Schizophrenia - General Discussion

I’m wondering if schizophrenia can just be a one-time thing in someone's life, or is it a lifelong cycle? My sister went through one episode, which doctors labeled as F20. We didn't go for hospitalization and things eventually settled down, but I’m still living with this constant anxiety...
It mostly happened during an incredibly stressful stretch—objectively speaking. It manifested as these delusional ideas, like people were following her or watching her from the windows of the apartment building next door, or everyone was plotting to hurt her. She would talk total nonsense—stories where the "characters" were people we know personally, even though they had absolutely nothing to do with whatever topic she was spinning, all supposedly part of a plot against her. Many of these people she hasn't seen in years, let alone having any connection to her situation. There were cycles of her talking this nonsense (the whole family would just sit there listening, too afraid to tell her it wasn't true) and crying. She also became convinced all her friends were in on the conspiracy to harm her.
So... I accompanied her to the doctor for the first time, and then a few more times when I could. In my opinion, that first doctor handed out such a heavy diagnosis far too easily. They even referred us to a social worker who pushed for hospitalization. What I resent most is that despite the symptoms I described, the doctor added hallucinations to the mix, which isn't true! The doctor claimed my sister said she saw eyes, but that’s just false. I was right there while she was explaining how she thought people were following her, and the doctor asked, "Right, do you sometimes see eyes too?" My sister, being completely lost and overwhelmed, replied, "No, I don't see them, I don't know, I don't see them." And this idiot interprets that response as a "yes." If I hadn't been standing there, who knows...
Ultimately, things stabilized through a combination of medication, sleep, and taking some time off work. After about four months, she went back to her job. Since then, she seems to function normally, though she's become very withdrawn, so I don't really know the details. What do you all think? Does anyone have similar personal experiences or stories about a close loved one?

I’ve been following this thread since the very beginning because, honestly, it’s just brilliant—totally out of the blue. I’m sticking with it, and I just have to say: you guys living with schizophrenia are easily the "most normal" group (if you can even call it that!) I’ve encountered in my Psychology studies. You seem to be the most upbeat crowd, too, and definitely the least likely to spend all day complaining.😁 Sending much love to everyone. This might not mean much to anyone else, but I just felt like I had to get it out there.

Carl Jackson said:I’m wondering if schizophrenia can just be a one-time thing in someone's life, or is it a lifelong cycle? My sister went through one episode, which doctors labeled as F20. We didn't go for hospitalization and things eventually settled down, but I’m still living with this constant anxiety...
It mostly happened during an incredibly stressful stretch—objectively speaking. It manifested as these delusional ideas, like people were following her or watching her from the windows of the apartment building next door, or everyone was plotting to hurt her. She would talk total nonsense—stories where the "characters" were people we know personally, even though they had absolutely nothing to do with whatever topic she was spinning, all supposedly part of a plot against her. Many of these people she hasn't seen in years, let alone having any connection to her situation. There were cycles of her talking this nonsense (the whole family would just sit there listening, too afraid to tell her it wasn't true) and crying. She also became convinced all her friends were in on the conspiracy to harm her.
So... I accompanied her to the doctor for the first time, and then a few more times when I could. In my opinion, that first doctor handed out such a heavy diagnosis far too easily. They even referred us to a social worker who pushed for hospitalization. What I resent most is that despite the symptoms I described, the doctor added hallucinations to the mix, which isn't true! The doctor claimed my sister said she saw eyes, but that’s just false. I was right there while she was explaining how she thought people were following her, and the doctor asked, "Right, do you sometimes see eyes too?" My sister, being completely lost and overwhelmed, replied, "No, I don't see them, I don't know, I don't see them." And this idiot interprets that response as a "yes." If I hadn't been standing there, who knows...
Ultimately, things stabilized through a combination of medication, sleep, and taking some time off work. After about four months, she went back to her job. Since then, she seems to function normally, though she's become very withdrawn, so I don't really know the details. What do you all think? Does anyone have similar personal experiences or stories about a close loved one?

It is possible for everything to remain just a single psychotic episode. The key is ensuring she takes her medication exactly as prescribed, and any changes or reductions in therapy should only happen in consultation with her doctor.

