Category Archives: Schizotypal disorder

Reading

Growing up, I had two passions: Drawing and reading. Once I grew out of wanting to be Superman when I grew up, I wanted to be either an artist or a writer. To this day, I still want to be an artist or a writer. Depression put a serious wrench in my artistic aspirations however and after about 7 years slugging through university with little more than a useless bachelor’s degree to show for it, I had to finally acknowledge my reading problems.

Again and again I would force myself to sit down and read a text and while I understood each individual word, by the end of the page, I had no idea of what I’d just read. I could still read novels okay and follow the story as long as it was simple enough. No Dosteyevskij or even George R.R. Martin for me, unfortunately. My psychology textbooks and academic articles? They may as well have been written in German for all the good they’ve done me. I’m amazed I managed to make it as far as I did.

Some information would make it through my brain soup and stick around for a while, but then some new information would come along and knock the old right back out again. I had the bizarre experience of re-taking an exam and pulling the exact same topic from the first exam. An article on language learning and Broca’s and Wernicke’s areas.  A couple questions I answered correctly the first time around, I couldn’t remember the second time, but I answered other questions correctly the second time around. Luckily for me, I passed the second time. I was just happy I wouldn’t have to re-visit the article from hell a third time.

Even something as supposedly simple as job applications can be hard for me to work through sometimes. Going through dozens of them in a day to find just one or two that sound promising? That is seriously taxing work. More than once, I received a call from a workplace I couldn’t even remember from all the applications I’d sent. Makes for a pretty lousy job interview when you can’t even remember what job you’re applying for.

Other times, I’d apply for a job only to later realize they were located about half-way across the island if not at the exact opposite end. Some people can commute two hours back and forth to work. I can’t. Two hours of public transit in the middle of rush hour? Yeah, no.

It was something of a revelation to find out others with schizotypal disorder had similar problems with reading. I’m still not entirely sure if it’s a schizotypal thing in particular or more of a general effect of long-term stress. I might try to look that up sometime.

A part of me still refuses to acknowledge that I can’t actually read anything more complex than the equivalent of a Harlequin novel. I was the born academic. I’ve always loved reading and learning. What good is an intellectual who can’t even read? About as much good as a boat made of Swiss cheese, that’s what. So I still routinely expend and exhaust myself trying to slug through all the reading and writing I can manage. It’s still almost entirely simple romance novels and roleplay posts, but I like to think I’m slowly working my way up to something more substantial. Maybe I’ll even eventually find a good use for all the light novels and roleplays I’ve devoured.

Anyway, this whole post came from trying for months to stable together something more academically grounded for this blog. I’ve been ruminating over one topic in particular: The relationship between Asperger’s and Schizotypal disorder, or the differences and similarities between the two. But I wanted to study up on what kind of research has been actually been published on the topic. As you might have guessed from this whole post, it’s not going so great for me.

Psychopharmacology

Medication against mental illness has always been an iffy topic full of taboo. Many believe we are being over-medicated, that mental illness should be treated mentally through therapy and not physically through medication, and so on and so forth. I tend to fall more towards the “no medication” than the “yes medication” end of the discussion. But I also think it is unwise to refuse medication entirely. I realize that my feelings on the matter are just feelings, not actual facts, and ultimately irrational.

I’ve never been a fan of antidepressants and am even less inclined to like antipsychotics. A big part of it is an irrational fear that the drugs will turn me into a completely different person somehow. Like the drugs will make me think and feel different than I normally do. But you could also say that my disorder makes me think and feel differently than I normally would. When you’re sick for so long, it can be difficult to discern where you end and the illness or disorder begins. Am I me or am I just the drugs?

Another big part of my reluctance to take any medication is, I’m embarrassed to take them. Especially when I visit my dad on the weekends. I don’t want him to see me take any pills. It’s a stupid, stupid reason not to take medication, I know. Even so, when I was on antidepressants, I often found myself “forgetting” to bring the pills or forgetting to take them when I did bring them. When I finally took them, I’d always covertly swallow them while no one was looking.

Because of my own stance on medication and the fact my symptoms have always been relatively mild as far as I can tell, my experience with medication is very limited. I’ve been on mild antidepressants twice in my life. Both times I abruptly stopped taking the medication. I’ve never been on antipsychotics. Why would I want antipsychotics when I’m not psychotic? Although, perhaps the classification is a little misleading. Perhaps it’s more helpful to think of them as thought-regulating medication? On second thought, that might actually be worse… It’s silly to get hung up on names and specification, I know but what can you do? My brain’s just full of excuses.

I’ve heard some medication can help with excessive thoughts. I considered something like that, but my thoughts feel more slow and rusty than excessive and I was afraid the medication would somehow slow my thinking to a crawl or even stop completely. I should probably have talked more about this with my psychologist at OPUS. Probably he would have been able to clarify what sort of medication does what and what might be a better fit for me. But I didn’t.

My biggest hang-up against psychopharmacology is perhaps the side effects. Sometimes, the side effects of some medication can be quite severe and it can feel a bit like cutting off a leg to save the arm. It’s a different kind of debility but still one way or the other, you’re still not whole. There are other medications you can take to treat some of the worse side effects, which is good. But at the end of the day, it’s just more pills to take and that can get a little exhausting just to think about.

The first time I took antidepressants, I was 18 and living at home in Nuuk, Greenland. I was diagnosed with mild depression and a visiting psychiatrist (meaning he worked there for a short time before returning to Denmark) prescribed me with Citalopram, I believe. It worked great for a couple of months. Then it stopped working. So I stopped taking them. I didn’t like my psychologist at the time either and when she failed to make a new appointment one session, I simply stopped coming. Instead of ineffective medication and useless psychologists, I decided to treat my own depression by making a point of exaggerating the enjoyment of the few things I still enjoyed. It worked well enough for a while. Focusing on the good things in life is helpful short-term, but if you don’t treat whatever’s making you miserable, eventually all those bottled up emotions are going to come crashing down. It may take years, but it’ll happen sooner or later.

