Schizophrenia anxiety and anxiety can be intertwined with personality. When you have a severe mental illness, it is difficult to distinguish symptoms of that illness from your personality or life experiences (like upbringing, traumatic events, relationships, etc.). It can be hard to tell what is me and what is anxiety or schizophrenia. Some things are easy to pinpoint. For example, when I hear voices or become paranoid, it is clear that those are symptoms of schizophrenia. It is also easy to identify episodes of anxiety because that is so physically uncomfortable and obvious to me.

A lot of worrying comes with my schizoaffective anxiety. I am constantly worrying—ask anyone who knows me. Even someone who doesn’t know me that well knows that I worry all the time. And to top it all off, I blame myself for my worrying, even though it's anxiety-related. Here’s what it’s like.

I consider antipsychotic medication the most critical piece of my treatment. However, no matter how well the drugs work, I'm still human and have other things going on. On my best days, when I have very few symptoms of schizophrenia, I am still in relationships with others. I still have memories. I have habits. I have patterns of communicating, traumatic events that I've experienced, and a connection to myself. For example, I'm living with the grief of my dad moving into a nursing home and the aftermath of a global pandemic. For me, antipsychotics and therapy work together.

I have an extreme case of schizoaffective anxiety, and I’m preparing for major surgery. I’m getting knee replacements in both knees--one at a time. This anxiety spike about surgery is multi-faceted.

I want to make it clear that my identity is not just related to my schizophrenia. For nearly seven years, during my thirties, I lived almost schizophrenia and anxiety symptom-free. It was before I developed an anxiety disorder, and shortly after the period where I became treatment compliant and took my medication every day. I look back at that time as remarkable.

Support groups have helped me a lot with my schizoaffective disorder over the years. Here are some ways support groups have been beneficial. (Note: this post contains a trigger warning.)

Schizophrenia and routines are good partners. As someone with schizophrenia and generalized anxiety disorder (GAD), my mind can often feel chaotic. I might simultaneously experience olfactory hallucinations (smells), paranoia, and cycling thoughts about worst-case scenarios or other symptoms. These symptoms leave little space in my brain for health and wellbeing. That is why when I am at home, I follow a routine to add order and a sense of safety. Routines can give us a feeling that we have something we can count on when we have schizophrenia. They can also offer structure that can help with feeling out of control.

I formerly used earplugs to drown out the noise and chatter in restaurants and some other public places, but now I’ve switched to noise-canceling headphones to deal with the anxiety those noises cause. Let me tell you about them and about why I need noise-canceling headphones for anxiety in the first place.

Schizophrenia and addiction seem intertwined for me. I don't know if I am more prone to addiction because of my mental illnesses, but it seems like it. For years I smoked cigarettes, and I believe they were masking my more problematic symptoms and emotions or that smoking was a coping mechanism for the symptoms, which were increasing the older I got. I didn't have my first episode of psychosis until my late twenties. Still, before that, I dealt with anxiety, often staying up late into the night, going over every detail of every conversation I had earlier in the day -- constantly worrying that I said or did the wrong thing. 

Which is worse, having really bad arthritis in my knees or hearing voices? I don’t know. They both stink, and I’ve suffered from both. Not that rank needs to be pulled, but maybe I’ll figure out which one is worse--or which one I can cope with better--by writing about hearing voices versus arthritis.