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Summary
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A 19-year-old describes years of feeling watched or followed, internal conversations, and perceptions of people in shadows. Recent heart surgery and upcoming college plans add uncertainty about whether to tell someone.
The response urges prompt psychiatric assessment rather than keeping the experiences private.
It raises psychosis-related conditions as possibilities, while acknowledging that the information is insufficient to know what is happening or whether surgery is related.
Its central concern is obtaining professional evaluation early so symptoms and disruption can be addressed if treatment is appropriate.
Question
Reader · Identity withheldEver since my freshman year i have always believed someone was watching me, following me, telling me to do different things. I have all these random thoughts and conversations constantly in my head.
\nIf I see shadows I see people who are following me, I don’t know if this is normal or not.
\nNow I am 19, had my second heart surgery this year, and I still have all of this going on, at work I just get lost in my mind, at home, I see things in a different way than I usually did.
\nI don’t know if I should talk to a counselor or therapist about this. I am going to college though soon, do you think I should see a counselor there to talk to about this, or should I just keep this to myself?
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Answer
Mark Vigil Dombeck, Ph.D.You should talk to someone about this stuff. Preferably someone who is a Psychiatrist (a doctor specializing in the medical treatment of mental disorders). Preferably as soon as you can. Here is why. It is not particularly normal for someone your age (or any age) to experience the sensation that they are being followed, or commanded to do things for extended periods of time.
\nThis type of thing is generally called paranoia, and it may indicate that you are vulnerable to a variety of illness called Schizophrenia, which tends to come on in early adulthood. This vulnerability, if it exists for you at all, may be related to your surgery, but it may be a completely separate thing too. Schizophrenia is a brain disease. The voices occur because of some still incompletely understood problems with brain chemistry. There is no cure for Schizophrenia, but there are medicines that can suppress symptoms fairly well in many cases.
\nThere are multiple varieties of schizophrenia, but the most common kind is called Paranoid Schizophrenia, which is characterized by two defining symptoms: 1) hallucinations (usually the sensation that a person or people are talking to you, often criticizing you or telling you to do things when there really isn’t anyone there), and 2) delusions (which are beliefs that don’t seem to have any basis in reality, but which the delusional person nevertheless persists in believing).
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In paranoid schizophrenia, the most common presentation is for there to be a delusion that someone is following you around or watching you, perhaps with the intention to do you harm, and for them to be speaking to you (though no one is around to do the speaking), or somehow controlling your thoughts, or inserting thoughts into your head.
\nThe way Schizophrenia tends to come on over time is important, and it gets right to the point of why I think you should talk to a Psychiatrist as soon as you can. This is an illness that usually develops gradually, in an otherwise healthy teenager or young adult. In the early presentation, it might present similar to what you are describing, where there are no full on hallucinations or delusions, but it seems like someone might be talking to you, and they might be wanting to do you harm, etc.
\nThere is this fuzzy sort of onset in some cases where you are still grounded in reality pretty much, but are having these weird experiences that you can’t otherwise explain. What happens next for some people is that they go on to have a full psychotic break – that is to say that their weird experiences become all consuming, and they lose touch with reality and can no longer differentiate what is real from what is delusion or hallucination. The people around you generally won’t do anything to help you until the break happens, because until they they will make allowances for your odd behavior and not think there is anything really wrong.
\nIf you have a psychotic break, you will be very likely to act in very bizarre ways that will make sense only to you. You’re likely to get picked up by the police and taken to a psychiatric hospital against your will. Once in the hospital, you’d be medicated with some of the drugs that can help suppress symptoms. The thing is, however, that once you’ve had a psychotic break, you are likely to have more of them in the future.
\nThe more times you have a psychotic break, the harder it can be to get back to reality, and the more disruption the illness causes to your life. For instance, it is not particularly possible to attend college if you are having a psychotic break (you just get too crazy to do the work properly and they are likely to ask you to leave). Not finishing college will have further consequences for your life.
\nI’m recommending that you go see the doctor BEFORE you have the full break (if in fact that is something that might indeed happen to you – I cannot know given the information I have) so that you can get the medicines that suppress the symptoms (should the doctor think they are appropriate to prescribe) BEFORE your life gets completely upside down.
\nIn this way, you may possibly avoid ever having the break in the first place; a result that would be in your best interests. It is possible to have a reasonablely mainstream life with schizophrenia, provided you accept and comply with treatment and things don’t get too out of hand inside your head. The earlier you go for that treatment (if you are vulnerable to schizophrenia as may be the case here), the greater your chances of having that reasonably mainstream life might be.
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