However, I don't quite understand why they gave her a schizophrenia diagnosis right away. Typically, a first psychotic episode isn't labeled as schizophrenia, even when it seems pretty obvious. Usually, that diagnosis is reserved for when a decompensation happens again. 🤷 At least, that’s how my doctors explained it to me, and it's how the procedure worked for several other cases I've known.

Hallucinations aren't a requirement for schizophrenia; a patient doesn't necessarily have to experience them for it to be classified as the illness. (Though, of course, that doesn't justify the doctors attributing symptoms here.)

Michelle Evans said:It is possible for everything to remain just a single psychotic episode. The key is ensuring she takes her medication exactly as prescribed, and any changes or reductions in therapy should only happen in consultation with her doctor.

However, I don't quite understand why they gave her a schizophrenia diagnosis right away. Typically, a first psychotic episode isn't labeled as schizophrenia, even when it seems pretty obvious. Usually, that diagnosis is reserved for when a decompensation happens again. 🤷 At least, that’s how my doctors explained it to me, and it's how the procedure worked for several other cases I've known.

Hallucinations aren't a requirement for schizophrenia; a patient doesn't necessarily have to experience them for it to be classified as the illness. (Though, of course, that doesn't justify the doctors attributing symptoms here.)

It seems weird to me too. If you don't account for all the stress and the circumstances surrounding the episode, and just base everything on one 10-15 minute conversation, then yeah—that diagnosis comes way too fast.
I wasn't about to let such a rushed, thoughtless diagnosis follow her around for the rest of her life, so I went to see a "distinguished" private neuropsychiatrist for a second opinion. He was in a rush. He told me he couldn't say anything until he saw her, then practically kicked me out after two minutes while still charging the full session fee... as if we’d been there for 45 minutes. Fine. So she goes in, and he repeats the exact same diagnosis. Of course, he saw the initial report, and I told him that was specifically why we were there. He prescribed some meds—I can't remember the names because I was in a complete fog from everything—but we paid about $275 for the visit. Then he suggested hospitalization. Those meds just made her sleep constantly, which honestly wasn't the worst thing. We went back to the local clinic where the first doctor was, and it was the same old story: more meds, more talk about hospitalization, end of story. It makes me wonder how they handle young people facing these issues for the first time if this is their approach... how do they even deal with them in a hospital setting? We didn't go through with it. I was leaning toward it at certain points, but my dad definitely said no, so she wasn't hospitalized. The worst part was the weight gain from the medication; eventually, she just decided on her own—I'm not sure when exactly—to stop taking them. My dad supported her stopping, but I didn't. But what am I supposed to do with a 26-year-old adult? I can't tie her down and force-feed her pills. I can't achieve anything without her cooperation. Mostly, things just settled down and we stopped talking about it, especially not in front of her, but I'm still constantly anxious. She's still depressed, almost non-stop, angry, and we have to walk on eggshells around her...

What should I do? Is there any way to approach people this sensitive? Can anyone with experience tell me what the actual symptoms of living with schizophrenia are? I read here on the forum that it mostly hits young people around age 18; is that true?

I was just wondering, is there any actual chance for a younger family member to get some kind of disability benefits, or like, any sort of government assistance in any form, seeing as they aren't able to work and the diagnosis is F20?

Carl Jackson said:It seems weird to me too. If you don't account for all the stress and the circumstances surrounding the episode, and just base everything on one 10-15 minute conversation, then yeah—that diagnosis comes way too fast.
I wasn't about to let such a rushed, thoughtless diagnosis follow her around for the rest of her life, so I went to see a "distinguished" private neuropsychiatrist for a second opinion. He was in a rush. He told me he couldn't say anything until he saw her, then practically kicked me out after two minutes while still charging the full session fee... as if we’d been there for 45 minutes. Fine. So she goes in, and he repeats the exact same diagnosis. Of course, he saw the initial report, and I told him that was specifically why we were there. He prescribed some meds—I can't remember the names because I was in a complete fog from everything—but we paid about $275 for the visit. Then he suggested hospitalization. Those meds just made her sleep constantly, which honestly wasn't the worst thing. We went back to the local clinic where the first doctor was, and it was the same old story: more meds, more talk about hospitalization, end of story. It makes me wonder how they handle young people facing these issues for the first time if this is their approach... how do they even deal with them in a hospital setting? We didn't go through with it. I was leaning toward it at certain points, but my dad definitely said no, so she wasn't hospitalized. The worst part was the weight gain from the medication; eventually, she just decided on her own—I'm not sure when exactly—to stop taking them. My dad supported her stopping, but I didn't. But what am I supposed to do with a 26-year-old adult? I can't tie her down and force-feed her pills. I can't achieve anything without her cooperation. Mostly, things just settled down and we stopped talking about it, especially not in front of her, but I'm still constantly anxious. She's still depressed, almost non-stop, angry, and we have to walk on eggshells around her...

