Family and Caregiver Schizophrenia Discussion Forum

So hypersensitive

I have a consistent issue with my son that I am still trying to understand. I want to reach out to the forum to see if this is something you have seen with sz. He is being successfully treated with a monthly Abilify shot, moved into his own place and is employed–we’ve come a long way! However, there is still an ongoing symptom that is always there. We can be talking about anything and he will usually interpret much of what is said by us in the worst possible way. He reacts as if what we say is usually criticism and a direct attack on him. If you are talking to him in an animated conversation and you interrupt a little he gets mad and stops talking. You can just start talking at the same time and he overreacts. And if you add something to the conversation, he assumes you are telling him he’s wrong. Everything is interpreted by him as rejection or criticism. The result is us tip-toeing around him and saying as little as possible. He can be acting completely normal in every other way-- but this keeps being a problem. Is this a quirk with sz? Is this just a persecution complex? Any insight from you would be appreciated!

Hi Grace, my daughter has schizoaffective disorder and went off meds 3-4 months ago. I noticed increasing level of sensitivity as her medication wears off. For my daughter, she aims to become more independent, hoping to graduate this year and get a job so most of the sensitivities are centered around that. Before she went off meds, she would seek for constructive criticism. Now, for me it is mostly listening and holding back comments. I am hoping that once she gets the meds working the situation will improve.

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It’s interesting you say your daughter has schizoaffective disorder bc that is what my son was originally diagnosed with. They changed his diagnosis to schizophrenia and took him off the mood stabilizer bc they saw evidence of psychosis outside of a mood episode—I guess that’s then main criteria. I still question his diagnosis and wonder if this behavior points more to schizoaffective disorder. He is on a monthly Abilify injection which I think gives some help with mood symptoms. I just wonder if he’s not being fully treated bc don’t you have to take a mood stabilizer and antipsychotic with schizoaffective disorder? You are right about holding back—so hard to navigate.

One more thing…what medication(s) do they recommend for your daughter? That’s quite a while to be without meds. I hope you are hanging in there.

She was on abify and lithium. She is now recovering in the hospital. The big reason she went off meds is due to the side effect. They are trying her on rexulti (brexpiprazole) which hopefully will have less side effects.

@Grace It seems like our son has always been like this, but now that I think of it it probably began sometime in his teens, long before his SZ diagnosis which was only a year ago. We never understood why he would take everything that was said to him as a personal attack or criticism. It could be the most diplomatic, non confrontational statement and he would completely take it out of context and over react. Now, and even more so since reading your post, we realize that this was probably a very early symptom of what was to come. Our son has only been consistently medicated for about a month and a half (monthly haldol injection) and it seems we already see less of this behavior but it may be due to us learning to be more aware of what we say to him and how we say it.

Hi grace. Quick question: was this a behavior that was NOT noticeably happening while he was on the mood stabilizer?
I’m extremely curious because this is a VERY familiar thing too for me during conversations with my unmediated partner and it has always been that way. It can make it extremely difficult to have a meaningful conversation at times or discuss important relevant topics. As you stated, I always figured it was some form of persecution complex also, or maybe a compulsive issue where he may feel that contesting or arguing every single statement in dialogue makes him FEEL like he’s having a meaningful conversation of sorts… in his own ill-understanding of basic acceptable social interactions in his own slightly diluted reality. And I thought also too about what I call the ‘defeatist attitude’ or ‘fatalistic attitude’ where the conversation goes nowhere because everything is always ‘all is lost’ and ‘already over’ and ‘dead already’ so there’s no bringing him back to the conversation to move forward in the dialogue with any progression.
These three ideas, interestingly, (persecutory, defeatist, fatalistic or catastrophising) are all considered ‘Pillars Of Irrational Thinking’ in some schools of practice like CBT (cognitive behavior therapy). Which, by the way, is not a therapy specific to mental illness. A lot of us actually do these a lot in our own minds all the time for a lot of different reasons without realizing it when we’re feeling low or depressed (nobody likes me anyways, birds are always shitting on MY car etc…) Overpersonalizing things that otherwise often have a completely reasonable explanation.
So, is it a mood disorder, or is it part of the more severe MI diagnosis like schizophrenia and bipolar commonly associate with delusional symptoms? Is there a way that we can actually determine that?
Let us know what you learn. Best of thoughts.

Congratulations on the progress thus far! You guys are an inspiration!

Catnip, you are singing my tune. I think this all started in high school as well, bc that is when he started to lose his friends. He had a very contentious relationship with one friend in particular. In light of his ultimate diagnosis, everything in his past takes on a new light and becomes so painful to analyze. It is hard as a parent to look back at “warning signs” bc of guilt and being so hard to watch. I have no idea what really happened, but I suspect he was combative with people. There weren’t a lot of places for him to go socially in his high school, so I think this compounded his mental health issues. Watching and reliving the “unfolding” of this illness is hard to put into words but parents in the forum get it. You are only one month into medication and I pray he gets better with each passing day. My son has been taking Abilify shots for 2.5 years and he has come so far. I was terrified of him when he was acutely ill and now he has mostly good days. This hypersensity is hard to handle when it rears it’s head, but I guess I have to remember where we started. Like you said, educating yourself on how to approach a conversation is important for us.

