Derealization? – Fear of going crazy and feeling like everything is absurd?

Photo en contre jour d'une personne qui monte un escalier en pierre en pente douce entre les montagnes
Alone in my destiny and my head, I felt like the rest of the world was fake, that I was the only one there?

It seems to me that the name of this symptom is "derealization", but I'm not sure.

During those moments that come when I've experienced too much stress for too long or I don't have treatment, I feel that everything is absurd and that I'm afraid of going crazy if the intensity of this feeling of absurdity is too great.

Definition of derealization:

Derealization (DR is sometimes used) is a state of consciousness or an alteration in the perception or experience of reality that appears to be dissociated or external to oneself. Depending on the case, notions of existence or reality, usually rooted in personality, may be questioned. Derealization is in a way the concrete experimentation of a metaphysical doubt. It is not a disease per se. Otherwise, it may be a dissociative symptom that can be experienced during periods of intense and prolonged stress. Some "meditation" practices can also cause derealization. (Wikipedia)

Indeed, I was often afraid at these times, and it still happens to me sometimes that the world is not real as in the Matrix movie or that others do not have a soul, so I would be alone on earth to really live. So this can be taken for a questioning of the reality described on Wikipedia.

Un dessin au crayon à papier représentant une gare et le chemin de fer à côté dans le far west
In westerns, everyone is wild and mean for free, during those worrying times I saw the world that way.

When I was going through periods of great stress because of the fluctuations of my illness…

… I had the impression that everything was hard to live, there was a metallic tone and no warmth, humanity in everything around me and in the relationships with others, just hidden aggressiveness…

… by dint of several days in this state of mind everything became absurd and at worst I had an intense fear of going crazy. There was no benevolence in the eyes of others that I felt, just an aggressive judgment towards me to say that I should not be like that, that I think like that, that I suffer like this. And not the idea: "thin then it's hard this suffering, but it's not my fault".

I had the idea that if I was going badly and I feared that it would get worse, I was the culprit, I would have to twist in my brain the ideas responsible for it so that I could get better, I did not see myself as a victim but as a culprit at those times. It could be by dint of putting pressure on me after a large workload, that I ended up feeling this. There were only aggressive sensations from the outside, from the world, by dint of accumulation of its aggressive sensations, I think we have the impression that the world is absurd. When I didn't have treatment, it was constantly and very, very intensely that I felt that way, it was horrible. Now that I'm back under solian in low doses it happens to me a little but it remains light.

To feel this absurdity felt in schizophrenia, think of the movie Mother or watch it (if you've never seen it). Everything is deeply disconcerting, absurd, disturbing, after two hours of this film we are frankly out of whack. I had seen it with a friend, and I had thought about myself, this is what I feel because of my schizophrenia, my friend took a few hours to get back to the absurd side of this film, at that moment I was doing quite well and in ten minutes after the release, it was already getting better:(

During these periods I created ephemeral beliefs that would be solutions to my future without a way out.

In the moments when I was going very badly and sometimes now when I have too much stress, when I fear that my psyche will get worse, that I will become crazy worried for life, that I will end up in a psychiatric hospital, lost in a deep despair and a deep worry about the future that revives me every second, I still create very ephemeral little beliefs in my mind, which say that if I think like this and I continue to think like this, it will scare away my obsessions, my worries and it will save me.

Unfortunately these beliefs of being able to be saved are immediately taken into default because I immediately realize that it is foolish, which worries me intensely.

Here is one of my recent writings on the subject: "I understand that it is what I imagine of the judgment of others on me that creates derealization in me, that creates this guilt. So the moment I feel that this derealization is coming, I say to myself "I should not be afraid of the eyes of others because on the one hand it is frowned upon to be afraid of the eyes of others and on the other hand this is what in the end will give me the impression that everything is absurd, so I should stop feeling that the gaze of others as incisive." and I feel guilty for not being able to do it and staying worried."

But in the end, to do this is only to impose a nasty and aggressive judgment on me: "I must make an effort to save myself, otherwise I am cooked and it is justified", so it is a harsh and violent world constantly that I feel, with the idea that I am the culprit. These beliefs that are created were therefore themselves violent against me, I was suddenly a little defensive. a bit like in a machination.

chemin en Corse dans la verdure un peu sèche donnant sur la mer
Illustration to embellish the site.

I realize these weird ideas right now, which worries me if I'm in this mode where I feel guilty, usually I don't understand what's going on in my head at this level and these ideas get out of my mind, which is pretty much better. At the limit we should not stimulate patients to realize these ideas and understand them, because if they are trained to understand them, to highlight them in their minds, without forgetting the idea they have just had, it risks creating a vicious circle, they will make knots, and worries, if they are in this mode of guilt where they have to save themselves. This may be what happens in borderline patients in psychoanalysis where the disease can worsen or in hypnosis for schizophrenics.

This feeling that it's not okay, this fear of going crazy, it's also the feeling that if a thought doesn't go into my mind, I'm like balancing on a thread, and then I'm going to fall into the endless worry that leads to disasters.