What should I do? Is there any way to approach people this sensitive? Can anyone with experience tell me what the actual symptoms of living with schizophrenia are? I read here on the forum that it mostly hits young people around age 18; is that true?

From what I can see, the hurdle here is that she doesn't want to be hospitalized, but it might be (or even likely is) necessary. When you're in a facility for a month or two under 24-hour medical supervision, it's much easier to find the right treatment plan than it is after a single 45-minute talk. People are often hospitalized for much milder issues than schizophrenia.
Secondly, regarding the diagnosis itself, it doesn't mean much to me personally. It changes constantly; in my five years of psychiatric treatment, I think I've had about ten different diagnoses. My latest is F20.0, but after my last hospital stay, it was F20.4 (postschizophrenic depression). One doctor I see for psychotherapy told me my condition looks more like bipolar disorder, while my primary doctor insists it's probably schizoaffective disorder because of my frequent mood swings. Yet, the diagnosis remains F20.0. So, the label itself isn't the most important thing to me; it's more about the medications I take.
Maybe try talking to your sister again about agreeing to hospitalization—try explaining that it isn't a prison, it's a hospital, and that she will actually feel better.
You can develop schizophrenia at any time, though it most commonly manifests around age 18.

electricharbor30 said:I was just wondering, is there any actual chance for a younger family member to get some kind of disability benefits, or like, any sort of government assistance in any form, seeing as they aren't able to work and the diagnosis is F20?

I actually have a friend who deals with psychosis and is unable to work, and since she doesn't have a formal employment history, she receives disability payments from the state$417.

Carl Jackson said:It seems weird to me too. If you don't account for all the stress and the circumstances surrounding the episode, and just base everything on one 10-15 minute conversation, then yeah—that diagnosis comes way too fast.
I wasn't about to let such a rushed, thoughtless diagnosis follow her around for the rest of her life, so I went to see a "distinguished" private neuropsychiatrist for a second opinion. He was in a rush. He told me he couldn't say anything until he saw her, then practically kicked me out after two minutes while still charging the full session fee... as if we’d been there for 45 minutes. Fine. So she goes in, and he repeats the exact same diagnosis. Of course, he saw the initial report, and I told him that was specifically why we were there. He prescribed some meds—I can't remember the names because I was in a complete fog from everything—but we paid about $275 for the visit. Then he suggested hospitalization. Those meds just made her sleep constantly, which honestly wasn't the worst thing. We went back to the local clinic where the first doctor was, and it was the same old story: more meds, more talk about hospitalization, end of story. It makes me wonder how they handle young people facing these issues for the first time if this is their approach... how do they even deal with them in a hospital setting? We didn't go through with it. I was leaning toward it at certain points, but my dad definitely said no, so she wasn't hospitalized. The worst part was the weight gain from the medication; eventually, she just decided on her own—I'm not sure when exactly—to stop taking them. My dad supported her stopping, but I didn't. But what am I supposed to do with a 26-year-old adult? I can't tie her down and force-feed her pills. I can't achieve anything without her cooperation. Mostly, things just settled down and we stopped talking about it, especially not in front of her, but I'm still constantly anxious. She's still depressed, almost non-stop, angry, and we have to walk on eggshells around her...

What should I do? Is there any way to approach people this sensitive? Can anyone with experience tell me what the actual symptoms of living with schizophrenia are? I read here on the forum that it mostly hits young people around age 18; is that true?

Most cases emerge by age 25, though it can certainly happen later...

Regarding the symptoms you asked about, the progression, and treatment options, your best bet is to look through these articles from the "living with schizophrenia" brochure. They explain everything clearly and thoroughly:

1.

2.

3.

4.

