Doctor thinks Dd has schizophrenia

[MHIssues]

I’m a little bit freaked out. She’s 20yo and this has pretty much come out the blue. I’ve known she’s been a bit depressed and had anxiety for years. We paid for her to have counselling last year which she said helped.

She’s been back to the doctor today as she is hearing voices and seeing things round the house. She says it’s been going on since she was 14yo, she’ll be fine for a few months and then it starts again and she says it’s been bad for the last week. She’s not told me about this before.

Dr has asked Dd to ask if anyone in our family has a history of psychosis. I always thought there was something seriously not right with my mother mentally though she thought she was fine and refused to see a doctor. Me and my dad thought she had bi polar as she was so up and down (violently so at times). One time she did tell me she’d heard God talking to her while she was cleaning!

Dd is going back to the doctors next week and has been told they probably want to start her on medication.

Please don’t people have a go at me. I’m sitting her crying and am struggling coping with this.

@MHIssues

I know nothing about it and I guess just have this image of it being a condition where you have to keep the household knives locked up….which I’m sure isn’t true. The only stuff I’ve read about it is in the media where someone who is schizophrenic goes on a rampage and kills people!

unfortunately ignorance around this condition is rife and this doesnt help things. people who constantly say they support mental health awareness often only mean depression/anxiety. the stigma needs to be removed. speaking as someone with a friend with this condition , your remarks are really unhelpful.

Your daughter 100% needs to see a psychiatrist for a diagnosis from a specialist.

Is she on any medication for her other conditions?

My DD had auditory hallucinations for nearly 2 years before she told us;
turned out to be a result of steroid-induced psychosis

@MHIssues

I’m incredibly sympathetic towards her and seem to spend my whole life supporting her. I’m aware that any “drama llama” tendencies could be due to her mental health and ptsd. I’m maybe not explaining myself very well but I think I’m hoping for her sake that maybe her tendency to exaggerate stuff may be leading her GP down a false road??! 🤷‍♀️

Don't ever refer to someone with ptsd as a 'drama llama' it's so offensive. If she is prone to emotional lability as a result of trauma, it's possible that she is seeking validation and attention medically - that's very serious. There are any number of reasons she could be manifesting this way but you do sound incredibly dismiss. If you are sympathetic, the language you choose needs to show that.

Your dds gp can't make that diagnosis. She will need a psychiatric evaluation to eliminate other conditions as well as ruling things in. These can take a long time. I've worked with voice hearers and some hear them due to all sorts of conditions. I'd be very wary if her gp is going to try and diagnose your daughter himself.

I’m always sympathetic to her. I would never call her a drama llama to her face. I’m just trying to explain how she is on here for the purpose of this thread. You’ve made me cry @CandyLeBonBon. Thanks.

Wow some of the posters on here sound completely lacking in the empathy they are telling you to have more of. 🙄

Your DD definitely does need a MH referral for a proper assessment. There are several conditions which can have psychotic features it does not necessarily mean it is Schizophrenia so try not to panic.

If it is a diagnosis of Schizophrenia then a team which deal with early diagnosis and treatment would hopefully be involved and the results from that these days mean a lot of people can live normal lives unlike the old days when I did my MH nurse training.

If you want to PM me anytime op please do.

It could be schizophrenia (my sister developed this around the same age), or it could be psychotic depression (given she already has a diagnosis of depression). Your GP needs to refer her for an urgent specialist mental health assessment. If she has thoughts of self harm or harming others I would keep the knives locked up (speaking from experience).

I think you can be equally sympathetic of your dd and frustrated at her occasional exaggeration. Mental health problems don't make you impervious to human flaws!
She's at an age where she is quite impressionable, and often Drs can ask quite leading questions. As previous posters have said, a lot of people hear voices! It's not schizophrenia unless it's repeated, if it just happens to you once or twice in a particular time frame then it's psychosis. A lot of new mums get psychosis but we wouldn't say they were schizophrenics.
A lot of people share the old fashioned idea of locking away the knives. It's not true. Most schizophrenics are normal people who hear voices and actually some miss the voices if they go away. A good MH team will be able to speak to her more about her experiences and then guide her should she want a more formal assessment. Try to stay calm and don't think the worst.

Schizophrenia should be a diagnosis of exclusion after every other possibility has been ruled out and the diagnosis needs to be done by a psychiatrist so if the GP hasn't referred her on, he is being negligent.

OP, this sounds very hard. I understand why some may have bristled at the language that you used about your daughter but I get that there can be a level of burnout that can come with years of living with someone with severe mh difficulties and trying to help when you don’t know what’s actually going on.

Try to take this a step at a time. This is my professional area so I’ll do my best to offer some sensible advice here. First of all, a GP is absolutely NOT qualified to diagnose or medicate for psychosis, first of all. She needs a referral for a psychiatrist assessment, as other posters have said - the first priority is to ensure that happens and she’s properly assessed. Symptoms of psychosis eg unusual experiences and beliefs, hearing voices, can have many causes, including trauma and post traumatic stress, medications, drug use, particularly hallucinogenics and more psychoactive forms of weed. If your daughter is saying she can’t remember anything before 14, what she means is that she may have some “memory blackouts” relating to that time rather than no memories at all. The memory is patchy rather than nonexistent, which can be scary, because while the mind can’t recall, the body can and does. There is a book called The Body Keeps the Score which may be helpful to understand some of the long term effects of trauma, particularly in childhood. Education is your friend when it comes to trauma and that will be practically of more use than just sympathy.

