Early Warning signs

Hi, i recently read a set of study notes a friend of mine had on schizophrenia (he studies psychology) and a lot of them seemed to fit with issues that have been troubling me since my late teens, specifically anhedonia and emotional flattening which lately have been getting worse and making daily life and university work harder. I've never had any visual or auditory hallucinations, although apparently hallucinations are less common in cases of disorganized schizophrenia where negative symptoms (i.e. anhedonia) are more prevalent than positive symptoms. I went through the list of symptoms in the DSM-IV and I've copied out the one I can identify with.

Physical Symptoms
--A blank, vacant facial expression. An inability to smile or express emotion through the face is so characteristic of the disease that it was given the name of affective flattening or a blunt affect.
--Staring, while in deep thought, with infrequent blinking.
--Clumsy, inexact motor skills
--Sleep disturbances - excessive sleeping
--Involuntary movements of the tongue or mouth (facial dyskinesias). Grimacing at the corners of the mouth with the facial muscles, or odd movements with the tongue.
--An awkward gait (how you walk)
--Movement is speeded up- i.e. constant pacing

Feelings/Emotions
--The inability to experience joy or pleasure from activities (called anhedonia)
--Sometimes feeling nothing at all
--Appearing desireless- seeking nothing, wanting nothing
--Feeling indifferent to important events
--Feeling detached from your own body (depersonalization)
--Hypersensitivity to criticism, insults, or hurt feelings

Mood
--Depression- feeling discouraged and hopeless about the future
--Low motivation, energy, and little or no enthusiasm

Changes in Behavior
--Dropping out of activities and life in general
--Inability to form or keep relationships
--Social isolation- few close friends if any. Little interaction outside of immediate family.
--Increased withdrawal, spending most of the days alone.
--Becoming lost in thoughts and not wanting to be disturbed with human contact
--Neglect in self-care- i.e. hygiene, clothing, or appearance
--Replaying or rehearsing conversations out loud- i.e. talking to yourself (very common sign)
--Finding it difficult to deal with stressful situations
--Inability to cope with minor problems
--Lack of goal-directed behavior. Not being able to engage in purposeful activity
--Functional impairment in interpersonal relationships, work, education, or self-care
--Deterioration of academic or job-related performance
--Inappropriate responses- laughing or smiling when talking of a sad event, making irrational statements.
--Drug or alcohol abuse
--Smoke or have the desire to want to smoke (70-90% do smoke) - note: this is a very normal behavior for people who do not have schizophrenia also!
--Frequent moves, trips, or walks that lead nowhere

Cognitive Problems
--Ruminating thoughts- these are the same thoughts that go around and round your head but get you nowhere. Often about past disappointments, missed opportunities, failed relationships.
--Racing thoughts
--In conversation you tend to say very little (called poverty of speech or alogia)
--Suddenly halting speech in the middle of a sentence (thought blocking)
--Trouble with social cues- i.e. not being able to interpret body language, eye contact, voice tone, and gestures appropriately. --Often not responding appropriately and thus coming off as cold, distant, or detached.
--Difficulty expressing thoughts verbally. Or not having much to say about anything.

Most of the symptoms I've listed here (specifically the physical and speech ones) I don't experience chronically, but rather when I find myself alone (though I have caught myself spouting random, out of context phrases in public without meaning to) or when i feel depressed or stressed (which is happening more often and for longer periods). However, the emotional symptoms, mood symptoms and most of the cognitive problems listed I've felt chronically since my mid to late teens. I should also mention I have these elaborate fantasies in my mind about other worlds (i'm not going to go into details but they're all pretty self-centered) which I've been retreating into more often. Just to clarify, YES i know they're fantasies but I'm always paranoid I'm going to retreat into them too far and start believing them. I was using cannabis fairly regularly though recently I've stopped (imaginary things were getting too real) which has severely lowered the amount i retreat into my mind, however without that retreat I'm finding the real world and emotional flattening very hard to deal with.

I don't feel crazy though. Am i just reading too much into things and exaggerating symptoms in my mind or am I at risk of developing schizophrenia. Any advice would be greatly appreciated. Thanks

Inortix wrote:I don't feel crazy though. Am i just reading too much into things and exaggerating symptoms in my mind or am I at risk of developing schizophrenia. Any advice would be greatly appreciated. Thanks

Have you read about Schizoid Personality Disorder? Your state seems to be almost exactly that. Schizoid PD looks a lot like the negative symptoms of schizophrenia (flat affect, anhedonia, apathy, asociability, etc) but without any of the positive symptoms (paranoia, hallucinations, ideas of reference, etc). I have been diagnosed with Schizoid PD and have always been afraid of developing schizophrenia (especially disorganized schizophrenia, which is like an extreme exaggeration of Schizoid PD). I've been told that a schizoid has about 1% chances to slip into schizophrenia but also that the longest you have been schizoid, the less likely you are to slip into schizophrenia. That is, that if you have been anhedonic and flat for more than 2 years, usually you are "safe" and unlikely to become schizophrenic; schizophrenia being usually preceeded by an extreme exageration of emotional flattening seemingly coming out of nowhere, and that happening within a year.

If it would happen that you really are schizoid, then the problem of your life would be more about how much is the emotional flattening and anhedonia a problem for you. In my case I really don't like how anhedonia makes life seem pointless, and when it gets really strong it becomes hard to accomplish anything and I lose all capacity to focus at all, even thinking becomes difficult.

Thanks for the reply Peptron, just out of interest how long does something like Schiziod PD take to diagnose?

It took me about a year and a half. SPD is a diagnosis of exclusion, which is why it is long to get.