It’s unfortunate that she stopped her medication on her own without medical supervision. It’s even harder when the family supports that decision. Family involvement is vital to recovery; if relatives feel ashamed and try to sweep the issue under the rug instead of providing proper support, it makes things much more difficult...

Hospitalization is standard procedure during psychosis, regardless of age, so the doctor's recommendation isn't unusual, even if it feels shocking to you...

I don't understand why they would assign a schizophrenia diagnosis immediately. Typically, for a first psychotic episode, you wouldn't label it schizophrenia, even if it seems obvious. Usually, you only record a schizophrenia diagnosis once a decompensation recurs. That is how my doctors explained it, and that was the standard procedure in several cases I am aware of.

Yes, it is certainly not standard practice to list F20 right after the first psychotic decompensation. Even when the schizophrenia is clearly evident, clinicians often opt for F23 due to the "psychological impact." Similarly, there are patients who clearly meet the criteria for F20, yet the diagnosis is never officially recorded because the therapist realizes the patient wouldn't be able to handle it if it were verified.
Therefore, while it is technically possible to document F20 immediately in rare instances, it is truly not the norm.

Just asking, is there any chance a younger family member could receive disability benefits or some form of government assistance, given that he is unable to work and his diagnosis is F20?

They should contact the American Statistical Association in their local area.

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driftinggull21 said:

I don't understand why they would assign a schizophrenia diagnosis immediately. Typically, for a first psychotic episode, you wouldn't label it schizophrenia, even if it seems obvious. Usually, you only record a schizophrenia diagnosis once a decompensation recurs. That is how my doctors explained it, and that was the standard procedure in several cases I am aware of.

Yes, it is certainly not standard practice to list F20 right after the first psychotic decompensation. Even when the schizophrenia is clearly evident, clinicians often opt for F23 due to the "psychological impact." Similarly, there are patients who clearly meet the criteria for F20, yet the diagnosis is never officially recorded because the therapist realizes the patient wouldn't be able to handle it if it were verified.
Therefore, while it is technically possible to document F20 immediately in rare instances, it is truly not the norm.

Just asking, is there any chance a younger family member could receive disability benefits or some form of government assistance, given that he is unable to work and his diagnosis is F20?

They should contact the American Statistical Association in their local area.

Wait, does that actually happen?
I'm talking about the part in bold.

Is there actually anything left?

Harold Anderson3 said:It really frustrates me how doctors and hospital staff tend to downplay things, acting like schizophrenia isn't that big of a deal—or that any mental health struggle isn't. They essentially try to sugarcoat it for us, but once you step back out into the real world and leave the hospital behind, you realize how overwhelming it really is and how much of a struggle it can be. The medication makes me feel a bit slowed down, and I catch myself daydreaming quite often, which people definitely notice... I'm speaking from experience regarding how this affects my job.
And don't even get me started on the idea of trying to maintain a relationship with someone who doesn't have these struggles.
My advice to you, Larry Lewis, is to try and stay active with some kind of work. I deal with mood swings too, but I've managed to hold down the same job for over three months now. It's nothing fancy—just feeding metal sheets into a machine and catching them as they come out—but I actually find happiness in it.
Hang in there, 😉

I mostly struggle with low moods, though my soul feels somewhat at peace. I honestly don't think a job would help me—it never did before, and if anything, it just makes things worse because I can't stand being told what to do by authority figures. If I were to hit the jackpot in the lottery, 🙂playing sports is really the only thing that helps me.

driftinggull21 said:

I don't understand why they would assign a schizophrenia diagnosis immediately. Typically, for a first psychotic episode, you wouldn't label it schizophrenia, even if it seems obvious. Usually, you only record a schizophrenia diagnosis once a decompensation recurs. That is how my doctors explained it, and that was the standard procedure in several cases I am aware of.

Yes, it is certainly not standard practice to list F20 right after the first psychotic decompensation. Even when the schizophrenia is clearly evident, clinicians often opt for F23 due to the "psychological impact." Similarly, there are patients who clearly meet the criteria for F20, yet the diagnosis is never officially recorded because the therapist realizes the patient wouldn't be able to handle it if it were verified.
Therefore, while it is technically possible to document F20 immediately in rare instances, it is truly not the norm.

Just asking, is there any chance a younger family member could receive disability benefits or some form of government assistance, given that he is unable to work and his diagnosis is F20?

