Elena Sorokina, Woman, 30 years old
Good evening Igor Evgenievich! I am 30 years old. A year and a half ago, due to the accumulation of several very big life shocks, my tearfulness sharply increased, then OCD appeared (although, as it turned out, I had an attack of OCD in childhood, but I didn’t know what it was then; over time, everything passed and I I even forgot about it). A few weeks later, the first attack of depersonalization and derealization appeared. I almost died from fear then. I turned to a psychiatrist. The psychiatrist wanted to prescribe me antidepressants, but at the same time warned that they would not help for a long time and that I needed psychotherapy. I agreed to psychotherapy. I went through 10 sessions without any results. I didn’t want to continue visiting this psychiatrist because I didn’t see any improvement at all! They didn’t even really tell me the diagnosis (they said “you have mild disorder, it's okay!"). This was followed by visits to two more psychiatrists: there was already a diagnosis of "anxiety disorder", they also advised antidepressants, but at the same time pointed out their ineffectiveness and advised psychotherapy. Here it is necessary to draw your attention to the following point: while waiting When I visited my first psychiatrist, I studied the problem of depersonalization very carefully. I read that depersonalization is one of the main signs of schizophrenia. Since then, this fear has been added to my whole bouquet of fears, which still haunts me! three psychiatrists dismissed schizophrenia from me, but it always seems to me that they overlooked something, didn’t pay attention to something! After the last visit to the psychiatrist, I decided that I would try to get out of all this hell myself and, you know, depersonalization and derealization gone, no OCD! But now my whole life consists of looking for symptoms of schizophrenia! The main horror is that I am afraid of hearing voices! I constantly listen to any rustle, my ears already hurt! Every day it seems to me that today I will definitely hear them. I’ve even tried to imagine voices several times in order to understand how all this happens. I understand perfectly well that you can’t do this, I perfectly understand the delusional nature of your actions, but I can’t help myself out of fear! I'm afraid that's where schizophrenics start! I spend days reading forums of people suffering from this disease to understand exactly how they hear these voices, to understand whether it has started for me or not! I am constantly afraid that I have a sluggish form, which psychiatrists simply have not identified! I am also tormented by the question: can an anxiety disorder turn into schizophrenia? One of the psychiatrists told me that if you are afraid of her, you can get sick! You see, I am well aware that voices are not the first sign of schizophrenia, that with this disease, the first thing that happens is the personality is destroyed. But my fear is precisely hearing the voice. Although, I am now involved in charity work, after reading an article that said that schizophrenics, for the most part, are selfish. I have reconsidered my attitude towards the environment, I am trying to understand my loved ones even more (although I was always responsive before)! Help me please!!! I beg you very much!!! Thank you in advance for your attention and please forgive me for such a long letter!
Help for you may consist, perhaps, in competent treatment of your banal anxiety neurosis with severe lysophobia. Any neurosis never “grows” into an endogenous mental illness. The maximum that can happen is an erroneous diagnosis in the early stages of a mental illness, when its first vague manifestations are misinterpreted as neurosis. However, in your case, this option is excluded even with correspondence counseling - the neurotic picture is too obvious. To say that “if you are afraid, you can get sick from it” is the height of professional illiteracy, not to mention the essentially ANTI-psychotherapeutic effect of such conclusions. Regarding the statement that “antidepressants will not help for a long time and psychotherapy is needed” - I would also say that things are exactly the opposite, although psychotherapy acquires its important significance once the effect is achieved drug treatment. In any case, I would not recommend taking psychotherapy or antidepressants from "specialists" who say this. (Unless, of course, you took something out of context.) All your suffering comes down to practically one thing - typical neurotic lissophobia. (I don’t even see anything similar to “ocd” in your description.) Like any phobic neurosis, it can be ideally cured. All you need is one properly prescribed serotonin-selective antidepressant. If their treatment is supplemented with cognitive behavioral psychotherapy, it will be simply ideal, but this is not always necessary.
Neurosis-like schizophrenia has pronounced periods of remission and a favorable course; it requires timely diagnosis and treatment.
Remission of the disease can last from several months to several years. At the first signs of deviation, you should immediately contact a specialist for additional advice.
