The Darkness of Shame

 

Shame, we all know this feeling.  It is a feeling that keeps us in the shadows and isolated from others.  Often shame prevents us from doing what is best and holds us back from getting the help that we need.  You may even be reading this blog post debating whether or not to go to therapy or treatment.  Our mind chatters away thinking thoughts of worry, “what will others think of me or what will happen if so-and-so finds out?” Shame can be crippling, painful, and lonely; however, it can be escaped.  Dr. Brene Brown, famous author and professor at the University of Houston, is the shame guru.  She has been on talk shows such as Oprah, authored multiple #1 New York Times best seller books, and published many scholarly articles regarding shame and how to be resilient.   

schizotypal vs schizoid

With so many psychotic disorders and personality disorders it can be hard to keep them all straight. There is schizotypal personality disorder, schizoid personality disorder, schizoaffective disorder, schizophrenia, and more. You might be wondering what exactly the difference is between them.

The first thing that is important to mention is that schizotypal and schizoid personality disorder are indeed personality disorders. In contrast, schizophrenia is what is known as a psychotic disorder. There are many differences between schizophrenia and the other two disorders mentioned above. However, here I focus specifically on the differences between schizotypal and schizoid personality disorder.

What is Schizotypal Disorder?

Schizotypal personality disorder is one of many personality disorders described in the DSM-5. Because it is a personality disorder the symptoms tend to be pervasive, entrenched, and long-standing . Schizotypal personality disorder specifically is characterized by a pattern of social and interpersonal difficulties. Someone with the disorder might feel uncomfortable with close relationships and therefore have very few of them.

Symptoms of Schizotypal Personality Disorder

The symptoms of this disorder center around social problems and delusional beliefs. For a very succinct explanation of the symptoms you can look here. According to the DSM-5 these are the symptoms of schizotypal personality disorder:

  • Social and interpersonal deficits
  • Thinking that coincidences or events have personal meaning
  • Magical thinking or “odd beliefs”
  • Bodily illusions or strange perceptual experiences
  • Being suspicious or paranoid
  • Not expressing emotions
  • Behavior that is eccentric
  • Lack of close friends
  • Social anxiety

It is very important to note that these symptoms do not happen during the course of another mental disorder such as schizophrenia, bipolar disorder, depression, or anything else. In order for someone to be diagnosed with schizotypal personality disorder the symptoms must happen when there is no other disorder present.

Prevalence and Risk Factors

One study found that the lifetime prevalence of Schizotypal personality disorder was 3.9% in the general population. There is some evidence to suggest that people with addiction or substance use disorders have a higher prevalence of the disorder. Schizotypal personality disorder is slightly more common in males than in females. So, males might be at higher risk for developing the disorder.

Other risk factors include genetic or social considerations. It seems that the disorder is slightly more common in people who have a mother, father, or sibling with the disorder. Although it is not conclusive, there is also some evidence to suggest that people who have relatives with psychotic disorders (like schizophrenia) might be at higher risk for schizotypal.

What is Schizoid Personality Disorder?

Much like schizotypal, schizoid personality disorder is listed with the personality disorders in the DSM-5. This means that the symptoms will also be pervasive and long-standing. Schizoid personality disorder specifically is marked by a detachment from social relationships and a difficulty expressing emotions. People who have this disorder might seem disinterested or apathetic in close relationships. They also don’t appear to get the same of pleasure from social relationships that others do.

Symptoms of Schizoid Personality Disorder

The symptoms of schizoid personality disorder center around detachment from close relationships. Here is the symptoms for the disorder as they are described in the DSM:

  • Pervasive pattern of detachment from close relationships
  • Difficulty expressing emotions in the presence of others
  • Does not enjoy or desire relationships
  • Choses to be alone most the the time
  • Little, if any, interest in sexual activity with another person
  • Takes pleasure in very few activities
  • Does not have close friends
  • Seems indifferent to praise or blame from others

Someone cannot be diagnosed with schizoid personality disorder if the symptoms of it only show up during the course of another psychological disorder. It also cannot be due to the psychological effects of medication or another medical condition.

Prevalence and Risk Factors

There is evidence to suggest that the lifetime prevalence of the disorder is 4.9%. It is diagnosed slightly more often in males. It is also possible that the disorder causes more impairment in males than it does in females. Regarding risk factors for the disorder, there is some evidence to suggest that people who have family members with schizophrenia or schizotypal personality disorder are at increased risk.