They should contact the American Statistical Association in their local area.

At the end of the day, the specific diagnosis matters less than the actual health of the patient. We use working diagnoses for a reason. It’s ungrateful and risky to pigeonhole someone into a specific category too early, only to find out later that they don't actually fit that mold.

Harold Anderson3 said:From what I can see, the hurdle here is that she doesn't want to be hospitalized, but it might be (or even likely is) necessary. When you're in a facility for a month or two under 24-hour medical supervision, it's much easier to find the right treatment plan than it is after a single 45-minute talk. People are often hospitalized for much milder issues than schizophrenia.
Secondly, regarding the diagnosis itself, it doesn't mean much to me personally. It changes constantly; in my five years of psychiatric treatment, I think I've had about ten different diagnoses. My latest is F20.0, but after my last hospital stay, it was F20.4 (postschizophrenic depression). One doctor I see for psychotherapy told me my condition looks more like bipolar disorder, while my primary doctor insists it's probably schizoaffective disorder because of my frequent mood swings. Yet, the diagnosis remains F20.0. So, the label itself isn't the most important thing to me; it's more about the medications I take.
Maybe try talking to your sister again about agreeing to hospitalization—try explaining that it isn't a prison, it's a hospital, and that she will actually feel better.
You can develop schizophrenia at any time, though it most commonly manifests around age 18.

I actually have a friend who deals with psychosis and is unable to work, and since she doesn't have a formal employment history, she receives disability payments from the state$417.

driftinggull21 said:

I don't understand why they would assign a schizophrenia diagnosis immediately. Typically, for a first psychotic episode, you wouldn't label it schizophrenia, even if it seems obvious. Usually, you only record a schizophrenia diagnosis once a decompensation recurs. That is how my doctors explained it, and that was the standard procedure in several cases I am aware of.

Yes, it is certainly not standard practice to list F20 right after the first psychotic decompensation. Even when the schizophrenia is clearly evident, clinicians often opt for F23 due to the "psychological impact." Similarly, there are patients who clearly meet the criteria for F20, yet the diagnosis is never officially recorded because the therapist realizes the patient wouldn't be able to handle it if it were verified.
Therefore, while it is technically possible to document F20 immediately in rare instances, it is truly not the norm.

Just asking, is there any chance a younger family member could receive disability benefits or some form of government assistance, given that he is unable to work and his diagnosis is F20?

They should contact the American Statistical Association in their local area.

thanks

Harold Anderson3 said:From what I can see, the hurdle here is that she doesn't want to be hospitalized, but it might be (or even likely is) necessary. When you're in a facility for a month or two under 24-hour medical supervision, it's much easier to find the right treatment plan than it is after a single 45-minute talk. People are often hospitalized for much milder issues than schizophrenia.
Secondly, regarding the diagnosis itself, it doesn't mean much to me personally. It changes constantly; in my five years of psychiatric treatment, I think I've had about ten different diagnoses. My latest is F20.0, but after my last hospital stay, it was F20.4 (postschizophrenic depression). One doctor I see for psychotherapy told me my condition looks more like bipolar disorder, while my primary doctor insists it's probably schizoaffective disorder because of my frequent mood swings. Yet, the diagnosis remains F20.0. So, the label itself isn't the most important thing to me; it's more about the medications I take.
Maybe try talking to your sister again about agreeing to hospitalization—try explaining that it isn't a prison, it's a hospital, and that she will actually feel better.
You can develop schizophrenia at any time, though it most commonly manifests around age 18.

I actually have a friend who deals with psychosis and is unable to work, and since she doesn't have a formal employment history, she receives disability payments from the state$417.