Finally, episode of psychosis also does not equal schizophrenia. GP is jumping the gun here.

In addition to the psychiatrist assessment and medication, they should also look at what other help can be offered, such as group or individual therapies, learning coping strategies, psychoeducation to help both of you understand what is happening and why. Once she is stable, trauma therapy of some kind (trauma focused CBT, EMDR, talking therapy or preferably a combination) might help to address some of the underlying causes if she has had symptoms of or a diagnosed episode of psychosis.

As above a GP cannot diagnose schizophrenia and it sounds like he is simplifying a diagnosis to hears voices must be that, whereas other conditions can have psychosis including bipolar, or it could be, from.whqt you have said, that she is making it up like the no memories, which still means she needs help. Either way she needs referring for further assessment.

The Royal College of Psychiatrists have an amazing website where it explains in easy to read language about many different mental health conditions. I have used it to help people understand their diagnosis and to take away other people's fears about schizophrenia. After reading it they have realised it isn't as in the movies or papers but that outcomes are positive. It has statistics which evidence that it is only a very small percentage of people who have significant difficulties. www.rcpsych.ac.uk/mental-health/problems-disorders/schizophrenia

There are also movements such as Hearing Voices Network who help people learn to manage the voices they hear, such as by working out the positive and negative ones and listening to the ones which help (bit over simplified).

Hope that helps.

She reckons she has no memories at all from before the age of about 14yo. Which I’m not sure can be true. And she says that but then a few weeks later will say about something which demonstrates she can remember stuff before the age of 14yo.

That’s interesting OP - I too have very very few memories of my childhood, most memories are actually from photos I saw again later. I had a traumatic childhood until I had was about 11 or 12. If her trauma happened in childhood then this may be accurate. Sometimes I will get a snippet of a memory but it’s very vague, and more often it’s me remembering a photo or a story I’ve been told rather than the event

I think if anyone is lacking in empathy it's the posters who are choosing to criticise the op's language at a hugely stressful time in her life. Is this how you would support a friend in this situation?

Op, sending you all the best for you and your daughter.

I'm also aware that with dd what she says the GP said may not exactly be what the gp said. She was talking like it was pretty much a done deal and that the gp was thinking about what meds to start her on.

@CandyLeBonBon just stop, you are not helping at all.

And I'm sure she doesn't do that on purpose... Its more to do with her negative outlook. He might mention a few possibilities and she genuinely hears that she's got schizophrenia

@MHIssues

I'm also aware that with dd what she says the GP said may not exactly be what the gp said. She was talking like it was pretty much a done deal and that the gp was thinking about what meds to start her on.

Op. I wasn't being deliberately harsh. I just know how dismissive it feels as someone who has gone through similar experiences as your dd, to be labelled dramatic, or whatever. It's incredibly distressing. But if I've upset you, I apologise. As a fellow MH sufferer I agree that this doesn't appear quite right. A referral to the primary mental health team where she will get a full psychiatric evaluation is what happens in my area and I imagine it's similar elsewhere?

Your GP isn't qualified to make a diagnosis but prescribing meds is possible - mine did before I saw my gp but I'd been presenting with symptoms for some time so they were aware of the history and a psychiatric referral took a while. Not sure what the case is for you but that might be helpful in understanding the process a bit? (I understand trusts can operate differently).

My CPN started me on an anti psychotic. I have never seen a psychiatrist. Some of these posters are misinformed. Stay strong, you are doing a good job supporting your dd.

It may be the GP is seeing her in a week to continue to assess her risk whilst a psychiatrist appointment is awaited. If there's any change in risk, they could request she's seen more urgently.

Hearing voices does not equal psychosis. The experience of previously called pseudohallucinations can also be part of the complex PTSD presentation or borderline personality disorder for example. I'm not saying it is either of those but voices doesn't equal schizophrenia is what I'm trying to emphasize.

Also, I'm a qualified psychiatrist.

I am also a psychiatrist, with a 30-year career in treating schizophrenia. Just to emphasise as others have done: She needs to see a psychiatrist, the GP cannot make this diagnosis. This could be schizophrenia (and there are different types within that diagnosis) or it could be a number of other diagnoses, as has been explained.

Agree other conditions need to be ruled out first, coeliac disease can have symptoms in the brain rather than the gut and can lead to B12 deficiency which can cause hallucinations. It is also auto immune so could relate to her other auto immune conditions.

@Ladderinmytights

Your case will have been discussed at a Multi Disciplinary Team Meeting where there will have been psychiatrist input, even if you’ve never seen the psych yourself. CMHTs work in teams where they all advise each other. Just as an aside, who decided you needed long term input from a CPN if you’ve never seen a psych? Generally the psychiatrist in charge decides how key workers/ care cos are allocated.

@candylebonbon thank you. I'm always very careful to not come across to dd as being dismissive. I am genuinely aware that even when it seems like she's exaggerating, etc that it's all very real to her.

@LiveintheNow

Agree other conditions need to be ruled out first, coeliac disease can have symptoms in the brain rather than the gut and can lead to B12 deficiency which can cause hallucinations. It is also auto immune so could relate to her other auto immune conditions.

She has coeliac disease amongst other stuff. Her vit b12 though when they tested it recently was abnormally high.