Can anyone decipher this odd symptom?

[DrLee]

I have spent a lot of time reading and analyzing several of your other questions in Y.A and some of your blog besides this question. It would be difficult to be understood by ordinary people and sometimes even confusing to some professionals. That’s because they don’t do text analysis and you do obsess over those ideas with one or two hallucinations. But you are not suffering from schizophrenia because some essential positive and negative symptoms aren’t present. Plus your ideas are coherent, despite the tedium and Korean-heritage grammatical errors. I have extracted a lot of useful information about your background, life events, the features of your problem, and how it has affected you.

That is often more than what patients tell doctors and mental health professionals in the early sessions. But, of course, I can’t see how you look, how you talk, and how you interact. Your father probably suffered from paranoid schizophrenia. Mental illness often runs in families. But children do not necessarily develop the same type of disorder. Schizophrenia is a broad category of psychosis and your disorder is a type within that category. I think you have Delusional Disorder of the “unspecified” sub-type or variety. (If I were in the committee of the DSM board I would insist they call it the “omen”sub-type). Anyway, you will still need to visit a psychiatrist or clinical psychologist to get a diagnosis.

Your condition affects how your brain perceives your surroundings. It makes you narrowly pay too much attention to unimportant or small things in your environment, such as a statement made by a stranger who is not talking to you, common everyday phrases, numbers on a digital clock, or a few printed words here and there. Then you over-think it and make them important by looking for a meaning, message, or sign from what you see or hear. Over time you were on the lookout for these very common features of the environment: for example, people talking in subways and digital time displays. You thought the similar occurrences and co-incidences have personal significance simply because they are repeated or found anywhere. So you form ideas about them. Then a collection of these ideas formed your belief that they are “signs” or special directions to guide you in life and what to do next. Sometimes they don’t make sense to you or you find it hard to interpret their “message” to you; so you naively went to psychics and tarot readers for help. The truth is that there is nothing to interpret and nothing to decipher because there is no personal message or guidance from the random things you notice.

Wikipedia experts say there are “no prominent hallucinations” in delusional disorders (http://en.wikipedia.org/wiki/Delusional_disorder ). The keyword is “prominent”. Yes, hallucinations are not the common feature of your condition. You had one minor visual hallucination of people wearing sunglasses indoors. But Wikipedia claims visual hallucinations don’t count. I disagree. Psychiatrists and psychologists of the Diagnostic and Statistical Manual (DSM) Board were wrong in the past about visual hallucinations not being common in schizophrenia and they were wrong in the past to classify all delusions as “paranoid disorders”.

Your entire delusional disorder is made up of these 4 types of disordered thinking:
•You mostly have “delusion of reference” beliefs: these are concepts that a casual incident or external stimulus has a direct meaning for you. For example, you thought that the McDonald’s customer in front of you at the counter was referring to you when he made a joke about “processed food” to his girlfriend. You thought the universe made him remind you not to eat processed food. But many people make jokes about McDonald’s food even while in one of its restaurants. So, of course, you’re eventually going to hear something that you already believe

Delusions of reference start out as new “ideas of reference”, I say. Just because you saw a new random number or words to interpret doesn’t mean it’s a new symptom. It’s not a symptom. That is just an idea of reference that you assume has meaning. It is merely another random thing that your delusions have made you notice. But there is really no difference between an idea and a delusion of reference. Hair-splitters claim that “ideas” are not firmly held but just feelings and thoughts that can be abandoned once a person is convinced that such ideas are wrong. But those experts can’t explain how several ideas collectively become a belief that they then call a delusion. That is why their talk therapy for those with strong delusional disorders is often weak. So I hypothesize that delusions of reference are created and maintained out of the underlying “magical thinking”, obsessive rules, and “co-incident significance”.

•You have what I call “co-incident significance” thinking: it is the mistaken idea by people, who don’t understand mathematical probability, that random and unrelated events are somehow meaningfully related because they are similar. This is related to “gambler’s fallacy”. You were mistaken about the protestors: they weren’t protesting against all processed food but against the employment practices of the company that makes canned food or imports cheaper versions and don’t label their products truthfully. You only saw a bit of that protest and over-focussed on only one sign with the words “processed foods”. You did not pay attention and read all the placards they held. It was pure chance or co-incidence that you walked pass them around the time of visiting McDonald's. ©M.H L 18 Feb 2014.

Another example is that you used the wrong keywords to search for nearby bars in your local area. You probably typed “drink alcohol” instead of “licensed bars, {insert name of your local area}" because using the right keywords would have made you consciously uncomfortable with some guilt. That was why you got irrelevant search results. Google wasn’t giving you a sign to start or stop anything. The blogger’s title about her father was not about you figuratively. It was you forcing meaning into what you saw because you wanted to stop yourself from going out to enjoy a drink.

•On rare occasions you have suffered from “magical thinking”: these are superstitious thoughts, sometimes fleeting and other times clear ideas, that if you do something against the made-up rules in your head then something bad might happen. It also includes believing that thoughts alone can make something good or bad happen in reality. For example, you used the Google “search limit” as a sign to deny that you felt guilty about searching for local bars because you wanted to avoid thinking about breaking your “no alcohol” rule. It was more comforting for you to see it as a good sign to avoid something bad happening within a month of you going out. But drinking one or two glasses of alcohol isn’t drunkenness. You need to learn that occasionally drinking a bit of soda/soft drink and alcohol won't cause you problems

•You have a set of obsessive rules: you made a long list of rules to live by a few years ago. It is ok to have a few personal rules but yours are too many and too rigid. Some of them are irrational. Being rigid about them and fearing punishments if you break them are also irrational because you created those rules and no event or person can punish you. Irrational rules become an obsession; you even named them “positive rules”. For example, you said you had a “positive rule” about eating only organic and vegetarian foods. That rule made you feel guilty for even walking into McDonald's. The stranger's comment and one protester's placard were coincidences that made you feel that your strict food rule is absolutely right and that you were wrong for buying from McDonald's. You really need to realize that you have rigid and extreme rules (i.e. all or nothing, and time limits) that make you feel guilty and anxious. Then you will be ready to give up on 1 or 2 of them and modify the other rules to make them reasonable. It is self-discipline - not signs - that help people stick to rules. ©M.H L18 Feb 2014

Those signs have stopped you from living a meaningful and productive life since graduation. Be free of the delusion that they might guide you. You’ve been trapped by them and going around in circles. I urge you to turn up at a general family practice or free medical clinic to see a doctor first. General medical doctors can prescribe you medication without a psychiatrist. However, they will usually refer you to a psychiatrist or clinical psychologist first. If there is a psychologist that practices Rational Emotive Therapy (r.e.t) in your area then you should choose that kind of psychologist. Otherwise Cognitive Behavioral Therapy will do.

You mentioned in one of your earlier questions that when you were homeless the police arrested you. They always mistake mental illness and the ragged, dirty look of homeless people for “suspicious behaviour” and drug intoxication. You don’t want that to happen again. Mental illness is a disability that you might be able to use to get public housing or some financial aid if you get a doctor’s report. Tell the medical doctor that you have had delusions for four years without any treatment and it has caused you to be homeless. For someone who went to college and has a degree it is a shame that you have not sought the right diagnosis, professional counselling and medication to control your delusions. People with delusional disorders are capable of working full-time or part-time without medication if the condition isn’t getting worse.