Symptoms of schizophrenia

In books on psychology you can see varied opinions regarding what obsessive states are. Some authors and scientists argue that obsessive thoughts are schizophrenia, others have a different opinion, believing that such thoughts and conditions are a separate mental disorder or one of the symptoms of obsessive-compulsive disorder. In this article, obsessive thoughts will be considered from the point of view of one of the parts of schizophrenic personality change, so it will be possible to agree with some points, while others will cause some debate.

Are obsessive thoughts always a sign of schizophrenia?

What are obsessive thoughts?

This is a fairly severe anxiety disorder, characterized by frequently repeated, barely controllable thoughts that lead to specific ritual actions. In such situations, a person is literally forced to perform certain actions, behave in a specific way, in order to satisfy and indulge his thoughts.

A simple example can be given. A person has a fear that he constantly forgets to do something when leaving home. As a result of obsessive thoughts, every day before leaving, he checks whether all the windows are closed, whether the gas is turned off, whether the ventilation system is working correctly, and after leaving the house at a distance of 5-10 minutes of walking, he returns to his apartment again to double-check whether he closed front door or not.

Naturally, such thoughts can be a common precaution, but if a similar situation is repeated day after day, then we should talk about obsessive states. In addition, these thoughts can take on a very severe form, leading to various problems in life and communication with other people. A person begins to behave very strangely, he is inhibited in his actions, and at times delusional ideas arise, which is why obsessive thoughts are often called one of the main symptoms of schizophrenia.

Symptoms of catatonic schizophrenia

Symptoms of catatonic schizophrenia include specific conditions and behavior that complicate the diagnosis by the reluctance of such people to contact the doctor, or anyone else. In addition to the general criteria of the disease (F20.0–F20.3), any of the following signs of catatonic schizophrenia must be observed over a period of at least two weeks:

• waxy flexibility;
• stupor or mutism;
• aimless motor activity;
• freezing in unusual positions;
• automatic obedience;
• “negative” motor activity;
• rigid posture.

Obsessiveness in schizophrenia

As you know, schizophrenia is an insidious mental disorder in which a person’s consciousness changes, he begins to think, act, express his emotions, and perceive reality completely differently. Moreover, “differently” is not just a different opinion, it is abnormal behavior, accompanied by a variety of symptoms: aggression, delusions, hallucinations, etc.

With schizophrenia, a person’s consciousness changes, his obsession acquires delusions, hallucinations, etc.

Obsessive thoughts, by the way, are also one of the signs of schizophrenia, especially if we talk about them not just as a person’s established opinion, but as an opinion that is not based on anything, but is accompanied by ritual actions that are repeated every day.

Symptoms of paranoid (paranoid) schizophrenia

In addition to the general symptoms, the symptoms of paranoid (paranoid) schizophrenia (some are listed above; or see F20.0–F20.3 according to ICD-10) include delusions of a special nature:

• persecution;
• jealousy;
• meanings and relationships;
• bodily transformation;
• special mission;
• high origin.

“Voices” also refer to signs of paranoid (paranoid) schizophrenia. They can be commanding or threatening; Deceptions of taste, smell and bodily sensations may be present.

Symptoms

Obsessive ideas in schizophrenia are represented by a large number of different manifestations, from which it is not difficult to guess that a person suffers from this and not any other disease:

1. The emergence of thoughts in a person that are alien and unacceptable to him. For example, a person constantly remembers unpleasant moments from his life, the death of loved ones, and therefore tries in his own way to solve a problem that actually does not exist.
2. Emotional disorders. In this case, a person’s intellect is seriously affected, he experiences sudden mood swings - from cordiality to aggression, from intense joy to endless grief.
3. Even if obsessive thoughts irritate the person himself, he does not stop replaying them in his head again and again. Example: a person has the idea to start counting cars passing by. When it gets boring and even annoying, he cannot stop - “one more car and that’s it,” “okay, one more,” etc. He continues the strange activity until he can switch to something else.

As experts note, obsessions can be seen in most people on our planet, but their most striking manifestations may indicate that a person has schizophrenia.

A person cannot control his thoughts, even if they irritate him, he repeats crazy ideas in his head again and again

Symptoms of low-grade schizophrenia

The striking signs of sluggish schizophrenia include features of a “style” that runs counter to generally accepted norms and norms of recognized subcultures. Such a person can create the impression of being emotionally cold and detached from reality. His appearance may contain eccentric details that emphasize flashes of non-standard behavior.