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Hi Wisdom. These are very good questions. When he was first sick the first dr thought he had psychosis related to a mood disorder, so she put him on Olanzipine and Depekote (mood stabilizer). From there he went to an outpatient psychiatric treatment hospital and they just couldn’t pinpoint him and their answer was to send him to a university affiliated SZ outpatient research center to “tease out” the psychosis symptoms. Looking back that Dr was careful not mention the most terrifying word to a parent that is “Schizophrenia”. They originally diagnosed him with Schizoaffective disorder and gave him both antipsychotic and mood stabilizer. He had to take a medical leave of absence from college and take a local class to prove he could reenroll. The only way the dr would let him go back to college was on a shot and that was the leverage we needed to get him to agree-thank God. He graduated college and got a job. Then when he came back they took him off the mood stabilizer, claiming he simply had SZ bc they saw psychotic symptoms “outside of a mood episode.” He has stayed on his shot thus far bc he was so terrified by what happened to his life. He’s an anxious person-and this has worked to our benefit-bc he’s terrified of going back to where he was, even though he has no idea what happened. After all of this, the mood aspect is the hardest to figure out for me bc alot of what people post here seems to be cut and dry psychosis. I think someone can have schizophrenia AND bipolar, right? Maybe the Abilify is simply blunting the mood disorder symptoms and treating psychosis at the same time? I have been trying to figure out if mood symptoms are misinterpreted by family and are typical in SZ? Or does it mean there is more going on that should be treated with medication? Great day with him yesterday so easy to ignore, but it will come to surface again. He chomped my head off the previous weekend and it put me in a dark place. He lives near us and we see him most weekends. His dr at outpatient doesn’t want to work much with families.

Yeah, it’s hard to diagnose my daughter’s condition as well during the early stages and even now there are still questions. During this period, I see confabulation, forgetfulness leading to paranoia with bouts of agitation, sadness, anxiety and happiness. When my daughter showed symptoms of psychosis, she went from home based care to hospitalization (low dependency ward) and now to high dependency ward. Part of the reason for the downturn is due to a change in medication from Abilify+Lithium to Rexulti. The aim is to find a medication regime that would minimize her side effects while maintaining a high functioning capability. When my daughter was in home care, there were visits from her care team. The care team’s visit has a stabilizing effect on her and it was useful to give my feedback to the team so they are able to better assess her overall condition. While she was in a low dependency ward, it seemed my daughter’s condition was improving. She was polite and was not disruptive. She became highly agitated last week and thus put into the high dependency ward so she has a better environment to recover. The hospital has also restarted her on Lithium. That’s our story so far and I can understand the difficulty you experience with your son. On the bright side, there are new medications on the horizon and things can only get better.

Best wishes.

Hi ! My daughter is schizophrenic and is on a monthly injection of abilify. She is doing well but is not working. She is trying school for about the third time and is 26 years old, married. She is very sensitive and since diagnosed and treated , I have to be careful of my wording and what I ask and send through texts. This has caused many issues that should not have been and she misunderstands what I say. I have now let thing slide, by not talking to her as much and plan what I say more carefully … her husband is Bipolar and also difficult to talk too. I miss my daughter and her easygoing nature. It is just different. Often I wait for her to find a reason to call me , which is a real treat. She asked about an assignment . So, I guess, step back and enjoy the little things.- Julie

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I’m not sure caregivers can fully appreciate what a blow to your ego and confidence developing SZ (or in my case SZA) can be. To accept your diagnosis is tantamount to admitting you can’t trust yourself and your senses by definition.

Yet in recovery, you strive to regain that confidence and thus your autonomy. And while drugs can be helpful, they aren’t perfect and residual cognitive, perception and other deficits may remain. Yet you’re required to fake “adulting” until you make it— all the while knowing you might relapse, being painfully aware you are behind your peers and possibly an embarrassment or disappointment to your parents. So you remain ever vigilant, so you don’t fall down whatever holes that landed you in a mental hospital or psychiatrist’s office in the first place. It feels like the ultimate imposter syndrome, because if you know you’re “crazy” recovery means faking you’re “normal”.

My take on my sensitivity in early stages of my recovery was I was standing up for myself to preserve my ego and autonomy. It’s not unlike the sensitivities of teenagers as they gain autonomy and responsibilities and react melodramatically to anything that looks like controlling or criticisms of their decisions. It’s doubly hard emotionally to regain these once you’re enjoyed some freedom and autonomy after hospitalization or other setbacks. Elders in care situations and people recovering from traumatic accidents exhibit similar behaviors, so caregivers may want to factor in the human factors of such setbacks before they fully implicate schizophrenia.

Beyond this, I think caregivers unconsciously project worry and anxiety and impatience with growth within the recovery process and sensitivities can arise out of awareness of their presence. Even if this isn’t the case, it can feel like they are by the cared-for via projection. It’s difficult to eliminate parent/child, spousal or sibling dynamics, so I think it’s best not to try and leave desensitizing such sensitivities to talk therapists.

In my case I had a Jungian therapist and “rolled-my-own” Cognitive Behavior Therapy (CBT) with self-affirmations, and mental gymnastics surrounding more likely explanations to my suspicions, reality-testing and logical reasoning— in short, I thought my way out of my insecurities. While Jungian Therapy worked for me, it’s not for everyone and can be expensive and painfully slow (10 years in my case, with 4-5 years of follow-up later). I might be more inclined to try CBT instead if I could find an experienced practitioner. I’d be less inclined to search for a solution in a bottle by way of adding a mood stabilizer or switching to another drug if sensitivities are your chief concern.

My opinion is people get too wrapped up in diagnostic labels unless you are pursuing drug-only therapies, even then I think you’d be hard-pressed to get two psychiatrists to agree in mixed diagnosis cases, and I think laypeople broadly mistake “moodiness” (a transient symptom component of many SMIs) for mood disorders which have high and lows measured in months rather than days or hours.

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