Fading and blocking

photo d'une sculpture dans le mur d'un batiment en Espagne représentant un chateau
When I had these fades, I was not as powerful as a squire, I really had no confidence in myself at all.
Barrier definition: abrupt interruption of the subject's speech during a sentence. The speech resumes after a few moments on the same or another subject. The subject cannot say what happened in him during the time interval, there was a "blank", a "void" of thought. This symptom is quite characteristic of schizophrenia.
Fading mental is a minimum equivalent of blocking: thought engulfs for a few moments. (Wikipedia)

In clearer (if I understood correctly what I was told) the patient starts a sentence, slows down his speech and does not end his sentence, then resumes on another sentence.

I think I've already had this symptom and here's how I felt at those moments.

With friends, when I spoke during these periods where I was surely worse than usual, I had the impression, when I said a sentence that what I was saying was stupid, null, uninteresting, that people would end up finding it frankly stupid if I continued, then turning the gaze elsewhere, this impression was very strong and I was ashamed, so by an uncontrollable reflex, so strong was my gene to say a silly thing, I gradually stopped my sentence telling myself that I had done well to stop it before the end because it would have been silly to go to the end, the others having certainly already understood what I wanted to say and already found it uninteresting. In fact I didn't realize that others surely didn't understand what I meant at all and might find it strange.

Also surely at these moments, my mind filled with constantly flowing ideas had trouble understanding what others understood from what I was saying at the moment I said it, I had trouble visualizing what others must have understood with my words, often I had the impression that they had enough elements to understand where I wanted to go, while surely not, I realized that I was misunderstood, but I could not express myself to be well understood.

And then I also had frequent memory lapses, my mind invaded by ideas, making me think one thing and then another, and then I forgot the first thing I had thought of. So much so that my word was hard or impossible to follow.

I think if you are psychiatrists and ask your patient why he has this fading, he will not give you my explanation, because he may be embarrassed to reveal that he is ashamed of his sentences, that is what I would have done at those times. Also because his mind confused in a thousand worried ideas, impressions, he can have a lot of trouble understanding what drives him to do this.

On the other hand, if you put a patient several months later, when he is much better, facing this fading, I think he may be able to tell you that yes, he stopped his sentences gradually because he was ashamed to finish them, if he remembers this moment.

I'm not completely sure that others feel this way during their fading, but I have this memory of not finishing my sentences because I was ashamed to finish them during these periods.

Thoughts about schizophrenia, difficulties in understanding others, compassion and empathy, psychopathy and antisocial disorder.

I think that contrary to what we can imagine of schizophrenia, (who are people known to misunderstand others and who often have symptoms of high-level autism), schizophrenia does not decrease empathy, it increases it. You have to understand how empathy and compassion work to understand this and understand why I think empathy is increased in schizophrenia (contrary to popular belief).

Here is my point of view on the empathy that I have developed after many years and after confrontation with people who lack it: it is the mirror neurons that must manage this surely…

Their role is to understand what another person feels who is in a certain situation, and they also allow to have a certain introspection, to understand oneself or even, to understand why one had such emotions, such feelings, following what event (it is brain imaging studies that have determined this). In fact I tell myself that it works like this: with our experience (whether it is real experience or lived experience in scenarios that we imagine) we notice that when we are in this or that situation we feel, we think, we want this or that thing, for example when we bend down with our hand towards the ground, it is that we often want to catch something fallen on the ground, when we are naked in front of people we are ashamed (unless we are exhibitionist :))

In relation to this experience we will be able to operate our mirror neurons: If we see a person bending down with his hand towards the ground, we will automatically imagine that he wants to pick up something, if we see a naked person in front of a crowd, we can imagine and feel that he is ashamed, (unless one is a pervert :)) etc etc. We will feel what others feel, think or want according to what we would feel, think or want in the situation of the person we see or imagine (if we read a book for example).

So why do people with schizophrenia misunderstand what is felt by others (at least without treatment or that the treatment is not great)? I think that it is not only this mechanism that works badly, it is that the experience of schizophrenics is very different from the general experience, so they can not feel what others feel, since they themselves do not feel that.

une place à Lille bien remplie de monde
The population, the people frightened me, I wondered how the others managed to live there peacefully.

Me when I went to a party, I was afraid of people, I felt embarrassed, I was ashamed of not saying anything, not knowing what to say, I imagined that what I could say would pass for null, stupid or serious and shameful, I was half stunned, stuck in a corner of the room where there is the evening, being afraid to pass for the null, the twisted, the madman of the moment. So it was difficult for me to answer a person who told me that I was happy to go to a party, I could not conceive that it was possible so much my suffering in this situation was intense, I absolutely did not feel the happiness of this person when he told me that, and so I couldn't interact well with her, telling her, for example, that I was happy for her.

une vieille machine à traiter le blé dans le musée d'une ferme
The gas engine of my thoughts!

When I passed an exam, given that I was afraid of the future and ending up in a psychiatric hospital (because I believed that there was no treatment for my problem), success in this exam did not make me happy to succeed in life, it was just a burden, an inhuman effort that I had made to have this exam and that I had betrayed myself to make myself suffer like this.

