Can a person with Schizophrenia also have a second personality or identity that they interact with at the same

Question

time?

Like can the original identity or person talk to/interact with the second identity as if it were a second physical person?

(For a fictitious character, his/her condition has to be accurate)

Answer 1

Please, please do not confuse Schizophrenia with Dissociative Identity Disorder!!!! They are two separate and distinct disorders with very different origins and treatment. Colin Ross does postulate a subtype of schizophrenia called dissociative schizophrenia which has origins in trauma, however this would be a small fraction of true schizophrenics, many of whom are misdiagnosed and are more accurately assessed as DID. The confusion comes from an overlap in symptoms-both experience auditory hallucinations. In schizophrenia, voices come from outside the head whereas in DID they come from inside the head and represent different alters communicating with one another.
If you are looking for accuracy in portraying a fictional character, please read the following information:

Schizophrenia:

Schizophrenia is an illness that is biogically based. You inherit a predisposition for the disorder which is generally triggered by stress. The typical age of onset is in the late teens to early 20's (the college years).

The general characteristics include both "positive" (acute) symptoms and "negative" (residual) symptoms and there is a prodromal phase, acute phases and residual phases. There are a lot of technical aspects to the correct diagnosis which I won't elaborate, but in general the characteristic signs are any combination of the following:

"Positive" signs:
-Hallucinations (primarily auditory, less often visual and rarely tactile, gustatory or olfactory)
-Delusions (fixed or variable, paranoid/persecutory and grandiose, somatic, erotomanic, nihilistic, etc.-they run the gamut of various types, "ideas of reference" where a person believes that random events have a special meaning meant just for them, delusions of thought control or thought insertion)
-Disorganized Thinking ("Loose associations" where thoughts are strung together with little cohesiveness, "perseveration" where a person gets stuck on the same thought or theme over and over like a needle that skips on a record and keeps replaying )
-Disorganized Behavior (catatonic excitement, catatonic stupor which is like posturing-usually only seen in extremely severe cases and rarely any more)
-Poor Concentration and inability to focus on a thought, sometimes "blocking" where a thought becomes interrupted in midstream)
-Disorganized speech (incoherence, rambling or circumstantial speech-lots of fancy terms like echolalia, word salad, verbigeration, clanging)
-Inappropriate Affect (inappropriate giggling, tears, silliness, etc. that is out of context to the situation)

"Negative" signs:
-social withdrawal and preference to isolate
-flattened or blunted affect (emotional expression)
-Amotivation (lack of motivation, apparent apathy)

There are 5 distinct types:
1-Paranoid: most organized thinking of the types-prominent delusions and hallucinations
2-Disorganized (Hebephrenic): Grossly disorganized thinking and behavior predominates and inappropriate affect
3-Catatonic: catonia, rarely seen any more
4-Undifferentiated: no clear predominant symptoms
5-Residual: Primary negative symptoms-often seen as a "burned out" version where there are fewer positive or acute symptoms

Schizophrenics often are able to maintain jobs in low stress environments with minimal interpersonal demands once they are stabilized. Others may work in sheltered employment with support and guidance. Social skills are greatly impaired and schizophrenics often have great difficulty reading the social cues most of us take for granted and thus they misjudge or misread social situations which reinforces their tendency to self-isolate as do paranoid symptoms. Intimacy is exceptionally difficult as well and they rarely form close or deep bonds with others, making it difficult to function as husbands and parents. They tend to appear aloof and distant emotionally, although often this is a way of coping with feelings of being overwhelmed by other people's emotional expression and demands.

Medication often serves to either completely control the acute symptoms or dampen their impact, but tends to have minimal impact on the negative symptoms. The side effects are often horrendous and intolerable and this leads to a familiar pattern of stopping medication, beginning the trend of repeated courses of decompensation leading to re-hospitalization.

The ineffectiveness of meds and the emotional blunting they can cause often leads to attempts to self-medicate with alcohol or marijuana (usually) which often increase symptoms.

Schizophrenics often perceive the world in unigue and idiosyncratic ways which can cause them difficulty in complying with social norms and expectations, even simple things like generally accepted standards for cleanliness or hygiene. It can also lead them to exceptional creativity and expression in arts and abstract disciplines. Examples of famous schizophrenics are the poet and artist, William Blake (I have many of his works in my office for inspiration) and John Nash, the Nobel Prize winner featured in the movie "A Beautiful MInd".


Dissociative Identity Disorder/Multiple Personality Disorder:

DID is the existence of two or more separate personalities or personality states within one person, with each alter having distinctly different ways of thinking, feeling, behaving and relating to the world and distinctly different memories, each part having amnesia for the other parts' memories. It is born from repeated and severe abuse and involves the defense mechanism of dissociation and generally develops before the age of 10 as children are far more likely to dissociate.
DID is often misdiagnosed and it is very common for a person to have had multiple different psychiatric diagnoses before it is definitively identified as DID. The symptoms frequently overlap with symptoms of schizophrenia, Bipolar Disorder, Depression, Anxiety Disorders (all), PTSD, other Dissociative Disorders and Somatoform Disorders as well as Borderline Personality. It requires extremely careful assessment and a high level of trust by the patient before alters reveal themselves. The diagnosis cannot be finalized before a therapist has actually made contact with another alter and observed the switch between alters.
The hallmark symptom is amnesia, which can be partial or complete depending on the level co-consciousness that exists between alters. Folks with the disorder describe the amnesia as "missing time" or blank periods, often daily or weekly, where they cannot account for their whereabouts or behavior. It is this amnesic barrier between parts that often leads to the most bizarre and distinctive signs and symptoms: not recognizing familiar people; not remembering highly significant events in their lives (like the birth of their first child, for example); finding purchases or articles of clothing/possessions, writings or drawings that they have no recollection of having bought or created. They are frequently accused of lying because they disawow their own behavior which is remembered by one part, while the amnestic part is completely unaware of it. Other unusual symptoms include: an exceptionally high tolerance for physical pain (they split off physical sensation which becomes encapsulated in one or several alters without others feeling it); not recognizing themselves in a mirror; using different names; having dramatically different skills and abilities that seem to be alternately present and then vanish (one alter may be able to drive a car while the sudden emergence of a child alter results in complete loss of this ability until the adult alter re-emerges); completely different opinions and behaviors (leading to the mislabelling of Bipolar or Borderline Personality.
Often communication across between separate alters takes place in the form of hearing voices, hence these folks frequently get misdiagnosed as schizophrenic. The key distinction here is whether the voices are experienced as coming from inside the person's head (DID) or outside one's head (Schizophrenia/Bipolar Disorder).
The separate identities develop in response to traumatic experiences which the child is unable to integrate and so they become "split off" from awareness and begin to take on a life of their own.
Folks with DID often self-injure, frequently a result of internal battles between persecutor alters and weaker alters and there are continual battles for control of the body and "time out" in the body between competing alters.
Symptoms of depression and anxiety are frequent and common and the picture is further complicated by the fact that one alter can meet all clinical criteria for Depression, while another part experiences no symptoms whatsoever. One part can be psychotic and experience no side effects from meds while another non-psychotic part has all the side effects and will stop taking meds.You can imagine that attempting to medicate such a disorder becomes an absolute nightmare.
Other symptoms include flashbacks and nightmares, hence the confusion with PTSD. Sometimes there are fugue states and clients will switch and "come to" in the body and have no idea how they arrived in the situation they are in, not know the people they are with and be completely disoriented. I had one client call me from another state after being away for a few days and having no idea how she got there or how to get home. Depersonalization and trance states are common and hence the overlap with other Dissociative disorders.
Folks with DID frequently experience multiple somatic symptoms for which there is no organic basis. They experience partial body memories of abuse without the actual memory of the event and thus exhibit strange physiological symptoms and are often labelled as Somatoform disorders or hypochondriacs.
I could go on and on, but suffice it to say that virtually any symptom of any disorder can be found at some point in a person with DID. Treatment is almost exclusively through psychotherapy as medication is merely palliative and an adjunct during periods of acute anxiety or depression. Treatment aims at initially contracting against suicidal and self-destructive behavior and attempts to establish safety first. Many DID folks enter treatment in horrendous circumstances where they are frequently in highly abusive relationships or are themselves abusive. Given the multiple alters, they may be both victim and perpetrator both within themselves alone and in the context of their relationships. The second primary goal is establishing communication and negotiation among alters to decrease amnesia and contradictory, self-defeating behavior. Ultimately the goal becomes integration of alters into one cohesive whole which involves sharing of memories and feelings across alters and a merging, where all parts continue to be present, but constant.

Answer 2

My mom had schizophrenia she was different from day to day. She was really scared of everything and everyone even her own family. I'm not sure as far a professional advise but as far as personal I have more info. one person should ever know about the incurable decease. My mom was normal until I was about 16teen then she got depressed and then the same year she went missing for a year leaving me and my sister behind. Not normal for a mother who took her children to church 2 or 3 day a week and never let us go out after dark. She was a good mom. The decease was CRAZY and I mean CRAZY. She came home and one year she would be ok and the next really sick. She would go missing about 3or 4 times a year and go live on the streets always running. But yes she was not herself to me it almost seemed demonic. It is a sad and strange disease. I had always thought of schizophrenia of someone that had always crazy. not my mom's case. They are ok if they are on there medicine but guess what they are usually scared of there medicine. My mom was there for my last son birth he was born in Aug and she hung her self in November. 2003 so from day to day things could change but I'm not sure about second identity. I was twenty four when she took her life. I know that my mom would have never did what she did but she was sick. I hope this helped if not It helped me to write about it. Good Luck.
Angie

Answer 3

What you're describing sounds more like Dissociative Identity Disorder (Multiple Personality Disorder). Schizophrenia is a much different disorder.

Answer 4

contrary to what a lot of people believe, schizophrenics do not have multiple personalities(ex. when Jim Carrey in me myself and irene is diagnosed schizophrenic) however one of the core components of schizophrenia is hallucinations. this can include seeing a person beside you that is not really ther. this can be paires with hearing that person talk and can seem so real to schizophrenics that they are almost impossible to convince some that the person is not real, and yes they will interact with them at times. hope that helps.

Answer 5

Definitely. Though I think that is more to do with psychosis which often goes along with schizophrenia.