Stressed Daddy questions

[random]

Kind of an update with a question to my previous post on this subject. Anyway the father was in family court today and the presence of his ex spouse and the stress of court induced a brief psychotic episode. He is so susceptible to stress!!!! He was doing perfect his mental health worker and psychiatrist cut him loose no prescriptions to take no counselling and now this. He is normal now the symptoms having lasted for an hour and a half and were accompanied by an anxiety attack. WHAT IS THIS???? He was absolutely fine until today. Symptoms were not severe but he said he experienced auditory hallucinations directly related to her like he could hear what she was thinking. This woman has made his life very difficult any help would be greatly appreciated. The only diagnosis he ever got was psychotic illness with schizophrenic like symptoms which is a catch all as far as I am concerned.

[iNow]

Frankly, I would directly challenge your assumption that hes was "perfectly okay" before the episode today. If he were truly not having mental health issues, he'd not have been so prone to a reaction such as that you describe. Your premise that he's fine may be more of a mild delusion... or, to be less harsh... little more than wishful thinking, but not a valid description of reality.

 

I don't know, though. I've never met the guy. You can't ask for medical or psych advise on the internet and not take it with a grain of salt... or a whole salt mine.

[Marat]

First, I would strongly suspect that the patient is still having problems with schizophrenia, since a psychiatrist previously diagnosed that condition, and it does not really ever go away, though the symptoms can be managed.

 

There is considerable overlap in the characteristic features of psychiatric diagnostic categories, with paranoid features appearing in many types of mental illness, and hallucinations appearing in everything from schizophrenia to severe biopolar illness. However, 'thought broadcasting,' that is, imagining that the unspoken thoughts of other people are broadcast into your mind, is a distinctively schizophrenic symptom, so I would guess that the recent episode is a case in which the underlying and persisting schizophrenic illness was unmasked by the stressful events. Social stress causing the return of previously dormant vocal hallucinations is quite common in schizophrenia.

[random]

Actually there are alot of reasons for psychosis I have been searching the internet and I am convinced now that he suffers from complex post traumatic stress disorder. His psychiatrist was not alot of help 1 meeting of 10 minutes allowed her "catch all diagnosis" she was reluctant to clarify it any further no evaluation or anything just his self reporting. It was rather hasty. No matter they are all treated the same way (with anti psychotics) Anyway here is a link that allowed me to make this amateur diagnosis it is well worth the read. And it fits him and his situation to a Tee I reviewed the symptoms with him tonight and it looks like it will be an accurate diagnosis because everything well almost everything fits I encourage you to read the article http://www.bullyonline.org/stress/ptsd.htm

[Marat]

Many features of mental disorders are common to a number of different psychiatric illnesses. For example, hypervigilance is found in both post-traumatic stress disorder and paranoia, so it is important to look at the whole clinical picture. But more importantly, there are certain classical symptoms of schizophrenia which are striking in this case. Auditory hallucinations in which the patient imagines that his own private thoughts are being broadcast to the world or that someone else's thoughts are being inserted into his head just shout 'schizophrenia' to anyone trying to make a diagnosis of this case at a distance. Symptoms like this are not characteristic of post-traumatic stress disorder.

[ScaryPirateMan]

I'm in the military and I can tell you from meeting indivduals that have been in combat and on stressful deployments that PTSD can mess people up. If the woman was giving him enough trouble, breaking him down and such, coupled with the stress of being in court, it is very possible he just snapped. People snap all the time with no obvious symtoms prior to. When the governement gives us training, they frequently cover PTSD due to the higher percentage of Military members affected.

[random]

With a little bit of time to collect himself he revealed that it was more of a flash back scenario the thoughts he was having about her thoughts to him were the ridiculing and abusive ones she had previously subjected him too however........ for that brief time he was sure she was having and directing those thoughts to him in the present. I'll stick to the complex PTSD diagnosis as the symptoms fit bottom line she messed him up he was fine til her so it's logical until given definitive proof otherwise.