As a result, it was difficult for me to conceive that others could really be happy by seeing the results of their exams, yet they seemed to be seeing their outpouring of joy at the results of the baccalaureate, I thought that I was seriously abnormal not to understand them.

Besides, it made me very strange to see happy people in situations where I would have been in distress. A feeling of guilt, that I should have been different.

I had heard that in borderline disorder there is a similar phenomenon: these people imagine that others feel what they feel, while often people feel something different, borderline have such a distorted vision of what others feel, because they too feel things a little differently from others.

I feel like for autism, it may be a bit like extreme shyness, or contact with others is only felt as a fear, yet it's possible that their mirror neurons work well. It seems to me that often autistic people feel the guilt and possible suffering of others (but I may be wrong on this point, it is not a subject that I know well)

photo d'un dessert fait de fraise avec de la chantilly sur une tableau au restaurant
Antisocial people don't think of others, especially when it comes to sharing dessert. Me too sometimes I don't want to share the dessert, but it's because I'm greedy.

how antisocials work

Antisocial people or those who behave badly such as paranoid personalities,

I feel it, they, on the contrary, have mirror neurons that work badly. They feel little suffering in others, and little the feelings, thoughts and wills of others.

This is what I understood by opposing people who were more or less bad with others in their word (they yelled at others, and given the subsequent situation of subordination of the people yelled at, they were afraid of the consequences if they responded, such as being fired, so they were tyrannized and stunned during these situations, it was quite obvious when we saw the scene), by making them understand that their behavior was intolerable and especially made others suffer for this or that reason, I realized that these people did not realize that they were making these people suffer, but saw these people as culprits who sought to spoil the situation,

these somewhat antisocial people fell from the clouds when they understood from my explanations that in reality the people they were yelling at were more terrorized victims than culprits.

… they understood and largely stopped this bad behavior. This obvious reaction of understanding that these people were terrorized victims did not exist in these somewhat antisocial people.

To draw a parallel, when you stumble on a stone in the forest, if you are a little angry, you can start insulting the stone. On the other hand, if we are in the same situation but it is another person who makes us stumble involuntarily, then we will hold back even if we may be a little angry, because we should avoid scaring him and accusing him of something of which he is innocent, which would be unfair. For an antisocial person whose mirror neurons work badly if he stumbles against a person he will insult him because for him the person who made him stumble is like a stone, it is just a thing that is painful to him and that opposes his path.

Apart from the fact that mirror neurons are used to understand others, the rest of the things I say here about empathy, schizophrenia and antisocial disorder remain hypotheses that I created, however it seems very coherent to me, in my opinion it is surely right.

Intense depreciation

escargots derrière une vitre dans un aquarium
Do snails feel dumb?

Realizing that I had these not normal ideas in mind was proof for me, that I was someone deeply serious and not normal and that I did not deserve to be equal to others, that my ideas sucked, that I sucked.

I didn't have confidence in myself, so if someone thought I was normal or that I had certain abilities, I was afraid that he would value me and that suddenly I would disappoint him if he learned that in reality I am not normal, null or that I do not have these abilities suddenly, I made it clear that I was null and not normal for fear that the person would realize it for himself, to avoid disappointing him. I thought I should have been someone who trusted himself…

… because it sucks not to have confidence in itself, but I found it unthinkable that one day I really have confidence in myself. I imagined that if I told my thoughts, I would be ashamed of them, so much so that if I had been forced in some way to tell them, I could not and I would have blushed. I felt that I was not allowed to assert my ideas because it was silly and null what I could say or think. At the same time I had the intense desire to make megalo projects and assert my ideas, but I could not do it blocked by this feeling, it was frustrating and despairing, but I had the hope that one day it would get better, that I would find the solution, at the very bottom of a very deep malaise and continuous anxieties.

I was also afraid to broach the subject of depression, because I had heard the story of this great depressive aunt who missed her life, this kind of story particularly scared me and that's why I tried to imagine that I was not depressed, not schizophrenic, the idea of being mentally tortured for life by my illness created me dread so I twisted reality a little to tell myself that depression was not my symptoms (which sometimes was during periods of crisis).

Le côté tortueux de la sagrada familia
The hidden, ugly side of the sagrada familia, a basilica in Barcelona!

fear of being exposed

Any circumstances where I felt that my mental illness might be exposed in some conversation (and it happened very often that I feared this), I had a deep shame,

… for example, every time in a conversation we talked about schizophrenia (because I understood that there was a chance that I was schizophrenic), I felt targeted and afraid of being exposed, that I was on the point. My heart was beating fast, I felt trapped, because I imagined that a person in the conversation was going to ask me a question that would put me in default, and that would reveal a secret about my unhealthy thoughts or showing that I was sick, and that I could not answer, stunned by shame. Because I was intimately convinced that it was going to happen, it bothered me crazy, these impressions, I knew they were abnormal, but I had no way to prevent them, I told myself that they were proof that I was sick, and it was a reason intimately, in my feelings, to be even more ashamed of myself, it was a vicious circle.