The second time, I started taking basically the same drug, but a different brand because I felt mildly depressed while I was at OPUS and I had a lot of trouble sleeping. This time, I felt no difference at all from the drug after taking it for about a month. Rather, I suffered the unfortunate but very common side effect of being unable to orgasm or taking ages and ages to get there, without the actual intended benefit of the drug. And so, when I forgot to pick up my new prescription just before Christmas the year before last, I simply stopped taking the pills when I ran out. This turned out to be a very reckless move. As it turns out, going cold turkey on antidepressants can have some pretty uncomfortable side effects. Like dizzy spells. At first I thought it was simply lack of sleep that caused the dizziness, but after talking to my psychologist, I realized it was probably the drug. Thankfully, I didn’t suffer any worse side effects and the dizzy spells disappeared on their own.

I’ve heard a few other horror stories about medication, like the schizophrenic patient who spent her time drugged into a stupor and her medication messed with her hormones making her obese and grow unsightly facial hair that she hated so much she would escape into another world where she wasn’t sick and had a successful life with a career and family. Sometimes, I dream about being able to just park my body in some institution and disappear into my own head and live in my own dream world where everything is exactly how I want it. I feel like I’d be happier that way. But I’m much too proud to allow myself to live out my days like some institutionalized drugged-out potato.

So, do I believe psychopharmacology’s all bad and should be avoided at all costs? No. I do believe drugs can be helpful, even necessary. For all the horror stories, there are many more happy stories where drugs bring relief from internal torment and allow for a relatively normal life. I know someone who takes medication for her anxiety and it relieved her of the terrible stomach pains she suffered from due to the anxiety. I know of a family friend who takes antidepressants because he simply can’t function without them. I don’t think medication is the ultimate solution, but it can bring relief where it’s needed. Recognizing that need is an important step towards recovery.

If your own brain torments you so badly you can’t be in your own skin, if your anxiety is so bad it causes physical pain and leaves you trapped in your own head, if you feel so awful death seems the only escape? Then perhaps trading off happy-fun times with your favorite sex toy doesn’t feel like such a bad deal. And perhaps it won’t have to be for the rest of your life, but just until you’re in a better place overall. The important thing is, you get to a point where you can live well.

inappropriate or constricted affect

What on earth does that even mean?

A quick Google search describes constricted affect as a restriction in the range or intensity of display of feelings. While inappropriate affect is the display of feelings inappropriate for the situation.

I’ve already talked some about the restriction in the range or intensity of display of feelings in Symptom: Emotionally Inexpressive.

Inappropriate affect however, I haven’t talked about at all. It’s fairly easy for me to find examples of this in my own life.

Two memories in particular stand out to me:

The first, I was younger than 15 at least. Maybe 13-14 or a couple years younger? I was in an indoor swimming pool with my dad, his girlfriend and my youngest half brother. I knew the girlfriend could swim. She would jump into the deep end and dog-paddle around. Then, suddenly she began calling for help while splashing around in the deep end of the pool. Maybe she had suffered a panic attack and forgotten how to swim. She wasn’t a very good swimmer to begin with. I didn’t understand any of this. All I saw was that this woman, who I knew could swim, was splashing around as if she didn’t and people were starting to look concerned. It was so funny to me, I couldn’t help but laugh. Being the one closest to her, I simply swam over and pushed her to the shallow end of the pool where she could reach the bottom and get out of the pool herself. Chuckling all the way. It was an indoor pool. Where was the danger? The harm? Of course, I was reprimanded by the attending life guard for laughing. She could have drowned! But she knew how to swim! I know now, that being able to swim is not the same as being unable to drown.

Looking back now, I can see how inappropriate my laughter was. But I still remember how absurd the whole situation was to me. The way she splashed around looked really funny. I just didn’t understand the gravity of the situation.

The second memory is somewhat similar. This one was in high school. The high school I attended had a proud history with not a single suicide among its students. This is significant, given the high suicide rate in Greenland. That record was broken when the school was hit with a suicide epidemic in my second or third year. 3 students killed themselves that year. Including one of my classmates.

After every suicide, the school would gather all the students and hold a memorial. 1 minute’s silence for the poor sod, every single time. By the third time, it went from horribly tragic to downright absurd. Students started asking each other: “Who’s next?” As if there was some invisible serial killer going around offing random people.

At the last memorial, I stood at the back, chuckling to myself. Laughing in the face of tragedy. This time I was well aware of how inappropriate that was. It was no laughing matter. But it still struck me as funny. 3 people, who’d suffered were dead by their own hands and all the rest of us could offer was a speech and a minute’s silence. It was so goddamn sad it was funny.

But yeah, laughing at a memorial is hardly appropriate behavior.

We tend to do odd things when we don’t know what to do. Some lash out and become violent. Others are paralyzed and overcome with their own inadequacies. Some, like me develop a warped sense of humor and laugh at tragedy.

Behavior that is inexplicable or inappropriate when looking from the outside, usually makes sense when seen from the inside. Our behavior, no matter how insane are bound by their own internal logic. Even if we can’t quite explain it, it makes sense to us. It feels natural. I couldn’t not laugh.

Reacting to horrible things by smiling or laughing isn’t actually as out there as it might sound. Laughter and smiles are mechanisms deeply ingrained in humans. They have a relaxing, calming effect. Even disarming. After all, people will like someone who’s smiling better than someone who’s frowning. It’s an excellent coping and defense mechanism. For example, we automatically laugh when we get tickled. I don’t know about you, but I don’t particularly enjoy being tickled, even though it does feel good to laugh.

So, do I laugh at horrible things because I’m a horrible person who lacks empathy? I don’t think that’s the case at all. But it’s very easy to make that assumption. If tragedy makes you laugh, you’re assumed to be horrible, if comedy makes you cry, you’re assumed to be overly sensitive and if you get angry at nothing at all, you’re an excellent target for bullying.

