Schizophrenia is pretty interesting this way. It's rare for it to show up outside of a certain age range, somewhere around 20 to 35 iirc.

It's strongly correlated to genetics, and most people are totally asymptomatic, no idea they have it until one day they do.

The story of sudden-onset schizophrenia inducing a psychosis making the patient unwilling to consider treatment is depressingly common.

> It's strongly correlated to genetics, and most people are totally asymptomatic, no idea they have it until one day they do.

Depending on whose stats you go with, you can also argue that most people with schizophrenia never know they have it due to anosognosia.

if you are a man and make it past age of 29 without starting to hear voices, you can breathe a sigh of relief (I did)

Unfortunately, this is just statistics. There are cases that lie outside of that age range. I know of two cases, personally.

Things like stress, drugs, childbirth, significant life changes, etc can trigger psychosis and latent schizophrenia at any age, it's just statistically more likely to happen during adolescence and the period right after.

Another way to look at this is that adolescence is when someone experiences new stresses, significant life changes, drug experimentation, etc, which can be triggers for schizophrenia especially during age-correlated prodromal phases.

Yeah, in this case it seems to be menopause + losing her job and having all the free time and nothing to focus on plus who knows what other stressors. I think something bad happened with her Phish friends.

The really tough part for me is she was out of work, so I paid her to be a beta reader for my book. She's a brilliant person and very detail-oriented. She went way over and beyond what I asked for. She spent months and took three passes on the book making different kinds of notes. Then her problems seemed to come on right at the end of that. I worry that all the increased mental activity, and then suddenly not having anything to focus on again, might have been the trigger.

Sounds like it was bound to happen. If she hadn’t hyper focused on your book, she’d likely have found something else.

I can identify with the guilt. In my case with my friend, their behavior lead to me distancing myself from them, not knowing what was going on, and I was his main source of socializing. Same thing happened with several of his other friends. The isolation definitely was something that amplified the progression of his illness to detachment with reality. Didn't help that the people he sought friendship from in lieu of us were scammers who fed into his delusions to take what little he had even when he became homeless.

If I could go back in time, I would do things differently, but at the same time I can't blame myself for not understanding what was happening and doing what was, at the time, the healthiest thing for myself.

Sorry to hear about your friend.

indeed, it just becomes less likely

I kinda heard lots of whispers when I was very young (like 6-7) and now I'm 40 and haven't had any such problems.

I blamed it on the drugs I got prescripted for sleeping (I had bad allergy and was scratching myself to the point of bleeding during sleep so I got some "pacifying" drugs).

Older antihistamines were anticholinergics, the latter of which are famous for causing vivid auditory, visual and somatic hallucinations.

Well, not just drugs-children are more likely to experience hallucinations even without drugs.

I still have vivid memories of experiencing what (in hindsight) I realise were hypnopompic hallucinations, around the age of 6 or 7. I wasn’t taking any regular medications, that I can remember. But, I grew out of it, as kids usually do.

A fun aside here: experiments in which people who’ve taken hallucinogens are placed in brain scanners reveal activation patterns which look an awful lot like what we see when we put small children in brain scanners, and this somewhat accords with the neurogenesis vs pathway pruning see-saw model of brain development.

I’ll say personally my experiences with psychedelics brought back memories of childhood - how I engaged with the world, how my mind would go off down different paths, the intensity of focus - so, you’re probably not far off here.

I always said psychedelics reduce you to a child, with reduce having no negative connotation, just a word that describes the experience. It's like sending your perception back in time in some ways, while retaining some matured aspects.

Also known as "delirium". They cause delirium. Benadryl (DPH) for example does that. It is very dysphoric.

Lower doses can induce hallucinations before it becomes full on delirium that you see in higher doses. You'll regularly hear about people seeing "spiders" after taking 25-50mg of Benedryl, the recommended dose.

I think that may be more common in the elderly. I had full-on delirium from 5 x 50 mg, however. I would not recommend. It took me months for my body to recover. The auditory hallucinations lasted the longest (2-3 days), but my body and my mind was a wreck for months. Thanks to our beautiful hospital that did not administer the antidote for anticholinergic toxicity.

Were you afraid you had it at 29?

We dont even know what constitutes a mental voice. Hell, a huge percentage of people cant hear their own voices in their heads

During psychosis there is no question about what you hear. You hear it. You may know it isn't real, but you hear it.

I think people often imagine hallucinations as glaringly fake—I did, at least.

It was an eye-opener when I finally realized the faint FM radio sounds I kept hearing in the middle of the night were actually manic hallucinations.

As someone who had psychedelic experiences, I thought they'd be like that.

In the few hours I experienced hallucinations after not sleeping for ~7 days, I also heard a radio playing faintly in the background. "Faintly" doesn't do it justice because it was very much undeniably audibly there, even if I knew it wasn't.

I also heard footsteps, felt their vibrations, heard and felt stuff on shelves shake in response to the stepping. It was stunning how in concert and real it was. It was like it was more real than reality itself.

I was aware it wasn't real which made it fucking terrifying, but it was both beautiful and absolutely fascinating at the same time. I was both in awe and horrified that it could be permanent.

Brains are crazy stuff and I can see just how easily someone can become delusional based on what is very much factual in their own experience of reality. There literally is no boundary between reality and true hallucinations, which is a terrifying prospect and

I wonder if there are any schizophrenics with dissociative identity disorder. We're not schizophrenic but we have voices (we don't hear them as from outside though)

I have met a few people online who told me they were diagnosed with both.

Schizophrenia spectrum disorders (SSDs) and DID can apparently co-occur.

From [0] (2016): > One study showed that in a sample of patients diagnosed with Dissociative Identity Disorder (DID) 74.3% also met diagnostic criteria of a SSD, 49.5% met diagnostic criteria for schizoaffective disorder, and 18.7% met diagnostic criteria for schizophrenia.

The study cited in [0] is dated from 1996, however(!), so it was done not long after the change from changing the name MPD to DID. Not sure how much weight to put on a study that old.

From [1] (2022): > Numerous studies have shown that up to 50% of patients with schizophrenia meet the diagnostic criteria for dissociative personality disorder.

The two linked studies cited in [1] are dated in 1998 and 2004. So also, still old, but not quite as much.

It seems well-known that the two conditions co-occur. I don't have access to the linked studies, however, and am not willing to pay the subscription or single-paper fees.

I do have DID but SSDs have been thoroughly ruled out for me (I was checked for both, as well as other potential conditions). My assessment seemed quite thorough.

[0] https://pmc.ncbi.nlm.nih.gov/articles/PMC5216848/ [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC8885543/

I'd be willing to try institutional academic accounts if you ever have some paywalls article you want to read. Just shoot me an email at partner_privacy@proton.me

Also, my partner likely has DID and is struggling with it somewhat. If you have advice or are willing to answer some questions, I'd appreciate talking about it. But I know it's a big ask, respectfully, so I understand if not.

> ...if you ever have some paywalls article you want to read. Just shoot me an email...

Thanks. I appreciate it. Will do if I come across something.

> Also, my partner likely has DID and is struggling with it somewhat. If you have advice or are willing to answer some questions, I'd appreciate talking about it.

Sure. Not sure if you're wanting advice/help for yourself, your partner, or both, but email me at shippage_hn@proton.me if you'd like to talk. I know more about my own particular kind of DID than others, but am willing to talk about what I know of the generalities, too, as well as a bit about my experiences (including getting a diagnosis) if that helps you or your partner.

We also have DID and would also be open to talking; you can find our contacts on our Keybase (or contact us on Keybase itself).