The initial symptoms can be confused with, so it is required early diagnosis. Self-therapy in this situation is inappropriate, as it can aggravate the patient's condition.
Classification
Schizophrenia happens:
- Type: continuously progressive, paroxysmal, coat-like, recurrent.
- By stages: initial, manifestation, final.
- According to the speed of development: malignant, paranoid, sluggish.
- By appearance: catatonic, paranoid, disorganized, sluggish, biopolar, neurosis-like, latent, adolescent.
- By nature of origin: congenital, acquired.
Schizophrenic or neurotic?
Very often, patients confuse schizophrenia with neurosis, so in order to promptly seek professional help, you need to know the differences between these two deviations. As for the general thing, these concepts are united by a nervous disorder.
– group of diseases nervous system, which are reversible. Whatever the form or stage of the neurosis, a specialist will be able to select therapy and solve the problem with minimal risk to health. As for schizophrenia, it is not treatable; with it, the patient’s condition stabilizes until the next wave of exacerbation. Schizophrenia occurs as a result of pathological, irreversible changes in the functioning of the nervous system.
These diseases also differ in treatment methods. In case of neurosis, the patient may not be prescribed medications (the best option– psychotherapy sessions), and it is impossible to improve the patient’s condition in schizophrenia without medications; during periods of exacerbation, hospitalization may even be required.
When diagnosing, the symptoms of deviations must be taken into account, especially since schizophrenia, although it has neurosis-like symptoms, still differs from neurosis (symptoms of a paroxysmal nature) in its constancy.
How to independently distinguish neurosis from schizophrenia?
As mentioned earlier, neurosis and schizophrenia are completely different in symptoms, diagnosis, course, causes and, of course, treatment. It must be remembered that with neurosis, the patient can calmly tolerate criticism, is able to ask for help, will try to understand his condition and problem, will undergo examination from a specialist.
As for the condition, even with neurosis-like schizophrenia, the patient does not understand where he is, what day of the week or date it is, and associates himself with some famous person.
Even in in good condition with this deviation, the patient is not able to treat himself with full criticism, those around him consider him strange, wonderful because of his behavior, the patient is absurd in his emotional state.
At the same time, the person begins to suffer because of his condition and what happens to him, refuses professional help and hides his problem from close relatives.
The patient may also be disturbed by hallucinations or delusions, although deceptions of perception can also be observed in neurosis, but in such a situation they are temporary and too simple, they can occur before bed or in the morning.
With schizophrenia, the patient’s thoughts are obsessive, constantly repeated, and he may be haunted by some images, patterns or pictures.
Hallucinations in this case are of a violent nature, voices in the head can even argue with each other, criticize the patient, exert influence, force. With neurosis, delusional thoughts and ideas are completely excluded, which is necessarily present in schizophrenia.
... and neurotic
A person constantly says ridiculous phrases and statements; in such a situation, the patient may show aggression or refuse to communicate with relatives. Delirium with this deviation is systemic in nature, the patient completely refuses the real world.
The main distinguishing feature between the two diseases is the preservation of personality during neurosis. The patient may have problems with mood, but there is no violation of individuality, determination, or emotionality. With schizophrenia, personality deformation occurs over the years, emotions become scarce, the patient is constantly lethargic, lives in his own world of sick fantasies.
It must be remembered that timely initiation of therapy for neurosis can return the patient to normal life, which is impossible in schizophrenia.
Neurosis-like schizophrenia
Neurosis-like schizophrenia is a protracted neurosis characterized by obsessive state and movements, is permanent and has long periods of remission. This disease can lead to disability.
With schizophrenia, the patient follows the voices in his head, gives preference to them, loses contact with reality, voices for him, first of all. All images become intrusive and monotonous, he can even talk to them and consult with them. With this type of schizophrenia, the patient not only experiences fear of something, but tries to get rid of it, doing some rituals.
Schizophrenia of the neurosis-like form belongs to one of the subtypes of sluggish, in most cases it is diagnosed between the ages of 12 and 20 years. The main symptoms of this form of schizophrenia are. In this situation, the patient is convinced that he is ugly, while focusing his attention on a certain part of the body, but in fact the defect is absent or insignificant.
Also, with this form of deviation there is metaphysical intoxication - the patient constantly talks about “eternal problems”. He constantly thinks, but does not act in any way; it is noted that the patient is fixated on one topic.
