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Raziel
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25 Sep 2012, 6:37 am

I don't understand quite where you draw the line between bipolar and schizoaffective!?

So, when you are bipolar and you are also schizotypal, is this considered as schizoaffective?
And what's with being schizoid?
:?


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OddDuckNash99
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25 Sep 2012, 10:15 am

While it's often very difficult to distinguish between psychotic mania, schizophrenia, and schizoaffective disorder in a diagnostic setting, the clinical definition of schizoaffective disorder is easy to explain. If the psychotic symptoms last once a person's mood has returned to normal (2 weeks or more of psychotic symptoms without mood abnormalities), this is indicative of schizoaffective disorder. It really is a combination of bipolar disorder and schizophrenia. As for schizoid and schizotypal, these are not psychoses. They are personality disorders. Often, a person who goes on to develop schizophrenia later in life will show schizoid and/or schizotypal tendencies earlier in life. Schizotypal is sometimes referred to as "schizophrenia lite." But neither of the personality disorders include ACTUAL hallucinations or delusions.


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AardvarkGoodSwimmer
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25 Sep 2012, 10:47 am

Following is a pretty good article by a psychiatrist at Emory:

http://www.cnn.com/2010/HEALTH/expert.q ... index.html



Raziel
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25 Sep 2012, 10:50 am

Thanks for your answer OddDuckNash99! :D

But in schizotypal PD you have:

- Ideas of reference (excluding delusions of reference)
- Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g. superstition, belief in clairvoyance, telepathy, "sixth sense", or bizarre fantasies or preoccupations)
- Unusual perceptual experiences, including bodily illusions
- Odd thinking and speech (e.g. vague, circumstantial, metaphorical, or stereotyped speaking)
- Suspiciousness or paranoid ideation
- Inappropriate or constricted affect
etc.

So, a person with Bipolar and StPD or SPD is right on the edge to schizo-affective?
Is it possible to say it that way?

And can you first have Bipolar and then develope schizoaffective?


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Raziel
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25 Sep 2012, 11:32 am

AardvarkGoodSwimmer wrote:
Following is a pretty good article by a psychiatrist at Emory:

http://www.cnn.com/2010/HEALTH/expert.q ... index.html


Thanks! :D

Okay, I was never manic, just hypomanic, but I allready had psychotic like symptoms but they were just three times and every time connected to a trauma. Other than that nothing. I have some schizotypal traits though, but no odd believe or so.

What I would say, I have from the schizotypal symptoms is:
- Suspiciousness or paranoid ideation (this was also in connection with the trauma, so not really actually)
- Inappropriate or constricted affect (I also have a flat affect)
- Behavior or appearance that is odd, eccentric or peculiar
- Lack of close friends or confidants other than first degree relatives (not even that much and that's also autistic)
- Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self. (I have some social anxiety, but it get's better and not that strong, just in the environment where the trauma occourt I just totally "snap" and freak ot :oops: )

So I think I have some "schizophrenic tendencies" but not that much actually.
I don't think that I would qualify as having schizo-affective, but that I have some tendencies in this direction.


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OddDuckNash99
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25 Sep 2012, 11:37 am

I consider a good character example of a schizotypal to be Luna Lovegood from Harry Potter. She is very quirky and believes in magical creatures and ideas that nobody else believes, outside of her father. Schizotypals can go on to develop full-blown schizophrenia later on. It does seem to be a higher risk factor. But schizotypals are, by definition, not psychotic, and not all will get schizophrenia. Note that your definition says IDEAS of references, excluding DELUSIONS of reference. Schizotypals have a lot of superstitious "magical thinking," but they are not delusional.

This is similar to how pure obsessional OCD contains "magical thinking" but not delusions. Ideas of reference contain very superstitious associative thinking. Like, the person might be very keen to pick up on "signs" that something is going "right" or "wrong" for them, even though most people wouldn't think anything of these observations. I have pure "O" OCD, and I do this a lot. The reason it's not delusional is that, deep down, we know it's silly and illogical. We just cling to it for comfort and reassurance. If you're interested, look up some articles on PubMed finding high ratings on schizotypal characteristics in people with pure "O" OCD.

I honestly haven't ever read any case studies of someone who was bipolar and schizotypal, let alone if they went on to become fully schizoaffective. But this is probably because schizoaffective disorder is highly, highly understudied.

I also haven't heard much about people who started off as classically bipolar and then went on to show a more classic schizoaffective presentation. But it is certainly possible, yes. If a bipolar person experiences psychotic manias, depressions, and/or mixed states, there is always a chance that, after the most recent mood episode has cleared up, the psychotic symptoms could stay on. On the flip side, it's also possible for someone to at first have plain schizophrenia but then develop psychotic mood episodes later in life. Another PubMed topic I encourage you to look up is the schizobipolar rating scale recently developed by researchers, where "0" is "purely bipolar," "9" is "purely schizophrenic," and the rest shows the spectrum from bipolar/schizoaffective/schizophrenic.

