hallucinations when I was about 14 or 15, and that’s when I started having thoughts of killing people. At first the thoughts were of killing people at school, like a random school shooting, and then killing myself. Then came the thoughts about killing my family members and then myself. I skipped school all the time because of it. I feel sick just typing this. I want to delete it and pretend it never happened.

This one is deeply disturbing. Some sort of homicidal thinking she had actually led to her trying to kill her brother, probably when she had schizophrenia:

I’ve had thoughts like that before too. I used to go to school with a girl who I thought was perfect. I wanted to kill her because I felt so flawed next to her. The point is, NEVER act on these impulses. Never hurt anyone or you will regret it horribly. I tried to kill my brother once and he avoided me for years (can you blame him?).

As you can see, homicidal thinking is extremely common in schizophrenia. In fact, the vast majority of schizophrenics seem to experience it at some time or other. Some of this stuff looks very OCD-ish to me. Whether it justifies an additional diagnosis of OCD or not, I have no idea. You will notice that in many cases, anti-psychotic medication specifically for schizophrenia made the thoughts go away. This implies that it was not an OCD process driving the thoughts but instead it was a schizophrenic process. If it was an OCD process, the anti-schizophrenic drugs would not have worked.
The question is how does the schizophrenic homicidal thinking above compare to the OCD-type ideation in quality? Honestly, I do not have the faintest idea.
One way it differs is that in schizophrenia it can take the form of command hallucinations ordering the person to commit violent acts. Fortunately, they do not give in to the thoughts most of the time. There is something a bit similar in OCD where the person experiences thoughts inside their head ordering them to carry out various homicidal and violent acts. The difference is that in OCD it will be a thought and in schizophrenia it will be an external voice. And in schizophrenia, there is much more likelihood that the person will act on it. The chance that a person with OCD will act on the thoughts is just about nil.
However, in schizophrenia, this thinking is much more dangerous as it regularly leads to episodes of violence. However, as you can see above, only one of the schizophrenics above ever acted on their homicidal thoughts, so in many cases, they are able to control themselves.
I have never worked with schizophrenics, and I don’t know how to deal with homicidal ideation in schizophrenia. I imagine it is a very tricky area to determine a schizophrenic with this type of thinking is dangerous or not.
People come to me after reading my articles. They are basically self-diagnosing with OCD, or they have already been diagnosed by a clinician. I have found that people are pretty good at self-diagnosis for this condition. They often write me telling me that it is as I could see inside their minds and tell them what was going on in there. All of the people who came to me with homicidal or violent thoughts had OCD so far, so I haven’t had to worry much about differential diagnosis. I did have one client who was truly homicidal, but that person was thinking in a completely different way and it wasn’t OCD driving the homicidal ideation, it was something else altogether. There wasn’t much I could do about that person either.
Unfortunately, I think most of the people who are truly dangerous are simply not going to show up for counseling or therapy. They either like to feel this way or don’t care, and they don’t see any problem with their way of thinking.

Drugs, Mental Illness and Psychiatrists

Sutanu writes:

Hi Robert,
Your article was very interesting, I have a very personal experience with schizophrenia and I do not know the role marijuana had to play in it. I have been a pot user since I was about 22. My wife was a cigarette smoker since age 18 and alcohol user since 20.
She started smoking pot since age 24 – sometimes 3-4 times a week sometimes once daily. Around the age of 29 she started developing symptoms of schizophrenia, which was full blown by the time she was 30 (with auditory hallucinations). She has been in treatment for the last nine years.
In the opinion of her psychiatrist, it was the use of pot that triggered and maybe even possibly caused the illness. Reading your article and your responses, I am now confused whether this is possible as you have said that the safe age to start on pot is 21. Would love to hear your thoughts on this.

Statistics show that there is no increased risk of schizophrenia after age 20. Your risk is almost all used by age 19 or 20 anyway.
Anyway, the cannabis-schizophrenia link does not appear to make any sense. Of all of the recreational drugs out there, cannabis is one of the easiest of all on your brain. Schizophrenia appears to be characterized by extensive damage to the brain. Since cannabis does not cause extensive damage to the brain, there is no way that cannabis could possibly cause the sort of brain damage that is present in schizophrenia.
Since the 1960’s, rates of cannabis use have gone through the roof and the rate of schizophrenia has been completely flat. In fact it has actually declined a bit. If cannabis were causing any schizophrenia at all, much less tons of schizophrenia, we would have expected rates to have increased if not skyrocketed since the 1960’s They have not, so the notion that cannabis or illegal drugs in general cause schizophrenia is very dubious.
I have known hundreds to thousands of cannabis users in my life. Two developed schizophrenia. One had very extensive meth use for decades. They other has a mother with schizophrenia.
It’s certainly possible that cannabis can trigger schizophrenia in a vulnerable person. However, those persons were probably going to get it anyway. Cannabis may bring schizophrenia on sooner than before. This is a tragedy as each year lost to the illness is a year is a lost year for the person who has it.
Psychiatrists are assholes. They all hate illegal drugs, and they think that illegal drugs cause tons of mental disorders. If you have a drug history and you go to a psychiatrist, the asshole will automatically and immediately say that the drugs caused your disorder, no matter which disorder you have or how little you drugs used. If you smoked one joint in your whole damned life, the asshole psychs will insist that it caused whatever you might have.
Psychologists on the other hand for some reason to not seem to have these same prejudices against illegal drugs and in general to not seem to blame illegal drugs for causing tons of mental illnesses.
My observation has been that heavy drug users sometimes appear to be mentally off in some way or another, and sometimes their behavior is disordered. In general however, the off mental behavior seems to clear up when the person stops using, and they just go back to their previous psychological state. I do not believe that drug use in general causes long term psychological damage persisting after the use of drugs has ceased.

The Man Who Thought He Was a Cat

Repost from the old site.
While I was at the university getting my Master’s Degree, I used to read a lot of journals. I really liked this one journal called the Journal of Nervous and Mental Disease. In one issue I found a case study of a man who suffered from the delusion that he was a cat! As a cat lover, I kind of enjoyed this case. I don’t think I’m a cat or anything like that, but sometimes I wonder if my two female cats make better companions than the women in my life.
He was a 40 year old man who worked as a technician in a laboratory. Considering his delusion, one of the most peculiar things about him was that he actually looked like a cat! He was kind of thick and heavyset and had a big full beard. All of this contributed to a rather strange appearance somewhat like the Lion Man in the Wizard of Oz.
The man stated flat out that he was actually a cat and not a human being. All attempts to disabuse him of this notion were met with airy dismissals. He had believed that he was a cat for a long time, possibly since childhood. He said that as as child and young man, he had spent a lot of time playing with cats, especially in open fields. He got down on all fours and walked around in fields and spent hours socializing with the cats out there. He continued to engage in this behavior to this day.
He said that cats had a special affinity for him, because they realized that he was actually a cat and not a human. Hence, he said that cats accepted him as a fellow cat and treated him as such. He said that cats are actually very intelligent – much more intelligent than people think they are.
Over the years rolling around in fields with cats, he learned that cats actually had a spoken language in their meows. He had finally learned this language over time and could now communicate with cats in their language. He also said that he had had sex with cats on many occasions out in the fields (How does one do this?).
Over time, he had learned that most people did not want to hear about the fact that he was a cat, so he had learned to stop talking about it. He was diagnosed with Delusional Disorder and it was recommended that he take an anti-psychotic. I am not sure of how the case resolved. I believe that he did not see any problem in being a cat and refused treatment.

More OCD and Psychosis: Differential DX

Let us look at some more cases from the Internet.
Case 1 here and here.

I’m trying to pin down one of my major symptoms that can and has completely impaired my life. My OCD revolves around harm, such as fears that I will harm someone, violent thoughts of harming someone, and even urges to harm someone. I don’t think I want to hurt anyone, but my OCD tells me differently. Sometimes I will get a violent thought when I am standing near someone, and I will not hurt them, but I will quickly walk away to avoid any chance of ever acting on my thought/urge.
Ok, here’s the weirdest part: Later on, after I have walked far away from people in order to avoid hurting them, I believe that I actually did hurt someone after all, and that my memory of avoiding him/her is a false memory, or I just forgot the true memory of actually harming the person in question. I truly have believed many times that I was a murderer, despite tons of evidence to the contrary.
Looking back, I realized I’ve wasted so much time believing I’d done something terrible and waiting to be locked up forever. However, at the time, my beliefs were unshakable and persisted despite all the evidence that my family/friends/counselor threw at me to try to convince me that I had done nothing wrong.
I think my OCD may involve hallucinations as well. Whenever I think I may have harmed someone I hear police/ambulance sirens. Coincidence? Maybe, I’m not sure. When my OCD started to improve at school I was hearing less sirens.
This is the situation I’m in. It started with me walking beside people on my (very hilly) campus that has a lot of ravines. I got the anxious thought “What if I pushed someone into one of the ravines?” So I’d actually go DOWN into ravines to search for bodies. Crazy huh?
Well, it got crazier. One day, the thought or belief (delusional) came into my mind: I DID push someone into the ravine and kill him/her. I compulsively searched, but I couldn’t search very well because I was embarrassed and scared because I was getting weird looks.
So I dropped out of school. And I believe that there is STILL a body in one of those ravines (even though I called my counselor numerous times asking if there were missing students and she always said no) and I checked the news for five weeks – nothing. No evidence, but I still believe I killed somebody.
I had to drive today as an OCD exposure and I had to drive very close to a bicyclist because he was hogging the road. I drove as far away from him as possible, even onto the curb to avoid him. Of course my senses were heightened and I would have felt a bump even if I sideswiped him, which I don’t think I did.
There was no damage to my car or anything, and when I drove back on the opposite side of the road cars were driving normally and I didn’t see emergency vehicles but I still believe deep down that I hit him. It sucks. And I can’t check the news either – in program we are discouraged from checking and other compulsions.

