Schizophrenia - General Discussion

Let’s get one thing straight first.
Anyone who actually bothered to look at my profile can see I’m not a doctor—I’m a medical technologist. So, I can give you my take based on my own perspective, drawing on what I’ve seen firsthand working in mental health facilities and my own experiences dealing with private and hospital psychiatrists.

I’m slammed right now, so I’ll drop a full response this afternoon if you want. We can also move this to DMs. 😉

So, I just finished reading through my medical report, and there’s this note in the description about being treated for psychotic decompensation within the context of Borderline Personality Disorder... and now I’m honestly feeling a bit lost. What does that even mean? Is this just a personality disorder that doesn't technically count as an "illness," and can it actually be managed just by talking things through with a psychologist?

Dana Vaughn said:So, I just finished reading through my medical report, and there’s this note in the description about being treated for psychotic decompensation within the context of Borderline Personality Disorder... and now I’m honestly feeling a bit lost. What does that even mean? Is this just a personality disorder that doesn't technically count as an "illness," and can it actually be managed just by talking things through with a psychologist?

Look, a personality disorder is essentially a permanent shift in how your psyche is structured from the ground up.

Think of a personality disorder as a lifelong diagnosis—it’s basically the blueprint you have to navigate every single day. It isn't a disease in the traditional sense where there's some physical ailment you can go in and fix with a pill or surgery; it's more like a fundamental "state of being."

There are definitely therapies designed to help people function better despite these disorders, and when it comes to Borderline, Dialectical Behavior Therapy (DBT) is the gold standard—there's been plenty of discussion about it on this forum over the years. To a small circle of specialists, and honestly, to a slightly larger group of laypeople, personality disorders aren't really "things" themselves, but rather clusters of symptoms used to describe people whose baseline behavior deviates significantly from what society considers the "average" or "normal" standard.

Out of all the different personality disorders, Borderline is really the only one that tends to lean toward those short-term psychotic episodes; most other types stay relatively stable in that specific regard.

Bluejacket said:
She’s Psychotic, schizophrenic—who knows.
It’s just a brief episode of acute psychotic disorder.
It happened, but it doesn't mean it'll happen again.
The real issue lies in the root causes.
Why did this even go down?

Honestly, there's a real chance Rainbow wasn't even Psychotic to begin with.

Look, being paranoid isn't the same damn thing as being Psychotic. My own mom is totally paranoid—she's constantly looking over her shoulder at every little shadow—but she still manages to hold it together and function perfectly fine in the real world, which proves she isn't Psychotic. True psychosis is when you're completely consumed by your terrors, where you can't stop spiraling through those fears no matter how hard you try to snap out of it.

Does anyone happen to have the contact information for a psychiatrist based out of a facility similar to Bellevue? I’ve managed to lose the number for a specific doctor I was seeing, and if anyone could assist me by sending it over, I would be most grateful. To be perfectly honest—and this is difficult to admit—I had a rather violent outburst today where I bit a friend quite severely. There was blood involved, and frankly, I am feeling quite unwell because of it. It seems inevitable that I will have to return to the hospital, but I was hoping to consult with a highly competent psychiatrist first. I can't recall the individual's name at the moment, though I am certain there is an exceptional specialist at the local psychiatric center who is widely considered the best...

My brother is spiraling. I honestly don't know how much longer he can keep this up... Here’s a snippet of one of our talks

Him - man, what a trip, I just realized that at a quantum level, a human is God, and none of this bullshit matters anymore
ME - well, at least you know you're God, haha

HIM - no, it's not a joke. Just because some extremist pulled a bluff, the whole universe is going to clash with God
man is - God
he'll screw over the universe and the extremist
because the extremist won't back down
and the universe is just a total joke
that they declared to be God
just so they could kill God

