Schizotypal Persoanlity Disorder

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I've been diagnosed with an Autism Spectrum Condition (undifferentiated) and, co-morbidly, with Schizotypal Personality Disorder (SPD). I'd like to hear from others who have the SPD diagnosis.

The psychiatrist that assessed me appeared to lean toward giving me just the SPD diagnosis until he administered the RAADS-R test which strongly indicated that I have AS. I definitely have some of the nine symptoms of SPD spelled out in the DSM-IV-TR, but I struggle to always identify them in myself.

For instance he seemed to think that I qualify as having 'ideas of reference' (which can exhibit as paranoid thinking). I often suspect that others, including my wife, are more interested in their own selfish desires than in some sort of shared achievement that takes my desires and wishes into account. My suspicion leads me to question the motives of others, to stubbornly refuse (or at least resist) to co-operate with them (because I feel that they're trying to manipulate me), and to challenge them about what they really want.

In writing the above, I can clearly link my experience with ideas of reference. However when it happens I really do think that I'm right and that my suspicion and opposition are warranted. Most of the rest of the time, I vacillate between the two positions which makes me feel very unsure of how to relate.

With some of the other nine criteria I similarly can sometimes see that they apply to me, but at other times I cannot. Despite that, I find that the SPD label fits. It describes my experience over many years at least as accurately as having Asperger's or HFA.

I'm particularly interested to hear from others with SPD about how they experience life and their condition. How do you cope (or not) with the paranoia, the excessive anxiety, and other symptoms? I have low motivation and a lack of energy a lot, and I tend to see things as not possible to improve. Do you have the same, and how do you cope with it?

I'm (fortunately) married, and these symptoms cause a lot of problems with my wife, who has AS. Any stories or advice there?

Finally what medications or therapies have people found useful for treating their SPD?

Ja, we seem to be a rare breed. At age 13, I was diagnosed with Asperger's disorder and schizotypal personality disorder in the same session by the same doctor. I find that the ideas of reference, paranoia, and magical thinking match well, but also the social impairments and restrictive interests. I developed what we now recognize was psychosis at age 14, which seemed to bear out the schizotypal diagnosis.

As for the paranoia, just a couple nights ago, when I walked up to my door with a key and dropped the key. I immediately saw an image of the guy who was about 50 feet away running over to rape me; I could hear the rustle of the grass under his feet as he ran. I then snapped out of it, and was a little afraid. As a teenager, I was taught "stop interrupt redirect refocus" and I seem to do it automatically, but it doesn't stop my mind from generating the ideations in the first place. (Note that paranoid ideations are common for me. I'm not responding to any specific trauma from my childhood. I've also had beliefs at the time that if I went by the window at night, someone would be looking through it ready to shoot me when I appeared.)

It gets annoying, to say the least.

I find that interesting because it's the same for me. I can remember thinking bizarre fantasies even as a child, and I've never remembered any event or trauma that would account for them. The most potent one would happen when my father and I were traveling alone in the car. He was generally a silent man, and I would wonder if he was taking me somewhere to kill me. I frequently returned to that same idea whenever we were alone in the car. It always made me feel a bit sick to my stomach, but also oddly excited.

I hadn't linked that experience into my later paranoia until I read your post. Thanks.

Ja, I would have that odd excitement with it, too. There was this sense of almost an empowerment, especially in times when I would give my ideations time in thought, times when I took them more seriously and gave them more time and didn't just dismiss them.

Maybe that's the dopamine system acting up? When I had my psychotic break at age 14, I had that similar odd excitement effect. I was terrified of the implications of my delusions, but I felt this odd excitement at the same time. According to my psyche at the time, I had really weird moods and would often laugh at inappropriate times. I remember at one time noticing I was scaring the people near me, when I was laughing during that time in response to the odd excitement I felt inside. I wonder if that excitement feeling provided the reward that got me deeper and deeper into psychosis at age 14.

I've never thought much about that excitement before. I can easily remember feeling it in the situations in the car where, as you say, I gave it time. I'll have to ponder on whether I felt it, along with the flattened sense of dread, at other times but just dismissed the thoughts.

These days I sometimes get a similar excitement when I think about society collapsing due to a cataclysmic series of events or when I hear about and then think about something horrific such as Columbine-style shootings. I don't abandon myself in these fantasies however in that I usually imagine myself surviving. While I get a mix of excitement and dread/fear, it's qualitatively different than what I felt as a child.

Also I have noticed that thinking violent thoughts calms me down when I'm very agitated. Yet I feel ashamed whenever I act aggressively in reality, even mildly aggressively. I don't like thinking of myself as a violent person.

There's something here about being in control or being at the mercy of someone or something else. There's also something about desperately wanting change, any change, from the same-old same-old patterns.

I can imagine a different way of living, more calm but also more exciting. A disconnection exists between those thoughts and the reality I manifest, and a sense of helplessness in bridging between the two.

Ja, I don't know if it's something specific to schizotypal or general to the schizophrenia spectrum, or if it's related to something else entirely. It'd be nice to get some answers on this.

BTW, one of my old psychological records from childhood did mention how my level of internal arousal, as they called it, seemed to increase in response to themes involving tension, conflict, etc.

It seems like you have had the same issues with internal arousal.

Now, as a kid I was diagnosed with conduct disorder (by age 9). This excitement might be a feature of the underarousal that is often present in people with conduct disorder and antisocial personality disorder. Maybe they were referring to that in my report.

Have you heard of multiple complex developmental disorder? I think this is a term that explains my childhood pretty well. It's where you have symptoms from the autism, schizophrenia, and bipolar spectra, originating in early childhood.

No I haven't heard that term before. I saw in another post that you've received a bipolar diagnosis as well. Sounds like quite the combination to live with.



Yes, it does. My internal arousal is uneven. Most 'positive' experiences don't generate much. Most of my thinking does generate some but with quite a bit of anxiety. Certain events result in substantial arousal, e.g. dangerous situations, whether real or perceived. Some kinds of physical activities, such as working with my hands, results in a moderate level of arousal without anxiety which I find quite pleasant. Certain kinds of fantastic thinking generates intense non-anxious arousal, and, although very attractive, I've found that combination dangerous. It has addictive qualities.



Yes, it would.