Kind of like it's extremely serious, extremely shocking, extremely not normal for someone to have these ideas.

It is disturbing to share your fantasies

dessin comme une bande dessinée en noir et blanc basé sur le tableau
My modesty led me to find it disturbing to imagine that adults in the 19th century could have painted this naked woman on the grass!
I had the feeling of gene, of discomfort to share my fantasies with my parents. I think it's a normal thing but greatly exacerbated in schizophrenia.

I had the impression, if I was in a somewhat fantasy situation with my parents, to be happy and smiling, that I had to, like the people on TV in the series, be able to share anecdotes about who I was in love with, when it really bothered me terribly to talk about it. It was a kind of torture, a form of obligation, a bit like a rape of the spirit, or I felt that the situation forced me to share my fantasies with my parents, that it was not normal not to share them. For me being in love with a girl and wanting to date her was already an unspeakable and ridiculous fantasy. In the end I never talked about it with my parents and so much the better, I was not ready for that deep down.

I didn’t like sharing my experiences with doctors or my family, if they forced me to, I felt extremely disturbed.

I think this can be found in patients at the onset of schizophrenia without treatment or when the treatment begins to take effect, when the family asks the question of what the person having schizophrenia feel. The person will deflect the subject unresponsive, very embarrassed, as having a kind of mind-raping feeling to bring up topics that they feel are very personal, very disturbing, very shameful from their point of view (I remember feeling a bit like being extremely ashamed of the content of my thoughts and being forced to describe them, rather than being soothed by the realization that my thoughts aren’t that serious, it would have made me even more ashamed, with the impression that the others are looking at me and judging me like: “you must not think like that”, a bit as if we had to make him accept that he was wrong to think so), perhaps friends and not family (whose family we mechanically have more modesty) could more easily approach the subject. I have very distant memories of these very deep genes to approach subjects, I don’t remember very well, I tell myself that it’s a bit as if we are terribly afraid to admit that we are a virgin, we imagine that if we admit it everyone will fall on us and lecture us, and that we will feel guilty and that we will not dare to answer or reject these requests, this modesty of confessing one’s feelings is very similar to this, it is annoying for the patient’s family who would like to help the patient by understanding him, but you should know that broaching these subjects can be terribly disturbing.

Existential questions

Photo en contre jour d'une personne qui monte un escalier en pierre en pente douce entre les montagnes
Alone in my destiny and my head 🙁

Existential questions created a fear in me, and I felt guilty for having them, told me normal people don't have these disturbing ideas, I felt that it was my fault that I suffered from these ideas that I should not have. For example, to say that life has no purpose, no meaning. And to think that it's not normal that I can't feel that my life has a meaning. That it was serious to feel that way.

In fact I think that the way I describe it there is poorly explained, I had the impression of being sickly mentally serious to dare to think that life had no purpose, no meaning, and at every moment then I tried to find a goal, a meaning to reassure myself. Except that everywhere around me I saw a future filled with psychic suffering and anguish (all the contacts with people created anxiety in me, any effort to do a job created anxiety, I could only very hardly work like this and I would risk ending up a tramp and dying like this, I would be ashamed to be a burden to my parents if they talked to me and if they ever saw that I was sick not being able to work, I would have been embarrassed that they also knew that I was crazy), so I could not understand how people could do to have a purpose in life, it made me suffer terribly to see that I couldn't do it and that I would have to live the rest of my life in absurdity.

I had existential questions like:

  • "Why am I living the life of a human rather than that of an ant, when ants are much more numerous on earth? but yes, why then?"
  • or "why does the universe exist and not nothing instead? indeed if I look for a reason for everything, we can not find a reason why the universe exists, so is all this, the universe, the world only in my head?"
  • or "How can we feel things when the current time in which we live is infinite end compared to past or future time?"

In fact, behind the intense existential questions there is, I think, often the impression of the person to think that it is not normal to have them, that it is frowned upon to have them, and to feel guilty about it, that these questions actually reveal concerns that I have trouble explaining!

My brain stays activated in the background on what I’ve seen or done for a very long time after stopping that task.

Dessin stylisé de pleins de choses (creeper de minecraft, nuage, tablette de chocolat volante etc.)
Overloaded mind, I have lots of ideas in mind in the background. I realize the next morning that the night before, I was stuck on certain ideas. For example, when I did this drawing a few years ago, I remember my mind was stuck on the idea that I had to do amazing art to wow the audience.
What I describe in the title is a phenomenon that has importance in the functioning of my thinking, especially when I had no treatment but even now. I don't think it has a name, but it's important.