Ideas become valuable to him; it is impossible to convince him otherwise. Criticism is perceived sharply and emotionally, while the patient is convinced of the correctness of his thoughts. All ideas are ridiculous, but the patient can think about them for hours, he can even keep notes that mean nothing to a healthy person.
Provoking set of causes
Neurosis-like schizophrenia can occur for the following reasons: 
- frequent complaints that are associated with fear of life, wealth and health;
- lack of interest in the opposite sex;
- obsessive movements and thoughts that do not leave the patient day or night;
- frequent;
- heredity, genetic predisposition;
- impact viral infection on the fetus during pregnancy;
- viral disease in infancy;
- violence in childhood or adolescence.
Clinical picture
Sluggish neurosis-like schizophrenia is characterized by the fact that it can have both negative signs, and productive symptoms:
TO negative symptoms The following signs include:
- impaired thinking, emotional condition, will;
- and fear when communicating with relatives and friends, refusal of contacts with the outside world;
- the patient only talks about some goals, but does not try to take any action;
- the patient stops responding to the world, his emotional state is at zero, he ceases to be interested in hobbies and work;
- on early stages disease, laziness arises, which gradually develops into complete apathy.
TO productive symptoms The following signs include:
- the patient increasingly begins to hear voices directly in his head, which become main goal in life, he constantly listens and does everything like they do;
- it seems to the patient that someone is following him, he can commit suicide in this state, also noted in this case crazy ideas, auditory hallucinations, the feeling of everything done;
- human can long time is in one position and looks at one point, or, on the contrary, to be disinhibited, fooling around or making faces.
Establishing diagnosis
When diagnosing a disease, much attention is paid to symptoms. Concerning laboratory research, then they are used only to exclude accompanying illnesses and brain abnormalities. It is recommended to undergo blood and urine tests.
The specialist talks for a long time with the patient, as well as his relatives. To begin treatment, it is necessary to determine when the symptoms began to appear. warning signs, which could provoke this condition.
A child psychologist or psychotherapist must conduct conversations with children in the presence of parents so that the little patient feels at ease.
Providing medical care
Treatment will depend on the form and stage of the disease, as well as age group. In children, therapy involves control over 
some signs, psychotherapy and reception medicines, sometimes Aminazine, Fluphenazine.
Complications and prevention
Neurosis-like schizophrenia has a positive prognosis with timely and high-quality treatment. If therapy is not provided on time, the disease can develop into a complex or paranoid form, and then gradually acquires schizoid and hysterical features. As a result, the patient may be assigned a disability group. With severe disorders, the patient is capable of committing suicide.
Prevention is as follows:
- eliminating frequent stress;
- do not drink alcohol or smoke;
- you cannot drink coffee and tea, especially strong;
- you need to walk and play sports more;
- eat properly and balanced;
- seek help from a specialist in a timely manner;
- exclusion of negative emotions;
- limited supply of information;
- support of loved ones.
Schizophrenia – serious pathology, which can lead to irreversible consequences, so it is necessary to pay attention to the patient’s symptoms and abnormalities, and contact a specialist as soon as possible.
Neuroses, as well as many other endogenous mental pathologies, which can also include low-grade schizophrenia, are called diametrically opposed diseases by psychiatrists. They have their similarities, but there are also differences. The treatment of neuroses is carried out by a psychotherapist, without the help of a psychiatrist, while the treatment of endogenous mental pathologies is the prerogative of psychiatrists. Determining neurosis or schizophrenia is not always very simple, since patients can deliberately imitate the clinical picture of the disease.
It should be noted that what distinguishes schizophrenia is that this disease does not have a so-called starting point or cause. This is a chronic genetic pathology, which in extremely rare cases can develop against the background of prolonged stress, alcohol abuse, after childbirth, and these are considered only trigger factors.
Neurosis is often caused by some situation that has affected the human psyche. It could be severe stress or fear, fatigue. It is important to understand that such a pathology is unlikely to be chronic and continuous with rare attacks of exacerbation. It is also necessary to understand that the fear of transformation of one disease into another has no basis.