There is a lot of back and forth about this in various threads for some reason. She also has a dx of schizoaffective disorder, which is never explained. Various people feel that this symptom is a combination of OCD and a psychotic symptom, but I am not so sure about that. The part about searching the ravines is also OCD, though it’s rather extreme in that it made her drop out of school.
I honestly feel that this presentation is simply OCD of the Harm OCD type. The person fears that they will attack others, but they never do it. Apparently it’s all just fear.
Going back and checking over and over to make sure she didn’t kill someone or push someone into the ravine is also very OCD-like. A psychotic person simply says that they killed someone by pushing them into the ravine, and that’s that. There’s no going round and round about it, checking the ravines, calling people, reading the papers. That’s called “checking,” and it’s an OCD thing.
Although these symptoms are very disturbing in that they involve violence, a person with this type of OCD is very unlikely to act on the obsession, and probably will never act it. They are less likely to commit a violent act than anyone else. The presentation is rather strange in that most OCD folks don’t have this degree of certainty in the obsession.
The hallucinations of police sirens are odd. Some clinicians are saying that there can be hallucinations in OCD, but they are generally minor. The whole idea of hallucinations in OCD seems very strange to me, and I don’t know what to make of it. OCD experts claim that there are no hallucinations in OCD.
Case 2 and here

The other night I had a thought about gouging my dog’s eyes out; it was terrifying to me. I could never do that, but the thought alone was enough to keep me obsessing about it for hours. Made me very anxious.
Woke up the other day worried I was going to spontaneously run someone over or grab a knife and stab someone, like it would be a compulsion I couldn’t control. My therapist said that’s classic OCD.
Sometimes I hear music playing, like tonight I was hearing a band playing, but it turned out to be just some noise from the a/c cause i left the room and returned.
Sometimes I hear people saying “hey” or think I heard someone else say something when they didn’t, but that’s really not a big deal, I imagine everyone has thought someone said something once in awhile, but the music thing is pretty real.
It sounded like a parade going on outside my house, until I got up and moved around. Not a big deal, just enough to make me stop what I was doing and listen.

This is classic stuff – Harm OCD. In general, they never act on the thought, even if they are thinking of it 24-7. There is controversy on whether or not there have been cases of people acting on antisocial or violent obsessions. Some say there have been some cases, but I have never heard of any. I do therapy with some people who have this type of “harm OCD,” and I never worry that they will act on it.
Note that this person is also worried that they are going to go psychotic, just as Case 1 is obsessed with whether she is psychotic or not. The worry that one will go psychotic is pretty OCD like right there. People with psychotic disorders don’t generally worry about such things.
The part about the hallucinations is stranger. First of all, they are not hallucinations. He just thinks he is hallucinating. He heard the AC, and it sounded like music because he didn’t realize that it was the AC. We live in a noisy environment, and mechanical objects will often make sounds that sound like auditory hallucinations. Other noises in the environment can also fool you. These are called illusions, not hallucinations.
Case 3

I have thoughts that someone is going to poison me or slip me drugs or somehow do something “bad” to me. When I was a kid there was all the talk about people putting razor blades and drugs in Halloween candy; there was a rash of OTC drug packages that were tampered with that killed someone and had these drugs pulled from the shelf, and there was also a case of someone getting poisoned by their friends. This was all in a relatively short span of time.
I seem to have latched on to all of that in an unhealthy way.
I don’t think people are out to get me. I don’t think there’s a conspiracy to hurt me. What I fear is that there are a lot of nutty homicidal people out there, and they may decide to tamper with food or whatever, and that it would be my luck to be one of the unlucky people that would be the victim.
I’m afraid that people are crazy, unpredictable, and there’s just a lot of random Bad Shit out there that people do. I also worry that somehow food will be contaminated with deadly microbes – botulism is a fun one to worry about.
I know this is insane. I know that the likelihood of something like that happening is very small. Still, it can drive me to panic attacks and anxiety as well as some fun compulsions. If there’s only one of something left at the grocery store, I can’t buy it. I have to take the package of food that’s the second one back, not the first.
I inspect packages. I give my dog food that is “suspect” knowing that if she’s okay, I’ll be okay. I know it’s stupid and silly, but the actions reduce my anxiety so I don’t have a panic attack or start freaking out.
In some ways it feels like a fear of flying. It could happen, even if the chances are low. Very low.

Strange case. The doc said that these were symptoms of “paranoia,” but I don’t agree. I think it’s just OCD. Thing is, your food could be being poisoned at any time. Most of us just assume it is not and go ahead and eat it anyway. That’s all you can do in life really.
Case 4

I have similar thoughts. Whenever I go to the supermarket, I’m always thinking that the food that I’m about to buy has been tampered with. So for example, when I grab a jar of pasta sauce, I start to think that someone injected poison into the the jar.
So I put that jar back and grab the one behind it. But then I become convinced that the person who poisoned the jar would know that someone like me will be expecting the jar in front to be poisoned, so they must have put the poisoned jar in the second row instead. So then I put the second jar back because I get convinced that it may have been poisoned. Then I sit there debating the whole thing in my mind because I don’t know which jar to buy. Ultimately I just say fuck it and take one of them.
I also worry that people will tamper with my food at restaurants and food courts. So lets say I’m eating at a food court by myself and I sit at the table and realize that I forgot to get a straw, when I go back to food place to get a straw, I always make sure that I keep an eye on my food the whole time.

Not sure what to do with this one, but it looks like Case 3. The way he takes jars our and puts them back and stands in front of the shelf debating which jar to take looks awfully OCD like. It’s a Hell of a way to live your life though, I must say.
Case 5

I was at a comprehensive psychiatric clinic/ward recently, and one of the patients there had very bad OCD. He would often ask me for reassurance about things that really didn’t make any sense at all. On the night that his new roommate was moving in, he was terrified that he brought a bomb in his luggage. He asked me if I thought that his roommate brought a bomb, and I obviously told him no.
Later that night (maybe under an hour later), he decides to pull the fire alarm and make a run for it (he wasn’t able to get too far because of the severity of his OCD). I don’t believe that he ever actually thought that there was a bomb with complete certainty. The uncertainty just became so severe that for him to act as if there was actually a bomb became the better option. It was the only way that he could diffuse his anxiety.

As you can see, the illness gets pretty weird, but it’s just OCD. He pulled the fire alarm because he could not be completely sure that this roommate had not brought a bomb into his room in his suitcase.
Case 6

Does anyone else have such poor insight into their OCD that instead of knowing that its irrational, you think its real? For example, I think that I’m a dead person living in a fake world to the point that its considered delusional. I’m also paranoid to the point that I truly believe people are poisoning me because they have something against me.
My doctors are confused as to whether I have OCD with psychosis or just OCD. Multiple doctors have said they can’t tell, but most lean towards OCD. Anyone else experience this?
Also does anyone else hear voices in their head which aren’t their own but instead like a family member or a priest or even someone you don’t know?

Strange case. The responders are all saying that this is psychosis rather than OCD. I am inclined to believe them. He hears voices apparently, and believes that he’s dead and the world is fake. But he says he hears voices in his head. This is crucial? Are they really just inner voices like we all hear (in which case they are not hallucinations) or is he actually hearing them with his ears (in which they are auditory hallucinations). He also thinks people are conspiring to kill him.
Case 7

Ok I have a boyfriend, and he is 30 yrs old, he said he had OCD and phobias, lately after some stress, he came to me crying and asked, “What if no one else but me exists? I feel so lonely like I am alone in the universe and that everything else is fake.”
Then I asked him, “What r u talking about?” And he replied, “I walked out of my office onto the street, and I thought ‘if I see someone I know this thing I am thinking its true.'” He saw one of his colleagues, and now he thinks that this thought of his is true, and he is anxious and crying.
Do you find this normal for a 30 year old? Then he asked, “I thought, What if I am a cat?” He listened to some cats meowing, and he started crying and asked, “What if I am a cat???” Is this normal? He had lots of stress before he starting saying all these things; he was afraid that he had some serious illness but in the end he didn’t, and after that he started this paranoia.

I am afraid that this is just OCD, but it’s pretty serious. He is not psychotic, although the symptoms are strange.
Case 8

Years ago I went through a serious bout of depression. I had fits of rage and crying and purposely avoided friends and places I enjoyed. A doctor put me on Lexapro, an antidepressant. I got better. Years later, I have a new problem. I thought it was the same old depression with a new twist. But it’s not.
My last psychiatrist tried treating me for a problem I had. He diagnosed it as depression and said that I also had OCD. This was because I had a depressed mood and frequently battled thoughts of anxiety.
This doctor tried me on a few different medications. Either they had no effect or they had terrible effects. They made me more depressed, anxious, and at one point suicidal. They were all small doses, but they showed their effects within days. The drugs that had these disastrous effects were Imipramine and Lexapro.
I’m seeing a new doctor now. This one says the root problem is NOT depression or OCD. He says it’s psychosis. His reasons for his diagnosis are this:
The obsessive negative thoughts are a manifestation of the paranoia attribute of psychosis. These thoughts include worrying about getting diseases, worrying about dying tomorrow from something, worrying about aging or getting Alzheimer’s, worrying about thinning on top, worrying about getting diabetes, worrying that I might be schizophrenic, worrying that I got brain damage from the smell of a dry-erase marker, the list goes on and on.
Some of these are too irrational to list. Some days they’re tolerable, other days they make me anxious, even cry, or prevent me from doing my work.
Another symptom that I had described to both doctors was the fact that nearly every task that I start, or even think about starting, causes me stress and anguish as if it were some daunting job having to clean up after a hurricane. This is true for nearly everything I do, including things I enjoy doing. Hanging out with friends, just watching a movie alone, or painting which I love to do will sometimes feel this way and compel me to avoid these things.
The first doctor said that this anxiety over starting things was possibly ADD. He tried me on Ritalin for that with equally disastrous results. Then he tried me on biofeedback treatment. It improved my memory, that I am sure of. The second Doctor said that symptom was also due to psychosis because it shows there are two thoughts fighting each other simultaneously with each of these actions I take. Things do seem much easier for me when decisions are made for me.