So, I think inappropriate affect is an expression of a divide between what goes on on the inside and what goes on on the outside. Either due to the outside stuff being interpreted incorrectly inside your head, like putting 2 and 2 together and getting chicken pot pie, or because you’re reacting to something going on inside your mind that doesn’t necessarily have anything to do with the outside world. I find that spending too much time with your own thoughts tends to dull awareness of what’s actually going on around you. My point is, the inappropriate behavior has meaning and logic behind it. Just not meaning or logic that’s obvious when seen from the outside.

Sickness – reason or excuse?

One thing I tend to struggle with a lot is distinguishing between genuine need for rest and laziness. I’m constantly second-guessing myself whenever I decide to call in sick from work for instance, because there’s nothing physically wrong with me. I know I could technically go to work and get it done, although not as well and I’d be exhausted and utterly miserable. On top of that, I’d usually be looking forward to an even more miserable time the following day.

Eventually, if I kept pushing myself, I’d reach a point where I can’t make myself do anything at all. That’s surely not a healthy work ethic. I certainly don’t think it’s very constructive to push myself to the breaking point. But when is it okay to stop up and take a break? And how long should that break last? At which point does need for restitution become plain laziness?

I’ve been on a very long sick leave from job-hunting and even though I don’t at all feel ready to go back to that particularly unpleasant rat-race, I felt more or less forced to. It was either that, or stay in an internship I felt entirely unsuited for and found increasingly more stressful and confining.

I didn’t want to drag myself out of bed and either spent most of the day twiddling my thumbs, waiting for customers to service, a task I’ve always despised, even if it’s really just scanning in wares and accepting payment. Most of the time. That is when there was a bar to scan and it showed the right price. Then there was the greens. At the store I worked, we sold surplus goods, so the actual wares tended to wary and the greens varied a lot in type and quality. Often times, the prices could even change throughout the day, depending on quality, quantity and how well they sold. It was confusing and I hate that kind of uncertainty.

It’s the weirdest things that can wear you down. Simply standing around all day wears on the feet and back like you wouldn’t believe. Doing nothing at all tires and stresses and simply not knowing what to expect from a workday can, when you’re not the sort of person thrilled by surprises, really, really drain your energy levels.

Then, when you’re spending all your energy out at work, you come home to dinner that needs cooking, dishes, cleaning, laundry and all the wonderful elements of being a responsible adult. I consider myself very lucky I don’t have any children to look after on top of all that. Sometimes I wonder how anyone can manage all those things. My parents have both done a pretty decent job of it for decades. In my dad’s case all alone for most of my youngest little brother’s life.

For them, simply pulling yourself together and get the job done seems to do the trick. Most of the time anyways. But for myself, I find that approach absolutely miserable.

If I can make work and chores fun on the other hand, it’s so much easier to get done. And taking lots of breaks tends to make things much easier and more fun. Trouble is, breaks can take hours, even days. And then the work piles up to epic proportions, to the point where I’m exhausted just looking at it. To the point where I feel I need to take a break before I’ve even begun.

It’s so much easier, to sit down and disappear into my own, little world instead of with all the things I should, but really just don’t feel like.

It’s understandable that when you’re sick, you can’t do as much as when you’re healthy. But in my experience it’s maybe not so much a matter of whether you’re sick or not, but how sick. For longtime sickness, you tend to have good days and bad days. It’s not like the flu or a cold, where you’re sick and then get over it. Sometimes, it’s hard to tell if it’s a good day before I get out of bed. Most mornings, I’m tired but otherwise feel okay. Most days the mood will generally hold throughout the day, other days, I can suffer a major panic attack right after breakfast or on the way out the door.

In reality, the panic attacks aren’t something that come straight out of the blue. None of my symptoms are. It’s usually a slow build-up where I feel maybe a bit stressed, a bit down, but otherwise okay. I think it’s better to alleviate some of the strain while it’s nothing but that. I just have a hard time figuring out a way to properly do that without taking the whole day off. And it feels so incredibly wrong to call in sick when I’m still more or less okay. It’s much easier to justify staying home, when I can barely get out of bed or the mere thought of stepping out the door sends me hyperventilating. It’s either one extreme or the other. Neither’s a good solution. Life shouldn’t be a choice between working yourself to death or be dismissed as lazy and selfish.

I started this post intending to write about whether or not I might be using my diagnosis as an excuse to work less and play more. Instead it became a bit of a rant about how much I dislike work. But they’re sort of connected. Work sucks, play’s fun. I’d much rather play than work.

So then, do I feel like crap because I’m actually sick, or because I’d really, really just rather stay home and play, and just can’t find any better excuse besides making myself sick? Or maybe do I dislike work so much I make myself sick to avoid it?

Thinking about it, it’s possible, isn’t it? When you’re sick, you get to stay in bed. Exactly what I most feel like doing most days. Then it feels more like a reward than a necessity. If you’re sick, you can’t be expected to work, which we’ve already established I’m not exactly a fan of.

Am I so lazy that I’m making myself sick just to have an excuse to laze about?

Symptom: Emotionally inexpressive

This one I found incredibly hard to write about because it covers feelings and emotions, which I find incredibly difficult to talk about even on the best of days. I’ve written and rewritten the entire post about half a dozen times. I do hope the end result isn’t nearly as messy as my thoughts on the subject.

This is not a symptom I myself am fully aware of. I can’t tell how much or how little emotion I actually express unless others comment on it, which few actually do. And even then, they might comment on it in a sort of roundabout way, like someone might say I look more relaxed/happy after we’ve known each other for a while. I never actually realized I could be considered emotionally inexpressive until my doctor made note of it at the time of my diagnosis.

I don’t know how long I’ve had this particular symptom. For all I know, it’s something I’ve always had. Maybe it can even explain a lot of why I have such a hard time in social situations. It could be the reason I’ve sometimes felt as if there’s a glass wall between me and everyone else. It makes sense. People tend to avoid someone who’s aloof, who doesn’t mirror their own emotions. Someone who does not display weakness becomes unrelatable and unapproachable.

I can think of three main reasons why I might not express myself openly:

  1. I don’t actually know how I feel.
  2. I fear the consequences of my own feelings.
  3. I simply take a long time to warm up to new people.

