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I've been diagnosed with schizophrenia but I don't meet the DSM-5 criteria for it.

The DSM-5 criteria states that you need 2 or more of the following

Delusions

Hallucinations

Disorganised speech

Disorganised behaviour

Negative symptoms


But it does say delusions by itself is sufficient for a diagnosis if they are "bizarre". Hallucinations by itself is also sufficient if they consist of a running commentary.

So in the past I have experienced 3 of these symptoms (voices, delusions and disorganised speech) but I have been symptom free for over 1 year now so I'm pretty sure I don't have schizophrenia.

The only symptom I still have is voices (which is caused by anxiety, not schizophrenia) but it's not running commentary, it's mostly insults trying to make me feel bad about myself. I've been discussing this with my psychiatrist but she refuses to accept that I no longer fit the criteria for a schizophrenia diagnosis.

She says I am suffering from anosognosia, which is a lack of insight... That I am refusing to accept my illness. It's not that I'm refusing, it's just that I literally don't meet the criteria.

I want to come off my medication to prove that I'm not schizophrenic but she won't approve it. She said I should continue taking it for another 6 months and we will do a med review to see about lowering the dose if I am still displaying no symptoms.

I don't understand why she is ignoring the DMS-5. I don't match the criteria anymore so therefore my diagnosis is wrong / invalid.

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Reply 1

I completely understand your point and I am so sorry to hear that. Are you doing all of this through the NHS? I have heard some not so pleasant things about how they treated some of my friends who have anxiety, BPD and other neurodivergent cases.
(edited 3 months ago)

Reply 2

I would contact Rachel Brown, she is an amazing psychiatrist with a completely different approach than the mainstream.

Reply 3

Original post by nabs9953
I completely understand your point and I am so sorry to hear that. Are you doing all of this through the NHS? I have heard some not so pleasant things about how they treated some of my friends who have anxiety, BPD and other neurodivergent cases.

Yes, NHS. I'm with a community mental health team and have to attend regular appointments and stuff.

Reply 4

Original post by evident-moonshin
Yes, NHS. I'm with a community mental health team and have to attend regular appointments and stuff.

I really don't mean to put you off or anything, but I have heard quite a few negative things about the NHS. Even without knowing you though, you seem like a really strong person and I am positive whatever the issue, you will do a fabulous job of dealing with it, I wish I could be of more help, but as I said, I am sure you will tackle it. I hope everything sorts out very soon, but best of luck until then!

Reply 5

Original post by evident-moonshin
The DSM-5 criteria states that you need 2 or more of the following

Delusions

Hallucinations

Disorganised speech

Disorganised behaviour

Negative symptoms


But it does say delusions by itself is sufficient for a diagnosis if they are "bizarre". Hallucinations by itself is also sufficient if they consist of a running commentary.
So in the past I have experienced 3 of these symptoms (voices, delusions and disorganised speech) but I have been symptom free for over 1 year now so I'm pretty sure I don't have schizophrenia.
The only symptom I still have is voices (which is caused by anxiety, not schizophrenia) but it's not running commentary, it's mostly insults trying to make me feel bad about myself. I've been discussing this with my psychiatrist but she refuses to accept that I no longer fit the criteria for a schizophrenia diagnosis.
She says I am suffering from anosognosia, which is a lack of insight... That I am refusing to accept my illness. It's not that I'm refusing, it's just that I literally don't meet the criteria.
I want to come off my medication to prove that I'm not schizophrenic but she won't approve it. She said I should continue taking it for another 6 months and we will do a med review to see about lowering the dose if I am still displaying no symptoms.
I don't understand why she is ignoring the DMS-5. I don't match the criteria anymore so therefore my diagnosis is wrong / invalid.

It feels like you are not convinced of your diagnosis. We wonder what your sympptoms were like before you started your medication? Have you considered that your medication is working as it should be in controlling your symptoms? Maybe it would be worth asking for a second opinion if you are unsure about the diagnosis you have been given? If you are experiencing any thoughts of suicide, please call Hopeline247 on 0800 168 14 14 or text 88247 and a trained suicide prevention adviser will be able to advise and support you.