Strange case. One thing for sure, this person is not psychotic. I don’t see the OCD. Where is it? The worries about bad things happening could be a variety of things, GAD, OCD or depression. In the context of the Depression that is going on, these could well be what we call depressive ruminations . Feeling like everything is too much is also not ADD, it is instead just a symptom of Depression. The inability to get things done or even start things in the first place is typical of depressives.
Case 9

When I saw my psychiatrist last year, he seemed to think I had OCD because I was having problems with various obsessions including a morbid fear of death or dying young and several compulsions (such as repeating actions and counting in sets of 4 whilst avoiding ‘bad’ numbers etc) to prevent bad things from happening or ward off my obsessive thoughts and images. I would often see images of myself lying dead in bed, and it would freak me out.
However that was a year ago. He wanted me to change to Anafranil at the time, and I freaked out because I have a fear of chemicals I am not familiar with and didn’t return to my next appointment thinking I could deal with it myself. It did lose its intensity after a while but didn’t go away completely. Now I seem to have developed a completely new obsession, if that is even what it is.
I fear that I am suffering from some kind of psychosis because I feel spaced out a lot of the time, as though I’m walking around in a dream state. I am also having problems with chronic daily headaches. I am now spending hours researching psychosis, schizophrenia and headaches on the internet. I am analyzing every single thought I have to check for signs of psychosis, and it is driving me around the bend.
How much research does one person need to do anyway? It’s not like im a Dr. and can diagnose myself? Why cant my brain just drop the subject until I have seen my Dr. about it again?
I have made an appointment to see my psychiatrist again shortly, but I am terrified that he will want me to try the Anafranil again. Not only do I have to contend with my original fear regarding changing medications (which in short is that I will take it, and I will have a bad reaction it and become ill or die) but now I have this awful fear that I will take it, get worse, won’t know what im doing and will hurt my son as a result.
I’m terrified, I couldn’t stand it if I hurt my son, the thought is making me feel sick. I am worried that I may not know what I’m doing and hurt someone or my son at the best of times, especially with feeling spaced out, but I am even more concerned that the Anafranil will make matters worse. It does say on the cautions list not to give it to patients who suffer from psychosis or schizophrenia.
I used to have a fear of hurting myself or my son in my sleep so I’m not sure if this is a variation of that one or not? I do know that my mother suffered with anxiety and depression and during her later years (65 onwards), she became paranoid and delusional. I am terrified that my depression and anxiety will take a similar course.
I also feel like I can’t organize my thoughts as well as I used to be able to. I will try to organize my household chores for the day, my brain will take one look at the washing pile and give up because it doesn’t quite know where to start! I also can’t remember when I took my medication. I’m on painkillers for sciatica and my headaches, and I will often need to debate with myself over when I took my last dose.
I will go to take one and will find myself thinking “Am I sure I haven’t already taken one?” to which I respond “I’m sure I haven’t, but I could have, but I don’t think I have anyway,” to which I respond again, “Am I sure I haven’t taken one? Perhaps I shouldn’t take it in case I have already taken one,” to which I then respond, “I’m sure I haven’t taken one,” and then start trying to retrace my steps over the last 4 hours to check I haven’t in fact already taken one.
I worry I will forget that I have taken one, take another one and overdose by mistake, become ill and then die as a result. I have tried writing down when I take one but then I find myself questioning if I have written it down correctly. I have tried putting out what I need for the day/hour, but then I worry I that I didn’t put them out correctly in first place.
Also I have a nagging feeling that I have forgotten something a lot of the time, and I don’t know what exactly. The last few times I’ve left the house, I’ve had to check I had my keys and purse 4 times before I even shut the door!
I feel like I’m developing early onset Alzheimer’s or something, its seriously doing my head in.
I also tend not to go out very much at the moment because I’m afraid I will forget who I am, where I live, get confused or not know what I’m doing and hurt someone when I’m outside. So I find myself only going out when I absolutely have to in order to avoid the anxiety it creates.

This really looks like OCD. It doesn’t look like anything else. The doubting about whether or not she has taken her meds, the fears of going psychotic, fear of medication, Harm OCD about her son, having to check for her keys over and over, the endless checking to see if she has schizophrenia or not, etc. The spacey feeling is disassociation, which comes from anxiety. Get rid of the anxiety, and the spacey feeling goes away.

Paranoia Versus Social Anxiety

As if people were not confused and idiotic enough about the mental disorders.
This is one of my pet peeves. Even very educated people don’t seem to know the slightest bit fuck-all about mental illness. I’m not really sure why this is. Most of them don’t have a dx, but many others do. Typically, the ones that do have never been formally diagnosed or treated by a clinician. This is really unfortunate.
There’s nothing really wrong with having a mental dx. If you have one, you have one, right? Isn’t it best to know, and to treat it as best you can, than to go on in denial, screwing up your life by acting crazy, denying that you have a problem, and not doing anything about getting better?
I am always stunned at the number of educated people who don’t even know the difference between neurotic and psychotic disorders. In addition to the third way split with the personality disorders, these are three of the top splits in mental illness. If you don’t understand the nature of these splits, you don’t know fuck-all about mental illness. If you don’t know anything about it, you have no right to talk about it, and you need to STFU.
This is a painful subject to me. I have OCD. That’s a neurotic illness, or more precisely an anxiety disorder. Anxiety disorders have a certain flavor about them, but the main one is that the person with the neurotic illness is still in touch with reality, that is, he is not crazy. Even Freud recognized this. In fact, he isn’t the tiniest bit crazy in any way, shape or form, which is what makes these illnesses so puzzling to deal with. In general, neurotics are not the slightest bit dangerous either.
I’m not sure why this is. Perhaps it is because of the nature of the person who gets these illnesses. This is often a very nice person. Nice, fearful, cautious, conservative. They are do-gooders. I’m told that people with OCD have the lowest rate of violence of anyone else, much lower than any random person.
So why are they non-violent? In addition to the reasons above, all of the energy is directed inwards, not outwards. This is characteristic of the introvert, and it why introverts are so nonviolent. The beloved extrovert externalizes most of his energy and almost all of his problems and issues, putting them onto other people. Hence, the average extrovert is many times more dangerous than the average introvert.
Indeed, almost all of the world’s serious violence is caused by extroverts. If all or nearly all of your energy is going inwards instead of outwards, you simply are not directing enough energy to the outside world to get violent, or even very aggressive. In order for substantial external aggression to occur, quite a bit of energy must be directed outwards towards the object(s) of the aggression.
With the introvert, so much energy has been exhausted going inwards that there is simply not enough reserve left over to put enough outwards to do anything violent. Combined with the introverts fears and worries, basic conservatism and do-gooderism and extremely high morals, and you just don’t see a lot of serious violence in these folks. Not to say some won’t fight back though. Some will, and people are always stunned at a counterattacking introvert.
They are ready to call the police, because they are sure that he must be insane or homicidal. This is because his behavior is so contrary to his nature. But even counterattacking, the introvert’s violence will be measured. He will throw food, dishes, water or books. If a serious object is flung, he will deliberately miss you. He will scream and yell and call you horrible names. If you really deserve it, he will punch you, but not very hard. Everyone has a breaking point.
Extroverts’ violence is much more likely to be the initial violent blow, to use fists or kicks or other weapons, or to have serious consequences. This is because the extrovert, by his nature, does not think of consequences of acts so much as the introvert does. He’s more likely to get caught up in things.
One of the things that is annoying about having OCD (other than having it) is dealing with all the dipshits who don’t understand it and insist that I must be crazy, a criminal, a killer, a rapist, a schizophrenic, a psychotic, a manic depressive, or some other bullshit. Some idiots keep on with these delusions after I have known them for years and they really ought to know better. It’s very frustrating!
Paranoia is totally misunderstood by your average dipshit. One of the prime splits in paranoia is between social anxiety and paranoia. It’s true that it’s a bit hard to tell the difference sometimes, but I am convinced that these are two completely different ways of looking at the world. They might as well be on two different planets.
The person with social anxiety may or may not be falsely evaluating situations. I have known folks who were afraid to go out because they thought that people thought that they were weird. Guess what? I knew these folks, and definitely, people did think they were weird! So that wasn’t a false analysis at all.
But many social anxiety types take this way too far. They assume that everyone that they know or meet hates them, usually because of some inadequacy that they may have. People are always talking about them behind their back. Whenever anyone laughs, they are laughing about them.
I’m convinced that this is probably a false analysis. The news is that most people are not looking at you all the time. If they are laughing, most of the time, they are not laughing at you. Sometimes they are looking at you, but you often can’t tell what the looks mean. Once in a while they might be laughing at you, but what of it? Let them laugh.
The problem here is that this person thinks that the world is focused on them. Not so. Most people are just thinking about their own stuff all the time and are not thinking about you at all. If you are acting very strange, a lot of people will be more likely to pay attention to you. The more normal you act, the less people will care.
I don’t generally think that everyone is looking at me. Most people seem to be ignoring me most of the time, which is the way it ought to be. When people are talking, most of the time, they surely are not talking about me. Every  now and then people seem to be talking about me. I try to figure out why, then adjust my behavior. Sometimes it’s something like, “Look at this guy staring at us.” In which case, I quit looking at them.
When people are laughing, I assume they are not laughing at me. A few times, I have caught some idiots laughing at me, and it pissed me off. I don’t know why they did it. Why doesn’t someone go interview them and ask them why? If I catch you doing that, I will hold it against you for a very long time, which is proper.
The truth that we are just not that important. We are grains of sand on the beach, blades of grass on the football field. Most people are not paying attention to you very much.
The paranoid takes this a lot further. The paranoid thinks people are watching them, following them, commenting about them in menacing ways, trying to kill them, trying to break into their homes, hatching conspiratorial plots against them, etc. In the vast majority of cases, this is simply not the case. Not only are folks too self-involved to notice you very much, but they surely have better things to do than hatch idiotic conspiracies against you.
Nevertheless, paranoids carry on with their paranoia. Why? For many, there is probably something wrong with their brains. They probably need to take a drug to make it go away. For others, they may have adopted an erroneous thinking style for some reason. For yet others, it seems to serve some sort of defensive purpose.
I don’t have much issues with paranoia. In fact, I’m the anti-paranoid. I tend to think that everyone likes me more or less and that no one or almost no one hates me. Sadly, this is just not true. I’ve definitely got some enemies out there. There are some others who just don’t like me. Where one ends and the other begins, I’m not sure. This is painful for me to acknowledge, so I keep falsely assuming that these folks are my friends. But they are not! And this causes me all sorts of trouble.
Where people may indeed by laughing at me, I am inclined to assume that they are not until proven otherwise. I assume that hostile persons actually are my friends, seeking out little bits of niceness amidst the emotional glaciers. Where people are talking about me, I assume they are not, or at best, it takes me a while to figure out that they are.
This anti-paranoia is probably better than being a paranoid, but it causes a lot of issues in that I am too friendly towards folks that just flat out don’t like me for whatever reason. I try to talk to them, and that’s typically a bad idea. I’m overcorrecting in the direction of mental health, but the best social actor is a very cautious person.
Here are some cases below, some of social anxiety, and some of paranoia.
Social anxiety first:
SA Case 1:

Well, what can I say? I am starting to believe that I genuinely suffer from one form of paranoia or the other. I started university last year and it has not been entirely easy, academically and socially. Although I have encountered feelings of anxiety and paranoia before in my life.If I am with a friend, who maybe has a closer friend with them who does not talk to me as much in the conversation, I always get the feeling that that other person does not want me around, or is slightly resentful of my presence. If someone I text does not text back, I assume it is because they do not want to talk to me, and just ignore or delete my text. I also feel they must be annoyed with me for bothering them, and wish I would leave them alone.
Also that they are only being polite with me in a conversation and eagerly want to talk to someone else who shows up.
When I am in shops or on the street, I presume they are watching me to see if I do something strange, so they can secretly laugh to themselves. Or if I have been in a group meeting, as soon as I walk away, they start making comments about how I acted. I also think people are going to make “look at loner/saddo” expressions when they see me on my own. I also panic and look to see if everyone else is with their friends.
I really want to be happy and stop looking behind my back for threats. I also don’t want to quit studying, and would like a job as an auxiliary nurse, as I do enjoy working with people on a professional level. I have one best friend and two or three other close friends, and people I talk to. However, I wonder if people pity me or think I am a loner because I do not go out clubbing or anything, and don’t have more buddies.
So do I suffer from paranoia, and/or low self-esteem? I really want to do something about this, and talk to someone professional who I can trust. But I am even afraid of a professional getting it wrong and putting me on a cocktail of drugs- which I don’t want! I would rather talk. I’m scared that I am just selfish, and want everyone to like me or at least think I am alright.