First reason is difficult to deal with. I have to take the time to process physical and emotional cues to pinpoint my feelings. Sometimes, they can be very indistinct or difficult to identify.

Let’s take fear as an example. I tend to avoid social situations, but I hesitate to say that I’m afraid of social situations or have social anxiety. The behavior is the same: Avoidance. But I don’t easily recognize the telltale signs of fear: accelerated heart-rate, sweating, the feeling of unease, the worrying about what other people think of me, difficulty breathing. Some of these things do register on some level, the heart-rate and difficulty breathing in particular. But they don’t necessarily become conscious. I might realize I’m suddenly taking long, slow breaths to compensate before I register the actual signs of fear. The worry about what other people might think of me becomes internalized so I worry about what I think of me instead and I’m convinced I don’t actually care what others think of me, even though maybe I actually do on some level. Or maybe I don’t actually care what others think of me?

The emotions themselves become lost in coping mechanisms and strategies until I can’t fully tell what’s what or where the cause to my reactions lie. Maybe it’s a result of suppressing my feelings for too long? Or maybe I’m just not very sensitive to my own feelings for some reason? Maybe the connection between my brain and face muscles is just naturally weak? Maybe I just overthink everything and make it more complex than it really is?

As a result I sometimes find myself in truly upsetting situations without having the first clue why it is I find it so upsetting. It often takes me a while of careful introspection and ruminating over the whole situation before it finally dawns on me. Maybe someone said something I didn’t like and upset me, but I’m loathe to make mention of it before I know exactly what it was that upset me. Otherwise, what’s really the point? You can’t ask someone to apologize over or not repeat something you don’t even know what is. There’s very little as upsetting as being upset over nothing or not knowing what it is you’re so upset over.

On top of that, it becomes especially difficult if someone comments how I seem to feel one thing when in fact I feel something else entirely. Maybe someone would make a comment that I look more relaxed and comfortable, when in fact I’m bored out of my mind and about ready to run off screaming. It annoys me and I don’t know what to do about it. I don’t want to tell people not to voice their impression of me, quite the opposite. But what do I do when that impression is wrong? Do I correct them and say: “No, sorry this isn’t my happy and comfortable face, it’s my dying of boredom face”? Wouldn’t that make the whole thing more awkward? What if they’re right and I’m the one interpreting my own feelings wrong?

The second reason is maybe kind of complicated. In my experience, expressing negative feelings tend to produce negative outcomes. I express anger, the response is often offended and defensive, I express sadness, the response is sadness. I don’t want to make others sad! Or hurt or offended. Especially not those I care about. So, I prefer not to express those feelings. That way, I’m the only one suffering. In the short term anyways.

Because the truth is, hiding feelings doesn’t make them go away. Eventually, they’ll boil over. I know this. It’s just that it’s easier to cover them up, to wait until I’m beyond caring. The short term relief means more in the now, the long term consequences is a problem for another day.

In much the same way, I’m very conscious of not “showing weakness”, especially when I’m not quite sure about the company I’m in. I’ll avoid complaining and automatically bury any embarrassment. Embarrassment especially is something I’ve become very good at avoiding.  If I don’t acknowledge it, it’s almost as if it isn’t there at all. If anything bothers me, I’m not likely to point it out. I go to great lengths to avoid crying in front of others as much as possible. However, when I’m with friends and family, I love complaining about every little, silly thing. I’m far more talkative as well. Almost as if to compensate, letting out a little of the steam I’ve been bottling up. But only with those few I know very well and very, very rarely anything serious.

It’s not hard to imagine that this kind of thing would affect my relationships a great deal. I have easy, comfortable relationships with all of my immediate family and my closest friends. But the minute they start digging into the serious things, the relationship crumbles and I can’t get away fast enough. But family and friends are supposed to be the ones that can handle the serious stuff. Those who’ll stick around for the bad as well as the good.

But then, there’s very little as painful as the realization that you can’t actually trust someone you thought you could rely on, that you’re supposed to be able to rely on.

I’m lucky in that my family and friends are all loving and supportive. I know I can rely on them. But there’s always that little doubt. Because we’re all only human. We have faults and I’d rather live in faith than truly test it and risk rejection. I’m afraid that if I told someone that I truly needed them and they couldn’t be there, I’d break. It’s easier to tell myself that I don’t need to say it, that of course they’ll be there if I need them, but I don’t need them that much right now.

Lastly, it’s very likely that this symptom has not only affected my existing relationships, but the forming of new relationships (or lack thereof). I warm up extremely slowly to new people. If I don’t know them, I don’t know if they’re worth spending time with, but I can only know them by spending time with them. And if I lack emotional expression, it’s likely it would put a great many people off. After all, why would you spend time with someone if you can’t even tell if they’re the least bit happy to spend time with you?

Mulling over this symptom and the possible problems and after talking to a social worker about how she connects with the people she works with, some interesting questions came to mind: Why do we find some people more genuine, approachable and relateable? Not because they’re perfect. We tend to resent people who seem to do so much better than us, seemingly without effort, do we not? However, when we see someone with flaws, someone who has to work hard for every, little victory, we can sympathize. They become more human to us. They become like us.

Everyone struggles with something and the struggle is something we can usually bond over. Things like embarrassment, frustration, fear, sadness, feeling inadequate. Most, if not all of us have been there one way or another. It invokes sympathy. I think we like being able to sympathize with those we’re with. But we tend to hate being sympathized, it quickly becomes pitied and patronized. I certainly do.

But then, by refusing to show weakness, by pretending nothing at all bothers me, I may inadvertently tell people, that I’m superior to them, that I wouldn’t be able to understand their flaws, that we have nothing to talk about or bond over. Essentially that I surely wouldn’t give them poor, faulty mortals the time of the day.

I’m often described as very intelligent and seem very mature and competent, but in truth I often feel so very far from all those things that the compliments sometimes end up seeming like outright lies to me. Me, intelligent? Hurr-durr, thanks I guess? I can’t seem to work out even the simplest of problems though. Competent? Yet routinely defeated by a pile of dishes. Mature? LOL.