Not only did she refuse to be admitted, but my dad was strictly against it too! I was sick, and honestly, I felt guilty for even suggesting hospitalization a few times... like I was just trying to get rid of the problem instead of helping. So, I gave up on the idea and never brought it up again. This all happened a year and a half ago, and since then, we’ve just been pretending it never happened.
As for the diagnosis, it doesn't matter for you because you're aware you have a condition that requires treatment—which is actually a positive sign, and perfectly normal for me. But my sister? She was in denial from start to finish, during the whole thing, and still is now. Total, absolute denial. After everything, everyone else is to blame: her supervisor, the circumstances that caused the escalation (stress, as if I wasn't stressed too, especially with Mom being ill), etc. Everyone is at fault except her. The doctors are crazy, and we're the only sane ones.
While she was out on medical leave, she still went to those follow-up appointments (she had to for the paperwork), but once she returned to work, she never went back. Every time I try to talk about it, I’m met with anger or indifference. Again, more denial.
Maybe I'm worrying for no reason. Maybe it really was just a one-time episode. But this low mood and depression are her daily reality. She fixates on trivial things, like her weight... always depressed because of a few extra pounds, yet she seems to eat more and more. Every day is a "new decision" to go on a diet, followed by the same meal every single day. Emotional connections? Zero. Nothing ever lasts; everything is superficial, brief, pointless.
I tell myself I can't live someone else's life for them... but still... I can't just look away or forget all these problems. I can't say anything. I just stay quiet, watch, and suffer endlessly.

Michelle Evans said:Most cases emerge by age 25, though it can certainly happen later...

Regarding the symptoms you asked about, the progression, and treatment options, your best bet is to look through these articles from the "living with schizophrenia" brochure. They explain everything clearly and thoroughly:

1.

2.

3.

4.

It’s unfortunate that she stopped her medication on her own without medical supervision. It’s even harder when the family supports that decision. Family involvement is vital to recovery; if relatives feel ashamed and try to sweep the issue under the rug instead of providing proper support, it makes things much more difficult...

Hospitalization is standard procedure during psychosis, regardless of age, so the doctor's recommendation isn't unusual, even if it feels shocking to you...

She was 25 when it all hit. Looking through the list of symptoms, I recognized almost everything except for hallucinations or that physical rigidity—I never saw those. But the paranoia? Absolutely. Strange, delusional ideas and conspiracy theories... people on the street, people in cars, even people on CNN—she thought everyone was conspiring against her. It was terrifying.
I honestly don't know how it finally subsided. At one point, we wouldn't even let her go out alone because she'd pick a fight with a clerk at a gas station. We couldn't leave her home alone either; we had to hide all the kitchen knives and everything else.
I don't see self-harm or aggression toward others explicitly listed in those symptoms, though that was our biggest fear. Honestly, you fear everything when you realize someone's reality just isn't real anymore...

car

http://www.youtube.com/watch?v=WVDBn4S61E8

Can these episodes trigger constant conflicts with people at every turn? Or maybe a better way to put it: are people living with schizophrenia inherently aggressive—like, feeling like everyone is out to get them all the time—or does that only happen during an episode?

Yesterday, I found out by accident that she got into a confrontation with her TA at college, then with a nurse at the local clinic, and of course, both were completely unprovoked (she failed her exam because she didn't know the material, so it was the TA's fault; then at the clinic, the nurse just asked how she could help, and she snapped, "You can't talk to me like that" 😕?). These are just everyday, normal interactions. Those people aren't the problem.
I have no one to talk to. My husband told me he’s had enough of discussing this every single day. I can't even mention it to my dad because he’s still in total denial... and I can't even bring up seeing the neuropsychiatrist again to her. I don't know what to do.

Carl Jackson said:Can these episodes trigger constant conflicts with people at every turn? Or maybe a better way to put it: are people living with schizophrenia inherently aggressive—like, feeling like everyone is out to get them all the time—or does that only happen during an episode?

Yesterday, I found out by accident that she got into a confrontation with her TA at college, then with a nurse at the local clinic, and of course, both were completely unprovoked (she failed her exam because she didn't know the material, so it was the TA's fault; then at the clinic, the nurse just asked how she could help, and she snapped, "You can't talk to me like that" 😕?). These are just everyday, normal interactions. Those people aren't the problem.
I have no one to talk to. My husband told me he’s had enough of discussing this every single day. I can't even mention it to my dad because he’s still in total denial... and I can't even bring up seeing the neuropsychiatrist again to her. I don't know what to do.

They can be aggressive during an episode, sure. But when they aren't psychotic, they're just as aggressive or non-aggressive as anyone else out there.

Henry Garcia9 said:They can be aggressive during an episode, sure. But when they aren't psychotic, they're just as aggressive or non-aggressive as anyone else out there.

You missed the mark on your grammar there—you probably meant "we can" instead of "I can," and you should have used "we are" instead of "I am"... just a little joke, though.🙂