ME - God is dead, long live God, hallelujah

HIM - no, no, go study some actual quantum physics
no more talking nonsense
ME - sure, as soon as I get home tonight, I'll tell my girl to go take a walk or hit the movies so I can sit here and study quantum physics
HIM - yeah, well, they tried to kill me, but they decided to just enjoy my absolute worst suffering instead and failed
now I know everything
and I can't die
ME - the main thing is that you're happy
HIM - I'm not, I'm in maximum pain, but they were supposed to kill me
instead, I'm coming back as - God
and that's staying that way
ME - then I guess you're happy
HIM - no, because I'm in terrible agony, but nobody else gets to enjoy it any more
no matter how hard they try
or spin around on a pole
you get it?
I'm not going to the grave just so someone can dance on a pole for the next 50 years
they need to give me a better reason, and there isn't one
Or just so some frog could hang out at Sarah's place
that's even worse
they completely missed the mark
maximum joy, maximum tripping
they should've used a Voodoo doll, not a bunch of Higgs bosons
lol
or they should have just put a bullet in my head and called it a day
ME - I'd say you're happy then
HIM - it's impossible like this
I'm not, I'm horrified, but I'm not going to the grave
ME - if I realized I was God and no one could touch me, I'd be happy
HIM - it's your fault you don't get it
that's your problem
ME - I'm happy without that realization, but someone who doesn't have it should be happy once they find out
HIM - that's your problem
I know what I know
I'm out, peace
End Chat

Keeping this brief before I delete it. Basically, it looks to me like he's on the edge of suicide; he's always talking like this. I tried to pull him back to reality through conversation, but looking at this transcript, you can see why I gave up.

It's been 5 years since his illness officially started. It feels like it's never going to get better.

Nice, warm, and straight from the hip 🙂

Dana Martin87 said:My brother is spiraling. I honestly don't know how much longer he can keep this up... Here’s a snippet of one of our talks

Him - man, what a trip, I just realized that at a quantum level, a human is God, and none of this bullshit matters anymore
ME - well, at least you know you're God, haha

HIM - no, it's not a joke. Just because some extremist pulled a bluff, the whole universe is going to clash with God
man is - God
he'll screw over the universe and the extremist
because the extremist won't back down
and the universe is just a total joke
that they declared to be God
just so they could kill God

ME - God is dead, long live God, hallelujah

HIM - no, no, go study some actual quantum physics
no more talking nonsense
ME - sure, as soon as I get home tonight, I'll tell my girl to go take a walk or hit the movies so I can sit here and study quantum physics
HIM - yeah, well, they tried to kill me, but they decided to just enjoy my absolute worst suffering instead and failed
now I know everything
and I can't die
ME - the main thing is that you're happy
HIM - I'm not, I'm in maximum pain, but they were supposed to kill me
instead, I'm coming back as - God
and that's staying that way
ME - then I guess you're happy
HIM - no, because I'm in terrible agony, but nobody else gets to enjoy it any more
no matter how hard they try
or spin around on a pole
you get it?
I'm not going to the grave just so someone can dance on a pole for the next 50 years
they need to give me a better reason, and there isn't one
Or just so some frog could hang out at Sarah's place
that's even worse
they completely missed the mark
maximum joy, maximum tripping
they should've used a Voodoo doll, not a bunch of Higgs bosons
lol
or they should have just put a bullet in my head and called it a day
ME - I'd say you're happy then
HIM - it's impossible like this
I'm not, I'm horrified, but I'm not going to the grave
ME - if I realized I was God and no one could touch me, I'd be happy
HIM - it's your fault you don't get it
that's your problem
ME - I'm happy without that realization, but someone who doesn't have it should be happy once they find out
HIM - that's your problem
I know what I know
I'm out, peace
End Chat

Keeping this brief before I delete it. Basically, it looks to me like he's on the edge of suicide; he's always talking like this. I tried to pull him back to reality through conversation, but looking at this transcript, you can see why I gave up.

It's been 5 years since his illness officially started. It feels like it's never going to get better.

I've been debating whether to even say this for the last few days. Seeing what your brother is going through is rough. Is he actually seeing a doctor?
Is he taking any medication for his condition?
If the answer is NO, why aren't you taking him to a clinic?
If he were just taking two pills a day, things would be significantly easier for him.
Just two pills. The symptoms would clear up periodically, he could live a normal life, and you wouldn't be under this constant stress.
Grab him by the arm and get him to a doctor. Now.