I like being praised and admired, even if I can’t quite believe the admired traits truly are ones I possess. It’s certainly better than pity or resentment. I want those around me to see the good, not the bad. So I tend to cover up the bad. Perhaps with time and practice, I’ll be able to open up more and then I’ll learn that I truly don’t have to be lonely.

Cognitive Training

When looking at indicators for successful recovery from mental illness, I’ve sometimes seen intelligence, IQ or cognitive abilities mentioned. Personally, I haven’t often viewed my own intelligence with much favor. After all, what good is an above average IQ, if you can’t even manage to keep your own kitchen in order? Furthermore, if you’ve found your IQ score a little on the low side, don’t worry. Like your muscles, you can improve your “brain power” with training – and as I explain later, being good at puzzles doesn’t necessarily mean being good at living. But that too is a matter of training and practice.

So, when talking about cognitive training, what is it exactly we’re talking about?

Cognitive psychology covers everything from critical thinking to attention and memory. It is what we use when we read, write, remember tasks and shopping lists, follow conversations and work on puzzles and challenges among other things. When you recall items on your shopping list, search out a particular item on the shop shelves or spot a friend in the crowd, you use your cognition to do so.

Attention and memory in particular have been shown to suffer when a person is in a state of prolonged stress. You might notice that you forget more easily or have a harder time concentrating on tasks when you’re under great pressure, especially if you’ve been under pressure for a long time.

So, how does cognitive training work? Simply by using your brain. You can easily find several good “brain training” around. On the App store on my phone, I found Brain Training by Triangle Labs Inc., Elevate by Elevate Labs and Lumosity by Lumos Labs Inc. for free. Even well-known puzzle and memory games like crossword puzzles and the like can be used to train your attention, concentration and memory – or various video games for that matter. However, you can sit all day and “git gud” at a game, but then all you do is get really good at that one particular game. The trick is to combine several games to train different skills and then transfer those skills into everyday life.

I, for instance have struggled a great deal with concentration and memory. I couldn’t concentrate on my studies and couldn’t remember the texts I’d read. I’d also constantly lose focus and had trouble keeping track of conversations. And yet I had little trouble remembering every Pokemon and their types, attacks and weaknesses. Or follow the juicy development between the main characters of this or that cheap romance novel.

So, I joined a cognitive training group to try and figure out what exactly was going wrong and try and train my brain not only to remember Pokemons, but shopping lists and scientific articles too.

The cognitive training part of the group consisted of playing especially developed games on the computer, where you use various parts of your brain to solve problems. There’re attention and memory games, where you remember figures and where on the screen you saw them, names and faces, spoken messages and puzzles like the Tower of Hanoi. Each game started would start out easy, then slowly grow in difficulty.

The games themselves were a lot of fun, but the really helpful part of the group was spending time in the group as a whole talking about the similarities between the games and tasks in our daily lives.

Suddenly, the Tower of Hanoi wasn’t just neat little disks on pegs, but piles of boxes in a cramped room that need to be moved to create more space or the random figure somewhere on your screen became your keys located somewhere in your room.

We also spent a lot of time learning each other’s names, going over a couple helpful strategies. Names and faces are a real chore to remember, especially when you have to remember a lot at once. But you can help your memory along by creating connections or more meaning. Like, “Her name is Mary, like my aunt”, “Michael likes knit sweaters”, “Basil like the spice” or “Stella is a star”. Then, when you see the person, you can help your memory along. My aunt = Mary. Knit sweater = Michael etc.

The cognitive training didn’t only stay on the computer, but was pulled into daily living and chores. When you clean up your room, you locate objects, identify them and categorize them to place them in their rightful places. Granted, real life is three-dimensional and full of distractions, but the task in and of itself is the same. It’s just like the computer game, but in hard mode. Once your brain becomes accustomed to performing the task in simple 2D on the computer, it becomes easier to perform in real life. All you need is to make the connection between the game and the real life task and your brain will know what’s needed.

Over the course of the group, I found motivation and interest in the computer games waning, but I’m still using my brain every day, concentrating on tasks and chores, remembering said tasks and chores and how to perform them. It’s become a fun, little exercise when I’m playing a game to try and think of ways how the game translates into real life.

One really helpful technique I’ve learned from the group is to chop up big tasks into smaller tasks and steps. Dishes get divided up by category, so a big pile of dishes becomes smaller, more manageable piles by category: cutlery, plates, cups and finally pots and pans. Cleaning and tidying is similarly cut up into steps. When tidying my room, I start by sorting the trash, then the laundry. Then I usually lose momentum and end up in front of the computer until the trash and laundry piles up again. But once each item has a box, place or category, it becomes easier to deal with. Feels like I’ve mentioned something like this before on the blog somewhere… well, memory’s still not the greatest, but it’s getting better, I think.

Have I mentioned I also find lists and plans helpful? Writing down each step needed to perform a task and how to do it helps keep focus and reduces a big chore to simply following a set of instructions. Cleaning the bathroom starts with filling up a bucket with soapy water, gathering up the necessary supplies and then starting pouring some cleaning solvent into the toilet, then with washing the walls, the sink and shower finishing cleaning the toilet and then the floor. Like following a recipe when baking.

Nowadays, I’m maybe still not at the level of scientific articles, but I’ve slowly upgraded to more meaty texts than cheap romance novels and at least shopping lists aren’t a problem anymore.

Symptom: Social Withdrawal

Social withdrawal is a negative symptom of Schizophrenia and can be present in Schizotypal disorders as well. It is when a person shuns social contact and spends large quantities of time by themselves, largely ignoring the world around them.

I think, for much of it, this tendency is closely tied to social anxiety. After all, we tend to avoid what we fear and brings us discomfort. But that’s not the whole reason behind it. At least for myself, sometimes I just get so tired or so distracted that social interaction becomes more of a burden than a pleasure. It simply takes too much effort. My brain, like a sore muscle, screams out for rest so it can recuperate.