My brain stays activated for a very long time in the background on what I saw a few seconds or minutes before, and it can create a vicious circle where it made me think about this situation for hours. For example when I saw the zapping (it's a 5-minute show on canal + that took excerpts from other programs, one after the other, they take excerpts where we saw surprising things, often funny, or strange, watching this show, it gave me the impression that canal + made fun of these programs), we are in the context where we wait for something surprising, funny, mocking, and well for 5 minutes after seeing the zapping when I changed channels, I still had the impression that there was something funny that had to happen in the TV shows I saw. In fact, looking at the zapping, I was in the situation where all the sequences are funny, where there's something funny or ridiculous to highlight, and my brain remained in that context, in that situation.

dessin ayant une symétrie verticale fait de trait à l'encre représentant des personnages étranges
I don't know why, my super-active brain was always seeing faces in the smallest drawings, lines, tags, shapes.

For example today, often when I work the day on a project, where I say to myself every moment: I have to move forward, I have to finish it, so the next night I stay until 7am in this context, when I wake up, I am not really relaxed, I remain in the idea that we must move forward on the project, that it is very important for this or that reason. It is, very often, only the sleep from 7am to 9am that makes me forget the stress and the situation of the previous day. This idea that I stay in the background about the ideas I have, about the motivation I had, for a very long time after it stopped, is often found at home in many other things, I guess it is also the case for other schizophrenic people, I think especially in weird ideas, or I keep a belief for a few hours for example.

The fear of being frowned upon by people, and having to justify oneself constantly.

photo de la verdure proche de l'automne en Corse donnant sur la mer
Illustration to embellish the site

I felt in conversations that if people knew I was in a group (e.g. homosexuals, homophobes, racists, anti-racists, intolerants, believers, non-believers, those who love the president, those who don't like him etc.) then they will judge me: "What do you think that, it's not possible to think that! you can't really think that" because they wouldn't find it unthinkable to be like that, so I felt feverish and hesitant. In these situations I didn't know where to put myself. I give you the example in a conversation about homosexuality, if I specified that I am not homosexual to reassure people who might think so, then I felt obliged to specify right after that I am not homophobic because I would imagine that they would think that I am homophobic, it's shocking to be homophobic.

I had to justify myself non-stop because I was afraid that I would be taken for what I was not without stopping, and it obsessed me.

For me they saw me in a group of people to banish, who basically don't really deserve to be considered their equal, that it was really shocking to be like that, that I had to justify myself.

With the caregivers I sometimes have the same feeling that they look at me as if I am not their equal from the moment I tell them that I am schizophrenic. Is it a total impression, a partial impression or a reality? I don't know.

This impression could perhaps have gone away by increasing my neuroleptic treatment, but I did not want to increase it since it is not good for health certainly.

So following documentary research on medical publications on schizophrenia, I asked one of my doctors for Bactrim (an antibiotic that can be taken in the long term) because I saw that it could be due to an infection, and it is after taking this antibiotic continuously that this kind of symptoms has decreased a lot in me.

Knowing that Bactrim fights against toxoplasmosis present in me and in 70% of people with schizophrenia, while only 50% of people without schizophrenia have it and that this parasite is suspected of playing a role in schizophrenia, I wonder if it is not toxoplasmosis that created these symptoms in me.

I wonder if these symptoms (justifying themselves all the time by apologizing, being very timid etc.), are related to toxoplasmosis also in other people.

quelqu'un qui monte dans un chemin pentu en montagne
I don't know how to explain how much I changed in character following Bactrim: I didn't want to climb the mountain of persuading others of my ideas, I was afraid of getting angry and I was afraid of hurting them in their ideas .

If I had been asked why I justified myself for not being homosexual and then not being homophobic, I would have been afraid of passing for someone who is afraid of being frowned upon, who justifies himself all the time, so I would have tried to hide that I was justifying myself because I was afraid of being bad. I was able to twist my ideas, pretend I didn't have certain ideas, deny them to myself, I felt like people were judging me on stuff, when in fact I wasn't. I felt, convinced that I was being judged on the fact that I had certain ideas that in reality I had not had either, but I still felt guilty. I have a hard time remembering and explaining that well.

It reminds me of a thing, I think quite common in schizophrenia: I dressed much too wide for fear of being dressed tightly and passing for a homosexual, I looked like a real potato bag when I see the old photos :).

Timoré I was afraid to say what I thought for fear of hurting the person and making a serious conflict, of being frowned upon. So, it really annoyed me to get out of a conversation by crushing myself, when I had deep down ideas that could be interesting.

It helped me a lot and it freed me from not having that anymore because it was very painful to always go in the direction of people for fear of embarrassing or getting angry, while I thought differently.

I believe these symptoms are those of dependent personality disorder.

And it was very difficult for me to say no when someone asked me for help, even if part of this problem comes from the fact that I worry about the difficulties of others, which is still the case today and so much the better.

Paranoia

Photo prise d'une tour de l'alcazar de Cordou
Illustration to embellish the site.

