Two days ago, I started having an obsession about the possibility of getting schizophrenia. I am now 29 years old, and I know that this lowers the probability of getting schizophrenia. However, I believe I have some important risk factors, and I would like to know the real probability of developing this mental condition.

Since I was 22 years old, I was diagnosed with OCD, and since then, with ups and downs, I have had lots of irrational fears (with nearly 0 of this thoughts in the last 2 years, until now). For 5 years I took escitalopram, which helped me. My psychologist always told me that my thoughts had nothing “psychotic” in them.

Also, I was diagnosed with ADHD when I was 6 years old, and took ritalin for 4 years. They tested me again when I was 13, and they said that the ADHD was gone. I believe that this is a risk factor for schizophrenia.

My younger sibling, had a psychotic episode when taking LSD (about 3 years ago), and was later prescribed with antipsychotics for some time; this was the only episode that he had. Also, we know that my mother´s grandmother was hospitalized many times in a psychiatric hospital, we do not know if she had schizophrenia or any other mental illness.

It would really help me to get advice from you. This obsession is really making my life a nightmare. Thank you!

As I’ve mentioned many times in this column, one of the most common inquiries that I receive are from people who worry about developing schizophrenia. It’s especially prevalent among individuals with anxiety disorders. If you think about it, it makes sense. People with anxiety tend to focus on worst-case scenarios. In the minds of many people, schizophrenia is a frightening disorder, perhaps the most frightening of all of the mental health disorders. Thus, people with anxiety disorders often believe and worry that they may develop what they perceive as one of the worst mental health disorders, which, in their minds, is schizophrenia.

If you don’t have any of the symptoms of schizophrenia, then it’s highly unlikely that you would have the disorder. You may have some of the risk factors, including a family member who may have had schizophrenia, but that is no way means that you will develop it. Even if you did have a family member with schizophrenia, it would only slightly increase your risk.

It seems that your younger sibling had a psychotic episode because of their use of drugs. Research consistently indicates that drug use is a common risk factor for the development of psychotic disorders and schizophrenia. Had your sibling not used drugs, there may never have been a psychotic episode. The fact that there were no additional psychotic episodes would indicate that it was not a disorder and instead the result of drug use.

You didn’t mention your use of illicit drugs. If you don’t use illicit drugs, this significantly decreases your chances of developing schizophrenia or having a psychotic episode.

It’s likely that your concern about developing schizophrenia is a symptom of your anxiety disorder. If so, that would suggest that your anxiety is not well controlled. In that case, you should consult your treating professionals about this matter. Perhaps you need a different treatment to assist in reducing your anxiety symptoms.

No one knows what causes schizophrenia. Research indicates that there are both genetic and environmental factors. Some people have described it in this way: genetics loads the gun and the environment pulls the trigger. In other words, an individual may have an increased risk genetically of developing the disorder however genetics alone does not ensure the development of schizophrenia. Environmentally speaking, individuals with schizophrenia often have a litany of traumas in their lives that may have contributed to their psychotic episodes.

As discussed earlier, sometimes drug use can cause psychotic episodes. People who use hallucinogenic drugs are particularly susceptible. If you want to reduce your chances of having a psychotic episode, avoid illicit drugs.

Nothing that you’ve written in this letter would suggest that you have schizophrenia. Your concern about developing schizophrenia is not a symptom of schizophrenia. It’s a symptom of anxiety.

The best way to decrease one’s anxiety is to believe in reality. It would seem that the reality of your situation is that you have no symptoms of schizophrenia and an overall low probability of developing the disorder. I would also encourage you to discuss your concerns with your treating professionals. They know your case well and may be able to provide you with additional facts that may ease your anxiety. I hope that my answer helps in some small way. Please take care.

Dr. Kristina Randle