For myself, I often have periods of time, a day or two usually, sometimes up to several weeks, where I can’t stand the thought of looking at another human being. During those periods of time I find communication, even by text, extremely difficult.

Usually, these periods of isolation coincide with depressive periods. I’ll huddle in my room, in front of the computer, immersing myself in fiction. Sometimes I’ll spend days just playing video games. Other times I’ll binge-watch TV or anime series or Youtube videos, or spend every waking hour just reading mindless, fluffy romance novels. Just anything that keeps my mind turned off, away from reality. If one pastime fails to distract me well enough, I’ll move on to another before I have to think too deeply on what it is I’m doing.

Any time I find myself under any kind of pressure, I risk lapsing into this isolation tendency. Exam periods were especially harrowing. I had to retake a couple exams, but somehow I managed to get through them in the end.

Too much social contact can also be a serious strain. I get exhausted just by being around a lot of people, even when I don’t have to talk to anyone. Talking to a lot of people over a period of time seems to be especially draining though. Even just spending too much time with family can leave me exhausted and irritable, to the point where simply having another person just quietly breathing in the same room becomes unbearable.

I’m extremely introverted by nature, and so I actually need some time to myself, to recharge and relax.  Otherwise I end up mentally exhausted and stressed out. Generally, a day or two a week, without social obligations is enough to keep me going, so I try to plan around that.

My most recent bout of social withdrawal, was likely brought on by too much social contact. I just simply couldn’t bear the thought of seeing, let alone talking to another human being. I felt almost like I’d shatter, if I did. Thankfully, usually after a couple days, or sometimes a week or two, depending on my level of exhaustion, I perk up again and become able to face the world once more.

I think, there are several points to keep in mind about social withdrawal. One is personality. If you have an introverted personality like mine, you might benefit from more time alone. But too much time alone isn’t good for anyone, regardless of personality.

During my worst time, I spent weeks by myself, hardly speaking a word to anyone. During that time, I found my speech greatly deteriorated. When I finally did speak, I spoke slow and haltingly, spending more time searching for words. My more psychotic symptoms became more pronounced, I felt increasingly detached from my body and the world around me. The more time I spent alone, the harder it became to simply set foot out the door. I was “lucky” enough that my local supermarket was open 24/7 at the time, and so I’d do my grocery shopping in the middle of the night to avoid other people as much as possible. I could hardly function day to day and that’s when I finally realized, I couldn’t keep going at the rate I was.

This leads me to another point to keep in mind: Day to day function. If your social withdrawal impacts your day to day life negatively, if you find your mood deteriorating, find tasks such as grocery shopping, cooking, cleaning, showering etc. increasingly more difficult, that’s obviously a big problem. Any time you spend alone isn’t in and of itself a problem, as long as it doesn’t affect your quality of life and your relationships.

If you can, holding up your behavior before and after getting sick can also be a good idea. Were you much more social before you got sick? If so, then the social withdrawal most likely due to your illness. As with any symptom, proper treatment might greatly reduce, if not completely eliminate it. Although, it goes without saying, that restoring a ruined social life is very hard work. Like most any course of recovery, it takes time and practice. You don’t generally start running the moment the cast is off your broken leg either.

Like our muscles, our brain requires use to function properly. This includes the parts of our brain governing language, speech and social skills. The more they’re used, the better and easier it becomes.

Since my biggest bout of isolation, I’ve come a long way, simply by interacting with the people around me, weekly talks with my psychologist, frequent visits to my dad and the like. I was also very lucky to get into a social skills training group, where we meet every week and take up various problems we face in social interaction. We’ll take a problem one of us faces and together discuss strategies and ways to overcome it.

For instance, maybe someone is facing a pending family gathering and is nervous about seeing family members they haven’t seen or talked to for ages. So then we’ll talk about what makes the person nervous, the negative thoughts they face like: “They’re not going to like me” or difficult questions like: “What do I say if they ask how I’ve been?”, “do I tell them about my illness?”, “if I don’t want to talk about it, what do I say if they ask?”

Usually, by the end of it, we’ll have a plan of action for the person and a whole host of good tools and ideas for everyone else.

To summarize: Social withdrawal may be a symptom of illness, but it’s only a problem if it’s bad for your relationships and quality of life. If it does become a problem, it can be treated with training and working out good strategies. Cultivating good relationships is crucial for a good quality of life regardless of illness, health or personality.

 

Lastly, these are, as always simply my own thoughts and experiences. I am by no means an expert and my experiences may not completely reflect yours. Take what you can use and leave the rest.

Symptom: Paranoid Thinking

When asked whether I suffer from paranoid thinking, I’d say no. I don’t really think the people around me want to deliberately hurt me. I don’t automatically think the worst of other people or assume anything about their speech or behavior without good evidence. Not that I’m aware of, anyways.

I do have this sense that I mustn’t show weakness, or show if I’m nervous/afraid/uncomfortable, that if I show other people that they can hurt me, they probably will. It doesn’t register to me as an actual fear. I simply quietly avoid it, let it pass me by without a conscious thought. And so, when people inevitably hurt or disappointment me, I know it wasn’t on purpose, because if they’d known, then surely they wouldn’t have said or done what they did. Maybe I’m afraid to find out that if I did give others the opportunity, that they would want to hurt me deliberately? So it’s better to hide and forgive any accidental toe-stepping.

I’ve heard that sometimes people suffering from schizotypal disorder can have small, momentary paranoid delusions, or maybe paranoid stray thoughts. They might be very self-conscious about it and feel that the thought is silly, that “of course my friend isn’t a government spy” or “bodysnatchers isn’t real and mrs. Jensen down the hall isn’t actually an alien in disguise” but… Often, such thoughts are fairly quickly and easily dismissed.

Sometimes, the idea might feel all too real and even if they sound silly to others, they make perfect sense to the person experiencing them. Those tend to enter the realm of full-blown paranoid delusions. Thankfully, I’ve never experienced this myself, that I can remember. I’ve enough in worrying that my subjective reality isn’t quite the same as objective reality, or the reality experienced by everyone else, so that there’s no chance I’ll ever be able to truly understand what others are talking about, or make myself understood. Could that be considered a paranoia?

