How likely is it for someone to develop schizophrenia as the result of a TBI without having the genetic predisposition. Also, if a person thinks they are being possesed by some spirit, entity etc, is that considered dissociation, delusion, or something else? Thank you.

The diagnostic criteria for schizophrenia specifically excludes an identifiable medical source of symptoms. That’s not to say your character can’t exhibit some schizophrenia-like symptoms, just that they would not receive the diagnosis of schizophrenia.

The relevant diagnosis would actually be “Psychotic disorder due to another medical condition”, which is a bit different from schizophrenia.

I’ll do a quick Demystifying the DSM 5 breakdown of the criteria!

Psychotic disorder due to another medical condition

Prominent hallucinations or delusions
There needs to be evidence (either from the patient’s medical history, physical examinations, or lab tests) that these symptoms are directly caused by a medical condition.
It’s not better explained by another mental disorder.
It’s not just part of a delirium (see here).
These symptoms cause the character significant stress and/or make their life more difficult.

The actual diagnosis needs to follow the following formatting:

“Psychotic disorder due to [[insert medical condition here]] with [[whichever symptom is more dominant, delusions or hallucinations]]”.

You’ll notice that some of the symptoms of schizophrenia are missing from this. That’s because these other symptoms are really uncommon when a medical condition is causing psychosis.

There are some other things you should note specifically for Psychotic disorder due to traumatic brain injury:

There’s a specific type of brain injury that has been found to cause psychosis (lesions to the frontal and temporal lobes).
The psychosis tends not to show up immediately following the TBI; there’s usually a significant delay (we’re talking anywhere from months afterwards to 5-10 years afterwards).
Despite negative symptoms being extremely uncommon when psychosis is caused by a medical condition, when we’re talking specifically about TBIs, the symptoms may look a bit more like schizophrenia. About 37% will show negative symptoms.
The most common symptoms are:
Delusions (92%) - most commonly persecutory delusions
Hallucinations (87%) - most commonly auditory
Psychosis is not going to be the only symptom of the TBI. It’s also associated with seizures and highly comorbid with cognitive impairments in memory and executive functioning.
The majority of people with this disorder find their psychosis improves when treated with antipsychotics.

[[Source]]

As for your second question, it depends. I can go into that in another post; this one is pretty long already!

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scriptshrink

queen-of-pinkskull asked:

Can a traumatic brain injury cause a person to develop ADD like symptoms or partial epilepsy?

Yep. TBIs can cause a whole host of problems that can resemble ADHD, and seizures in the wake of a TBI are very common.

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scriptshrink

Personal experience - TBI

I had a stroke/CVA due to Traumatic Brain Injury as a child. This caused half my body to be temporarily paralyzed and me to have to relearn everything, including speaking, walking, moving the right side of my body, running, writing, using scissors, etc. I also had emotional difficulties because of it including an inability to control my emotions and tears when upset, migraine headaches as often as twice a week, aphasia (difficulty finding words), in addition to switching handedness, and potentially gender identity (as there was a sudden change in the gender I saw myself as between pre-stroke and post-stroke). i have also have depression, anxiety, ADHD, and executive dysfunction, all of which could potentially be exasperated by childhood stroke (and are recommended for screening of children who have had strokes in ongoing care, as they are more common in stroke cases). An Individualized Education Plan was also necessary, as it took me as long as four times as long to complete tests and homework and in-class activities. If anyone has any questions regarding strokes and their affect effects, I can help answer them as I experienced them.

Thank you for sharing your personal experiences! - Shrink

Submitted by lacommunarde

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scriptshrink

Anonymous asked:

is there a mental illness that makes it so someone is physically unable to lie? even if they want to

Not that I’m aware of, thought it’s possible some kind of medical thing such as traumatic brain injury that may produce such an effect.

The closest thing I can think of is someone with OCD whose symptoms focus on not being dishonest, but they’d still be capable of lying (even if it causes them to experience severe distress afterwards).

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scriptshrink

the-13th-rose asked:

Correct me if I'm wrong, but depression can be caused by head trauma, right? I'm asking because one of my characters develops depression as she grows up, and while it's partially a product of the environment she grows up in, it's also caused by permanent brain damage due to a serious head injury she suffered while very young. Is this realistic?

Yes, totally realistic. Two out of three people with traumatic brain injuries experience depression within seven years after their injury.

However, it’s not conclusively clear whether this depression is directly caused by a TBI’s impact on the brain itself, or a reaction to the aftermath.

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scriptshrink

Personal Experience: TBI

Hopefully everyone knows that a TBI is brain damage. It happens because the brain gets smushed against the skull that should be protecting it.

Most of the TBIs people hear about are the severe ones, with a coma of more than a day. I was only out for about an hour, making mine fit into either the minor or mild category. This means mine is not representative of all experiences, however people who have had a concussion may find similarities, as that is in the same type of TBI. One fact that gets overlooked is that even minor ones can have pretty huge impacts on daily life.

I will be using the terms mostly as they were explained to me, so I apologize if there is any confusion.

Submitted by koohiss

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scriptshrink

tawghasa asked:

I'm sorry this isn't about a real mental illness BUT I often see the trope of characters with brain powers like telekinesis or mental shields getting nosebleeds when they brain-power extra hard (Eleven in Stranger Things is the most recent one). Or people getting nose bleeds as a symptom of their minds being controlled by someone else. When brains bleed, does the blood even come out of the nose? What do you think of the trope, and are there any alternative symptoms of brain trauma we could use?

Oooh, this is an interesting question! This is one of those tropes that is so ubiquitous that it’s really difficult to fight off (much like ‘telepaths have their hands by their temple when they’re using their powers’). However, there are some other symptoms of brain injury that can indeed be used. (source)

My favorites are:

blood or clear fluid draining from the ears or nose
one pupil (dark area in the center of the eye) looks larger than the other eye
seizures

So yes, nosebleeds can in fact be a sign of brain trauma!

Some of these are hard to ‘fit in’ with an immediate sign of ‘oh shit they’re really pushing themselves’, but could easily work in the aftermath of doing so.

confusion
loss of consciousness
blurred vision
severe headache
vomiting
loss of short-term memory
slurred speech
difficult walking
dizziness
weakness in one side or area of the body
sweating
pale skin color
behavior changes including irritability

@scriptbrainscientist , do you have anything to add?

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