Edit: Just read your new post, and I wanted to say that my close friend has a schizoaffective diagnosis and she's never been fully manic (just hypomanic). She is a hard case to place, but she seems to be more like schizoaffective, depressive type, more than schizoaffective, bipolar type.


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Raziel
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25 Sep 2012, 12:03 pm

Hm, I believe some people are hard to place.
I also think when diagnoses are very close this also makes it highly difficult to distinguish.
I have some "schizotypal thinking" I would say but not much and but I don't talk about it, because I know it's just, well my thinking and nothing more...!

I just totally "snaped" when I was in situations that reminded me on the trauma.
They first thought I was schizophrenic, than that I was borderline, than schizophrenic, than borderline and then not sure. :lol:

And now my new shrink thinks about bipolar, especially because it is clear now, that this time was just a traumatic episode and not my usuall self and I even showed years befor mood swings, but I'm just under supicion at the moment because it is hard to tell. Also one of my brother had ADHD, hyperactive type as a child and the other one schizophrenia.

Well I was neither one of those and those symptoms mostly dissapeared when I was out of the environment that remindec me on the trauma. But I think I have some "schizophrenic tendencies" and together with traumasymptoms where they got more noticable and not talking about it for a year what was really going on with me must have looked really bizzar. 8O
:oops:

Right after the trauma I couldn't really devide reality from my thoughts (no hallucinations), couldn't really find my way around, had memory problems and was highly emotional.

I also had psychotic like symptoms every aniversary of the trauma (so two times), but just slight, thinking someone is standing behind me, but I knew that there wasn't, seeing shadow people behind me, but when I turned there was noone and being slightly paranoid, but other than those occations in connection with a trauma, nothing.
But I'm not sure if those episodes were longer or shorter than two weeks, the last one was shorter, but I don't remember exactly the onther two.
But now, the trauma is mostly okay again. :D

But befor the traumatic event I never had any psychotic like symptoms and also afterwards nothing. :?

So I can't figure out right, what I have. :?


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Last edited by Raziel on 26 Sep 2012, 3:55 am, edited 2 times in total.

AardvarkGoodSwimmer
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25 Sep 2012, 10:14 pm

It has taken me a long time like years to come to grips with some bad things in my life such as my dad’s violence and my mom’s reasons why I shouldn’t be angry, such as workplace bullying, such as the abusive foreign policy of my own nation. A really big aspect of the whole thing is that people brush off all of the above with cheap little reasons. Essentially, they really do not want to hear about it. It’s their loss, but it’s also kind of my loss, too. :evil:



Raziel
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26 Sep 2012, 6:02 am

I do a personality test once in a while it is not a very reliable one, but it showes you a quick picture:

Those scores were in the traumatic situation with clear PTSD symptoms:
I allways write the average of the wepage in ( )
- paranoid 42% (50%)
- schizoid 30% (40%)
- schizotypal 90% (56%)
- antisocial 34% (46%)
- borderline 38% (45%) (I had big variations in those, so I figured those sympoms must be part of PTSD scoring between 30% and up to 60%)
- histrionic 18% (35%) (I believe it's so low because of strong depressions at that time)
- narcissistic 22% (40%) (I believe it's so low because of strong depressions at that time)
- avoidant 66% (48%) (this was higher because of anxieties of the trauma at this time)
- dependent 38% (44%)
Obsesive-Compulsive 58% (45%) (I believe this is mostly through autistic routines, that the score is higher)

and now being out of the traumatic environment since allready nearly 4 weeks, but still with some PTSD-symptoms left:
- paranoid 46% (50%)
- schizoid 50% (40%)
- schizotypal 70% (56%)
- antisocial 38% (46%)
- borderline 58% (45%)
- histrionic 42% (35%)
- narcissistic 30% (40%)
- avoidant 46% (48%)
dependent 46% (44%)
Obsessive-Compulsive 58% (45%)

So, what's remacable, that 1) my scores got more "normal" with still higher scores than average since I'm out of the traumatic environment, but especialy that my schizotypal traits are still a bit high, but also droped remarcable and it was for nearly two years constantly between 85% and up to I think it was 93%. 8O
But now having less traumatic symptoms I moved more from schizotypal in direction of schizoid how id seems. Is this even possible or is this due something else? 8O

And well the borderlinesymtoms who had since the trauma big variations in it are traumasymptoms, right now I'm a bit in a rage because of what happend, because the second aniversary of the trauma is just a view days ago.