Paranoid thinking could also be things such as, if a friend takes a little longer to reply to a text, “it’s because she’s angry or doesn’t like me”, or “everyone at work hates me,” even though there’s no real evidence for it. It could also be the immediate assumption that if someone says something hurtful, it’s deliberate, or interpreting general comments as referring to you personally. I heard a story of a man once, who, while suffering from paranoid delusions, became convinced that the happy smiley faces staff members left on whiteboard messages for general use were in fact caricatures of him, which the staff drew purely to mock him. It might sound like a silly, little thing, but it’s truly deeply disturbing and hurtful for the one experiencing it.

Mostly, my own fears are never so concrete or focused, although I’ll admit I’m absolutely terrified of ghosts (even though I don’t really believe they exist, I can’t say they definitely don’t exist either). It’s usually just a vague sense of “I’m not safe”, “I’m alone, but it feels like there’s someone else here” or “I’m completely, utterly alone in a cold and uncaring world”. I’m aware the latter is an incredibly ungrateful thought, that I have people close to me who care a great deal about me. But well, they have their own problems. They have their own lives to worry about. They don’t and can’t possibly understand what I’m going through. Although in truth, I’m sure they understand and recognize a great deal more than I’d think.

I hate this part of me, who thinks this way. Like an overly dramatic teenager. But I can’t quite get rid of her. It’s silly and stupid, but it’s the way I feel, and feelings aren’t so simple to change. The fact I feel ashamed for feeling this way in the first place makes it all the harder to admit to and discuss, even just with myself.

I don’t know what to do about the vague feeling of being unsafe. Mostly, I just try to ignore it, distract myself, turn on the lights so I can see around the room, play some music, read a book. But this often ensures I won’t get much sleep that night and I’ll be tired and cranky the next day.

Sometimes, if I catch myself thinking or feeling something negative, I use techniques from CBT (That’s Cognitive Behavior Therapy, not the… kinky one) and try to challenge the thought or feeling using reason. I’ll ask myself things like: Where am I? Have I ever experienced something bad here? How likely is it, that this thought/feeling is true and reasonable? If I’m feeling alone, maybe I’ll challenge the feeling by texting a friend. She usually texts back. Maybe I’ll line up examples in my head where my bad expectations were justified versus where they were proved wrong and usually I’ll find just enough examples to put my mind at ease. I can use this technique to determine the likelihood of a thought being true as well. Like, “if Mrs. Jensen down the hall were an alien, what’s the evidence for it? Could there be other, more likely explanations? Maybe she just had a bad day and goes back to normal soon enough?”

 

I’d love to hear if anyone else experience anything like what I’ve described and how you deal/cope with them.

Symptom: Unusual Perceptual Experiences

This is perhaps one of the more insane-sounding symptoms, but also one of the hardest for me to correctly understand and identify. In fact, it took me many years to realize what they were.

Sometimes, when I’m really stressed, I see shadows, either flickering out of the corner of my eye or appearing and disappearing from one blink of an eye to the next. They were always so brief they weren’t really worth paying much attention to. Easy to ignore and forget. At most, they might weird me out a little, but I got over them quick enough.

Whenever I stare at a blank wall, more often than not it will begin to waiver, wriggle and squirm as if it were alive. This happens so often it hardly registers as unusual. I know the wall is completely inanimate and that it’s just my eyes creating the illusion, so I can just ignore it.

Sometimes I’d hear my mom calling my name in this really annoying voice, even when she wasn’t. But I haven’t heard her calling my name since I moved away from home.

Phantom noise or cries is fairly common and not necessarily a sign of insanity. Parents to infants might experience hearing their baby crying even when it’s not, or perhaps they’ll hear a random noise, like a bird call or the like, and it’d sound like their baby crying. I suppose the stress of too little sleep and too much awful noise can get to anyone. But knowing this, I never really thought of my ‘hearing’ things as anything unusual or a cause for concern. In the end, it was easily ignored and soon became little more than background noise.

I’ve had problems with neighbors playing too loud music because the walls are stupid-thin, but sometimes I felt as if I was just hearing things. As soon as I left my room to complain to my neighbor, I wouldn’t be able to hear anything at all. Usually, there’d be a window or door open and that’s what made the sound carry. Other times the music would be loud enough to hear from outside as well. To this day, I don’t know if some of the noise was created solely in my head just out of the stress created by the actual noise. But that period of about two years was the one period I felt the most insane in all my life.

The worst case of seeing something that wasn’t there, that I can remember was when I was still living at home. One evening I saw a girl sitting in the corner of my room. But it wasn’t exactly how I’d thought seeing things was like. I could see the empty corner clearly with my eyes and knew she wasn’t there. But at the same time, I had the feeling she was there and I could see her clearly in my mind’s eye. Even though I knew she wasn’t actually there, I just couldn’t get her out of my mind. I had to leave the room and go sit in the living room for a while. I was obviously upset and worried my mother, but I couldn’t explain why or what happened to me. How do you explain seeing something, but not really? I never saw it as “seeing things”. Because it wasn’t exactly at the level of A Beautiful Mind, now was it?

When I was first questioned by a doctor on whether I heard or saw things that weren’t there, I said no. Because the squirmy walls, the shadows, the strange girl, the phantom noises, those weren’t “seeing” or “hearing” things, they were just a trick of my over-active imagination. They weren’t the signs of a mental illness. I was depressed, not insane.

It wan’t until much later, when I attended a lecture by a woman suffering from Schizophrenia and she described hearing voices as very similar to having a song stuck in your head, that my view of my own experiences began to change. As she said, most people have experienced a catchy song continuously playing in their head. She said that the voices were like that, but talking instead of playing music. And a lot more oppressive, upsetting and disruptive.