He’s been on Risperdal since 2008. Morning and night, he takes his dose. But honestly? I can't say he was ever actually "well" during this illness. When he stuck to the pills, he was just deeply depressed—miserable, disillusioned...
This sounds terrible, I know, but sometimes when he’s in those phases, I catch myself wishing the hallucinations would come back just so he’d feel important again, or more alive, or like there was something actually occupying his mind...
Then again, those hallucinations are a living nightmare, and he’s definitely even more miserable when they hit.

I think he isn't even taking the meds anymore. He tells me he's taking them, but says they don't work. I suggested maybe he's built up a tolerance and should see a doctor to switch things up, but he insists any other pills would be worse—that they just numb him out and turn him into a zombie.

We don't live together anymore. He’s staying with his parents. He had a doctor he trusted for a few years, but then once, the guy recommended he turn to faith and the Bible, and he just completely lost respect for him. He mocks that doctor now, but he refuses to see anyone else. It's been over a year since he's set foot in a clinic.

Getting him to go to a doctor is impossible. Back when he first started treatment, the police had to take him in. Now, I genuinely have no idea how to convince him.

The guy was incredibly smart, but he has no degree, no job, no wife, no house, and zero hope of ever having any of that. I think that's what's killing him.

Maybe the only thing that would help is if my parents or I suddenly hit the jackpot overnight and could provide him with a better life. But that's not exactly looking likely.

So I really don't know... No matter which way I look at it, nothing seems to be heading toward a good outcome.

Dana Martin87, man, I totally feel you. I’m going through something almost identical right now.

I find myself checking this forum constantly because my brother just isn't getting any better. It’s a constant cycle—they swap his meds, change the combo, tweak the dosage, even bumped up his Moden injection from 25mg to 50mg... and honestly? It hasn't made a single bit of difference.
It drives me absolutely insane... how is it even possible that none of these drug combinations actually work??????? He's been stuck in an extreme Psychotic state for two years straight now...

God, it's just so much.

So, it's me again. I wanted to follow up on how things have been going lately... just checking back in regarding my current state. Ever since I was discharged from the hospital and started this new medication regimen, everything has felt... heavy. There’s this profound lack of drive, no spark, no energy—honestly, I just feel a complete absence of will to live. I’m not the social, outgoing person I used to be. I find myself praying to God that I don't stumble into a job right now, because the thought of having any motivation or even the desire to work feels impossible. Everything just feels wrong. It actually feels like my brain has been damaged; I struggle to process things, and trying to read professional literature is out of the question. I can't make sense of anything I read, and my memory... well, it's gone. It’s a total disaster. I was doing some reading about the medication I've been prescribed—Solian—and was wondering if anyone here knows much about it. Apparently, it affects serotonin and dopamine levels. Is it possible that it's just numbing those hormones, which would explain why I feel so hollowed out?
Thanks in advance

Dana Vaughn said:So, it's me again. I wanted to follow up on how things have been going lately... just checking back in regarding my current state. Ever since I was discharged from the hospital and started this new medication regimen, everything has felt... heavy. There’s this profound lack of drive, no spark, no energy—honestly, I just feel a complete absence of will to live. I’m not the social, outgoing person I used to be. I find myself praying to God that I don't stumble into a job right now, because the thought of having any motivation or even the desire to work feels impossible. Everything just feels wrong. It actually feels like my brain has been damaged; I struggle to process things, and trying to read professional literature is out of the question. I can't make sense of anything I read, and my memory... well, it's gone. It’s a total disaster. I was doing some reading about the medication I've been prescribed—Solian—and was wondering if anyone here knows much about it. Apparently, it affects serotonin and dopamine levels. Is it possible that it's just numbing those hormones, which would explain why I feel so hollowed out?
Thanks in advance

Antipsychotics primarily target dopamine blockade, though they also partially affect serotonin and various other neurotransmitters. Since dopamine and serotonin are the neurochemicals responsible for experiencing pleasure in life, that is likely why you are feeling this way. Essentially, the nerves that would normally trigger excitement or enjoyment are being blocked.

ruggedtinker9 said:Antipsychotics primarily target dopamine blockade, though they also partially affect serotonin and various other neurotransmitters. Since dopamine and serotonin are the neurochemicals responsible for experiencing pleasure in life, that is likely why you are feeling this way. Essentially, the nerves that would normally trigger excitement or enjoyment are being blocked.