Paranoid delirium :
(be careful apparently this definition is not widely used in english medical word as it doesn’t even exist on english wikipedia)

  • is constructed from multiple mechanisms (hallucination, illusion, interpretation, intuition, imagination);
  • includes multiple nested themes, it is unstructured, hermetic, blurry, weird;
  • is unsystematized, that is to say that it does not obey any internal logic: the themes are linked without logical link, intertwine, merge giving an impression of disorganization of meaning and thought. (Wikipedia)

I will try to explain to you what this definition means, if I understood correctly what was explained to me during my medical studies:

  • … Delirium first:

    A delirium is a false and fixed belief that cannot be changed in light of conflicting evidence. (English Wikipedia)

    A delirium is for me, the impression that something is true, without having any evidence that holds the road of that. In truth, it must be understood that: "to be a proof that something is true or not" is subjective, so, depending on the doctor who examines the patient, he may find that the patient is or is not delusional, if the doctor finds that the evidence is not plausible then the patient, could be considered delusional, otherwise not. In reality when a patient is really very bad, and worries or imagines things really crazy and is agitated, then, yes there will be no doubt. If ever the doctor has a doubt, I think we must keep this doubt, try to investigate, if the patient wants well, and not bother the patient too much with it.

  • The mechanism of a delirium is simply how delirium comes to mind: by hallucination, illusion, intuition.
  • The theme is on what focuses the ideas, hallucinations etc that come to the mind of the patient, for example, if the theme is persecution, then the patient will interpret that if a person stays behind him it is to harm him, he will have the intuition that it is likely that the government of our country or another want to make us suffer, will have a hallucination of someone pouring a toxic product into their glass. I believe that often in schizophrenia the most common theme is persecution, but this is not always the case, there can be several themes at the same time. Another theme is the delirium of ruin where the patient will have the impression that everything will be destroyed that there will be disasters leading to the end of the world, in a worried and pessimistic vision.
  • What I understood in medical school of the word systematized is that it means that delirium is plausible, while when it is not systematized, it is implausible.

    For example, if someone tells you that a person got behind him at the ATM to look at his blue card code and then steal his card, it's plausible (it's then rather a paranoid delirium), of course the person must constantly worry about such things so that it ends up being considered a delirium.

    On the other hand, if a person explains to you panicked that aliens want to land on earth just to make people suffer by creating illusions in the sky, that, at least for me, seems implausible, so it is an unsystematized delirium. In schizophrenia, it is non-systematized delirium, therefore implausible. I think that the basis of the non-systematized, implausible delirium is to have the impression that it is probable, here that it is likely that extraterrestrials want to make us suffer for no real reason, we arrive at such an idea by accumulating elements that gradually support this hypothesis, while seen from another angle in a more serene person these elements are not really evidence thereof.

  • A certain polemicist who has focused his hatred on Muslim people certainly has a delirium of persecution, because although he manages to persuade some of his listeners which would suggest that his delirium is consistent, what pushes this polemicist to think this is surely that he is convinced that Muslim people wish him harm without valid reasons. What can be blamed on him is that he is attacking people, most of whom are innocent, and that he does not realize that these words are causing these people to suffer.

    fontaine en pierre au milieu de la verdure d'un parc
    An endless source of paranoid ideas was in my mind! It was hard.

    It can happen that people attack us for no reason, for example children at school sometimes abuse their friends a little for no reason. So it's not completely silly to have a delirium of persecution, this kind of worry can be a natural mechanism, however the problem in paranoid delirium, when it comes to persecution, is that we are convinced that it is very likely that people want us harm going so far as to kill us or make us imprisoned, even if there is no element to think so, or only very weak elements.

    For my paranoid delirium of persecutive theme my mind bounced off what could happen in a loop, creating the idea of a manhunt, a plot that scares and turns incessantly.

    While in normal times people are going to be just a little suspicious, they're just going to be a little bit afraid that other people can overtake them in a queue to buy something, nothing too serious;

    I could go to imagine that if the person doubles me in the queue and I dare to make a remark, it gets angry, makes the police intervene, that the police do not believe me, that they imprison me…

    … because following the annoyance at the fact that they do not understand me, they take me for someone dangerous, then if I flee the police station because I have no choice, that an army of policemen will pursue me, that even if I try to persuade him he will not believe me because I imagine him limited to not wanting to believe the common sense, that I will be forced to go abroad as a fugitive, then I should take all my cash from a bank before leaving so that I cannot be found by withdrawals of money from an ATM afterwards, etc. So suddenly, I tried to say very kindly to the person who doubles me, that I should not be doubled :). (Tonight, in correcting this chapter, I'm rather serene to such an extent that it's almost unthinkable for me to think that someone feels that way, but yes, I felt that way!).

    Here are some other examples of persecution delirium:

    I was afraid that a relative, someone who had been friends with me, whom I no longer saw, and who had a character that seemed to me to be manipulative, would go and tell everyone around me, after I had become angry with him and I no longer saw him, to the girl I no longer saw but with whom I was still in love, that I was a monster, a big asshole, that they would think it was real and that they hated me and my ex whom I had left and whom I was afraid would accuse me of rape (when no sexual relationship had happened, but I felt that she wanted revenge). And so that these people hate me, and it went around in circles in my head, it made in my mind a cabal, a manhunt where this ancient acquaintance did not stop, and would not stop for nothing in the world to hurt me like this, and that even if I tried to see and persuade these people there it will not convince them. And I made scenarios or even if I hit him, even if I tortured him he would continue to make me suffer, and in these scenarios that I created out of hatred and fear that it would never stop, even if I killed him it would create a curse on me until death and even after, who would have destroyed everything that was important in me, making me tortured forever. I imagined such scenarios, to be frank I hated this loved one and wanted him to harm, but I understood that my hatred was disproportionate, crazy and that certainly the ideas I imagined were false, even if I felt them without being able to control them, and so this was one of the reasons why I should not take revenge: So I thought that if I actually hurt him, I would go after an innocent person, and that would be serious, horrible, unfair.

