[25F] Experiencing hallucinations and anxiety with family history of mental illness

Patient Description

A 25-year-old female reports experiencing small auditory and visual hallucinations for approximately 20 years, occurring a couple of times a day and lasting less than a minute. These episodes are accompanied by anxiety, fatigue, lack of motivation, and indifference. The patient feels anxious and sometimes convinced that someone is out to get her, with recent worsening of symptoms affecting daily life. She experiences changes in social interactions, sleeps mostly well, but engages in emotional eating. The patient has had thoughts of self-harm twice in the last three months. She occasionally smokes weed and consumes alcohol but has stopped using other drugs. There is a significant family history of psychiatric illnesses, including bipolar disorder, ADHD, paranoia, depression, and schizophrenia. The patient has not been evaluated for schizophrenia and is not currently taking any medications. No known allergies are reported.

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Arora's Assessment

What might be happening

Your symptoms could be related to several conditions:

  1. Post-Traumatic Stress Disorder (PTSD): Given your history and symptoms like anxiety, indifference, and social withdrawal, PTSD could be a significant factor. It often involves emotional numbness, avoidance, and hypervigilance.

  2. Schizophrenia or Schizoaffective Disorder: The hallucinations and paranoia, along with your family history, suggest that these conditions might be worth exploring with a mental health professional. They often involve changes in perception and thought processes.

  3. Depression or Anxiety Disorders: The lack of motivation, fatigue, and emotional eating could be linked to depression or anxiety, which can coexist with PTSD or other conditions.

Typical treatments might include therapy, medication, or a combination of both. A mental health professional can provide a formal diagnosis and treatment plan.

What you can do

For Hallucinations and Paranoia:

  • Seek Professional Help: It's important to consult a psychiatrist or psychologist for a comprehensive evaluation. They can help determine if medication or therapy is needed.
  • Track Symptoms: Use MDandMe to journal your experiences, which can help your provider understand patterns and triggers.

For Anxiety and Lack of Motivation:

  • Therapy: Cognitive-behavioral therapy (CBT) can be effective in managing anxiety and motivation issues.
  • Lifestyle Changes: Regular exercise, a balanced diet, and mindfulness practices like meditation can help improve mood and energy levels.

For Emotional Eating:

  • Mindful Eating: Try to be aware of your eating habits and identify emotional triggers. A nutritionist or therapist can offer strategies to manage this.

What you should look out for

  • Worsening Symptoms: If you notice an increase in hallucinations, paranoia, or thoughts of self-harm, seek immediate help.
  • Changes in Mood or Behavior: Significant changes could indicate a need for urgent evaluation.
  • Support System: Reach out to friends, family, or support groups for additional support.

Remember, it's crucial to seek care from a healthcare professional for a formal diagnosis and treatment plan.

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4 mo ago

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People Also Ask


What are the common symptoms of schizophrenia or schizoaffective disorder?

Common symptoms of schizophrenia or schizoaffective disorder include hallucinations, delusions, disorganized thinking, lack of motivation, and social withdrawal. These symptoms can vary in intensity and may affect daily functioning.


How can therapy help with anxiety and lack of motivation?

Therapy, particularly cognitive-behavioral therapy (CBT), can help by providing strategies to manage anxiety, improve motivation, and change negative thought patterns. It can also help in developing coping mechanisms and setting achievable goals.


What lifestyle changes can help improve mood and energy levels?

Lifestyle changes that can help improve mood and energy levels include regular physical exercise, maintaining a balanced diet, ensuring adequate sleep, and practicing mindfulness or meditation. These activities can help reduce stress and improve overall well-being.


How can I manage emotional eating effectively?

Managing emotional eating can involve being mindful of eating habits, identifying emotional triggers, and finding alternative coping strategies. Consulting a nutritionist or therapist can provide personalized strategies and support to address emotional eating.


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