Yeah, I actually caught onto that. I was seeing my psychiatrist the other day and laid it all out for them. They ended up pulling me off Solian and switched me over to Azolar, which is supposedly designed to have an affinity for both serotonin and dopamine. I'm really crossing my fingers that it actually works that way. Have you heard much about it? If I don't start feeling any different soon, I’m going to ask about moving to Effexor... honestly, that feels like my last real shot at feeling human again.

Dana Vaughn said:Yeah, I actually caught onto that. I was seeing my psychiatrist the other day and laid it all out for them. They ended up pulling me off Solian and switched me over to Azolar, which is supposedly designed to have an affinity for both serotonin and dopamine. I'm really crossing my fingers that it actually works that way. Have you heard much about it? If I don't start feeling any different soon, I’m going to ask about moving to Effexor... honestly, that feels like my last real shot at feeling human again.

Dana, reading through your posts, I can tell you that I’ve been in the exact same boat. I dealt with two back-to-back Psychotic episodes back in 2009—the second one happened because I decided to stop my treatment prematurely. At the time, I was on massive doses of Seroquel and Risperdal (over 100mg and 50mg respectively), which left me looking completely drugged and perpetually exhausted, though I felt okay because even those heavy hits weren't quite enough to fully suppress the symptoms. As the illness started to recede over the next two years, my doctors began tapering my dosage down almost linearly. Eventually, those meds just felt too heavy, likely due to the lingering depression and lowered brain activity. Once I hit the 25mg mark for both, I still felt incredibly depressed. My doctor didn't want to lower the antipsychotics any further, so she introduced antidepressants—first Faverin and Ladiomil, and now I’m on 150mg of Effexor XL. Meanwhile, they swapped my Seroquel for Zyprexa, starting at 10mg, then 5mg, and now I'm down to just 2.5mg. In my experience, the depression isn't always just a side effect of the antipsychotics being too strong; sometimes it’s just an inherent part of the condition. My latest diagnosis is F20.4 (post-schizophrenic depression). To be honest, I haven't actually felt the schizophrenia itself for a long time now (thankfully, 🙂), it's just this depression that lingers. It might be worth discussing Effexor with your doctor, because if you taper off the antipsychotics too aggressively, the illness can flare up incredibly fast—kind of like a tiny spark that suddenly turns into a massive forest fire. That’s how my therapist puts it. Effexor shouldn't hurt you, especially at lower doses. I hadn't heard of Azolar before, but I did a little digging online and it really is a newer option, much more recent than Zyprexa, which used to be considered the "new" expensive standard.

And please, don't believe the idea that your brain is permanently damaged. Even though it certainly feels that way, it’s really just a chemical imbalance of neurotransmitters. Those aren't things that can be fixed overnight or easily, even with the most cutting-edge medicine available today. It's a tough reality, unfortunately 😢

It was recently mentioned that antipsychotics function by targeting dopamine. I have heard that certain psychiatric patients in clinical settings are actually administered dopamine via injection, or perhaps they receive a substance that either stimulates its release or increases the sensitivity of dopamine receptors. This typically results in a transient sense of euphoria.

This led me to wonder: in specific instances involving post-schizophrenic depression, could clinicians prescribe lower doses of dopamine when an antipsychotic triggers excessive side effects? For example, if a patient starts an antipsychotic and suffers from severe adverse reactions, making an immediate transition to a different medication difficult due to the intensity of those symptoms, would they ever be given small amounts of dopamine—or perhaps substances that support it?

Nicole Barrett76 said:It was recently mentioned that antipsychotics function by targeting dopamine. I have heard that certain psychiatric patients in clinical settings are actually administered dopamine via injection, or perhaps they receive a substance that either stimulates its release or increases the sensitivity of dopamine receptors. This typically results in a transient sense of euphoria.

This led me to wonder: in specific instances involving post-schizophrenic depression, could clinicians prescribe lower doses of dopamine when an antipsychotic triggers excessive side effects? For example, if a patient starts an antipsychotic and suffers from severe adverse reactions, making an immediate transition to a different medication difficult due to the intensity of those symptoms, would they ever be given small amounts of dopamine—or perhaps substances that support it?

