Might these symptoms fit?

Might these symptoms fit in the schizophrenia/schizoaffective family?

I’d really appreciate if anyone might share specifically what, if anything, stands out in this list, or relate similar experiences.

  • Persistant visual hallucinations. Started suddenly in later adulthood. Easily distinguishes hallucinatory images from reality. Images are interactive and non threatening.

  • Anhedonia. Loss of any pleasure in life, where there was once enjoyment. Looks forward to nothing. Days are empty and merely endured.

  • Withdrawal. Never had many friends but withdrew from even those few relationships. Nearly no contact with family of origin. Minimal interactions with spouse and minor child despite previous close relationships.

  • Time distortions. Believes events that happened 5+ years ago happened a few months ago, events from months ago happened a few days ago, etc. Does not seem alarmed when discrepancy is pointed out.

  • Paranoia that comes and goes. Inconsistent interpretations of same or similar events depending on the day.

  • Psychosis. A handful of times over the years.

  • Fever can cause lower level psychotic state, dating from childhood.

  • “Checked out.” Is often “vacant” or “nobody’s home” when doing nothing or tasks that don’t require concentration.

  • Loss of executive function. In young adulthood was able to plan and execute tasks, now is functioning at a very low level. Is not aware of this and believes he is very “busy” rather than seeing that his task list is long because he is not doing any items.

  • Good personal hygeine, daily showers, daily clean clothes, though inefficient with laundry - yet makes the effort. However:

  • Disorder in living space. Others in home ashamed to have others over but do not have energy to clean up after him. Doesn’t seem to see anything amiss.

  • Sleeps all day. High difficulty in managing basic errands as usually wakes up when businesses are closed.

  • Underemployed. Has skills and intellect for much better job but feels low level job is already nearly more than he can do.

There’s probably more but let’s end it there.

Are drugs or alcohol involved? This sounds reminiscent of my brother who’s diagnosed with bipolar disorder, but is also a binge drinking alcoholic. In his case I’m starting to suspect symptoms of Wernicke-Korsakoff syndrome aka “wet brain”.

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He has a bit of a dependence on alchohol but nothing near what I’d assume it would take to get wet brain. Say, 2-6 beers a day. Also, I’d say the drinking was more of a way to cope with whatever illness he has rather than the cause, they both increased hand in hand.

I’ll also add that he is on antipsychotics and is pretty stable. But also on the other hand quite ill.

He is rarely deluded. He has patches of times when he goes off the rails. So that could be bipolar. His delusions are not what I would understand to be bizarre. Only one time did he get to the point where he wasn’t even making sense.

So it could just be bipolar but I have to say, he seems less functional than I assumed bipolar would cause, but what do I know.

I’m sure he has a diagnostic code to get the medications, but nobody has ever told him he has this or that. I think they went with Brief Psychotic Disorder when he was hospitalized but they said they didn’t know what he had.

I know nobody here can diagnose and it probably doesn’t matter what label goes on it, but it would be nice to kind of understand a bit what is going on. I just wondered if it could be somewhere in the schizo family. He is not schizoid or schizotypal.

He is not going to seek any treatment, he just gets medication with minimal oversight and that’s it. He is aware he is mentally ill but feels very stable. And he’s not wrong, I think any psych would consider his treatment a total success. But I do feel very sad because his life - our life - has been stolen.

Depending on how long 2-6 beers a day has been sustained, it’s still a possibility, especially if other alcohol abuse preceded it. My brother can become intoxicated, agitated and belligerent after just a couple beers now. It seems the cumulative damage to his liver and brain has lowered his tolerance. He did have a period where he abused high proof hard liquor, but now says he only drinks beer.

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That’s what passes for treatment in most cases, and this sort of compliance is the envy of many caregivers. What sort of additional treatments would you like to see?

Schizoaffective Disorder is also a possibility, if you find comfort in labels.

I will keep wet brain in mind, but I’m just not sure it’s a fit, especially given the timeline. He was practically a nondrinker in his earlier years, and looking back he had some symptoms going back to childhood. He was already full blown ill by the time he had a drinking habit.

I totally agree that his compliance with medication makes me the envy of any caregiver, and believe me, it does not go unnoticed or unappreciated.

It could be so much worse. But it is still very bad. Our lives have ended in middle age, there is no hope and no joy, just running down the clock.

I don’t think there is any treatment beyond the pills, but I guess I wish the guy dispensing his pills would at least ask about his symptoms or something. All he does is send in the prescriptions. I feel scared and alone when I see any hint of starting to go off the rails, there is noone to call or help. I’ve experienced real, real fear before, and I’ve felt scared when I even suspected he might be going down that road again.

I can call emergency services when it’s to that point but it would sure be nice to have help when he is just going down that road and not only when it’s at the point of hospital or jail.

So you think schizoaffective is possible based on the above? I know you can’t diagnose, I just want to know if it’s like “yeah those seem familiar” vs “no, doesn’tvring any bells.”

It sounds like Schizoaffective, but I’m not a clinician/doctor. You mentioned “Loss of executive function” and I believe that is a huge Schizophrenia feature. Having SCZ is like permanent mind/brain damage to the point where cannot function like the norm. Thus, abnormal psychology.

What did medical professionals tell him what his diagnosis is? At some point, they should’ve told him the official diagnosis. Otherwise, if you could access psychiatric records, the diagnosis definitely will be in there.