The most noticeable symptoms of sluggish schizophrenia, which manifest themselves episodically from the people around them, include:

• pretentious speech;
• obsessive rumination;
• quasi-psychotic seizures with hallucinations;
• delusional ideas.

Often such people are committed to strange beliefs of a magical nature, which determine their behavior in society; it can be a unique picture of the world, different from existing ones, or individually complementing them.

Causes

If we discuss the topic of obsessions in schizophrenia, then the main reason for their occurrence is precisely a mental disorder. However, there are also accompanying factors that lead to the appearance of such thoughts:

• Biological factors. This should include the structural features of the brain and genetic predisposition.
• Psychoneurological factors. Here we should mention the human complexes that arose in childhood, the predominance of the qualities of anancastic personality disorder, in which a person has a certain obsession with an idea, a tendency to doubt, etc. We must not forget about the ordinary exhaustion of the nervous system.

Experts who have been studying psychotherapy for many years will help determine the exact cause of the disease. Moreover, diagnosing schizophrenia often takes a minimum of time and does not require large financial costs.

Is obsession always a schizophrenia?

Today, more and more people agree that obsession is indeed a symptom of schizophrenia, although one should never jump to conclusions. It is better to give clear examples of when such conditions can be considered schizophrenia:

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• Obsessive thoughts become uncontrollable and sometimes dangerous for people around them, but a person with such ideas cannot help himself.
• Ideas cause delirium, hallucinations, and a person’s thinking changes radically.
• Thoughts that cause overwhelming fear (fear of harming yourself, fear of being contaminated, fear of persecution, etc.).
• A person cannot make even the simplest decisions on his own.

At the same time, obsessions can sometimes simply be signs of obsessive-compulsive disorder: ideas of order and symmetry, checking household objects, entrance doors, making sure that loved ones are safe, constantly counting the same things, spending too much time for cleaning, etc.

Obsessive thoughts are not always schizophrenia, but if they turn into delusions, hallucinations, aggression, you need to seek medical help

Obsessive-compulsive disorder

Obsessive-compulsive disorder is a mental disorder, the second name of which is obsessive-compulsive disorder. The course of the disease can be chronic or episodic, with a tendency for symptoms to progress. The cause of most clinical cases of the disorder are disorders of a neurotic nature (stress, psychological trauma), and, much less often, serious illnesses. So, sometimes there is a combination of obsessive-compulsive disorder and schizophrenia.

According to medical statistics, about 1-3% of the population suffers from some form of OCD with varying degrees of symptoms. The first episodes of obsession usually occur at a young age - between 10 and 30 years. Not everyone seeks mental health care, and it can take 8 years from the onset of the disorder to seeing a doctor. The lack of adequate therapy can ultimately lead to temporary disability and hospitalization.

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Obsessive thoughts include a whole range of negative and destructive experiences for the individual: doubts, fears, ideas, visions of the future in a pessimistic light. The patient may live in anticipation that he will soon be fired from his job or will be diagnosed with an incurable disease. There is a fixation on obsession. But at the same time, a person understands the illogicality of his thoughts, but is helpless in the face of their appearance.

Obsessive thoughts can be of different types

Ideas and fears can cause a person to perform strange actions and rituals. This activity is called compulsion. For example, the fear of contracting dysentery forces you to constantly wash your hands or treat them with an antiseptic. Such “procedures” are sometimes repeated 20–30 times a day. And the person cannot help himself - his entire consciousness is focused on fulfilling the compulsion, although he recognizes the absurdity of anxiety and actions. As a result, the patient loses a lot of time, is distracted from important matters, faces ridicule and misunderstanding from others, which further causes discord in his psycho-emotional state.

The appearance of obsessions and compulsions is based on the mechanism of discharge of the nervous system. So, a person can experience old psychological trauma on a subconscious level. To prevent old memories from “resurfacing” again, the patient’s mind tends to concentrate on something else. Intrusive thoughts are an ideal option for this - occupying all the patient’s attention, they protect his mind from unwanted images of the past.

Treatment of OCD

Obsessive-compulsive disorder is a reversible mental disorder. Patients manage to maintain their personality, but in the absence of psychotherapeutic help, obsessive thoughts become constant. A person cannot live, work, or rest normally.