The Differences Between Schizotypal and Schizoid

After reading all of this you might be thinking, these sound pretty similar. Due to the similarities it can be difficult for people to get the correct diagnosis. It is important to look at the differences between them so that someone can be diagnosed with the right one. When clinicians do this it is called a differential diagnosis.

The main difference between schizotypal and schizoid personality disorder is that schizoid does not have any paranoid ideation or suspiciousness. This means that people with a schizoid diagnosis will not be overly worried about other people’s motivations or worried that people are out to get them. However, people with schizotypal personality disorder will have these kinds of beliefs.

The next difference has to do with the reasons people with these disorders isolate themselves. For people with schizotypal personality disorder the isolation and lack of close friendships is due to social anxiety or eccentricity. For schizoid personality disorder this type of isolation is due to a lack of interest in other people. Additionally, people with schizotypal personality disorder might still want to have social relationships. However, they might be unable to have them due to the social anxiety or strange behavior. People with schizoid personality disorder generally do not want close relationships.

The final difference between them has to do with behavior. People with schizotypal personality disorder tend to have odd or eccentric behavior. This behavior is usually do to paranoia or suspiciousness of others. People with schizoid personality disorder tend not to show this same kind of “strange” behavior.

Bipolar disorder is a mood disorder that affects nearly 6 million Americans every year. Defined as a mood disorder that is characterized by extreme changes in mood, thought, behavior, and energy level, it’s also commonly referred to as “manic depression.” This disorder usually starts in late adolescence and early adulthood beginning as subtle periods of depression and mania that gradually intensifies into the disorder. The illness is found in all ages, races, ethnicities and genders, as well as having been found to have a genetic link among families. Bipolar can affect the relationship between family members, coworkers, friends, significant others, and even neighbors, depending on the severity of the illness. Bipolar treatment centers offer individuals who are suffering from bipolar disorder a chance to stabilize through medication management, therapy, exercise, as well as various holistic and wellness approaches. The illness is described as having periods or “poles” of mania and periods of depression, lasting anywhere from days to weeks or months. The severity of the mood and the intensity of these periods are significantly different than clinical depression, as the disruption that they cause on the sufferer’s life can be sometimes devastating.

The symptoms of mania experienced by those with bipolar include:

  • Grandiose thoughts

  • Racing speech, racing thoughts, and/or rapid ideas

  • Impulsivity, poor judgment, distractedness

  • Reckless behavior

  • Impulsive spending

  • A decreased need for sleep or food with little or no effect on energy levels

  • Irritability and aggressive behavior

  • Heightened mood or exaggerated optimism

  • Hallucinations and delusions

While mania can sometimes last for as long as several months if left untreated, it is usually followed by a period of depression, commonly referred to as a “crash.” Much like drugs and alcohol, the euphoria of mania can be followed with great consequences depending on the severity of the symptoms as well as the behavior exhibited while in a manic episode.

The symptoms of Depression in Bipolar Disorder are:

  • Irritability, worry, anxiety, agitation, and anger

  • Changes in sleep patterns and appetite

  • Loss of energy

  • Feelings of worthlessness or hopelessness

  • Pessimism

  • Difficulty concentrating or making a decision

  • Loss of pleasure in former interests

  • Isolation and withdrawal from friends and families

  • Giving up on projects or hobbies

  • Thoughts of death or suicidal ideation

Types of Bipolar Disorder

There are two major types of bipolar disorder, the first being classified as having depressive periods as well as mania. The second, or bipolar II, is classified as having periods of “hypomania,” which is a period of elevated mood that doesn’t reach full mania. In many cases, those who are affected by bipolar will usually admit themselves to an inpatient bipolar treatment center, or an outpatient center. There are several types of rehab for bipolar, and finding the right center can be difficult.

What To Expect In Bipolar Rehab

Rehab centers for Bipolar usually offer medication management, therapy sessions both individually and in a group setting with a licensed therapist, psychiatry appointments, caseworker or social worker meetings on a weekly basis, as well as holistic and wellness options depending on the center that’s chosen. Medication management is an important component of treatment, as the right medication can make a world of a difference in the severity and frequency of changes in mood. Many bipolar treatment centers are anywhere from a month to several, depending on the progress made in treatment. Family members are encouraged to participate in group therapy sessions as well as in other areas, as permitted by their loved one.

bipolar treatmentHow Do I Know If I Have Bipolar Disorder?

Although with the Internet today self-diagnoses are becoming increasingly common, only a physician or psychiatrist should make a diagnosis as to whether or not you’re suffering from this disorder. If you’ve noticed any of the symptoms above or a loved one has noticed the symptoms above, it’s important to talk to your doctor to see if you need qualified mental health treatment. Usually in periods of depression, people suffering from bipolar turn to their therapists or psychiatrists for help.

