| If you’re experiencing unwanted thoughts about losing your mind, becoming psychotic, or developing schizophrenia, it may actually be a sign of obsessive-compulsive disorder (OCD). You might find yourself constantly questioning the state of your mind, which can cause you to be overly focused on feeling different than usual. Though your health anxieties can be overwhelming or even debilitating, take it from me as an OCD specialist: you can get better, and these fears don’t have to rule your life. Let’s start by gaining an understanding of exactly what’s going on. |
How are fears about schizophrenia related to OCD?
| When intrusive worries about schizophrenia strike—or thoughts about one’s mental capacity in general—they tend to result in intense anxiety or fear, which then might lead to other physical sensations, such as dizziness. Or perhaps your preoccupation with the thoughts makes it harder for you to concentrate, leading you to question if those symptoms too could possibly be related to experiencing psychosis, and your anxiety grows. It can quickly become a vicious cycle, leading you to doubt the most important things in your life: you may question your ability to support yourself, hold down a job, or engage in healthy relationships. In response to these thoughts, doubts, and increasing anxiety, you may search for anything that might provide you with solid ground, firm answers, or certainty about what you’re experiencing. You research what you’re experiencing, read about similar experiences from others, and ask people in your life to make sure you’re acting normally and that your experiences match up with reality. You might even avoid places, people, or activities out of fear that they’ll trigger your thoughts again. You may fear that there is no way out of this cycle, but there is hope. As a trained and experienced OCD specialist, I’ve helped many people with similar fears and compulsions regain control over their lives, with a greater tolerance for anxiety and uncertainty around their mental health and experiences. People who have a fear of schizophrenia or psychosis themes in OCD can regain confidence and purpose in their lives by doing exposure and response prevention (ERP) therapy with an OCD specialist. You can learn to break the cycle of obsessions, doubts, anxiety, and compulsive behavior. The first step of the process? Learning to identify and understand your symptoms, starting with obsessions—the “O” in OCD. Certain sensations or intrusive thoughts can lead to fears about your mental health, memories, and emotions. Here are a few more examples: |
Common fears and obsessions related to schizophrenia:
- Am I losing my mind?
- What if I can’t live my life “normally” ever again?
- Am I able to take care of myself?
- What if I can’t support my self financially?
- How can I even tell if this is real life?
- What if my memories aren’t actually real?
- Will I always live in a state of fear?
- What if I can’t continue my friendships or relationships again?
Common triggers
People who have intrusive thoughts about developing schizophrenia might start to feel highly self-conscious, perhaps feeling as if others are watching them or laughing at them, especially in crowded settings. They also might feel triggered when feeling certain physical sensations, such as lightheadedness, fatigue, confusion, or difficulties with focus and memory.
These triggers and obsessions can form a vicious cycle, as many symptoms of anxiety are also triggers for people with fears of developing schizophrenia or psychosis. In OCD, when an obsession is triggered, it causes further anxiety, therefore reinforcing the cycle of symptoms.
External triggers might include being around others who have mental illness, watching movies or TV shows involving mental illness, or using psychoactive substances.
Other triggers may include:
- Feeling overstimulated, such as by loud noises, crowded places
- Not remembering details of events or what was said in conversations
- Feeling lightheaded or dizzy
- Difficulty falling asleep
- Feeling as if others are watching you, or possibly laughing at you
- Feeling out of control
- Coincidences
- Deja vu
How can I tell if it’s OCD, and not anxiety, cautiousness, stress, or actual psychosis?
This type of concern can be tricky to address, since seeking certainty about what you’re experiencing can quickly become a compulsive safety-seeking behavior. It’s best to ask a licensed professional who has experience and specialized training in treating OCD.
Qualified professionals with the right training and experience, like myself, will look for a few different things in order to determine if what you’re struggling with is OCD. Are you experiencing repeated and unwanted thoughts or worries about your mental health or developing schizophrenia or psychosis? Do these thoughts cause anxiety or distress? Do you engage in mental or physical compulsions in an attempt to minimize anxiety, find certainty, or avoid a feared outcome?
If these three circumstances are met, you may be experiencing OCD focused on the theme of schizophrenia. The cycle of repetitive obsessions with compulsive behaviors in response is what sets OCD apart from other conditions.
It’s also worth pointing out that schizophrenia and related disorders tend to be characterized by limited insight into one’s symptoms. This means that paranoid delusions experienced by people with schizophrenia feel entirely real, and are generally difficult to distinguish from reality. People with OCD, however, have greater insight, recognizing—at least partially—that their fears or doubts aren’t entirely rational.
In OCD, what often causes the most distress is the rampant doubt and uncertainty surrounding these fears: “What if I’m delusional or schizophrenic?” These doubts can feel impossible to shake, since 100% certainty is impossible to gain.
Common compulsions related to fears about schizophrenia
You may be aware that your worries or thoughts aren’t real or rational; however, this understanding isn’t enough to make the thoughts and doubts stop or make the anxiety decrease. You may begin to wonder if your doubts themselves are a sign of psychosis or schizophrenia. Your continued struggle against your thoughts and worries can cause you to worry about your mental state even more .
You may become more and more preoccupied with physical symptoms, such as feeling overly sensitive in loud settings, or feeling more self conscious in social settings. Your rational mind can feel like it is losing its credibility, so you seek reassurance, feeling compelled to keep looking for answers.
Reassurance-seeking and continued research to find certainty are common compulsions in response to fears about schizophrenia or psychosis.
Other compulsions may include:
- Reviewing social interactions, reviewing any possible symptoms you have been experiencing, and reviewing others’ reactions to your behaviors and conversations
- Researching symptoms of schizophrenia
- Seeking reassurance from medical professionals repeatedly, or from friends/family about how they perceive you
- Avoiding situations that might seem over stimulating or stressful
- Checking to see if you are thinking “correctly” about something
- Attempting to cope with anxiety and fear by using substances
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
How you can recover from your fear of schizophrenia
Schizophrenia related OCD can be debilitating, but it is highly treatable. By doing exposure and response prevention (ERP) therapy with an OCD specialist, you can learn to manage OCD and live free from constant fear.
You will start by identifying your thoughts and triggers and ranking them by the level of anxiety they cause. You’ll also identify any safety-seeking or compulsive behaviors you are using in an attempt to reduce your distress or resolve your fears. The compulsions might involve reviewing current and past behaviors, seeking reassurance from others and/or yourself, researching about various psychotic disorders, seeking multiple medical assessments and opinions, or avoiding situations and media that might trigger the thoughts and feelings.
As you build an awareness of these factors, you will then build a treatment plan to go through gradually and intentionally with the help of your therapist. Over time, you will practice purposely putting yourself in situations that trigger your worry and anxiety, and learn to lean into this anxiety without trying to alleviate it by engaging in compulsions.
Instead, you will learn to sit with uncertainty, possibly telling yourself non-engagement messages like “maybe I am, or maybe I’m not.” This process will allow you to learn that you can tolerate anxiety and uncertainty, which will make it easier in the future to manage the distress whenever it comes in the future. In time, your thoughts and worries may feel like little more than background noise.
Key takeaways
- Intrusive fears about developing schizophrenia or psychosis are a common theme in OCD. Unlike schizophrenia, OCD involves insight into the irrationality of fears, allowing individuals to recognize their doubts.
- Exposure and response prevention (ERP) therapy is a highly effective way to treat fears of schizophrenia related to OCD. In ERP, you learn to tolerate uncertainty and break the cycle of obsessions and compulsions.