    I was also divided by something else, I felt that he felt very bad (because I told myself that he had psychic problems, indeed, today I think he had a borderline or antisocial disorder) and I felt responsible somewhere for his suffering, I worried about the suffering of everyone and felt responsible for it. He because I felt in the end that he voluntarily made me feel even more guilty for having made him suffer by abandoning him, I found that he was a manipulator, who destroyed my innocence because by trying to help him, I received only his hatred and the guilt of not having helped him who would continue to pursue me until my death. I hated him all the more for having killed in me this innocence, those last moments when my mind was still serin.

    I must specify that first these scenarios of revenge scared me extremely, I was afraid of hurting him, I would most certainly never have hurt him even if I had never had treatment, I would have just become hateful for life :(. Also I realized that my fears were foolish, indeed why feel that absolutely, necessarily he would want me bad? but yet they were these fears, and there was nothing I could do about it.

    This person who was somehow a friend that I had not chosen and who had been seeing me for two years was, I still think, quite bad at least at that time (I had not chosen him because I did not like him well from the beginning, but being extremely timid, I had never dared to oppose him for fear that he would get angry), he was a problem for a lot of people around me, but I must admit the fear of persecution was totally disproportionate. My ex-girlfriend was also really quite resentful, but here too the paranoia was really too intense, I hope she would never have accused me of rape when we had no intercourse while all our hugs were consented. It must also be admitted that the situation I had experienced with her had certainly made her suffer because of the misunderstandings and the fact that I rejected her without being able to control myself, I blamed myself and still blame myself for this, I did not manage to contact her again.

    The likelihood of being attacked for free depends on what's in other people's brains, which is actually unknown. However seeing that it never happens or very rarely that people attack other people we should end up being reassured.

    Here are examples of arguments in favor of our paranoia that I have gradually accumulated:

    For this acquaintance that I met for two years, the fact that he told me that he was extremely resentful was an element that made me not able to think of anything other than: "now that I have suddenly abandoned him he wants me badly because he is upset that I hate him". Or the fact that constantly during our conversations he seemed angry that I did not appreciate him enough was proof that he was sick and would like revenge, indeed his look and behavior barely hid that he was exasperated by the fact that I am not interested in him, it meant two things: he doesn't care about hurting others, because he doesn't hesitate to make me feel guilty, he's resentful and can't stand for a long time that I wasn't interested enough in him, he's dangerously crazy. Vexed that I did not recognize him, he who seemed to see me as a father, at least someone important to him, I could not find reassuring elements to tell me that he would not attack me.

    Having spoken to him again the other day, he seems to me to remain someone quite susceptible, but more pleasant than before, but apparently he did not blame me more than that for having abandoned him. It left him with a question but no more.

    When you have schizophrenia, you can be paranoid without there being any real arguments, but if in addition there is more or less a real reason to be worried, as here with this person who behaved badly with others, there is a way that the situation catches fire in the brain with worries and crazy scenarios that we imagine.

    It was, in front of him, scenarios where I imagined that he was going to humiliate me, make me look like a monster or an asshole by telling lies about me to the girl I loved but whose contact I no longer had etc etc …

    the shame of being sucked when I was little:

    I developed at a very young age the idea that if we are weak, ridiculous, psychically fragile, and null, that others would go to see him and take the opportunity to make us turn into a mess (at least that was my feeling). I then totally lost confidence in myself and feared that it would show that I would suck and that I would be persecuted. I had to hide from others the fact that I sucked, otherwise I would be attacked or harassed. I feared in the face of the scum I was afraid of, that my null side would be noticed (I'm sorry to use the word scum with racist connotations, but it's true that young (10 – 12 years old), because of the lying media or their face that may seem a little more aggressive, I was afraid of Arab people, fortunately this is no longer the case 🙂 ).

    We can not say that the idea that "some people want to make fun of others just to laugh" is completely absurd, moreover it happens for children from time to time and sometimes for adults also that they make fun of others for no reason. But what is notable is that these ideas invaded my mind, with the impression that it was highly probable, and so it led me to fear such an act of aggression, mockery or harassment all the time. And I felt guilty if I had that kind of worry about being harassed. Every time an idea made me suffer I felt guilty for having this idea and tried to reject it, to no longer have it.

    Besides, it makes me think of this symptom whose name I do not know:

    Feeling like the laughter around comes from people making fun of us, (this is a common symptom of schizophrenia).