Is Treatment Right For Me?

If you’ve newly been diagnosed with bipolar disorder, or you’ve been struggling to find the right combination or medication that works for you, then treatment is a step in a positive direction. Inpatient bipolar rehabs aren’t hospitalized settings. They’re community living situations, with amenities and tools to ensure comfort as well as success. The idea of treatment is to allow you to live in a setting as close to how you normally would, so that when you’ve completed the program, you’ll be able to adjust back into your regular routine. The misconception about treatment for mental illnesses is that they’re hospital settings made famous in movies and television. Although those places do exist, they’re usually only reserved for extreme cases or for those without the resources to attend an inpatient program.

What Else Should I Know About Bipolar Disorder?

Bipolar disorder is a treatable mental illness, and can easily be managed with medications, therapy, diet, exercise, proper sleep schedules, as well as through meditation and mindfulness. Although being diagnosed may seem scary at first, people with bipolar are often among the most creative types of people. Nearly six million Americans are diagnosed with having bipolar disorder every year. You’re not alone, and there’s no need to suffer if you or a loved one has been diagnosed. Talking to your therapist or doctor about different treatment options is the first step in receiving proper treatment. Talking to your family and loved ones about different options is especially important, as support in your journey can go a long way. Making the decision to get help is just the first step, as this mood disorder is a lifelong illness.

The difference between suffering from a mental illness and living with one is deciding to get treatment. Medication is an extremely important piece to recovery, as well as therapy and emotional support and connection. Bipolar does not discriminate between race, culture, gender, or age.

If you or someone you know has been having thoughts of suicide, or harming themselves or someone else, please dial 9-1-1 immediately, and call your psychiatrist or doctor. Help is available, and is only one step away.

Call Crownview today at 760-443-4357 (HELP) to find help!

Types of Schizophrenia

What is Schizophrenia?

Schizophrenia is a mental disorder that can be diagnosed by a mental health professional. When someone has schizophrenia they might show symptoms of:

  • Delusions

  • Hallucinations

  • Disorganized speech

  • Disorganized behavior

  • Negative symptoms.

Let’s start by defining what all of these different symptoms are.

 

Paranoid Schizophrenia Treatment CentersDelusions are strongly held false beliefs. People with schizophrenia often cannot be dissuaded of these delusions no matter how much evidence is presented to them. These false beliefs often center around different themes. The most common themes for delusions are persecution, grandiosity, jealousy, erotomania, and somatic. Delusions of persecution happen when the person thinks that other people are conspiring against them. An example of a grandiose delusion would be someone who thinks they are god. Delusions of jealousy often show up as people thinking their partner is cheating on them. Erotomanic delusions can be when someone thinks a celebrity is in love with them. Finally, an example of a somatic delusion could be someone thinking that there is a tapeworm living inside their body.

 

Hallucinations happen when someone perceives something that is not actually there. Just like with delusions, there are different types of hallucinations. These might include auditory hallucinations, visual hallucinations, or somatic hallucinations. That is hearing things, seeing things, or feeling things that are not actually there. Although all types of hallucinations have been documented in schizophrenia by far the most common are auditory hallucinations.

 

Disorganized speech and behavior are when someone acts and talks in a very strange way. This might show up as someone speaking in a way that seems to go off on tangents without ever making a point. Disorganized behavior can show up in a few different ways. It might be that a person with the disorder is unable to properly shower or feed themself. It could also be that their emotional responses seem inappropriate for the situation.

 

Negative symptoms are the absence of something you would expect in someone who does not have the disorder. This might be a little confusing, but negative symptoms are something that seems to be missing. There are many examples of this, such as showing no emotions, not moving or speaking, and no or little interest in other people.

 

It is important to note that in order for someone to be diagnosed with schizophrenia they must have symptoms that last for at least 6 months. Also, the symptoms must significantly impact someone’s functioning.

Types of Schizophrenia

In past versions of The Diagnostic Statistics Manual (DSM) there were different subtypes of schizophrenia. These subtypes mostly had to do with which symptoms were predominant. For example there was a subtype called paranoid schizophrenia for people who were mostly experiencing paranoid delusions.

 

The newest version of the DSM, the DSM-5, no longer has these subtypes. Instead it leaves the option for clinicians to give other specifiers. These include specifying if this is the first episode, if symptoms are in remission, if the person is currently having an episode (meaning they are showing symptoms), if the person has catatonic symptoms, and how severe the symptoms are.