SA Case 2:

I have suffered with paranoia for most of my life and I’m now heading for 40. The worse time i have with it at work. I had a manager a few years back who bullied me and got me thrown out of my job and made it clear that it was because I was a threat to her position. Ever since then I fear that in any job I do that people are talking about me behind my back, unfortunately in my last long term job I had this did turn out to be true.

I am now in a job that is temp to perm and there has been issues in getting me perm and I cannot stop the thought that they never will and that they will get someone else in and they will take my place because of my paranoia as I am not fit to keep down a job.

The fear of being made unemployed and thus losing my place I live is tearing me to pieces. It hasn’t been helped by my parents pointedly telling me that if I ever need somewhere to live I could not live with them as the only spare space they have is reserved for my niece and nephew whenever they stay over.

I suffer badly with self esteem and I know that a lot of this stems back to my childhood as my mother was always telling me that I was an accident and that my younger siblings were planned and wanted. My mother also is still to this day very happy to tell anyone who wants that she has never been able to love me and only tolerated me because she gave birth to me.
I am doing my best to fight my paranoias but it is hard to keep going on your own.
My doctors refuse to listen to me and just want to prescribe drugs all the time, but they just make me very ill and the only option open me they state is lithium and i refuse to take that or any other antidepressants as they don’t solve the issues or actually help me.

SA Case 3:

I always think my friends don’t like me and people are out to get me and I don’t have any confidence in my self I think I am ugly and fat even though people tell me I am not I still think I am I also get depressed and angry very easily what can I do lol I’m glad I’m not the only one that feels like this though 🙂

SA Case 4:

I’ve always felt that, when I go down hallways with people in them, they’re looking at me, making fun of me, ridiculing what I’m wearing, my hair, no matter if they are or not. It’s even worse if I hear them talking about someone else, because then I just assume it’s me. No matter who I talk to, I feel like I’m annoying them, like no one wants to talk to me. Because of this, I don’t start conversations very often and only talk to a tight-knit group of friends.

I reminisce on old fights with my family and friends, thinking they still hate me over things that happened a long time ago. In essence, I guess it feels like everyone’s always out to get me, and that in reality, I’m a nuisance to everyone.

SA Case 5:

On a really bad day I hate people even looking at me – I image that they are thinking that I’m so ugly they really pity me. I hate it when people are walking behind me for the same reason. I’m sure that people hate being near or around me – and I agree with Ian that if I’m near a group of people and they start laughing I’m convinced they are laughing about me.

That ought to give you a basic flavor. The principle issue here is one of insecurity.
Now onto some real paranoia:
Paranoia Case 1:

I thought there was a camera in the lamp-post and a microphone in my button. I thought the cars behind were following me. People at work always seemed to use certain “phrases” – or I noticed them. Helicopters flew over our house and I was convinced they were spying on us and checking we were at home. I thought the phone was bugged.

I really noticed policemen – they seemed to be everywhere and police cars and vans were there because of me. I did not think there was something wrong with my thinking, I thought there was something wrong with society. Why didn’t society trust me’ I learnt in the end that maybe it was me not trusting myself and maybe I needed to do stuff that I “approved” of and felt good about.

Paranoia Case 2:

Like Alex I always think someone has come into my home and stolen the thing I can’t find. My son always says ‘who would want that’!’ it is a family joke now but I still think it immediately something is not where I thought it would be!

When very paranoid I think my phone is being tapped/I am being secretly filmed/being followed. I know it’s not real but at the same time it is real: ignoring these thoughts just help them to grow. I have nightmares about someone being in my flat when I am asleep.

I have started reading the book and am finding such reassurance from other’s personal accounts – such incredible relief to know I am fairly ‘normal’ for a paranoiac :o) I know why I feel the way I do but, before now, I didn’t have any solution to stop these thoughts.

Paranoia Case 3:

I always seem paranoid. I think when i hear people laughing, that they are laughing about me and slagging me off. The television, radio, books, mags all are disclosing personal information about me, like reading my mind. When i cant find something in my home i always think my friends or mother have stolen from me. I hate talking in groups because i think i am being judged by everyone.

Paranoia Case 4:

I hate my paranoia, i think people are going to attack me for no reason. I can’t get on public transport, i often think i hear the doorbell and there’s no one there. I hear people saying my name out in the street when I’m sitting in my room and there’s no one there. I think i hear the phone ringing as well. The doctor has put me on Seroquel (300mg) every day.

It’s taken over my life, I’m absolutely sick of it, I sometimes start to get really angry. I’m getting angry speaking about it now, it makes me feel stupid. Not right in the head. None of the doctors seem to want to help.

Paranoia Case 5:

I have had a lot of problems with anxiety in the past but recently I have been so scared all of the time. I often think people are following me, especially when I’m driving. Often I think that someone in front of me is slowing down and waiting to see which way I’m indicating then going the same way. I think people are watching me.

Tonight there was a car in the street outside and when he saw me looking out of the window he sped away. I cant stay at home on my own at night. I am just scared all the time that someone is going to harm me, try and break into my house or kill me 🙁

If you think this website is valuable to you, please consider a contribution to support the continuation of the site.

Differential Diagnosis: Schizophrenia Versus OCD

From Yahoo Answers:

I have really aggressive thoughts sometimes. I don’t even understand why I have them. Usually (not limited to) they’re about hurting people. I feel really crappy about myself after these thoughts. I won’t go into all of my thoughts because some of them are really disturbing and they come out of no where sometimes. It’s surprising and then I start feeling like maybe I’m just a really evil person although I’m considerate of other people, most of the time.

I have a heart but sometimes I feel like how can I have a heart with these thoughts in my head! They don’t pop up in my head unless I think about it.

So then I thought well these thoughts might be schizophrenia, I started looking up what schizophrenia was. Then right as I saw the symptoms and examples of the symptoms I started like displaying the symptoms in my head. It’s almost like once I absorb an idea my mind plays on it.
Like when I saw this CSI episode where this person got poisoned with Cyanide, I started worrying about cyanide poisoning. When I read the symptoms of Schizophrenia where you have like hallucinations (Like voices in your head) I started making a voice in my head. Once these ideas are in my head I can’t get them out. It’s like they become apart of me.
Like sometimes I think “what if” all the time for every symptom of schizophrenia. Like people watching you. I started thinking: WELL, WHAT IF someone was watching me. Errr! I can’t get these thoughts out of my head and I think I’m starting to convince myself that I have schizophrenia. I’m scared.
I feel like a sicko.
My mind is also very contradicting: Like if I say I’m not a bad person my mind says “yes you are” and really self-deprecating thoughts. Every time I want to feel good about myself my mind will convince me that I shouldn’t and that I’m a sick freak who thinks horrible thoughts. I’m 19 about to be 20 soon and I heard schizo starts early 20s. I just don’t know what to do…I don’t have any insurance to go see a doctor. I’ve been a worry-wart ever since I was in elementary school.
Also, like schizo, I heard you hear voices in your head and you believe what they’re telling you. Like let’s say something says, “This is God talking to you!” and I’m an agnostic and I don’t really believe in God. I like create scenarios and voices in my head ever since I heard about schizophrenia. NEVER before.
It’s like my mind is trying to give me these symptoms it’s hard to explain. It’s like I know they’re my voices but I don’t understand why my voices are saying these things. It’s like WTF? :\

A most interesting case. This is a completely clear-cut case of OCD, screaming loud and clear across the landscape. I won’t tell you how I know this, but I know this illness like the back of my hand, since I have it. Been there, done that, ok?
Not that subtypes matter, but this person has a couple of subtypes of OCD.
The first is Harm OCD.
The second may as well be called Schiz OCD. This is a person who starts to worry that they have schizophrenia. In the case above, he is starting to invent crazy voices in his head due to his fear. These voices in his head are causing him to worry that he had schizophrenia.
This person clearly does not have schizophrenia. First of all, the voices in the head. The person with schiz hears these as actual voices with his ears, the same you would hear the voices of the people around you. The voices sound just like the external voices of persons near you, so much so that it is hard to figure out who is really talking and what’s just a hallucination. So the voices are not really in the head but in the ears, so to speak. We all have internal voices in our heads that we hear all day long. Nothing to be alarmed about.
The “what if” questions are typical of OCD. A person with schizophrenia or other psychosis simply says, “People are watching me.” If you try to question them about the belief, you run into a brick wall and get a big argument. It’s a rock-solid delusion, and all delusions are hard as stone.
The person also has “contradictory thoughts.” This is unfortunately quite common with OCD. The person thinks a good thought, like “I’m a good person,” and the OCD chimes in with a contradictory thought saying, for instance, “No you aren’t. You’re evil. You’re the most evil person on Earth.” These thoughts will probably be violently resisted.
When doing differential diagnosis, look first of all at how hard the person fights or resists the thought. The more ferociously the person fights or resists the thought, the more likely you are dealing with an obsession.
A good rule of thumb is: If you try to stop the thought, it’s an obsession.
Unfortunately, clinicians understand OCD very poorly, and I doubt if this person is going to get a good diagnosis or treatment. In particular, OCD patients these days are often diagnosed as psychotic and treated with anti-psychotic drugs.

