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Suggest Treatment For Auditory Hallucinations And Symptoms Of Psychosis
Question: I've heard voices for about twelve years now. There are three male voices which I hear as coming from outside of my head. They are always there although the content of what they say can be determined by my mood. If it's low they're critical and aggressive. If it's normal they will just comment on what I'm doing (a type of running commentary). I was diagnosed with schizophrenia about ten years ago and put on a variety of medications. Clozapine was the only one that stopped the voices completely but I found the side effects of it to be intolerable and so stopped taking it.
About five years ago I moved and changed psychiatric care team. My new team changed my diagnosis to BPD and avoidant personality disorder. I am currently undergoing group therapy for personality disorder and in todays session I was told my voices are not 'properly psychotic' as they are caused by my PD. My therapist seemed surprised when I told her that they are constantly there (not just when I'm stressed) and have responded to meds in the past.
Do people with PD hear voices constantly and do they respond to medication? Is it possible that the PD diagnosis could be wrong or incomplete? I know diagnosis is not an exact science, especially not online but I wonder if I would get different treatment with a different diagnosis. I am currently not taking any meds, just having therapy, but find the voices can be extremely distressing at times and they are usually the reason for my self harm.
About five years ago I moved and changed psychiatric care team. My new team changed my diagnosis to BPD and avoidant personality disorder. I am currently undergoing group therapy for personality disorder and in todays session I was told my voices are not 'properly psychotic' as they are caused by my PD. My therapist seemed surprised when I told her that they are constantly there (not just when I'm stressed) and have responded to meds in the past.
Do people with PD hear voices constantly and do they respond to medication? Is it possible that the PD diagnosis could be wrong or incomplete? I know diagnosis is not an exact science, especially not online but I wonder if I would get different treatment with a different diagnosis. I am currently not taking any meds, just having therapy, but find the voices can be extremely distressing at times and they are usually the reason for my self harm.
Brief Answer:
Not PD; Hallucinations suggest psychosis.
Detailed Answer:
Hello
Welcome to HCM.
I have read yout details.
You have auditory hallucinations which have responded to clozapine. Your new psychiatric team thinks that you have personality disorder and your hallucinations are due to it.
Hallucinations are almost always suggestive of psychosis.
I donot agree with your psychiatric team for the following reasons:
1. BPD and avoidant personality disorders, or any of the PD for that matter, does not cause auditory hallucination.
2. You have continuous hallucinations which is causing distress. They even led you to harm yourself. This is very much against PD.
3. Hallucinations responded to clozapine. This also points towards psychosis.
Therefore, I donot think this to be PD.
And you need treatment for hallucinations, most importantly because it led you to harm yourself.
Since you have not responded to multiple medications in past and could not tolerate clozapine, the best treatment option in such case is ECT. This has no long term side effects like medications and is highly effective. But it is to be instituted only after you agree to it.
You can discuss this with your doctor.
Hope I have answered your query satisfactorily.
Feel free to ask further.
Kindly close the discussion if you have no more queries and give your valuable feedback.
I wish you good health.
Thanks.
Dr. Shubham Mehta, MD(Psychiatry).
Not PD; Hallucinations suggest psychosis.
Detailed Answer:
Hello
Welcome to HCM.
I have read yout details.
You have auditory hallucinations which have responded to clozapine. Your new psychiatric team thinks that you have personality disorder and your hallucinations are due to it.
Hallucinations are almost always suggestive of psychosis.
I donot agree with your psychiatric team for the following reasons:
1. BPD and avoidant personality disorders, or any of the PD for that matter, does not cause auditory hallucination.
2. You have continuous hallucinations which is causing distress. They even led you to harm yourself. This is very much against PD.
3. Hallucinations responded to clozapine. This also points towards psychosis.
Therefore, I donot think this to be PD.
And you need treatment for hallucinations, most importantly because it led you to harm yourself.
Since you have not responded to multiple medications in past and could not tolerate clozapine, the best treatment option in such case is ECT. This has no long term side effects like medications and is highly effective. But it is to be instituted only after you agree to it.
You can discuss this with your doctor.
Hope I have answered your query satisfactorily.
Feel free to ask further.
Kindly close the discussion if you have no more queries and give your valuable feedback.
I wish you good health.
Thanks.
Dr. Shubham Mehta, MD(Psychiatry).
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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