So I'm really not sure what to think about schizoaffective and all that...!? :?
My psychiatrist first wants to wait and see when I've less stressors and first gave me just a depression diagnosis, but a bipolar diagnosis in suspicion.


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AardvarkGoodSwimmer
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26 Sep 2012, 10:21 pm

I have experimented with under-writing and my method of writing 0, 1, 2, or 3 things down. And these are just single sentences, or maybe, maybe an observation which might take a couple of sentences. That is, I very much try and underdo it. And I might be at a university library leafing through geology books, or when I was working at H&R Block a few years back and thinking I might go into tax in a bigger way, I would study a topic in a college tax textbook and have a piece of paper to the side where I would be open to writing down a few sentences about an issue or situation bothering me. And the fact that tax (and geology!) are generally dry subjects somehow served to relax me, and then some of my feelings, and aspects that felt real and important, could float to the surface.

=====================

I had a miracle the morning of the first Sunday of November 2000. After taking a walk, coming back to the gate of my apartment complex, I heard screaming. Walking on one sidewalk, a lady was across a little green area on another sidewalk. I asked, Are you okay? She said, He won't let my daughter out. And she seemed distressed. I may have also asked, Is there anything I can do for you. She seemed uncertain. Okay, so it's a domestic disturbance/domestic violence type of thing. I felt it was better to call the police early rather than late. I walked to a nearby apartment and knocked on the door. A guy answered. I told him, We have a potential domestic violence situation, Can you please call the police. I felt I was operating at a high level. This was with twenty+ years of studying academic ethics, nonviolence, etc, and even marital arts. I was at the time thirty-seven years old. My dad had begun being violent to our family when I was sixteen.

Another door opened, a lady I knew a little and had talked with on a couple of occasions. She was with her boyfriend and asked if they should call the police. I said that might be a good idea, figuring two calls to the police would be better than zero.

I heard something and looked around. The guy had run outside and now had his wife in a headlock. I walked directly toward him, walking across the grass. Not only did I have my study of ethics, etc, the previous day I had seen the uplifting movie REMEMBER THE TITANS. In one scene, an athlete had challenged another athlete saying, That's the worse attitude I've ever heard. He didn't criticize the athlete's personality, or intelligence, or anything central, just his attitude. As I'm walking across the grass, it vaguely occurs to me that I'm going to need to lay hands on the man to pull him off her.

He let her go.

(I later decided that I walked across the grass with so much confidence that he might have decided I was an off duty police officer!)

I made the sports gesture of hands parallel to the ground and I said, "Let's just all calm down."

He said something about the police had a warrant out on her, and then he went back inside.

The police did show up. They weren't great. One cop twice referred to her as "a chick."

Apparently, there was a warrant on her for a previous drunk driving charge and I guess a missed court date. I don't understand why the police would not also arrest him. They have an eye witness to domestic violence in me. (At UH-Downtown, I saw a Houston Police Officer act great and winning when someone had a seizure and paramedics were called.)

I had helped someone.

It was like the universe had shifted. In a way I was able to go back in time and face down my dad. I am 5'6" and weight about 150 pounds. This violence, hostile individual who put his wife in a headlock weighed about 200 pounds. It was scary, it was real, it was unknown. Just like it had been with my Dad.

At the time, I shared it with someone who was kind of my friend. He didn't really feel what it meant to me.

I still had job diffficulties and the roommate situation I moved into wasn't great. But I did this good deed. I sincerely tried to help someone because it was important to me, and I succeeded. :D



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27 Sep 2012, 1:13 am

I've been diagnosed along various psychotic, affective, and personality disorders by different doctors. I can probablly anwser some of your questions.

Think of schizoaffective disorder as being "tripolar" That means its similar to bipolar but there are additional psychotic episodes which fluctuate seperately from the manic and depressive episodes.

Schizotypal PD is the symptoms of someone with schizophrenia who is in remission from psychosis. However they havent had a psychotic episode. Its basiclly schizophrenia without psychosis.

Schizoid PD is basically having only the negative symptoms of schizophrenia.

Schizotypal/Schizoid with Bipolar would be somewhat of a mild schizoaffective disorder but they wouldnt necessarilly have had a full on psychotic episode outside of an affective episode.

It would be common for doctors to not agree on a consistant diagnosis because the fine lines between them are vague.


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Raziel
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27 Sep 2012, 9:24 am

I thought about it a lot today and that's my conclution:

Schizpergers wrote:
Schizotypal/Schizoid with Bipolar would be somewhat of a mild schizoaffective disorder but they wouldnt necessarilly have had a full on psychotic episode outside of an affective episode.