Cannabis, Teens and Schizophrenia

Repost from the old site.
I received a mail today from someone who attended an interesting conference in the Midwest.
At a Mental Illness and Criminal Justice Conference today in Omaha, Nebraska, Dr. Frederick Frese, who is the Coordinator of the Summit County Recovery Project and Assistant Prof of Psychology in Clinical Psychology at NEOUCOM and Case Western Reserve U, and on the Board of Trustees for the National Alliance for the Mentally Ill, gave a session on teenage cannabis use and schizophrenia.
He has been a diagnosed paranoid schizophrenic for 40 years.
Frese stated that use of cannabis between the ages of 15 and 18 in persons who have a variant allele of the COMT gene will lead to an almost certain psychotic break by the age of 25. He said it’s because of the formative time that the brain is in during those years, in combination with that certain allele, together with cannabis use.
He said that if you have do not have the variant allele, no problem. Frese is so concerned about this that he and his team are going to start setting up genetic testing booths for kids at rock concerts because of the very real danger that the studies show exist.
I applaud Dr. Frese for the very real efforts he is taking to try to prevent schizophrenia in vulnerable youth.
I am dubious about how many kids this will save. The rate of schizophrenia has not gone up since the cannabis era began. This suggests that use of cannabis if anything will cause schizophrenia to occur sooner than it would otherwise occur, and it would occur anyway, just later.
The number of folks with this variant allele is high in absolute numbers, and many of them use MJ and don’t get schizophrenia. But it does cause a 10 times elevated risk. I think that Frese is wrong to say that it’s almost certain that these kids will get schizophrenia by 25 after smoking one jay between ages 15-18.
As I’ve said before on this blog, I have known 1000’s of cannabis users over my lifetime, many heavy users. The number who went on develop schizophrenia? Zero. This is why this whole subject makes me yawn.
I wish Frese good luck with his experiment though. Ideally, we could construct a good experiment this way. We could follow kids with the variant allele who wait til 19 to start MJ (Is this protective?) or avoid it period, with another group who did not avoid cannabis and see how many of each develop schiz and at what ages.
Tell the truth, I am quite concerned about use of cannabis by minors. I wish they would not do it. Period. Wait til you’re an adult!
I have OCD (another, though vastly less devastating, mental illness), and I have found that cannabis is actually a superb psychiatric drug for this illness. It works better than almost any med I have ever taken for this (The drugs work great at high doses, but nuke my sex drive, so what good are they?), and I have suffered for 26 yrs.
No clinician believes me when I tell them this; all insist that pot makes you mentally ill or worsens all mental illness or caused my problem in the first place (The gall of them!?), and all try to steer me to drug treatment or drug counseling when I tell them I use. I’m really getting tired of this shit. I’m 50 years old, and I’m being treated like a child.
I have some opinions about the mental health profession, but in general they are extremely low. For such a bunch of super-smart people, there sure is a lot of bullshit groupthink, scaredy-cat thinking and just general lack of an empirical outlook.

Problems of Democracy Under Capitalism

Repost from the old site.
I’ve always been opposed to public dishonesty, which is one of my problems with Communist states. They lied about so many things that now even when they tell the truth, people figure that “All Communists lie,” so they are unlikely to be believed even when they are honest. You get a “boy who cried wolf” syndrome.
Well, capitalists are pretty much the same. Almost all capitalists will always lie to defend their own interests. That is why whenever a businessman or business interest is quoted in the paper on some controversial issue, they are almost always lying. So it seems that in order to be a businessman in capitalist society, one must lie continuously.
There are cultures, such as Arab, Japanese, Thai and Filipino culture, where lying is definitely a state of art. American society proscribes all lying as evil, and your average American will tell you that he never lies. The Japanese mindset, which I subscribe to, is, “Only an idiot never tells a lie.”
So there is a time and a place for this sort of thing.
But in the sort of issues that we read about in our daily paper – controversial issues where two sides are sparring it out – you really want to figure out what’s going on. If the business side can be counted on to lie in defense of its interests nearly 100% of the time, this is very confusing. Especially when the media is so corrupted and dishonest itself that it’s not capable of sorting things out for you.
Fox News is a more or less 24 hour lie machine, but most Americans are too stupid to figure this out. American political campaigns are all about money and never-ending lying.
I can pretty much sort out the lies from the truth after a while, but it’s quite an effort. I figure most folks either don’t have the brains to do this, or they don’t want to know the truth, or they don’t care, or they don’t have the time.
Let me give you an example.
It is very hard for schizophrenics to tell hallucinated voices from regular voices. After a while, some of them get to where they can tell the hallucinated voices from the real voices.
Well, that’s what it’s like for me to winnow out the truth from the lies in our media. The media doesn’t’ really help you too much. I can figure this stuff out after a while, but it takes a lot of time. Time I figure most folks don’t have.
At any rate, elections that are nothing but waterfalls of money and lying are hardly exercises in democracy.
Under capitalism, typically the state is simply an arm of the business community. Some more progressive capitalist states (Europe, for instance) have gotten away from that somewhat, but it’s never really easy. Furthermore, nearly the entire media is usually controlled by the top 1% of the population, who use it to push their class interests at the expense of most everyone else, and surely the bottom 60-80%.
You would think that these things would be obvious to anyone living in a capitalist society, but toss that idea out sometime in a crowd and watch the hostile responses come back. It’s painful to admit that the media one loves so much is hostile and run by one’s class enemies. That hurts, and it makes you feel stupid. You’re reading your enemies’ propaganda, you idiot! That’s the message. People get their backs up.
In recent years in the US, the state has become more and more entwined with business interests, and hence has become more and more dishonest, just like the businesses that it is now essentially a part of. That is why the Bush Administration is a never-ending Lie Machine. That is why US administrations increasingly wage war on science – because under capitalism, businesses typically despise science.
Science is out to discover the truth, come Hell or high water. To the businessman, truth is whatever helps the bottom line and falsehood is whatever hurts the bottom line. If a businessman has to lie 20,000 times about 20,000 things to protect his bottom line, he will do it and not blink an eye. Then he will get up and start it all over again.
Since business sets the dominant cultural hegemony under capitalism, most capitalist societies will tend to be hostile to science.
So, living in a capitalist society, one is really swimming in an ocean of lies. Once you enter corporate culture, you need to become a lying sociopath like the corporation itself, or you are fired. The corporation is like an ant hill. Let us call this Lying Ant Hill. If the corporation itself is a sociopathic pathological liar, so must most of its component parts, the humans who make up the corporation.
An educated and aware populace is essential for democracy. Yet how is this possible in capitalism, where the elite-controlled media lies nonstop? Where the state itself is a lie factory for wealthy interests? Where business interests can never be counted on to tell the truth? You can be like me and try to get to the bottom of things, but it’s frustrating and time-consuming. Most folks have better things to do.
Democracy in most capitalist countries has serious problems. As long as the media is completely controlled by the wealthiest capitalist interests, the truth will be difficult to discover. The state itself can no longer be counted on, as it is captured by business interests and finds itself lying constantly to defend those interests.
In short, the classic Marxist argument that capitalist democracy has serious issues has a lot of truth.
The way out of the tunnel is to get some of the money out of politics via campaign finance reform. As almost all politicians are completely bribed and corrupted (bought and paid for), this solution is generally a nonstarter.
Media democracy is another route out. But it’s difficult due to high startup costs.
One solution would be to allow access to more of the radio band to local or pirate radio stations. The ferocity with which the government has attacked pirate radio shows how terrified the US state is of media democracy.
The TV band, which is mostly cable now anyway with up to 500 channels, should be in part licensed out to local entities. There should be channels available for all sorts of folks all across the political spectrum. If you’ve got the camera and the studio, do it yourself.
But the need to sell ads makes democracy in media under capitalism very difficult. Papers, radio, TV and magazines need to sell ads to survive, and hence necessarily become the mouthpieces of the business and corporate entities that advertise in their media outlets.
Progressive presses are usually only possibly via some wealthy benefactor who is willing to eat it on advertising in order to publish a Left or pro-labor paper. This is why public access channels are the only progressive and pro-people spots on the radio band – no ads. They are listener-supported, but listening to their endless fund drives makes you realize how tenuous their existence is.
Media democracy via licensing out the cable and radio spectrum to local outfits, however, is almost impossible because the government entities that license the spectrum out are completely controlled by corporate media interests.
Hence, our public airwaves, owned by you and me, worth billions of dollars, are given away to our class enemies for pennies on the dollar. The rest of us are then locked out of the band or even arrested if we try to break into the spectrum like the pirate radio guys did.
Even if public access is granted, the fact that we have allowed horribly abusive private cable TV monopolies everywhere in the US means that these companies would probably refuse to carry any progressive stations that somehow got on the air.
The Internet offered a breath of hope to this dismal state of affairs. The cost of publishing was down to just about zero, or at least nothing but time. The Communist dream (pure Communism, after the withering of the state) where media was so democratized that neighborhood media outlets sprung up everywhere and every man could be a journalist, seemed to be happening before our eyes.
The government and the big media are really scared. Progressive voices, anti-corporate voices (like this blog, for instance), could break into the media, and the circulation was limited only by how many readers you could somehow convince to come to the website.
Hence we see desperate efforts by the cable and telephone monopolies to create fast lanes on the Internet for big-money payers and slow lanes on the Net for everyone else, like for instance this site.
There is one important lesson here: capitalism never really tolerates dissent to its essential elite structures and business interests. They will allow dissent a lot of times, but the Hell if they will give it a voice or allow it any power.
Under capitalism, the elites and business interests have to control the media space, necessary to construct the Gramscian cultural hegemony.
In the Third World, dissenters against elite and business interests are regularly arrested, beaten, jailed, tortured and murdered. And if the voices get loud enough or strong enough, the capitalists will just launch a coup, overthrow the state, then launch an Argentine or Chilean style wave of terror to permanently shut folks up. If that doesn’t work, they will make the economy scream.
That’s “democracy” under capitalism in a nutshell. To put it mildly, it’s got some serious issues.