She described how she learned to cope with the voices, identifying when they grew worse, which was usually when she was especially tired or stressed out. They weren’t just always there. Knowing when and why they appeared helped her overcome the negative voices. Then, instead of being a torment, they became a reminder to take better care of herself.

Hers is the best advice I’ve found to cope with unusual perceptual experiences. The shadows and phantom cries aren’t the first warning sign that I’m starting to get overwhelmed and stressed out, but they’re probably the most obvious and easily identified.
These days, shadows hardly appear in the corner of my eyes, but when they do, I try to pay more attention to what I’m doing and how I’m feeling.

Occasionally, when I’m really tired, I’ve also started to ‘hear’ a whole crowded restaurant in my head, full of broken pieces of conversations, fragments of sentences that make little sense. It makes thinking or focusing on things really hard. Luckily, it doesn’t last very long and it’s not something that actually keeps me from sleep.

The unusual perceptual experiences I’ve described here may not sound very severe and in most cases are fairly easy to ignore. But when they start to chase you out of a room, keep you from going out the door or drive you so much to distraction you don’t have any attention left for the things you need or actually want to do, they can become very debilitating indeed. Like a hundred little streams that become a large river.

In summary: Unusual perceptual experiences can be small, almost trivial and little more than a distraction. But if that distraction is actually really upsetting or disruptive, it may be worth it to pay more attention to the situations in which they arise. The nature and experience of the unusual perceptual experiences can vary greatly from person to person. Some may not be able to distinguish them from reality, which is upsetting enough all on its own, whereas others may experience them as a figment of an over-active and out of control imagination. The point is, it’s not something you can control.
Reducing stress can reduce the impact of unusual perceptual experiences significantly.

Symptoms: Odd Thinking

I figured, rather than just copying the many pages describing schizotypal disorder, I’d take my time going through each symptom and just give my own perspective on them.

So let me start with the one that might be the most obvious when reading this blog: Odd thinking and speech (or in this case, writing).

The Encyclopedia of Mental Disorders I found here writes this: “People with schizotypal personality disorder may have speech patterns that appear strange in their structure and phrasing. Their ideas are often loosely associated, prone to tangents, or vague in description. Some may verbalize responses by being overly concrete or abstract and insert words that serve to confuse rather than clarify a particular situation, yet make sense to them.”

It’s a bit iffy and looking from the outside, it might be a bit hard to put your finger on exactly what it is that makes the speech or writing sound weird exactly.

Seen from the inside, I’m not actually sure myself that my thinking or speech really is that odd compared to anyone else’s. I make perfect sense to my own ears. The only clue I have is the way other people react to the things I say and do, which don’t always make any sense to me. As if they heard something completely different from what I said. Although it’s pretty rare.

In conversation and writing, I think I tend to turn to metaphors and allegories a lot when trying to explain things and depending on how complex the topic is, I might never actually manage to get to the true core of the matter. But it’s not something I’ve ever registered as a problem myself. I can imagine how it might become a little tedious for some.

Sometimes in conversation, I’ll taste test words, trying to gauge whether it fits the thought or feeling I’m trying to describe. If I’m writing, Thesaurus can be a big help finding just the right word. In speech, I’m stuck with my own memory and gut feeling.

Whether in speech or writing, it takes me a lot of time to organize my thoughts. The harder the topic, the longer it takes. On top of that, when I get nervous or insecure, my speech becomes very slow and halting. I’m sure you can imagine how that might make conversation a bit tedious and uncomfortable for everyone.

Most times, this symptom is really more of an annoyance than an actual problem for me, but it can get in the way of communication and thus personal relationships. It does tend to build up over time and the negative experiences stick out more in my memory than the positive experiences.

The little misunderstandings sometimes makes me hesitant to talk. Especially when I’m already in a mood or tired. Then it’s easier not to say anything at all rather than risk talking myself into a mess and waste time and resources I don’t have.

The misunderstandings unfortunately aren’t only one way. Sometimes, people have this annoying habit of not saying what they actually mean. Like for instance, someone might say: “It’s really hot in here.” And apparently that’s supposed to translate to: “Can we open a window?” Except sometimes, it’s really just an observation, not a request, and how on earth is anyone supposed to tell the difference?!

It takes me a while to realize when someone wants me to do something when they don’t tell me outright what they want and more often than not, it’ll be much too late when I finally realize what they actually meant.

Flirting and banter is perhaps the most difficult for me to deal with, because I get confused easily and end up doubting my understanding of the other person. Then, what’s supposed to be fun and lighthearted becomes a scary minefield at the flip of a coin.

The better I know a person and the longer I’ve known them, the easier it is to understand them and make myself understood. I have pretty good, close relationships with my immediate family and I have two very close friends whom I’ve known for ages. But I haven’t really managed to form a decent friendship with anyone since 7th grade, maybe barring a single internet friend. Even though the relationships I do have are generally good, misunderstandings can still make problems sometimes. The good thing about the old, close relationships is they don’t break so easily.

The problems with misunderstandings has made me very concerned with word choice and whether or not they mean the same to others as they mean to me. I’ll often agonize over word-choice and end up not saying what I wanted to say, because I’m afraid of hurting others’ feelings. In my most hopeless moments, I’m convinced that words really don’t mean the same to others as they do to me and that I’ve no hope at all for properly communicating my thoughts and feelings to anyone, ever.

My point is, communication becomes a whole lot more complicated and anxiety-inducing than it needs to be. It’s exhausting and so it’s so much simpler and easier to just – not.

The problem with this symptom isn’t that my brain’s a little funky in the way it works. When it comes right down to it, it’s not as if it’s all that alien. Everyone differs in their thinking one way or another. The problem is the isolating effect it has on my life.

It’s easy to imagine that my thinking and writing style might turn out to be a problem for what I’m trying to do with this blog. I try to keep on point and my posts are pretty heavily edited before I publish them. But things do slip. Sometimes, a digression doesn’t register to me as such. So I’d appreciate any loose threads pointed out to me, or if something comes out unclear. I do want my writing to be both legible and if not at all entertaining, at least useful in some way.