[19F] Experiencing hallucinations, mood swings, and difficulty forming relationships
Patient Description
A 19-year-old female has been experiencing auditory and visual hallucinations for a little over a year. The hallucinations occur sporadically, sometimes lasting for days or weeks, and are more frequent when she is sleep-deprived or under stress, though they can also start without any clear trigger. The voices can be distressing, mimic people she knows, and sometimes command her to do things. She also experiences delusions, such as believing people are in love with her, thinking people are coming after her, or feeling like there are cameras watching her through mirrors or smoke alarms. Additionally, she has noticed disorganized thinking, such as speaking too fast or too loud, having no emotions or facial expressions, and a monotone voice even when feeling sad or angry. She has significant mood changes, including periods of extreme happiness or sadness. There is no history of substance use. She has a family history of schizophrenia, bipolar disorder, and depression. Her menstrual cycles are usually regular. She is not currently taking any medications, over-the-counter drugs, supplements, or herbal remedies, and she stopped taking antipsychotic pills a couple of months ago but does not remember their names.
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Arora's Assessment
What might be happening
Based on the symptoms you've described, there are a few potential diagnoses that could explain your experiences:
-
Schizophrenia or Schizoaffective Disorder:
- Rationale: Hearing voices, seeing things that aren't there, experiencing delusions, and disorganized thinking are hallmark symptoms of schizophrenia. The family history of schizophrenia also increases the likelihood.
- Typical Treatments: Treatment often includes antipsychotic medications, psychotherapy, and support for social and occupational functioning. Regular follow-ups with a psychiatrist are crucial.
-
Bipolar Disorder with Psychotic Features:
- Rationale: Given your family history of bipolar disorder and your significant mood swings, it's possible that you have bipolar disorder with psychotic features. This can include hallucinations and delusions during manic or depressive episodes.
- Typical Treatments: Treatment usually involves mood stabilizers, antipsychotic medications, and psychotherapy. A psychiatrist can help manage and adjust medications as needed.
What you can do
Hearing Voices and Seeing Things:
- Seek Immediate Help: It's important to consult a mental health professional as soon as possible. They can provide a formal diagnosis and start you on a treatment plan.
- Medication Adherence: If you are prescribed medications, take them as directed. Stopping antipsychotic medications abruptly can lead to a return of symptoms.
- Stress Management: Since stress and lack of sleep can trigger your symptoms, try to maintain a regular sleep schedule and practice stress-reducing activities like mindfulness or yoga.
Mood Swings:
- Consult a Psychiatrist: A psychiatrist can help determine if mood stabilizers or other medications are appropriate for you.
- Track Your Moods: Use MDandMe to journal your symptoms, track your mood swings, and identify any potential triggers. This information can be very helpful for your healthcare provider.
- Healthy Lifestyle: Regular exercise, a balanced diet, and adequate sleep can help stabilize your mood.
Difficulty Connecting with Others:
- Therapy: Cognitive-behavioral therapy (CBT) or other forms of psychotherapy can help you develop better social skills and coping mechanisms.
- Support Groups: Consider joining a support group for people with similar experiences. This can provide a sense of community and understanding.
What you should look out for
Given the severity of your symptoms, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:
- Increased Frequency or Intensity of Hallucinations: If the voices or visions become more frequent or distressing.
- Suicidal Thoughts: If you experience thoughts of harming yourself or others, seek immediate help.
- Severe Mood Swings: If your mood swings become more extreme or you engage in risky behaviors.
Remember, while I can provide information and guidance, it's crucial to consult with a healthcare professional for a formal diagnosis and treatment plan. If you have more questions or need further assistance, feel free to continue the conversation.
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5 mo ago