Schizophrenia Facts

Prevalence

According to the DSM-5, roughly 0.3% - 0.7% of people are diagnosed with schizophrenia at some point during their lifetime. There is some evidence to suggest that schizophrenia associated with poorer outcomes is more common in males. However, when you look at presentations that have better outcomes the disorder seems to be equally likely to occur in both sexes.

 

Onset

Delusions and hallucinations often emerge between the late teen years or mid 30s. It is very rare for people to start to show these symptoms before adolescents. The most common age of onset is in the mid 20s for males and late 20s for females.

 

Risk factors

There is some evidence to suggest that there is a higher risk of schizophrenia for children who grew up in urban environments. Belonging to some minority groups has also been linked to higher rates of schizophrenia. These are considered environmental risk factors.

There are also some genetic factors that have been linked to schizophrenia. As of right now there is not one gene that indicates a higher risk for the disorder. Rather, researchers have identified clusters of genes that might be associated with a higher risk for developing schizophrenia.

 

There also seems to be some increased risk of developing the disorder for people who had parents with a number of different issues. For example, older paternal age might be a risk factor. Also maternal stress, infection, malnutrition, or diabetes have been indicated as risk factors. It is important to note that the vast majority of people with these risk factors do not develop the disorder.

 

Risk of Suicide

Roughly 5% - 6% of people with schizophrenia die as a result of suicide. Additionally, about 20% of people with the disorder attempt suicide one or more times in their lifetime. The risk of suicide is especially high or young males who also have a co-occurring substance use disorder.

Schizophrenia Therapy MethodsSchizophrenia Therapy

There are a number of schizophrenia therapy options. This might include psychotherapy, drug therapy, or case management. Although most treatment for this disorder often centers around medication, psychotherapy and case management can be integral parts of the recovery process. Within psychotherapy there are a number of different therapy techniques that might be helpful.

 

Cognitive Behavior Therapy (CBT) often centers around helping people rework cognitions and change behavior. This can be a particular challenge because people with schizophrenia often have delusions. Delusions are false cognitions. Generally, we do not want to reality test or challenge someone’s delusions. However, CBT asks people to rethink false cognitions. So how does this work?

Instead of outright challenging someone's thinking they might test the boundaries of the delusion. A therapist might start to test if there is any flexibility around the delusion and if there is they will start there. If there is some wiggle room they can see if someone can start to question the delusion they have. If there is little or no wiggle room they might instead work on cognitions that can be changed and on behavioral strategies.

 

CBT therapists might address other cognitions that might be more flexible, like negative perceptions about the disorder. They might work with someone to reframe their diagnosis. This means helping someone see how schizophrenia might make them unique or interesting rather than broken or damaged.

 

Humanistic Therapy can also be helpful for people who have a schizophrenia diagnosis. This type of therapy centers around positive regard and validation. In other words, making the client feel like they are heard and their feelings are valid. Sometimes people with schizophrenia feel like they are brushed aside or not taken seriously because of their disorder. Having a therapist who meets you with empathy and compassion can be exactly what is needed.

 

There is some debate among humanistic therapists about whether or not to validate delusions. In the past, this type of therapy has emphasized that someone’s feelings are valid and real without going along with the delusions they might be having. However, there are more clinicians recently who have decided to meet the client where they are. This might mean stepping into their world and going along with delusions. Either way, the point is to make someone feel like their feelings matter.

 

Psychoeducation is a technique that helps educate people about brain chemistry, symptoms, and the usual course of the disorder. This technique can be helpful both for the person with the disorder and family members. Often, learning more about a diagnosis can help people accept and understand it. Psychoeducation can benefit everyone involved by helping them see this is a disorder and not something the person can control or change on their own.

Schizophrenia Treatment Drugs

There are many medications that have been approved by the FDA to treat schizophrenia. Generally the types of drugs that are prescribed are antipsychotic medications. These seem to help curb delusions and hallucinations. There are two main types of antipsychotic medications, first-generation and second-generation.

