Thursday 30 January 2020

Breaking the Fear of Psychosis

Hello, I know you guys have answered these types of questions a hundred times but I’m just looking for a little extra guidance from an outside source.

I have had anxiety for most of my life and have had it fairly well managed with therapy and occasionally medication as prescribed. I always turn it around and end up feeling great and carrying on with my life. Ever since I was a little kid I had the fear of “being crazy.” It seems to be a common topic amongst us anxious people. It will rear its ugly head during my anxiety flare ups, and I’ll usually get it back under control and carry on. These last 5-7 months though I’ve not been able to shake it. I made the stupid mistake of reading about psychosis and schizophrenia and of course now my anxiety has damn near “mimicked” every symptom. My intrusive thoughts that I’ve always had, I now question and fear will become “delusions.”

My hyperawareness Clings on to the slightest movement out of corner of eye or the slightest off sound and then thinks “was that a hallucination”. Someone mentioned that the vents in my office building sound like birds flapping/faint whispers and now that’s all I hear when I am around vents/fans (which is darn near anywhere these days) so then I fear that because I associate a sound to another, something must be wrong with me. Or if I accidentally say the wrong word, etc.

I don’t know how to get my anxiety past this stage of hyperaware where it is searching to “prove” my fear of psychosis. It’s exhausting. My psychiatrist has assured me I’m having no hallucinations as I am experiencing these moments only as there is external stimuli but it’s still hard to shake it. All of this panic because someone simply suggested what they thought something sounded like and my anxious mind went running with it.

So my questions are as follows:
1. The obvious question is does any of this sound like I’m actually experiencing early psychosis. I can’t help but ask.

2. How do recommend learning to let go of the hyperawareness. I’m really open to all as I’ve been doing my therapy etc and am simply looking for a 3rd party opinion to calm the nerves.

On one hand, you describe your anxiety as being relatively under control. On the other hand, it seemingly is not, at least not for the last 5 to 7 months. Perhaps your current treatment is not working or an adjustment may be needed. That adjustment may require a different type of treatment, more intense treatment, or a different type or dosage of medication. It would be best to discuss these potential adjustments with your psychiatrist and/or therapist.

One of the things that seems to have exacerbated your anxiety is your searching for information about psychosis and schizophrenia online. Despite knowing that this does exacerbate your anxiety, you do it anyway. You write about it as though you have no control over it, but in actuality you do. No one is forcing you to do the searches. You are the one going to the computer and entering the phrases into the search engine. You are choosing to do the searches even though it causes anxiety. This is a way of indulging your anxiety. You know it’s wrong but you’re doing it anyway. You have to think about why you are engaging in behavior that you know hurts you. Why are you allowing yourself to indulge your anxiety? You can simply end this particular issue by not doing the searches and by not doing the things that you know will exacerbate your anxiety. You’re making a choice, the wrong choice but the good news is that you can choose otherwise. Choose not to search. Try not doing it. Give it your best effort.

Relatedly, you consulted your psychiatrist who has heard your symptoms and has assured you that there is no evidence of psychosis. His reassurance does not seem to matter to you. It could be that you are simply rejecting his expert opinion and are choosing to believe something else, something that inflames your anxiety. This again is a choice. Your choosing not to believe in objective reality is a choice. The key to overcoming anxiety is to believe in reality.

Your psychiatrist assures you that you do not have symptoms of schizophrenia. You don’t seem to be demonstrating any of the signs thus far. The slightest movement out of the corner of your eye and the other related faint whispers that you hear are not consistent with hallucinations or delusions. Force yourself to believe in reality. Use facts to stay grounded in reality. The more that you can do this, the easier it will be to overcome your anxiety. Understandably, that is easier said than done. Counseling is the ideal place to practice these skills.

At this time, you’re choosing to believe in things that are not real and are rejecting the objective opinion of your treatment professionals. That feeds your anxiety. You can control this. You can overcome this with counseling and by forcing yourself to believe in reality and the importance of doing so.

To answer your direct questions, it does not seem as though you are experiencing early psychosis however, only an in-person therapist could make that determination. Diagnosis over the Internet is impossible. You did have an in-person therapist who has already determined that you do not have psychosis but as I mentioned above, you are choosing not to believe his opinion. Believe his opinion. It could help you immensely.

My answer to your second question is, I believe, already contained in my response above. Work on believing in reality and staying grounded in the facts. Don’t allow yourself to indulge your anxiety. No one is forcing you to research issues that frighten you and inflame your anxiety. You are making that choice. You can make different choice in the future.

I hope this helps. Write again if you have additional questions. Please take care.

Dr. Kristina Randle



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