The 50 Craziest Rock Stars Ever

Here.
This article is pretty damn funny.
A lot of rockers are or were seriously nuts!
I’m having a hard time figuring out dx’s for a lot of these people. It seems to be something towards the more extroverted end. I suspect a lot of them are acting this way on purpose, sort of like a lot of artists act “deliberately insane.”
I only see a few who were obviously psychotic: Syd Barrett, Peter Green, Roky Erikson, Brian Wilson, Jim Gordon and Skip Spence for starters. I’m familiar with all these cases. They all had schizophrenia or schizoaffective disorder. It’s commonly said that they are all drug burnouts, but I doubt it.
For one thing, LSD does not appear to cause permanent psychosis. I’ve known too many completely normal folks who have taken it 100-300 times. It’s not even proven to damage your brain. The worst that can be said about it is that very heavy users sometimes do go psychotic and have to be hospitalized. Typically, they get better, but they often go back to heavy LSD use and become mentally ill again. No one has any idea how LSD even makes you temporarily insane.
All of these people simply developed schizophrenia. LSD can trigger schizophrenia, but no one knows how that works either. LSD-induced schizophrenia looks just like the rest of schizophrenia and it responds to the same drugs too. Since acid doesn’t damage your brain, I can’t see how it could cause schizophrenia. There are good reasons not to do acid, but fear of being permanently mentally ill is not one of them.
For the rest of them, dx’s are difficult. Some seem to have issues with narcissism and borderline personality disorder. Some were just seriously whacked out on booze and dope, often cocaine and/or heroin.
Ike Turner used cocaine for some 45 years until it killed him at age 76.
Sly Stone spent years on cocaine, even living on the streets smoking a crack pipe. No one quite knows what is up with Sly these days. He shows up at occasional performance, acts very strange, walks off stage in mid-show, gets on his motorcycle and rides away.
Rick James spent a good 15 years on a crack pipe.
Whitney Houston is ruined and is heavy into cocaine.
David Bowie went nuts on coke in the 1970’s, became full-blown psychotic and embraced Nazism.
Ol’ Dirty Bastard is on crack.
John Frusciante almost killed himself on heroin and coke.
Ozzy Osborne, Jerry Lee Lewis and Liza Minnelli were alcoholics.
Keith Moon was a drunk and a pillhead who liked to blow up toilets with dynamite for fun.
Elvis was a hardcore pillhead who apparently went insane from all the tablets.
Arthur Lee of Love spent 20 years abusing drugs heavily, became homeless, set buildings on fire and shot up his neighbor’s house.
Carlos Santana used acid heavily, then 20 years ago met up with an angel named Metatron who looks like Santa Claus who has been guiding his life ever since. He communicates with Miles Davis, a dead person, on a regular basis.
Miles Davis (while he was alive and not talking to Santana) spent years shooting heroin, beating his wife and just acting weird.
Little Richard spent years binging on cocaine, having sex orgies and sucking cocks in men’s restrooms.
James Taylor was a depressive and a heroin addict.
Some were suicidal.
Wendy O Williams sawed instruments in half with a chainsaw, then retired and blew her brains out.
Ian Curtis recorded some of the most depressing music ever made, then hung himself on the night of his US tour.
Adam Ant is a depressive.
Mariah Carey assaulted staff and reporters and slit her wrists.
Some like Courtney Love and Britney Spears simply cannot seem to function as adults.
Sinéad O’Connor is just a kook.
Lou Reed’s main problem is that he’s a terminal asshole.
R. Keely is just a weirdo with a taste for underage girls.
Sid Vicious assaulted fans, carved up his chest onstage, murdered his girlfriend, then OD’d on heroin as a grand finale.
Jaz Coleman, George Clinton, Captain Beefheart and Julian Cope are unclassifiable.
No one knows what’s up with Sun Ra.
GG Allin was just nuts, dx’d as narcissistic, Borderline PD and masochistic.
Michael Jackson was one of the weirdest of all. No one seems to know what was wrong with him. He seems to have been a homosexual pedophile. I’m familiar with most of his weird antics, but I never knew that he said he had fathered 2 “Aryan” babes named Prince 1 and Prince 2. Weird!
Just because you aren’t psychotic (and most of these folks are not) doesn’t mean you’re not nuts. You can be plenty nuts without being psychotic, plenty.

OCD and Social Anxiety Disorder: Differential Diagnosis

A new commenter confuses OCD with social anxiety disorder. Though I don’t know SA very well, they are clearly different illnesses. The problem is that there is overlap in all of the anxiety disorders, and in some cases, SA and OCD are both present.

You’re right about OCD including unwanted thoughts, but the shyness, nervousness, and anxiety sound more like social anxiety disorder or avoidant personality disorder.

No, nervousness and anxiety are prominent in all anxiety disorders. As far as shyness, this is just the kind of person that gets OCD. Social anxiety is a tough one, but OCDers don’t usually have this too bad. Most of the ones I deal with are more or less social on a regular basis. They’re hanging around people, but they are nervous.

It depends why they are avoiding people.

According to the DSM, if you are avoiding people due to one of the other Axis I disorders, then rule out SA. Keep in mind that people with schizophrenia and folks with some personality disorders like schizoid, schizotypal and paranoid personality disorders may also avoid people.

SA people avoid people due to massive anxiety relating to being around others. The anxiety is related to embarassment over doing something stupid or humiliating.

OCDers might avoid people due to the obsessions and the way that people react to them – heavy duty rejection. SA people are afraid they are going to be rejected in social situations, and social anxiety is pretty prominent.

Social anxiety is not necessarily so prominent in OCDers, but some have obsessions that tend to come out when they are around others. I dealt with this woman once who was afraid that when she talked to other women, she secretly made lesbian remarks to them. So she was nervous when speaking to women.

OCDers tend to be pretty nervous all the time. It’s not something that peaks when they get around others.

Harm OCD is a bad one, because they are afraid that they will hurt someone. It leads to a lot of avoidance.

If OCDers are treated well and treated as if they are normal people and not rejected or treated like shit, they will often hang around people a lot. And if you get rid of the obsessions, some will actually become social butterflies, since the obsessions might be the only reason for the introversion.

It’s true that extroverted obsessionals are quite rare, but that’s due to the nature of the illness. It only hits people with a certain personality, and that person is an introvert.

This Is Not Schizophrenia

Repost from the old site.

This is not schizophrenia. Let’s look at some symptoms here that a fellow is reporting in a weight-lifting forum. Many of the commenters are replying that the guy has “the beginnings of schizophrenia”, “mild schizophrenia” “schizophrenia”, etc, etc ad nauseum. Let’s take a look at his symptoms:

At night, no matter what I do. Not every night it always happens during the week when I have to work the next day, I cannot fall asleep. Music, TV, RX pills, Tylenol PM, melatonin. Even taken together, mixed and matched, I cant fall asleep sometimes. And my body is tired, but my brain wont shut up. And I’m not even thinking about anything important. Sometimes, just fucking music is playing.And it will keep my up, not sleeping 2-3-4 nights in a row. By the 3rd day, I feel delirious, and I didn’t want to train the other day, cause I was afraid I’d hurt myself from how slow, and tired my body felt. I’m trying not to smoke as much pot lately, cause I’m cutting, losing weight.

It’s effecting my home life, my job, my training, my relationships. Someone asked me if it was because I was depressed. I really don’t have much to be depressed about. I have a good job, I make good money, I get laid, my own place. If I’m depressed, I don’t know why.

It’s almost like I’m “tripping” is how much sense it doesn’t make -like when you’re on acid and your mind is racing and none of it applies to anything, or means anything. Random craziness.

I hear voices (not like telling me to kill or anything) but just random babbling and the voices change like they’re inhaling helium. It doesn’t make any sense. Other times, random songs play through my head and I cant shut them off. I can only control them by putting other songs in, but that causes me to strain my brain and think hard when I’m trying to relax my mind.

My head sometimes gets heavy too, like it weighs like 50 lbs, and my equilibrium gets off balance sometimes. Like a concussion.

OK, the guy is unable to control the thoughts in his head. Thoughts, crazy thoughts, random nonsense, just races through his head with little or no control over it at all. Songs, uncontrolled and unbidden, pop up in his head unbidden and play by themselves in his head.

He can’t shut any of this bullshit off, and the only way to stop the music is to substitute one stupid song for another. I am assuming the “voices” he is hearing are voices in his head, not outside of his head. Fortunately, you can hear all the voices in your head as possible without being mentally ill, though it really isn’t ideal.

It’s crucial to realize that psychotics who hear voices actually hear them with their ears, not in their minds. We all “hear voices” in our heads. Our “inner voice” is a voice inside of our heads. The idiot media and popular does not do us any good by refusing to differentiate these symptoms. Psychotic voices heard with one’s ears are transformed into “voices in his head”.

Obviously, if it’s sane to one one “inner voice”, it’s not psychotic to have more than one, or an unlimited number, though it’s not exactly ideal. You could even have animal sounds in your head.

Hang on.

OK, I just made some animal sounds in my head. There was a cow and a monkey and now there’s a lion. Does that make me schizophrenic? Come on.

If you follow the discussion, you will note that many of his friends on there tell him that he is developing schizophrenia. I do not believe he is doing any such thing, and this is not a symptom of incipient schizophrenia anyway.

I’ve been around folks in the prodrome of schizophrenia, and while their functioning was still ok enough, they were hallucinating (hearing voices) a significant part of the time. No amount of argument could convince them that the voices were not actually real, nor would they believe me when I said I didn’t hear them. This is a pretty typical picture of incipient schizophrenia.

Keep in mind that the vast majority of schizophrenics hear voices. In fact, if you don’t hear voices, I wonder if you really have schizophrenia.

What’s also interesting is that, terrifying and weird as these symptoms are, a number of the commenters admit that they have experienced them – they say they have had strange, out of control, unbidden random thoughts and music in their heads before. So, while it’s not optimal, this stuff seems to be pretty common.

What’s the diagnosis for out of control, random, unbidden thoughts and songs in your head? I say nothing. There’s no DSM dx that has a criteria like that as a sole criteria.

Just like “having a weird look in your eyes” does not give you a mental illness dx either. There are all sorts of folks walking around with all kinds of weird and crazy looks in their eyes. While it’s disconcerting, it’s not necessarily indicative of mental illness. There is no DSM dx for “has a weird or crazy look in their eyes.”

You need to be nuttier than just that. What gives people weird looks in their eyes if they aren’t nuts? Who knows? God knows what goes in people’s minds. But as long as your speech and behavior remains normal, you’re not mentally ill.

Why am I writing about this crap? I’m on a crusade to get people to quit being such morons about mental health. Even if we aren’t ill ourselves, it doesn’t help to give out false dx’s and go around accusing non mentally-ill folks of “being crazy”. It’s insulting, stupid and cruel.

Personally, I never refer to other humans with words like “weird”, “crazy”, “nuts”, etc.

Instead, I’m going to give you some specific description of their behavior, possibly with a potential dx. I can usually figure out what might be wrong with someone after spending a bit of time around them. I can almost always tell if they are psychotic or not, and usually if they are obviously dangerous or not.

Life’s tough for everyone and probably few of us make it out unscathed.

Thought Broadcasting and Thought Disorder: Pathognomic Schizophrenic Symptoms

Here.

