Schizophrenia: A Personal Journey Through Voices and Treatment - Psychiatry

Schizophrenia

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Hello Dr.
Lin, I would like to explain my condition.
I started hearing three voices around August 2011, one male and one female, and occasionally a child's voice.
At first, I couldn't understand what they were saying, but by April 2012, I began to recognize my inner thoughts as they echoed my thoughts verbatim.
This continued until around 2016 when those three voices suddenly disappeared, but I was still hearing voices (auditory hallucinations).
Instead, I began to hear more voices, up to five or six, all of which were malicious, criticizing, mocking, and attacking me and my family.
They would say that we were short, ugly, poor, and overweight, even though we have always been a middle-class family, and my mother is quite well-off (she divorced my father when I was four).
They also made derogatory comments about my brother (actually my cousin), claiming he was unwanted, even though he had been married for many years and tragically passed away in November 2011.

In May 2017, after moving to a new home, those voices continued to follow me.
By 2018, the female voice began to fade, leaving only the male voices, which still numbered up to five or six.
In 2019, while on a train, I saw a woman walking towards me, pointing at me and voicing my inner thoughts, criticizing me, and telling me to stop talking before she walked off the train, leaving me astonished but not scared.
I was intrigued by the idea that someone could know what I was thinking.
Similar incidents continued, and in July 2020, I was admitted to a psychiatric ward.
However, after being discharged, my condition did not improve.
Over the past ten years, I have changed doctors multiple times and tried various medications, but I never felt any improvement until I received a long-acting injection of paliperidone last August, which provided a slight improvement, akin to moving from 0 to 1.

Throughout these years, I felt that others could hear those voices too.
When they laughed at me loudly, people around would look in the direction of the voices, even though there was no one there.
I'm unsure if this is a hallucination.
Currently, I experience symptoms that seem to include auditory hallucinations, visual hallucinations, and delusions.
The auditory hallucinations come in three forms: the primary type occurs at the entrance of my home and in the vacant lot behind it; the second type occurs when I turn on the TV or computer while in the bathroom or outside my back door, where the original sounds are replaced by the same voices; the third type involves auditory and visual hallucinations related to others, which only occur when they are speaking.
I also suspect that my father can hear those voices based on his expressions and reactions, but this could also be a delusion.
I have experienced paranoid delusions, relational delusions, and a feeling of being scrutinized.
For over a decade, I believed that a group of people was monitoring me, represented by those voices, and I often misinterpret unrelated events as being about me.
For example, I enjoy watching political commentary shows, and even though they discuss politicians, I think they are talking about me.
This has been a daily occurrence.
For many years, I lacked insight into my condition until last year when I realized I truly had schizophrenia, which I thought was impossible.
Last year, I began recording audio to see if I could capture the voices.
I recorded about ten times, but only captured sounds three or four times, which I initially dismissed as nearby machinery.
However, on January 19 of this year, I recorded clearly audible voices criticizing, mocking, and cursing my family, which made me question whether everything was just my auditory hallucinations, delusions, or if my father could no longer hear those voices.

This has led to a significant decline in my mood over the past month.
I wonder if there are truly people with the ability to read minds, which has deterred me from considering electroconvulsive therapy (ECT).
Recently, I have been calmly reflecting on whether the voices recorded on my phone could also be my hallucinations.
During the New Year, I watched a Thai video on YouTube that also contained those voices, clearly stating my current thoughts, even though the video was uploaded three days ago.
I have a follow-up appointment on the 29th and plan to discuss ECT with my doctor.
However, I face a challenge because my father is likely to disagree, as he is extremely stubborn and difficult to persuade.
Therefore, I kindly ask you, Dr.
Lin, to provide compelling evidence that ECT is safe and not dangerous to reassure my father and allow me to proceed with the treatment.
You may wonder why I don't ask my primary doctor for this evidence; it's because a previous incident has led to a significant distrust of him.
Thank you, Dr.
Lin, for listening to my lengthy explanation, and I greatly appreciate your support and assistance!

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Niming, 30~39 year old female. Ask Date: 2024/02/24