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Fears about schizophrenia

6 min read
Kristin Jones, LCSW

By Kristin Jones, LCSW

Reviewed by Patrick McGrath, PhD

Aug 23, 2022

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If you’re experiencing unwanted thoughts about losing your mind, becoming psychotic, or developing schizophrenia, it may be a sign of schizophrenia OCD. You might find yourself constantly questioning the state of your mind, which can cause you to be overly focused on feeling different than usual. It might make you start noticing coincidences and giving random events significance, or wondering about spiritual forces that cause you fear and distress. 

These thoughts might result in increased anxiety, which then might lead to other physical sensations, such as dizziness, and or perhaps your preoccupation with the thoughts makes it harder for you to concentrate, leading you to question if those symptoms too could possibly be related to experiencing psychosis, and your anxiety grows. This cycle can lead you to doubt the most important things in your life: you may question your ability to support yourself, hold down a job, or engage in healthy relationships. 

In response to these thoughts, doubts, and increasing anxiety, you may search for anything that might provide you with solid ground, firm answers, or certainty about what you’re experiencing. You research what you’re experiencing, read about similar experiences from others, and ask people in your life to make sure you’re acting normally and that your experiences match up with reality. You might even avoid places, people, or activities out of fear that they’ll trigger your thoughts again.

You may fear that there is no way out of this cycle, but there is hope. People suffering from fear of schizophrenia or psychosis themes in OCD can regain confidence and purpose in their lives by doing exposure and response prevention (ERP) therapy with an OCD specialist. You can learn to break the cycle of obsessions, doubts, anxiety, and compulsive behavior.

Schizophrenia OCD – Common obsessions

  • Losing your mind or becoming psychotic
  • Not being able to live the life you want
  • Not being able to take care of yourself
  • Not being able to support yourself financially
  • Not feeling able to identify real experiences
  • Not being able to trust memories
  • Living in a state of fear
  • Engaging in behaviors that you might not normally do
  • Not being able to function socially
  • Not being able to have a relationship

Common triggers

People who have intrusive thoughts about developing schizophrenia might start to feel highly self-conscious, perhaps feeling as if others are watching them or laughing at them, especially in crowded settings. They also might feel triggered when feeling certain physical sensations, such as lightheadedness, fatigue, confusion, or difficulties with focus and memory. 

These triggers and obsessions can form a vicious cycle, as many symptoms of anxiety are also triggers for people with fears of developing schizophrenia or psychosis. In OCD, when an obsession is triggered, it causes further anxiety, therefore reinforcing the cycle of symptoms.

External triggers might include being around others who have mental illness, watching movies or TV shows involving mental illness, or using psychoactive substances.

Other triggers for Schizophrenia OCD fears may include:

  • Feeling overstimulated, such as by loud noises, crowded places
  • Not remembering details of events or what was said in conversations
  • Feeling lightheaded or dizzy
  • Difficulty falling asleep
  • Feeling as if others are watching you, or possibly laughing at you
  • Feeling out of control
  • Coincidences
  • Deja vu

How can I tell if it’s OCD, and not anxiety, cautiousness, stress, or actual psychosis?

This type of concern can be tricky to address, since seeking certainty about what you’re experiencing can quickly become a compulsive safety-seeking behavior. It’s best to ask a trained professional who has experience working with OCD. 

A medical professional with experience treating OCD will look for a few different things in order to determine if what you’re struggling with is OCD. Are you experiencing repeated and unwanted thoughts, worries, feelings, or images about losing your mental health or developing schizophrenia or psychosis? Do these thoughts cause anxiety or distress? Do you engage in mental or physical compulsions in an attempt to minimize anxiety, find certainty, or avoid a feared outcome?

If these 3 circumstances are met, you may be suffering from schizophrenia OCD. The cycle of repetitive obsessions with compulsive behaviors in response is what sets OCD apart from other conditions.

Common compulsions

You may be aware that your worries or thoughts aren’t real or rational; however, this understanding isn’t enough to make the thoughts and doubts stop or make the anxiety decrease. You may begin to wonder if your doubts themselves are a sign of psychosis or schizophrenia. Your continued struggle against your thoughts and worries can cause you to worry about your mental state even more .

You may become more and more preoccupied with physical symptoms, such as feeling overly sensitive in loud settings, or feeling more self conscious in social settings. Your rational mind can feel like it is losing its credibility, so you seek reassurance, feeling compelled to keep looking for answers.

Reassurance-seeking and continued research to find certainty are common compulsions in response to fears about schizophrenia or psychosis.

Other compulsions performed mentally or physically by people with fear of schizophrenia may include:

  • Reviewing social interactions, reviewing any possible symptoms you have been experiencing, and reviewing others’ reactions to your behaviors and conversations
  • Researching symptoms of schizophrenia
  • Seeking reassurance from medical professionals repeatedly, or from friends/family about how they perceive you
  • Avoiding situations that might seem over stimulating or stressful
  • Checking to see if you are thinking “correctly” about something.  
  • Attempting to cope with anxiety and fear by using substances

How to treat fear of schizophrenia

Schizophrenia related OCD can be debilitating, but it is highly treatable. By doing exposure and response prevention (ERP) therapy with an OCD specialist, you can learn to manage OCD and live free from constant fear.

You will start by identifying your thoughts and triggers and ranking them by the level of anxiety they cause. You’ll also identify any safety-seeking or compulsive behaviors you are using in an attempt to reduce your distress or resolve your fears. The compulsions might involve reviewing current and past behaviors, seeking reassurance from others and/or self, researching about various psychotic disorders, seeking multiple medical assessments and opinions, or avoiding situations and media that might trigger the thoughts and feelings. 

As you build an awareness of these factors, you will then build your treatment plan and work your way up your ladder of fears, starting with triggers that cause lower levels of distress to the higher levels. You will practice purposely triggering yourself to evoke various levels of distress, and learn to lean into the anxiety without trying to alleviate it by engaging in compulsions. 

Instead, you will learn to sit with uncertainty, possibly telling yourself non-engagement messages like “maybe I am, or maybe I’m not.” This process will allow you to habituate to the distress and uncertainty you feel, which will make it easier in the future to manage the distress whenever it comes in the future. You will retrain your brain that you are able to tolerate this uncertainty, which then results in a decrease in the distress you feel when the thoughts come up. In time, your thoughts and worries may feel like little more than background noise.

If you’re struggling with OCD, you can schedule a free 15-minute call today with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

We look forward to working with you.

Learn more about ERP
Patrick McGrath, PhD

Dr. McGrath is a Licensed Clinical Psychologist and the Chief Clinical Officer at NOCD. He is a member of the Scientific and Clinical Advisory Boards of the International OCD Foundation, a Fellow of the Association for Cognitive and Behavioral Therapies, and the author of "The OCD Answer Book" and "Don't Try Harder, Try Different."