[pioneer]

One can condition someone over a long period of time using a trigger to activate the conditioning. For example, say every time someone spoke another person rolled their eyes and said, "here he goes again being a know it all," Eventually you don't have to say anything, but can push the button with a roll of the eyes.

 

Say the wife's nagging included a look on her face, all she needs to do is create that look without actual nagging. The gun has been loaded for years and this will pull the accumulative trigger. That would explain the man appear to sense her nag, with her quiet (body language trigger).

[random]

That's a good point pioneer thank you. "Nag" doesn't quite serve justice to what she put him through though. She was and is more like a Dominatrix by that I mean she had complete control over him, Gave her all his money, severed all outside social contacts for him because she didn't approve of him having friends, moved to a quiet place in the country and wouldn't allow him to drive, IT's just the tip of the iceberg. He has been secluded from the world more or less for about 11 years then she ups and leaves him for a new man. He had a strong home based business running too she managed to bleed that and him dry and is now herself living on welfare. Hell she even charged him with assault and anyone who knows him knows it isn't true She likes to see him suffer and he lets her. Without a fight

[Marat]

An important thing to keep in mind is that stress elicits symptoms of all sorts of mental illness, but the symptoms elicited are those of the underlying illness of the patient. Thus under stress depressives will become withdrawn, manics will become incoherent, paranoids will become hypervigilant, and schizophrenics will start to experience auditory hallucinations. It seems that many posters on this topic are focusing on the fact that in this case, stress has produced symptoms, so the fact that the symptoms originated in stress must mean that the symptoms indicate the mental disease of post traumatic stress disorder. But this is not true: Stress can unmask any one of a huge variety of dormant psychiatric illnesses, including schizophrenia.

[random]

Thanks Marat that's true but the accepted method of diagnosing the illness is to find the illness of which the patient exhibits the most symptoms of having. He exhibits 1 single symptom of schizophrenia which could also be attributed to other illnesses and a host of those from complex PTSD as an update he has dependant personality disorder according to psychological testing. This just screams traumatized inducing complex PTSD if you ask me.

[Marat]

A problem throughout psychiatry is that there is widespread disagreement about the ontology of the diagnostic categories. There was a major scandal a while ago when it was found that British psychiatrists were diagnosing schizophrenia very differently and at different rates from American psychiatrists, which throws into question he whole notion of all these psychiatric disease categories being separate entities. Now that genetic studies are showing that families with a high incidence of schizophrenia also have a high incidence of depression, one naturally wonders whether there is just one disease here in various manifestations or stages. Early stage multiple sclerosis looks like a completely different disease from late stage MS, so how do we know that the 'different' psychiatric categories are not really just different stages of a much smaller number of distinct pathologies?

 

However, that said, it is important to realize that not all symptoms are created equal, and some have much more diagnostic clarity than others. So you just can't collect all the symptom reports, add them up, and count how many fall into one DSM category and how many fall into the other. Auditory hallucinations in response to stress are a strong indicator of schizophrenia, and not knowing the patient, the fact that a clinican in contact with the patient has also diagnosed this condition really makes it a strong candidate for being the right explanation for what is happening. The intensity of schizophrenic illness is now being ranked by some clinicians by measuring how much stress is required to start the patients hearing voices, so to say that because the symptoms arise from stress they must be PTSD and not schizophrenia doesn't fit the way things are diagnosed. PTSD is a diagnosis based on etiology, whereas most psychiatric categories are based on the phenomenology of symptoms displayed. PTSD could easily be overused, since stress can elicit almost every psychiatric condition or render it more clinically evident, so if we were to take an etiological focus on diagnosis, everything would quickly become PTSD.

[random]

Thanks Marat you do need to understand the psychiatrists diagnosis was made entirely due to the self reporting of the patient who really was not in a competent state to describe accurately what his hallucinations were. If i said I hear voices and only that i'd get a diagnosis of schizophrenia where as if i said when i am in a situation that triggers a memory of her I am flooded with images and auditory hallucinations of her yelling at me I get a panic attack as well. I'd be PTSD. IT is a brief reactive psychosis from an identifiable trigger event.