Fundamental difference
The main difference between neurosis and schizophrenia is that the first condition remains critical of itself. A person may realize that he has problems and fear. As a result, the patient tries to understand what is happening to him, can seek help from specialists, and undergo diagnostics. If there are no signs of somatic pathology, which should correspond to the complaints, the best decision would be to refer you for treatment to a psychotherapist.
Psychoses are characterized by completely different behavioral signs. Patients can hardly name today's date or day of the week, are confused about their location, and can sometimes call themselves another person or identify with them. Healthy mental functions familiar to all people, such as thinking, emotions and will, are significantly split. Even when the period of psychosis ends, it is difficult to say that this patient is normal. This is due to the fact that he has a significantly reduced criticism of the events around him, of himself, he can say ridiculous phrases and sentences, and the manner in which his emotions manifest themselves will only cause bewilderment in a healthy person. It is worth noting that not understanding oneself becomes painful. At the same time, such a patient will not go to a doctor for help, trying to hide the problems he has encountered from others.
Hallucinations
One of the most reliable signs that distinguish neurosis and schizophrenia is hallucinations. At its core, this is a deception of perception, which can be delusional in nature. They usually occur during the onset of psychosis in people suffering from schizophrenia. They can occur extremely rarely in neuroses, but their distinctive feature is their short duration, simplicity, and also the fact that they have close connection with sleep, that is, they occur during falling asleep or waking up. In neurotics, they can occur as repeatedly repeated thoughts, images, such as spots, pictures.
In patients with schizophrenia, hallucinations are often of a different nature, which may not even have an image, but be in the form of voices. They argue, swear, criticize the patient, make him afraid, thereby provoking feelings of influence on the person. That is, someone invisible forces him to perform some action. Sometimes schizophrenics say that they are subject to some kind of influence, for example, hardware influence. Distinctive feature Such hallucinations are the fact that voices or devices are visible only to the patient who is 100% sure of it.
Delusional ideas
This symptom develops exclusively in schizophrenics. It never occurs in patients with neuroses. It is important to note that there is no way to convince a person that his idea is ridiculous or crazy, and the response will be aggression or withdrawal. Delusional ideas are systemic in nature, and the perception of the world is significantly distorted.
How to diagnose
Schizophrenia differs from neurosis in that neurotics retain their personality. In other words, all the personal qualities that characterized a person before the disease - determination, emotionality - remain with the development of neuroses. It is also important to note that neurosis is reversible. The patient receives a course of treatment from a psychotherapist, after which he simply returns to his normal, familiar life, only he already acquires some new skills of self-control and reaction to various stimuli, which led him to neurosis.
Schizophrenia eventually leads to the development of apatoabulic syndrome. It is a condition in which a personality defect develops over the years. Patients are very lethargic, apathetic, emotions are manifested very weakly due to a decrease in the ability to do so. A clinical picture growing, voices and delusional ideas intensifying. You shouldn’t expect any initiative from such a person; he closes himself off in himself, his world, and is less and less interested in reality. This provokes disability; there are cases where patients have lost the ability to independently take care of themselves and care for themselves.
Distinguish neurosis from schizophrenia without outside help can be done using online tests for neurosis, which are available in free access on the Internet. It is important to read the instructions carefully to avoid misinterpretation of the results. If you cannot do this yourself, then you need to consult a doctor who knows exactly how to distinguish between these two diseases.
One form of schizophrenia is pseudoneurotic schizophrenia. It is not considered classical, which can be seen in all classifications of diseases. This is a state that can be quite comfortable for a person’s life, since he can remain in it for a very long period of time - up to 30 years.
At this time, psychopathic-like, neurosis-like and other disorders that occur in schizophrenia may develop. But most of all the patient suffers from fear and neurotic attacks. The difference is that there is no progression of the personality defect, and there are no hallucinations or delusions. Other manifestations of this disease may include:
- Unfounded fears;
- Emotional lability;
- The desire to study boring things ordinary person subjects - philosophy, mysticism;
- Decreased productivity in daily life;
- A person stops taking care of his appearance.
Such people remain socially active, but they rarely complete their education. Sometimes such patients even work, but this work is very unstable, since they give preference to those places of work where they do not need to be active, experience stress, or strain. They rarely have a family, which is due to constant fear with a tendency towards progress, as well as pathological lability of emotions. For example, if a person is afraid of something public transport, then over time he will simply stop using it completely. Sometimes these fears reach the point of absurdity.