I would feel a bit missdiagnosed with Schizoaffective, but I can see those tendencies.
Because I never had psychotic symptoms in my live, just some days in combination with a trauma on the aniversaries. So I think I'm right on the edge towards schizoaffective if you will.
I also did a schizoaffective and a schizophrenia test, they both were negative, but I had high scores on the bipolar tests.

On normal schizoid and schizotypal tests (not that fast one up there) I had higher rates and I can relate to that, but I think I have mainly just tendencies of both, or to put it in the middle of those two I guess. Sometimes I'm not schizoid at all and sometimes I behave more that way. So all together I still feel more conected towards schizotypal, but I guess at the moment I act more schizoid a bit, but just tendencies. So I would find it acurate in my case to diagnose both, but just tendencies or one and with tendencies of the other. Because I'm propably more in the middle of those two, than having them both.
And it makes sence to me, knowing that my halfbrother had schizophrenia.
ASD, Bipolar and Schizophrena are somehow all connected to each other, even more than most people think. At least that's my view on it.

Schizpergers wrote:
It would be common for doctors to not agree on a consistant diagnosis because the fine lines between them are vague.

Yes. :D
And there are some studies about it, but not many. I would guess that this area is mainly understudied:
Schizotypy and genetic loading for schizophrenia impact upon neuropsychological status in bipolar II and unipolar major depressive disorders.

"Both BPII and UP patients demonstrated significantly greater schizotypal traits than controls. Schizotypy was significantly negatively correlated with verbal comprehension both in BPII and UP patients and with working memory and processing speed in healthy controls. Patients who had one or more first-degree relatives with schizophrenia performed significantly more poorly than the remaining patients in all cognitive domains."

I also don't see autism so far away from there, because the negative symptoms of schizophrenia and ASD are highly identical and both are genetically related to each other. Autism is just more complex than "pure schizoid PD" and even more genetic. But even little babies can allready show sings of schizoid PD and then it is really the question how to differentiate this from "mild ASD symptoms" or if it's just in some cases the same. I allready acted highly schizoid/autistic as a baby and when I really have schizoid tendencies, than I have them since birth. My mother toled me that I was highly introverted as a baby and even in the first days of my life, that she even worried about it. Of course there are also extroverted autistic people, but I see it more as a spectrum and an autistic person who behaves schizoid or whatever, will propably be also a bit schizoid. But nevertheless I'm not a big fan of the thought diagnosing the people half of the DSM or ICD, just because it is possible, because I think it doesn't help at all if someone thinks: "oh my gosh I have 10 disorders" for example.

Psychiatry just starts understanding those disorders better and also how the connect to each other, how they differentiate and so on. Psychiatry also starts to recognice ASD and Bipolar in children and starts to understand those phenomenons better. Well psychiatrists are not allways correct about it, but psychiatry still has many questions to solve.

Schizpergers wrote:
It would be common for doctors to not agree on a consistant diagnosis because the fine lines between them are vague.


Yes and it is also difficult to find someone who takes his/her time and looks closely and really knows something about it. This is extremly difficult under normal psychiatrists to find, if someone doesn't go to an expert in that certain area and this get's even more complicated if you also have some comorbidities. Then it will be nearly impossible that even experts agree on the disorders and comorbidities a person has, especially if someone is not a "clear cut case".


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Raziel
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28 Sep 2012, 1:31 pm

on a schizoid PD test I had 19 points

21 - 24 points - mild schizoid
27 - 30 points - intermediate schizoid
33 - 36 points - "complete" schizoid.

and on a schizotypal test I did once:
Ideas of reference: 4.5 out of 9 (unsure: 0)
Excessive social anxiety: 5.5 out of 8 (unsure: 0)
Odd beliefs or magical thinking: 5 out of 7 (unsure: 0)
Unusual perceptual experiences: 5.5 out of 9 (unsure: 0)
Odd or eccentric behavior: 5.5 out of 7 (unsure: 0)
No close friends: 3 out of 9 (unsure: 0)
Odd speech : 5.5 out of 9 (unsure: 0)
Constricted affect: 4 out of 8 (unsure: 0)
Suspiciousness: 3.5 out of 8 (unsure: 0)
Total SPQ-A: 42 out of 74

I couldn't really find out how this I'm more on the edge of it.
So, trait's from both, clearly more from schizotypal PD.


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Raziel
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28 Sep 2012, 2:33 pm

here is something about StPD:

[youtube]http://www.youtube.com/watch?v=H8PzoXVXMTk[/youtube]

and here about SPD:

[youtube]http://www.youtube.com/watch?v=797yHq1CtPQ[/youtube]


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