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Vietnam Vet, PTSD or Schizophrenia?
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Vietnam Vet, PTSD or Schizophrenia?

I have been conversing online with a guy who came back from Nam with violent nightmares, but also the beliefs that he is a prophet specially chosen by God to carry a message that sin does not exist in God's eyes (he has rationalized killing during war to be God's will, as is all crimes committed).  He says he is capable of mind control and telepathy, though stops short of saying he hears auditory hallucinations.  The hospital that his wife put him in diagnosed it as schizophrenia, then after a second evaluation in the 1980's, they said it was 25% PTSD.  He does not believe he is schizophrenic at all, though I understand that many of those who suffer from this are in denial, and skip the medications.  He currently only takes 1 med to help him sleep, and seems afraid to take anything else, as it will "disrupt" his purpose of being God's chosen one.  He has been shunned by both his church and his family because of this.

Any advice?  Do schizophrenics believe they are telepathic?  
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585414_tn?1288944902
  "Thought insertion" and "thought removal" are two types of delusions  that can occur in schizophrenia although only a psychiatrist would understand the specifics  When a person has command hallucinations especially if they are in a state of grandiosity such as you described they need help right away. A person not understanding that they have schizophrenia and why treatment is needed is not uncommon. Sometimes a person is unaware they have auditory hallucinations as they seem like real voices to them. The best thing to do is encourage him to seek psychiatric help in a supportive manner as it will help him with recovery. The end goal should be for him to be stabilized on treatment and understand why he needs it. If he has thoughts like you described and they worsen he may need to go to the hospital regardless.
  I never reached that point myself as I always sought help on my own, responded well to current treatment and was finally able to stabilize on a treatment currently in Phase 2 FDA study. Antipsychotics can generally help a person stabilize enough to function in society and be free of the marked symptoms such as you describe although each person responds differently to each medication.
  PTSD and schizophrenia both can have psychosis but they are very different in cause and how they express themselves.A person can also have a mood disorder with schizophrenia such as in schizoaffective disorder which is my specific diagnosis. PTSD and schizophrenia also can sometimes occur at the same time. All this is best discussed with a psychiatrist and they can tell you what to do from there.
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1958148_tn?1330220055
Hi, thanks for your reply.  I copied a portion of one of his posts so you could get a feel for his thoughts (and yes, he wrote it in all caps):

"HOWEVER, JUST AS IT HAS BEEN FOR ALL THE OTHER PROPHETS AND MEN OF GOD THAT GOD HAS SENT INTO TO THIS WORLD TO BRING A GOOD-NEWS MESSAGE, INCLUDING JESUS, I AM BEING PERSECUTED. I AM TORMENTED BY UNGODLY NIGHTMARES AND I AM BEING BELEAGUERED BY UNGODLY PEOPLE. IF I CANNOT GET THE HELP I NEED FROM YOU, THE TRUE PEOPLE OF GOD, AND FROM THE GOVERNMENTS OF THE WORLD, INCLUDING THE GOVERNMEN OF THE UNITED STATES, TO STOP THESE VICIOUS ATTACK ON ME, I PROBABLY WILL NOT BE AROUND TO SEE THIS BOOK ON THE MARKET."

Paraniod schizophrenic sounding to me.  Anyone else have an opinion?
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675718_tn?1321008971
i have both PTSD+schizophrenia i suffer from nightmares flashbacks and auditory hallucinations as well, i agree with the paranoid sz. jaz71
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Avatar_m_tn
Oh, he definately sounds like he has the symptoms of almost bordering on pshychosis, which is worse than schizoprenia. Anyone that has it believes they do not, and they never want to take medication that will keep them rational. The 25% PTSD, Ive never heard a percentage based diagnosis, you have it or you dont. And Im not bellitleing this guy, because I have been in his situation.
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Avatar_m_tn
Deffinatelly give him your support and help finding proffesional care before something bad happens
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675718_tn?1321008971
that's right he should seek out treatment :)
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1958148_tn?1330220055
Hi, thanks for the replies.  I have suggested getting back on the meds, but he is convinced he only has PTSD (the more "socially acceptable" of the the diagnosis).  He won't discuss the details of what events happened that caused his wife to have him committed in 1984, but he is crushed about the isolation from his family for the past 27 years.  And yet, this mission from God is more important:  he has nightmares about people trying to kill him, accusing him of murdering while in Vietnam, he has been kicked out of his church, and his son and wife have had no contact.  At this point, his pride seems to be in the way, too, as going back on the meds would be admitting he was wrong all these years about his prophet fantasy.
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1958148_tn?1330220055
Here's another one of his posts:  "I could not be joined as one with my wife, so, I was turned over to the homosexuals. But, through their carelessness and unbelieving that God sent me into the world to bring a message, they have been causing me to be tormented for (27) years with telepathic dreams."

(For whatever reason, he believes that the psych ward of the Federal Mental Institution was full of telepathic homosexuals.)

What do schizophrenics do that lands them in a mental ward or jail?  He's been kicked out of his church, and I've never heard of such a thing.  Are sz's just really disruptive?  This guy argues the same points over and over, but of course, it's written, so even if he's mad, he still uses "please" and "God bless" in his posts.  
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1958148_tn?1330220055
What can I say to persuade this guy to go back on his meds?

What worked for everyone here?  Guilt, threats, being arrested, committed forcibly by family?
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585414_tn?1288944902
  I think the best thing to realize is that his behavior that may in some ways be manipulative and potentially psychotic means he is in need of help and if you have further concerns about how he can be required to follow up with treatment   if he is unable to understand the need it would be best to discuss this with his psychiatrist. Also it is crucial that he have appropriate outpatient treatment with community supports and services.
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Avatar_m_tn
n I really can count, and my illness is less threatening. See that he see's a doc asap, or else I really believe something bad will happen. Please?
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Avatar_m_tn
GET HIM HELP OR HOSPITALIZED please. for some reason it cut of the amount of my advice. Thank you and God Bless, your friend Really needs help asap. before its too late for him
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1958148_tn?1330220055
How????  I am not a relative, nor do I live near him.  He seems lonely and isolated, but is thrilled that he can connect with people online.  Of course, any posts he makes that would be nasty, angry or threatening would be removed by the moderators, so everyone obviously only sees the clean posts.

I do think that his candidness is a cry for help, though he seems protective of his condition.  He enjoys being a prophet from God on a special mission to rewrite the Bible.  I think he understands that on a cognitive level that to go on medication would remove this important status.

I have suggested going to the police or county courthouse for infomation on local walk-in clinics so that he can be (cough) re-evaluated about his "misdiagnosis" of SZ.
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585414_tn?1288944902
   Agencies like NAMI would likely have some information as to a list of walk in clinics. If things have worsened beyond that he might need to go to the hospital. Each state has specific laws about involuntary commitment and that would be a last resort but you could find that out. The first step would be to see if family members could be informed or if they will not help his psychiatrist. However if you are unfamiliar with any of this information then its more complex. Whatever site he is on might have specific rules about posts but might likely not be responsible for his welfare. It would be worthwhile to call this to the attention of someone who could. There are agencies that address this kind of concern if necessary.
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