This is a most unusual schizophrenic symptom that most folks do not know about. It’s probably quite rare to nonexistent in other disorders; in fact, I think it is pathognomic of schizophrenia or schizoaffective disorder. I doubt if you would see this symptom in a bipolar or unipolar depressed person.

As you can see if you read that post, this is a very terrifying symptom! It’s probably much misunderstood. For instance, right now, if I worked myself into an anxious enough frame of mind, I could imagine that my thoughts were being broadcast out to others. But that’s not what’s going on with these folks. Imagine of you could walking into a coffee shop full of people and suddenly all of your thoughts are being broadcast out loud to everyone in the room.

This is what you are going to experience. You will experience you own thoughts shot out into the environment, and they will sound as clear and as real as the voices of folks around you and other sounds in the environment.

In such a situation, schizophrenics often have a hard time believing that other people can’t hear their thoughts being shot out into the environment seemingly out of loudspeakers. As you can imagine, that’s quite a disturbing symptom! If I experienced a symptom like that, I’m not sure how I could go into public and try to function. It would be awfully hard.

They also often feel that they can hear other people’s thoughts.

Here is one guy’s experience:

This is a difficult concept for me in both experience and articulation to others…here is what can happen to me…I will be thinking some thoughts about something I am doing at the moment or something(s) I will do in the future…these thoughts are completely separate from my ‘voice’ hallucinations (??) ….and later in the day/week/month REAL PEOPLE (usually strangers) will come up to me & repeat these thought fragments or statements to me WORD FOR WORD!…

They aren’t generalized thoughts that most folks have in a day, but are specifically related to my own situation or something occurring in my personal realm…this has happened both in my own town and in several other locations (and other states!)…I’ve even had strangers say them from open windows of other cars at traffic lights, and even leave pieces of paper on the floor (ground) in my path with the EXACT thought or fragment on it!!…

What all this really is, I don’t know, but it seems to me to be a form of thought broadcasting (against my will)…very strange…

Whoa! I had to think about this one a bit! At first I thought the guy was psychic. Then I figured out what was going on. Those people are not really coming up to him and repeating his thoughts of earlier in the week word for word. This is a hallucination. Someone is walking up to him, and he hallucinates them saying his thoughts of earlier in the week.

Same thing with the folks at the traffic lights. They aren’t talking to him. He’s just hallucinating them talking to him.

The pieces of paper. He is just finding pieces of paper on the street and looking at them. Then he hallucinates the words of his thoughts on the paper.

Some schizophrenics experience their thoughts being broadcast out to others, sometimes insults, and then they hear the other people broadcasting angry response thoughts back to them. What a strange experience!

This case is very weird, and it was explained as so real that for a while I wondered if the guy was mentally ill. I thought he might have been psychic. He says he’s not mentally ill, just psychic, and he has not been diagnosed. All of those reactions are typical.

My own experiences began a long time ago when I noticed a conversation traveling circuits around a crowded room while remaining completely intact. It would jump from one group of people to another repeating itself, without any of those groups interacting on another dynamic. I watched this pattern loop through the room several times before I attempted to engage and alter it, rather than talking to its hosts directly.

This brought on a response I couldn’t have expected, in that suddenly a nonphysical intelligence began affecting the world around me, due to its sudden apparent sense of having been intruded upon.

Whoa! That’s really weird. Imagine being at a party. You hear a particular bit of a conversation.

“So anyway, Steve told me he really likes my hair. He was texting me but he said I didn’t answer. He doesn’t understand that it was 4:30 AM and I was out in the rain!”

Then the exact same bit of conversation, word for word, starts actually moving around the room, with different people repeating those same words above before it moves on to the next group of people. Then the conversation circles the room a few times. That would be a weird experience! I thought about this a bit and concluded that this could not possibly be actually happening. I mean, you could do it as a practical joke, but that’s not what’s happening. He is simply hallucinating this conversation going around the room.

Over years of having similar experiences of series’s of impossible coincidences, messages directed specifically to him, and the sense that this Entity was sending him missions of various sorts, he concluded that he was in touch with some psychic or mystical entity that he calls the “hivemind,” or universal consciousness. Granted, such a thing may exist, and for a while I thought the guy was psychic, but I doubt if he’s in touch with it, and I think he’s just mentally ill.

Over the years, I’ve been fascinated by the existence of this entity, and puzzled that so few (though they do exist) others are able to operate on a level where this entity has relevance. I have studied numerous metaphysical beliefs and philosophies attempting to find a corollary between it and something that was written down in history. I’m proud to say that I have found quite a few answers, but unfortunately most of them are not solid.

The entity appears to be some kind of “hivemind” entity that is in fact not conscious like we individuals are, and it seemingly does not interact with time in the same way we do. Nor does it recognize any concept of “self” due to its distributed nature. Despite all of that, it’s quite intelligent and has a decent sense of humor…For me, those moments all string together as “the entity” tries to talk to me. The message might take days to become complete and make sense, and the individuals, radio signals, television commercials, conversations on the street, cat acting funny, all of it…string together into one long coherent message…assuming I bother to listen. Furthermore, if I refuse to listen and try to block it out that’s when stuff starts going bad again.

The situation below is seriously bizarre, but I wonder what really happened.

I knew this pretty girl once who was dating a guy that represented authority to me. The guy was a lot like my father, and at the time he was being nasty to someone else so he could get what he wanted.

The girl is the focus here because of her role in that relationship. I met the guy through her in the first place, on the day I met her as well.

She was crashing his birthday party and needed a ride. Well, the message came through as the girl needing a ride again at a later time for a different scenario, but again I was the only driver available. The way she approached me about it was the message itself.

She kidnapped me and stole my car while I was sleeping in the back seat. The reason this is important about the authoritarian boyfriend is because she effectively took on his role in her own situation in order to put me in her role.

She had stolen my keys while I was asleep a few days before, and made a copy for herself. When I woke up halfway across the state from where I had parked, she explained that I could come along for the ride or wait for her to pick me up on the way back, but either way she was taking the car. I ended up driving. I would have taken her anyway had she asked, but she never asked.

This situation is so strange and is reported as if it really occurred, but I seriously doubt if it did, even though his description sounds so real.

The girl did not kidnap him and steal his car while he was sleeping in the back seat. Forget it. Simply did not happen.

Nor did she steal his car keys when he was asleep a few nights earlier and make a copy for herself. I don’t believe it. Forget it.

Nor did he wake up in the car halfway across the state from where he had parked it, with the girl driving and the girl telling him that she had stolen his car and he could either get out or go along for the drive. I simply do not believe that this occurred.

So what happened? I have no idea! But his story is so bizarre is simply strains credulity.

If you keep reading that guy’s posts (he’s not medicated), it seems like they are quite logical and make sense in a nice way, even though he is describing very strange things. But the more you read, the style of the writing itself starts seeming a little odd.

This is very typical of schizophrenic writing. At first it seems like normal speech or writing, but the more you think about it, the more there seems to be something wrong with it, though you can’t quite put your finger on it, and if someone asked you to explain why it’s strange, you could not really explain it very well in words.

This is usually called loosening of associations or formal thought disorder. Put another way, it is something like, “Talking without making sense,” but that doesn’t explain it very well.

Suppose I describe to you a series of wild and improbable adventures that I had that culminated with me going out into the woods, where bats flew out my butt and I was proclaimed King of Germany, Lord of the Jews, Prince of the Robert Lindsays and Warlord of the Race Realists at a huge feast which featured endless rounds of huge Subway sandwiches and mugs of near beer.

OK, that story is pretty weird, and no doubt it’s fiction, but it makes sense: it is intelligible and understandable. It has an intelligible story line with events described in a certain way so that everything fits together. The scenario is ridiculous, but it’s not incoherent.

Schizophrenic speech and writing is different. It is not intelligible in a very strange way. It is often almost intelligible, but not quite. For some reason, you can’t quite figure out exactly what it is the person is trying to say, and you can’t even figure out why or how it doesn’t make sense. That is thought disorder.

I believe that thought disorder is actually pathognomic of schizophrenia in a sense: that is, if you don’t have thought disorder, I don’t believe you have schizophrenia. Where there is schizophrenia, there must be thought disorder in most or possibly all cases.

This Is Not Schizophrenia

One of the many purposes of this site is to enlighten people about human psychology and in particular about abnormal psychology or mental illness. Even though most of us shout to the heavens about how sane we are, for some reason, we are terrified of discussions of mental illness. I notice that whenever I bring up the subject, it very quickly gets shut down.

There’s something strange going on. People are very afraid of mental illness, even the most minor, harmless and neurotic kinds. The psychotic stuff makes people very nervous too.

I don’t get it. People like me who are fascinated by mental illness and can talk about it all day long don’t understand. What’s the worry? Psychotics are frightening to be around, but not as much as you think. Anyway, if you’re just talking about them, it’s not like the conversation is going to jump out and kill you. Fear of discussing neurosis must be based on the idea that most of us are afraid that we might become neurotic, or more neurotic, ourselves at some point.

It never fails to bother me that most folks can’t tell the difference between neurosis and psychosis. Granted, there are some borderline folks, but generally the distinction is quite clear. If you have spent a lot of time around the two types, it’s like they are people from two different planets.

I remember 25 years ago, I was having a lot of anxiety issues. I thought I was mentally ill and recovering from a nervous breakdown, which I was more or less. So I went to this meeting of a group called Recovery.

Well, it turns out it was for schizophrenics. There were two normals running the show, there were the schizophrenics, and there was me. As nuts as they were, the schizophrenics very quickly figured out that I was not one of them, anxious as I was. The leaders figured it out too. It’s funny that people who are totally nuts can make obvious distinctions that supposedly sane folks cannot.

I do a lot of work with folks who have OCD, since I have it. It’s quite common for these people to tell me that people think they are schizophrenic, and they are often diagnosed with various forms of “psychosis,” by idiot shrinks.

People with OCD can go psychotic, but it’s rare, they are not all that nuts, there is extremely prominent anxiety, it’s pretty easy to pull them out of it – usually only after a few weeks or so – and of course they are never dangerous. It’s just some guy sitting in a chair shaking so hard he can hardly get out of the chair to go outside.

As Freud noted in his class study of the Rat Man, “They are not crazy. Nevertheless, OCD is certainly a crazy illness!” Freud was very insightful. “They are not crazy,” – in other words, they are not psychotic. “It’s a crazy illness,” – it’s very strange, and when they are very ill, they appear psychotic. The Rat Man was a wild case of OCD. The guy had an obsession that there were rats crawling into his anus. Of course that’s impossible, and most people figuring something who thinks that way is psychotic. But the Rat Man was not psychotic.