I haven't actually heard of patients being given dopamine, and honestly, it seems pretty counterproductive to give someone a drug that blocks dopamine at the exact same time you're giving them something to stimulate its release, especially if it's just for a fleeting moment of euphoria. If that were the case, wouldn't the symptoms of the illness just resurface alongside that feeling? They'd likely be just as temporary.
I'm hoping someone here with a bit more expertise can shed some light on how this works.

In the case of post-schizophrenic depression, antidepressants are typically prescribed, which focus specifically on serotonin; though, even then, higher doses can sometimes trigger mild Psychotic symptoms in people dealing with schizophrenia.

ruggedtinker9 said:Antipsychotics primarily target dopamine blockade, though they also partially affect serotonin and various other neurotransmitters. Since dopamine and serotonin are the neurochemicals responsible for experiencing pleasure in life, that is likely why you are feeling this way. Essentially, the nerves that would normally trigger excitement or enjoyment are being blocked.

But if that's how it works, then how come I’m taking these antipsychotics and I still—more often than not—actually feel some damn joy and excitement? 🤷

David Vaughn75 said:But if that's how it works, then how come I’m taking these antipsychotics and I still—more often than not—actually feel some damn joy and excitement? 🤷

Honestly, I’d just be grateful for the medication and my psychiatrist. If you aren't dealing with symptoms on top of everything else, it really means your dosage is right where it needs to be. 😉

Harold Anderson3 said:Dana, reading through your posts, I can tell you that I’ve been in the exact same boat. I dealt with two back-to-back Psychotic episodes back in 2009—the second one happened because I decided to stop my treatment prematurely. At the time, I was on massive doses of Seroquel and Risperdal (over 100mg and 50mg respectively), which left me looking completely drugged and perpetually exhausted, though I felt okay because even those heavy hits weren't quite enough to fully suppress the symptoms. As the illness started to recede over the next two years, my doctors began tapering my dosage down almost linearly. Eventually, those meds just felt too heavy, likely due to the lingering depression and lowered brain activity. Once I hit the 25mg mark for both, I still felt incredibly depressed. My doctor didn't want to lower the antipsychotics any further, so she introduced antidepressants—first Faverin and Ladiomil, and now I’m on 150mg of Effexor XL. Meanwhile, they swapped my Seroquel for Zyprexa, starting at 10mg, then 5mg, and now I'm down to just 2.5mg. In my experience, the depression isn't always just a side effect of the antipsychotics being too strong; sometimes it’s just an inherent part of the condition. My latest diagnosis is F20.4 (post-schizophrenic depression). To be honest, I haven't actually felt the schizophrenia itself for a long time now (thankfully, 🙂), it's just this depression that lingers. It might be worth discussing Effexor with your doctor, because if you taper off the antipsychotics too aggressively, the illness can flare up incredibly fast—kind of like a tiny spark that suddenly turns into a massive forest fire. That’s how my therapist puts it. Effexor shouldn't hurt you, especially at lower doses. I hadn't heard of Azolar before, but I did a little digging online and it really is a newer option, much more recent than Zyprexa, which used to be considered the "new" expensive standard.

And please, don't believe the idea that your brain is permanently damaged. Even though it certainly feels that way, it’s really just a chemical imbalance of neurotransmitters. Those aren't things that can be fixed overnight or easily, even with the most cutting-edge medicine available today. It's a tough reality, unfortunately 😢

I'm going to start taking that Azolar this Monday, though I have my doubts about whether it'll actually get me steady again. I feel like I probably need a heavy-duty antidepressant to boost my dopamine and serotonin levels and find some equilibrium.
It is a new drug, but unfortunately, my doctor didn't offer it to me right away.
I don't know which is worse—being psychotic or being stuck in this state. I completely understand where you're coming from.
I'm also taking Depakote; does that have any impact on your mental state?

Dana Vaughn said:I'm going to start taking that Azolar this Monday, though I have my doubts about whether it'll actually get me steady again. I feel like I probably need a heavy-duty antidepressant to boost my dopamine and serotonin levels and find some equilibrium.
It is a new drug, but unfortunately, my doctor didn't offer it to me right away.
I don't know which is worse—being psychotic or being stuck in this state. I completely understand where you're coming from.
I'm also taking Depakote; does that have any impact on your mental state?

And did the Effexor help you when you were feeling this way? How strong is it, really?