Reply 6

Original post by Papyrus Hopeline
It feels like you are not convinced of your diagnosis. We wonder what your sympptoms were like before you started your medication? Have you considered that your medication is working as it should be in controlling your symptoms? Maybe it would be worth asking for a second opinion if you are unsure about the diagnosis you have been given? If you are experiencing any thoughts of suicide, please call Hopeline247 on 0800 168 14 14 or text 88247 and a trained suicide prevention adviser will be able to advise and support you.

It's hard to be convinced of a diagnosis when you don't have the symptoms one would expect from it. It's like being told you have a broken leg but you can walk just fine except sometimes you experience a little bit of pain in your thigh or something.

When I was first diagnosed before taking medication I did have more than 1 symptom. I had delusions and disorganised speech and was psychotic. Then I started taking olanzapine and after a few months my mental state improved.

And since then I've been taking the medication but I've reached a point now where I'm questioning whether I actually even have schizophrenia because I'm not displaying any symptoms, except voices, which is caused by anxiety and not schizophrenia.

Antipsychotics have long term effects so that's an added reason as to why I want to come off them. First there's no point taking a medication I don't need and secondly, I'm risking long term effects from taking it.

I told my psychiatrist that I will come off the medication by myself if she doesn't approve coming off them because I know I don't need it. I'm going to request a second assessment with a different psychiatrist because diagnosing someone with schizophrenia after just 1 admission to hospital seems a bit hasty.

Reply 7

Original post by evident-moonshin
The DSM-5 criteria states that you need 2 or more of the following

Delusions

Hallucinations

Disorganised speech

Disorganised behaviour

Negative symptoms


But it does say delusions by itself is sufficient for a diagnosis if they are "bizarre". Hallucinations by itself is also sufficient if they consist of a running commentary.
So in the past I have experienced 3 of these symptoms (voices, delusions and disorganised speech) but I have been symptom free for over 1 year now so I'm pretty sure I don't have schizophrenia.
The only symptom I still have is voices (which is caused by anxiety, not schizophrenia) but it's not running commentary, it's mostly insults trying to make me feel bad about myself. I've been discussing this with my psychiatrist but she refuses to accept that I no longer fit the criteria for a schizophrenia diagnosis.
She says I am suffering from anosognosia, which is a lack of insight... That I am refusing to accept my illness. It's not that I'm refusing, it's just that I literally don't meet the criteria.
I want to come off my medication to prove that I'm not schizophrenic but she won't approve it. She said I should continue taking it for another 6 months and we will do a med review to see about lowering the dose if I am still displaying no symptoms.
I don't understand why she is ignoring the DMS-5. I don't match the criteria anymore so therefore my diagnosis is wrong / invalid.

Hello,
I am sorry to hear that you are feeling this way. I would strongly recommend that you do continue to take your medication if it does not have a negative effect on you, it may be that you are feeling better because of the medication.

Also, I am assuming that you are from the UK and if that is the case the DSM is not the main diagnostic tool used as it is more American, published by the American Psychological Association. Doctors in the UK tend to use the World Health Organisation's ICD-11 which although lists similar things to the DSM there are some differences. Therefore, it might not be that your psychiatrist is ignoring the DSM but rather she may be looking at the ICD-11 instead.

I hope this helps, if you have any further questions or want to talk about this further please feel free to let me know.

Charlie
Law LLB Student

Reply 8

What’s wrong with taking the meds for another 6 months then reducing as per the psychiatrists recommendations? That should reduce your risk of Relapse.
Psychosis is really bad for the brain, you want to avoid it if possible.

Reply 9

also voices are a symptom of psychosis not anxiety. Although stress and anxiety can make
voices worse.