 

First-generation antipsychotic medications are generally high-potency. They are very effective at reducing symptoms but people taking them may experience many unpleasant side effects. Here is a list of first-generation antipsychotic medications with the brand name and the generic name:

  • Prolixin® (Fluphenazine)

  • Haldol® (Haloperidol)

  • Loxitane® (Loxapine)

  • Trilafon® (Perphenazine)

  • Orap® (Pimozide)

  • Navane® (Thiothixene)

  • Stelazine® (Trifluoperazine)

 

Second-generation antipsychotic medications were developed to help alleviate the negative symptoms of schizophrenia. These drugs were also formulated to have less side effects than their first-generation counterparts. Second-generation medications help with positive symptoms such as delusions and hallucinations but they are not always effective as first-generations medications. Here is a list of second-generation antipsychotic medications with the brand name and the generic name:

  • Abilify® (Aripiprazole)

  • Saphris® (Asenapine)

  • Clozaril® (Clozapine)

  • Fanapt® (Iloperidone)

  • Latuda® (Lurasidone)

  • Zyprexa® (Olanzapine)

  • Invega® (Paliperidone)

  • Seroquel® (Quetiapine)

  • Risperdal® (Risperidone)

  • Geodon® (Ziprasidone)

It is important to consult with a doctor when you are considering taking medication for any mental health disorder. Additionally, it is imperative to talk to a doctor before stopping or changing any medication.

Schizophrenia Treatment Centers

Treatment centers for schizophrenia will usually use an integrated approach of psychotherapy, drug treatment, and case management. Offering all of these approaches in conjunction with one another can offer the most support possible to the affected person. Many treatment centers will also offer family programming that includes psychoeducation.

Schizophrenia is considered a long-term disorder that requires long-term care. This care might start with inpatient treatment in order to help stabilize the individual. Once they are stabilized they might be moved to a step down program like a community living facility or intensive outpatient program. Providing this type of continued care offers people the best opportunity for recovery.

Rehab for Depression

The National Institute of Mental Health estimates that depression directly effected almost 7% of people in the United States in the last year. That is, over sixteen million people experienced a major depressive episode, many of whom have faced depression before in their lives. Unfortunately, depression is more common than most people realize. The good news is that because of the prevalence of major depressive episodes, the medical and psychological communities are working hard to develop new treatments to help those that are suffering.

What is Depression?

Depression, or major depressive disorder, is a mental disorder that causes a variety of symptoms. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) lists many symptoms of depression, including depressed mood, a lack of pleasure-taking in normally pleasurable activities, weight loss, insomnia or hypersomnia regularly, fatigue, feelings of worthlessness, inability to concentrate, and more. Major depressive disorder often gets in the way of daily life, preventing the person from participating fully in activities such as work, school, social engagements, and self-care.

 

It’s not clear if there is one single cause for depression. When we experience major depressive episodes we may feel like it’s our fault, but there are many factors at play. There is evidence to suggest that genetics play a strong role in major depressive disorder, hormones may effect the release of chemicals in the brain, and neurotransmitters function differently in those with depression. Depression may be triggered by a life event such as pregnancy, grief, job loss, stress, illness, or any number of experiences.

Symptoms of Depression:

  • Feelings of hopelessness
  • Sadness and/or emptiness
  • Sleep disturbances such as insomnia or oversleeping
  • Decreased interest in normally pleasurable activities
  • Lowered libido
  • Change in appetite
  • Restlessness or agitation
  • Trouble concentrating
  • Rumination and fixation on past mistakes, feelings of guilt or shame
  • Unexplained physical pain
  • Thoughts of death and/or suicide
  • Lack of motivation

 

Depression InfographicCan You Go to Treatment for Depression?

Many people don’t realize just how serious depression can be. If you or a loved one is experiencing major depression, you know that it can be debilitating and difficult. Although many people recover with the help of therapy, medication, and/or support groups, depression can be tough to treat. Because of this, inpatient rehab for depression exists. At a reputable treatment center, you will receive care and attention that meets your specific needs.

 

The benefit of going to a treatment center that specializes in treating major depressive disorder is that you will be met with understanding and knowledge. Many treatment centers are not able to fully address major depressive disorder, as they may focus on drug abuse, process addiction, or other disorders. Although depression may absolutely occur in conjunction with substance abuse or other disorders, it's important to seek treatment that truly treats the depression. Without proper help, depression can be overwhelming and difficult to overcome. With high-quality care, those suffering from depression can recover, grow, and continue with the lives they are capable of living!

 

Crownview Depression Treatment

Crownview Co-Occurring Institute is a leader in treating those suffering from major depressive disorder. With decades of experience, knowledgeable and compassionate staff, and a beautiful location in Southern California, we have made it our mission to help those that come through our doors with the best level of care available. We will work with you to meet your individual needs, find a path to recovery that works, and overcome the depression with support and care. Crownview is not just another addiction treatment center that says they can help with depression; we are here specifically to work with those suffering from depression and mental health disorders. The Crownview Co-Ocurring Institute is a big family of compassionate individuals all seeking to grow.

Call Crownview today at 760-443-4357 (HELP) to find help!

 
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