Treatment
Treatment of neurosis-like schizophrenia consists of psychotherapy sessions, sometimes it is possible to prescribe mild tranquilizers or sedatives.
Typical neurosis can also be treated by visiting psychotherapists; the need for psychotropics rarely arises. Usually these are short-term courses.
Schizophrenia requires constant, sometimes even lifelong, use of medications.
Schizophrenia and neurosis are two diseases that can often be very similar in their external signs. Carry it out correctly differential diagnosis an experienced doctor can do it, but primary screening can also be done at home through online testing.
IN modern world It often happens that a person has to deal with neurotic and mental disorders. This is due to the fast pace of life, constant stress and problems, unstable emotional state.
Neurosis-like schizophrenia is called light form schizotypal personality disorder, which is similar to neurotic in some symptoms. This disease is quite rare, not more than 0.5% of all cases. As a rule, it is easily treatable and does not require isolating the sick person from society, but it is not completely curable and requires monitoring by specialists for the rest of his life.
Yes, these two diseases have similarities, such as:
- hypochondria;
- depression;
- obsessive states;
- the presence of fears in a person.
Many people believe that neurosis can develop into a schizotypal disorder, but this is not the case. Neuroses arise as a consequence of previous psychological trauma, as well as complex internal and external conflict, due to severe stress, chronic fatigue, after childbirth.
Such a pathology, most likely, will not be chronic continuously and will remind itself of itself with infrequent exacerbations. People around may not notice that a person is experiencing neurotic disorders. The patient remains critical of both himself and the circumstances around him. He notices changes in himself, worries about this, turns to specialists and experiences hypochondria, thoroughly studying the symptoms various diseases and trying them on himself, just like a schizophrenic.
Man with pseudoneurotic schizophrenia can live without noticing in himself serious changes for quite a long time, up to three decades. However, during the course of the disease, various neurotic and mental disorders personality. People with this disease rarely complete their education, work in the same place for a short time, and it often happens that they cannot start a family. The disease forces you to take medications for a very long time. for a long time, and sometimes throughout life. 
The patient has no desire to take care of himself, he looks unkempt, as a rule, everyday life does not bring productivity, a person experiences various fears absolutely unfounded, sometimes there is a craving for studying subjects that are boring for other people, for example, philosophy. Often, a patient’s phobias become simply absurd and progress; if, for example, a person is afraid of buses for some reason, he will soon stop using this type of public transport altogether.
Schizotypal disorder, unlike neurosis, occurs in a person regardless of whether he has experienced any stress that traumatized his psyche and regardless of his character. Patients may become confused about time and location, or confuse themselves with another person. Even when the period of psychosis ends, one cannot say with certainty that the person is absolutely normal.
So, what are the differences?
Neurosis-like schizophrenia
- Occurs after experiencing severe stress that affected mental condition sick
- Occurs regardless of the circumstances and character of the person, may occur due to genetic predisposition
- The life values and character of a neurasthenic do not change
- The disease radically changes a person’s personality
- The patient remains critical of himself and the circumstances surrounding him, and worries about his mental health
- A schizophrenic does not understand that he is sick, the ability to criticize is lost
- A person turns to specialists and wants to be cured
- The patient will not go to the doctor on his own, this happens at the insistence of people close to him
- A neurasthenic person in any serious situation is able to pull himself together and pull himself together
- A schizophrenic, even in a life-threatening situation, will not pull himself together
- May continue to remain social person, communicate with others, work, engage in education and build a family
- Antisocial, apathetic, avoids society, does not stay in the same job for long, is unable to build relationships
- A complete cure is possible
- A person is almost always doomed to lifelong medication and medical supervision
Sluggish schizophrenia is different from neurosis.
This disease has three types:
- psychopathic;
- simple;
- neurosis-like schizophrenia.
It is considered a transitional form, since the symptoms of the disease are superficial. While classic look leads to rapid degradation of the personality, then the sluggish person changes his personality slowly, affecting his behavior, manners and socialization, as described above. The differences between sluggish schizophrenia and neurasthenia are the same as mentioned above. It's absolutely two various ailments, similar only in some symptoms.