Reply 10

Original post by evident-moonshin
The DSM-5 criteria states that you need 2 or more of the following

Delusions

Hallucinations

Disorganised speech

Disorganised behaviour

Negative symptoms


But it does say delusions by itself is sufficient for a diagnosis if they are "bizarre". Hallucinations by itself is also sufficient if they consist of a running commentary.
So in the past I have experienced 3 of these symptoms (voices, delusions and disorganised speech) but I have been symptom free for over 1 year now so I'm pretty sure I don't have schizophrenia.
The only symptom I still have is voices (which is caused by anxiety, not schizophrenia) but it's not running commentary, it's mostly insults trying to make me feel bad about myself. I've been discussing this with my psychiatrist but she refuses to accept that I no longer fit the criteria for a schizophrenia diagnosis.
She says I am suffering from anosognosia, which is a lack of insight... That I am refusing to accept my illness. It's not that I'm refusing, it's just that I literally don't meet the criteria.
I want to come off my medication to prove that I'm not schizophrenic but she won't approve it. She said I should continue taking it for another 6 months and we will do a med review to see about lowering the dose if I am still displaying no symptoms.
I don't understand why she is ignoring the DMS-5. I don't match the criteria anymore so therefore my diagnosis is wrong / invalid.

they just don't care. i have a misdiagnosis in my records too, and they don't want to change/remove it. but i don't understand why you need her 'approval' to do what you want. i just stopped taking all the prescribed medication and removed myself as a patient from the clinic. not saying this is what you should do but it's an option?

Reply 11

Original post by Gydrgoesbing
also voices are a symptom of psychosis not anxiety. Although stress and anxiety can make
voices worse.

severe anxiety can actually cause mild hallucinations

Reply 12

Original post by Ciel.
severe anxiety can actually cause mild hallucinations

But not hallucinations intense enough for schizophrenia diagnosis

Reply 13

Original post by UoL Students
Hello,
I am sorry to hear that you are feeling this way. I would strongly recommend that you do continue to take your medication if it does not have a negative effect on you, it may be that you are feeling better because of the medication.
Also, I am assuming that you are from the UK and if that is the case the DSM is not the main diagnostic tool used as it is more American, published by the American Psychological Association. Doctors in the UK tend to use the World Health Organisation's ICD-11 which although lists similar things to the DSM there are some differences. Therefore, it might not be that your psychiatrist is ignoring the DSM but rather she may be looking at the ICD-11 instead.
I hope this helps, if you have any further questions or want to talk about this further please feel free to let me know.
Charlie
Law LLB Student

It seems like the diagnostic criteria in both is the same?

Reply 14

Original post by Gydrgoesbing
But not hallucinations intense enough for schizophrenia diagnosis

some doctors are too quick to diagnose imo

Reply 15

Original post by Gydrgoesbing
What’s wrong with taking the meds for another 6 months then reducing as per the psychiatrists recommendations? That should reduce your risk of Relapse.
Psychosis is really bad for the brain, you want to avoid it if possible.

also voices are a symptom of psychosis not anxiety. Although stress and anxiety can makevoices worse.


Yes but my auditory hallucinations are from anxiety and anxiety can cause hallucinations

Reply 16

Original post by evident-moonshin
Yes but my auditory hallucinations are from anxiety and anxiety can cause hallucinations

are they actually hallucinations or are they just your internal monologue voices - like, in your head, and you know they're not real? bc the amount of gen z mistaking the two on tiktok is staggering.....
(edited 3 months ago)

Reply 17

Original post by Ciel.
they just don't care. i have a misdiagnosis in my records too, and they don't want to change/remove it. but i don't understand why you need her 'approval' to do what you want. i just stopped taking all the prescribed medication and removed myself as a patient from the clinic. not saying this is what you should do but it's an option?

My psychiatrist said if I come off the medication without supervision I could end up back in hospital even worse than before and they might have to consider a depo injection if I am "noncompliant" with taking medication orally. Or something along those lines.

Reply 18

Original post by Ciel.
are they actually hallucinations or is it just the internal monologue voices - like, in your head, and you know they're not real? bc the amount of gen z mistaking the two on tiktok is staggering.....

They are not internal thoughts, the voices I hear are definitely not my own internal monologue. The voices have different sounding voices.

Reply 19

Original post by evident-moonshin
They are not internal thoughts, the voices I hear are definitely not my own internal monologue. The voices have different sounding voices.

that's unlikely to be anxiety-induced then tbh

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