    I believe that this symptom is simply due to the fact that we constantly fear acts of aggression, harassment but especially here mockery.

    I would sometimes see a group of cheerful young people pass by me, and I dreaded that they would laugh at me, and so as soon as they laughed, I inevitably wondered if it was that they half openly did not care about me!

    I felt with my depreciation that others saw me as a draw and I felt that they were going to make fun of me for it, I was afraid at every moment to make a blunder that would show that I sucked. I felt that it was justified to make fun of a draw, so as soon as I had an attitude, something that showed that I sucked (I don't have a specific example, but let's say for example stumble to the point of almost falling), so I tried to hide it (a bit like Pierre Richard in his films) because in a way it was justified for people to make fun of me. I should have if people really made fun of me for this, opposed them and told them that we should not take people for nullos if they stumble, but I felt that if I yelled at them if they laughed when I stumbled, that it would have been unwelcome, indeed this kind of laughter was not necessarily bad, I understood that something was wrong in my mind, but yet I kept the intuition, the reflex to think that the laughter of others if I stumbled were wickedly mocking at the moment they laughed, thinking just after that they should not be but it hurt me terribly anyway, I was susceptible to this, I understood that it would have been wrong to tell them not to be mean, because there was a good chance that in reality it was not mean laughter. I thought it was wrong to have these intuitions because they made me angry with these people, who should not laugh badly. It was the mixture of all these ideas at once when I was experiencing this.

    How do I explain the presence of these paranoid ideas in my brain?

    I had the impression, the intuition that a harassment would happen to me, that the global situation would worsen, that disasters would eventually happen to me, this intuition that I explain by the overactivation of the neural circuits leading to these ideas, leads to take into account in the mind first the elements that we see that are consistent with this harassment, this fear that this (imaginary) harassment will never stop… after all the fact of being of a certain mood means that we can see life in pink or life in black, that we see things differently depending on which part of our brain is over-activated or under-activated, there is no truth absolutely to which schizophrenics are completely foreign, there is no way to be completely sure that an idea is true or false, even for a schizophrenic person, it is just a discrepancy with the normal where paranoid worries come to mind so frequently with so much intensity, that we can not take the arguments that make us think that there is no reason to worry, and we believe in it strongly.

    Well for schizophrenia, I think that the brain is in a state that favors the consideration of elements that make us believe that there is a risk of harassment (I think that a more or less direct disruption of neurotransmitters is the cause, without the overall arrangement of neurons being faulty), that there is a risk that the global situation will worsen until disaster, by dint of seeing that the bad sides, to accumulate only the arguments in favor of this, and to have the overall impression that it is likely that one will be harassed, these bad points on the situation, without being able to see the good sides because our mind working at a hundred per hour, can not take the time to analyze the elements in favor of the idea that there is nothing serious, in the end we are intimately convinced that it is true, even if we can be aware like me, that some points do not hold and realize that we are a hundred times more worried than others and that this is not normal.

    The sentence to fully understand the feeling in this paranoia:

    "It feels like it's very likely that we'll end up being harassed, that others want to hurt us, are sadistic for no reason more than that, or just to have fun and make fun of us."

    For example when we watch the film Matrix the music (or for reports that want to highlight a hidden and harmful thing as we can see on TV) of conspiracy gives the impression, that there is something hidden, something to look for more deeply, if it can give you an idea of what we can feel.

    Whether it's for my virtual world scenarios like The Matrix or for my scenarios where I imagine that police officers will pursue me non-stop. The disruption of my brain that pushed me to think about these two things is the same, I had the impression that disasters were going to happen and that it is likely that people want to make me suffer for no reason, that I would be more and more harassed and cornered.

    Professor Jean Bernard Fourtillan has an explanation for this that seems to me quite conceivable: it would be the hormone of wakefulness that would be in far too great concentration in many cases of schizophrenia.

    I believe he measured it and various observations such as the fact that Alzheimer's is due to too low a concentration of this wakefulness hormone and that people with schizophrenia never have Alzheimer's are strong clues in favor of this hypothesis.

    I also find that this hypothesis holds the road because for me, the madness I experienced actually looks like a violent on awakening! Everything is too real, unlike a dream where the hormone of awakening is in low concentration and we worry little about reality, if an object disappears in a dream it does not shock us for example.

    Tachypsychia

    dessin en style impressioniste d'une maison avec ses deux fenètres derrière un balcon sur le sol et le jardin
    During tachypsychia, we no longer perceive anything serene, such a painting would have intimately evoked stress rather than calm.
    Tachypsychia, which means in Greek fast thought, during this symptom we have so many ideas that come quickly to mind that we start a reasoning but we do not finish it, interrupted then by another idea that comes to mind and so on…

    … Each time we think that the idea we have is very important to take into account and the ideas older than two ideas back, we forget them because hidden by the new idea that comes to mind, we realize that we forget something but we do not know what, it's annoying because it was important! At least that was my feeling. The mind is invaded by ideas that fuse.

    Obviously it's exhausting and I think it can manifest itself in the fact that the patient speaks a lot and very quickly.