Therapy.
Schizotypal disorders, as a rule, do not pose a threat to life and health, both for the patient and for the people around him, therefore the use large quantity potent drugs are excluded. Often the patient is prescribed antipsychotics or simple tranquilizers. 
If the disease becomes latent, the doctor prescribes antidepressants to the patient to suppress the surging depression. During treatment, psychotherapists use individual and group techniques to achieve healing. To achieve positive dynamics, the support of family and their constant presence is important.
During treatment neurotic disorders they also use various sedatives, tranquilizers and antidepressants. There are also many different non-drug methods, which are used depending on the nature and course of the disease. The following methods exist:
- hypnosis;
- breathing exercises;
- music therapy;
- color therapy;
- phototherapy and others.
Hypnagogic hallucinations in neurosis
Hypnagogic hallucinations- These are hallucinations that occur before going to bed. The reasons for such phenomena are stressful situations, depressive state, anxiety states, excessive emotionality, as well as alcohol and drug abuse.
Auditory hallucinations before sleep often accompany neurotics, but they have nothing to do with the various visions that arise in schizotypal, manic states and psychoses.
Hypnagogic hallucinations are different from pseudohallucinations and visual illusions. Hypnagogic hallucinations occur only in a state of drowsiness; many experts claim that every person sees and hears them, but simply does not remember them, because afterwards they fall asleep. But pseudohallucinations are familiar to schizophrenics and people with acute psychosis.
You should not be afraid or worry too much about hearing voices before bed; for people suffering from neurasthenic disorders, this is considered normal. You should consult a psychotherapist in order to get rid of the neurosis, along with which the hallucinations will disappear.
anonymous, Female, 24 years old
Good afternoon. I don’t even know who to turn to and get an accurate answer to my question. It all started 3 years ago, I was not very good good period in my life, I lived dream loved one, in subsequently I had an abortion from him, then dysentery, in general it was not easy. After some time, I started having panic attacks, I visited all the doctors, from neurologists to pulmonologists, but of course I didn’t get an answer. Even later, this fear of panic attacks, I I was afraid every time that it was about to arise. But I didn’t understand what would happen next... The panic attacks passed, but instead came constant anxiety sitting in my stomach, an incomprehensible fear, I started reading a lot of information on the Internet, I constantly came across symptoms of schizophrenia. I began to be terribly afraid of it, later I began to experience derealization, I stopped enjoying the environment as before, before even a small green bush brought me pleasure, I look at the whole world as if through a veil that distances me from this world... And it’s very difficult. Now I often begin to confuse words, bad memory, I’m afraid of everything, the dark, staying at home, getting sick, I’m constantly afraid of going crazy , before going to bed in absolute silence, I have some strange thoughts, there are hypnapomic hallucinations before going to bed. Sometimes my state is it gets better in the evening, and sometimes it may not be there at all, sometimes it could be 2-3 weeks or more. I went to a psychologist, visited a psychiatrist, the psychiatrist diagnosed a neurotic disorder, prescribed Noofen, I didn’t take it. Now I went to yoga, after the first class my anxiety got a little worse. What's wrong with me, doctor, could this all be the beginning of schizophrenia?
No, this can't be the beginning. This is a pronounced anxiety neurosis, and neurosis never turns into psychosis. If you do not treat it as expected, then it will most likely worsen: your quality of life will deteriorate even more, you will become even more socially maladapted, and neurotic symptoms will join in with anxiety and increase. But to mental illness it won't have the slightest connection anyway. Neurotic response is a property of mental healthy people. Mentally/mentally ill people develop psychosis, not neurosis. Not a single “psychotic” panicky searches for symptoms of his psychosis on the Internet and generally rarely realizes that he is sick. A “neurotic” person, without being sick, suffers from fear of illness. By and large, when anxiety disorders there is nothing to “treat” at all except fear. If only the “neurotic” himself could stop being afraid, then there would simply be nothing to treat. In isolated cases, this happens - at some point of internal awareness, a person says to himself something like: “That’s it, stop! Enough, that’s enough. I’m healthy. I’m stopping this. This will never happen to me again” - and it doesn’t happen. But such cases are rare. More often relief from severe anxiety neuroses occurs as a result of proper treatment.
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