There are 2 main areas of therapy for OCD:

1. Psychotherapeutic. This is the basis of treatment, allowing you to find and eliminate the cause of disorders. Behavioral methods, individual psychotherapy and group work are used. An important role is played by reducing anxiety levels and correcting inappropriate behavior. But the main goal of working with a psychotherapist is to find an avoidable stimulus of obsessive thoughts from past memories and slow down the reaction to it. This may require more than 10 sessions.
2. Drug therapy is impossible without psychotherapeutic help, and in combination with it it gives good results. Antidepressants and antipsychotics are used. The list of drugs, their dosage and dosage regimen must be selected individually in each clinical case.

Treatment usually brings good results. A long-term remission occurs. It is important that the therapist is able to differentiate between OCD and schizophrenia at an early stage.

Psychotherapeutic or drug treatment is prescribed

Treatment

Obsessions in schizophrenia can only be treated with the participation of a professional psychotherapist. Quite often it happens that a person is not able to be in society because of his obsessive thoughts, so he is placed in a hospital where he undergoes full treatment.

As a rule, such people are in a department created for patients with borderline mental disorders. After discharge from the hospital, the patient does not cease to be under the supervision of a doctor; he continues to take certain medications, as well as attend psychotherapeutic courses.

To reduce vegetative symptoms and get rid of obsession, the following medications are used:

1. Drugs related to tranquilizers. Their task is to quickly relieve acute attacks of anxiety and reduce anxiety.
2. Antidepressants. They are used for any anxiety disorders, calm a person and normalize his emotional state.
3. Neuroleptics. Used to treat psychosis and relieve symptoms of obsessive-compulsive disorder.
4. Psychological consultation. It can be carried out along with the use of drugs or without their use. The psychotherapist's task is to reduce the patient's anxiety, which leads to obsessive symptoms.

Psychotherapy in its various manifestations plays a huge role in the treatment of the disease. This includes autogenic and rational therapy, functional training and much more that can be performed in inpatient treatment. The patient must be under the supervision of specialists and under the supervision of relatives for a long time. This is the only way to hope that his condition will improve and the problem will be resolved.

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Schizophrenia

Schizophrenia is a severe psychiatric illness in which obsessions and compulsions can also be observed. In treatment, unlike OCD, long-term medication comes to the fore, and only then psychotherapy. The mechanism of occurrence of mental disorders is also different: if obsessive-compulsive disorder is most often provoked by trauma or stress, then the cause of schizophrenia is genetic abnormalities. External circumstances can only become an impetus for the development of the disease or worsen its course.

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With this disease, a person loses himself as an individual. An important difference between neurosis and schizophrenia is that in the first case the patient can be critical of his condition. He tries to drive away his irrational anxieties and ideas, understands their groundlessness and destructive impact on consciousness. Obsession in schizophrenia is perceived by the patient as a given and reality, and thoughts can take completely bizarre forms, accompanied by hallucinations and delusions. An experienced psychiatrist will be able to distinguish a person’s disease and make a diagnosis: neurosis or schizophrenia.

Schizophrenia is a severe mental disorder

Neurosis-like schizophrenia

It is quite difficult to differentiate obsessional neurosis from schizotypal disorder, which is also called low-grade schizophrenia. The symptoms are erased and not clearly expressed. One of the types of schizotypal disorder is neurosis-like schizophrenia, which is also characterized by obsessions.

Patients with this diagnosis do not experience hallucinations or delusions. No personality defects appear, although other signs of schizophrenia may be present to varying degrees. But still, the patient must be observed by a doctor.

How to distinguish between schizotypal disorder and OCD? With neurosis-like schizophrenia, there is a general strangeness in behavior and eccentricity, while deviations in the psyche of a neurotic are limited to obsessions and compulsions. Patients with schizotypal disorder are often obsessed with global ideas and plans, are careless about their appearance, and may become interested in occult teachings.

Another difference between sluggish schizophrenia and neurosis lies in relationships with the outside world. A neurotic person tries to maintain social roles and connections, while a patient with neurosis-like schizophrenia cares little about this. He quits his job and does not strive to start a family.

Strange behavior is one of the clearest signs of neurosis-like schizophrenia.

Combination of OCD and schizophrenia

Obsessive-compulsive disorder and schizophrenia are fundamentally different diagnoses. But they can be combined with each other. Danish scientists have found that neurosis of obsessive thoughts can become an impetus for the development of more severe psychiatric illnesses. Treatment of OCD in schizophrenia is complex: taking medications in combination with psychotherapy.

The main difference between nervousness and schizophrenia is the preservation of personality and a critical attitude towards one’s condition. If you start treatment on time, you can enter a long-term remission and return to normal life. Medications and psychotherapy will help avoid possible severe mental disorders in the future.