OCD one of the nuttier of the neuroses, but only on a surface level. This is because when it gets really bad, the anxiety and mental distortion are so extreme that an OCD person appears psychotic. However, a good clinician can pretty quickly figure out that they are not.

Let me give you an example.

An OCD guy I know, in a bad episode, was afraid to turn around in the shower. Why? He was worried that he was a child molester (though he wasn’t, and none of these folks ever molest anyone), and in the shower, he would get the idea in his head that there was a naked 9-year old girl in back of him. Logically, he knew that she wasn’t there, but OCD is powerful form of magic, and it almost convinces you that its bullshit is true. So he was afraid to turn around, because he was afraid that the naked 9 year old girl might be there.

To most people, that’s psychosis. Except that it’s not.

A schizophrenic person simply says matter of factly that when they take a shower, there’s a naked 9 year old girl in back of them showering with them, and this bothers them.

I knew another guy who had severe OCD that was not responding to treatment. He had harm OCD, with thoughts of attacking and killing people in general and those around him. He was also a dwarf with severe physical problems, which made his thoughts even more ludicrous. His Mom gave him a knife at one point and said, “Just do it! Stab me!” Of course he didn’t. They never do these things.

Why they never act on these horrible thoughts is an interesting subject, but it’s best for another post.

Anyway, the guy had various fears, and at one point, he got an intense worry that he was The Devil. OCD was telling him that he was The Devil. Most people will say this is psychotic, but I doubted it, though I found it disturbing. I questioned him further. “You know you’re not really The Devil, right? Or at least it’s unlikely you are?”

His response was interesting. “Logically, I know that,” he said. These people often say that, and it’s quite curious. It’s as if the mind is split between a part of the mind that knows this is all bullshit and an OCD part, terrifying and full of gale-force anxiety, that is telling you all sorts of scary crap. The OCD part has a powerful pull to it due to the psychological force of anxiety and fear, which can actually seem to bend emotions, self-image, reality and even perceptions.

At that point I knew the guy wasn’t psychotic, and I blew it off.

In contrast, a schizophrenic person simply reports that he is The Devil. Maybe it bothers him, maybe it doesn’t, but that’s just the way it goes. He’s describing obvious reality, like the sun rising in the east.

It’s hard to explain logically the difference between the two experiences, but if you’re intelligent and think about it a while, you should be able to figure out the clear-cut difference.

Here we see an example of something that looks like schizophrenia, except it ‘s not. It’s some kind of anxiety disorder. I’m not sure which, but it may be OCD:

Like I stated in my previous thread, I have not yet been diagnosed with anything because I have yet to see a doctor. I was wondering if there is any medication that one could recommend for me. This is the third week I have really been feeling strange, and I don’t know if I should start on medication yet even if a doctor recommends it.

My symptoms are:

Always hearing a different song in my head when my mind is idle (I know that it is in my head, not external).

Feeling uncomfortable talking to people or making eye contact (this comes and goes, really bad after a night of drinking, not bad after a good workout and sauna).

Depersonalized feeling, even when I am talking and joking around with friends, I feel outside of myself in a way, always worrying that I could be schizophrenic.

Less motivated.

Forgetful (always have been, recently a bit more then usual).
After a recent night of drinking, I even started to see objects sort of move or grow or something in the corner of my eye or only when I concentrate on them (this isn’t 24/7 tho).

There are a few things going on here. The person is worrying that they might have schizophrenia. A person with schizophrenia typically does not do that. Suppose your name is Jim Brown. Do you worry that your name is Jim Brown? Of course not.

Schizophrenia so contorts reality that the person does not know that they are ill. They don’t have the foggiest clue. The schizophrenic reality is simply their reality, and they don’t think it’s an illness. It’s just what’s happening.

When they get on drugs, they get much better and start figuring out that they are ill, but that’s different. Schizophrenics often have to rely on loved ones to tell them when they are going psychotic because they don’t have the foggiest clue when they are ill and when they are not. Some can sort of figure it out, but that doesn’t mean that it isn’t real.

Schizophrenic hallucinations are quite real and are not the sort of anxiety-driven nonsense that this excessively introspective individual is experiencing. If you worry that you’re hearing things or seeing things and start overemphasizing your perceptions and freaking out about them, you’re probably going to start thinking that you are seeing things and hearing things.

The visual hallucinations will often be peripheral vision things, but even normals see weird stuff out of the corners of their eyes all the time. Normals just re-analyze it, figure out what it really is, and move right along.

Sane people often think they hear things too. I’ve noticed that sometimes in the rain, I think I hear stuff. It was raining the other night in the parking lot, and I thought I heard someone yell, “Bob!” I turned around, and of course no one was there. I thought about it a little bit and then just drove away and decided not to think about it anymore. I know enough about psychotic hallucinations to know that that was not one. Once I start hearing stuff all the time, maybe I’m going to get worried, but until then, forget it.

These anxious types are overhyping their sensory organs, worrying way, way too much, and misinterpreting all sorts of normal sounds. Probably anyone can do this if you work yourself into a nutty enough frame of mind. Whatever it is, it’s not schizophrenia, nor is it psychosis.

It’s basically an anxiety issue, not a psychotic issue.

In general, these are different trajectories of craziness. One dichotomy is anxiety/psychosis. You’re either going crazy in an anxiety way, or you’re going crazy in a psychotic way. True, psychotic people can get anxious, but it’s for different reasons than the anxiety-disordered. You might get pretty anxious too if you were convinced that the Mafia had a murder contract out on you! See what I mean? The anxiety-in-psychosis and the pure anxiety disorder are coming from fundamentally different places.

Later in the thread, one fellow adds this helpful bit of diagnostics:

This doesn’t sound like schizophrenia. From what you’ve said it sounds like depersonalization disorder with comorbid social anxiety and OCD. It isn’t common, but this does occasionally occur with heavy cannabis use. It is also notoriously hard to treat. Maybe a benzodiazepine for the anxiety. Antipsychotics don’t usually work very well for depersonalization, but some individuals respond to them. I think the standard treatment is SSRI’s with a benzo. Sometimes Lamictal. Lamictal and low dose benzos would have the least side effects.

Sounds about right to me, but I’m no clinician.

Also later in thread is another guy with similar symptoms who thinks he has schizophrenia, but he doesn’t. He probably has a condition like what the fellow above has offered for a diagnosis.

Schizophrenia is a pretty clearcut illness. People who are actively ill are pretty easy to spot and typically don’t make a lot of sense when they talk. I can’t understand why someone would accuse a person with a run of the mill anxiety disorder of having something as complex and devastating as schizophrenia. The smartest people can be so damned ignorant.

Cannabis and Schizophrenia is Probably a Minimal Relationship

One thing that is interesting when you study certain issues a lot is that the more you learn about the issue, the less you understand it. In fact, most things just get more and more confusing and make less and less sense the more you study them. And this points to the limits of scientism. So many things just don’t seem to make much sense. Science claims it can discover the truth to anything and everything. In theory, it can.

But in praxis, it’s another thing altogether. So much of life remains fairly or seriously mysterious no matter how many studies and books are issued on the matters at end. Is science able to explian these things? Not at the moment anyway.

I often find that in discussions, I have to say things like, “Yes, I know it doesn’t make sense, but in this field a lot of things don’t make sense.”

So it is with cannabis and schizophrenia. Things just don’t make sense.

Those of us who went through the 1970’s watching 1000’s of people smoke cannabis heavily and never saw a single case of toxic psychosis, not to mention schizophrenia, are taken aback by the recent insistence that, say, cannabis ups the risk of schizophrenia by 38 times, or that 10% of regular adolescent cannabis users will become schizophrenic. Such theory punches right in the face of our very lived experience, so it makes no sense to us at all.

Yet the relationship keeps showing up, over and over, in study after study. It’s regular, independent of confounding factors, and even typically dose-dependent. That’s as good as it gets in science.

Nevertheless, it still doesn’t make sense.

The rate of schizophrenia collapsed while the rate of cannabis use exploded. Cause and effect indeed!

As you can see in the graph, a rate of schizophrenia of 12-13/100,000 from 1950-on collapsed starting in 1967, falling to around 3/100,000 as of 1983. It seems to have leveled off at around that rate ever since. Starting around the mid-60’s and continuing through the 1970’s at least, cannabis use in the UK went through the roof. It completely exploded. At the same time as the rate of schizophrenia collapsed by 75%. If there were indeed a relationship, the schizophrenia rate should have gone through the roof.

It doesn’t make sense.

Yet over and over, we see this relationship. The only explanation that makes sense is that something in the prodromal syndrome of schizophrenia makes pre-schizophrenics seek out cannabis in particular. The worse the prodromal symptoms, the more cannabis they use. Cannabis use clearly seems to be bringing schizophrenia on sooner in those who would develop it anyway.

This study is the best analysis yet. For every 4000 adolescents who use cannabis daily, one of them will get schizophrenia as a result. We have to prevent 4000 cases of heavy cannabis use by teens to prevent a single case of schizophrenia.

It hardly seems worth it.

How do we reconcile that cannabis is causing any psychosis at all nowadays, not to mention schizophrenia, when it never seemed to cause these reactions back in the day?

There was a young guy who was hanging out over here a lot a while back, an Hispanic gang associate type. He was a heavy user of this very strong “skunk” cannabis. When he used it, he was constantly peeking out the window, apparently looking for the cops. He also totally freaked out if I ever opened the blinds one bit. I’ve never seen anyone act so paranoid on pot before. I’ve only seen people act like that on cocaine, especially if they smoke it or shoot it.

The cannabis nowadays is much, much stronger than even the strongest pot we smoked in the 1970’s and even 1980’s. Sure, hashish and hashish oil were around back in the day, and sure we used it all right, but they were not widely used. They are breeding it for THC maximalization, and it has THC levels of up to 15-25%. It’s the THC that is psychotogenic, not the CBD. CBD acts like an antipsychotic, of all things.

Back in the day, cannabis had approximately equal levels of CBD and THC. The psychotomimetic effects of THC were counteracted by the antipsychotic effects of CBD.

I’ve smoked this new super-pot, and while I can handle it with no risk of psychosis or even serious freak-out (I doubt if any reasonable quantity of any reasonable drug would make me psychotic), it’s easy to see how it could bend someone’s head in a pretty bad way.

We are getting regular reports of people smoking this stuff and hearing voices afterwards, if only temporarily. That’s really strange; we never heard strories like that back in the day.

So the solution to the conundrum of how pot is psychosis now when it never seemed to in the past is that the pot is incredibly strong super-pot, which is almost like another drug altogether.