PDA

View Full Version : Mental illness and hallucinations



shaldna
04-07-2010, 02:53 PM
I need some help with mental illness, specifically any that cause hallucinations, or that have hallucinations as a symptom.

And other effects that this illness would have?

Thanks in advance guys.

CaroGirl
04-07-2010, 03:07 PM
Schizophrenia is characterized by hallucinations and delusions. As are some types of brain injury. The other symptoms are individual but can include such things as paranoia and OCD.

shaldna
04-07-2010, 03:38 PM
I was thinking about schizophrenia, perhaps more schizoaffective disorder because of the added complications of depression and/or bipolar.

Wiskel
04-07-2010, 04:08 PM
There is a little difference depending on whether you want auditory or visual.

Pretty much schizophrenia or any psychotic illness are the main candidates. Auditory hallucinations are the main types but visual are possible if less common. if you want to add some more detail, then auditory hallucinations sound real. They sound as though they have a point of origin in the room around you (you should be able to point to where they are coming from) and if it's a voice then you should be able to describe the voice. Then they get clasified as being either second person (talking to the character) or third person (like overhearing a voice talking about you). Third person hallucinations are what's called a first rank symptom of schizizophrenia meaning they are very uncommon in someone who isn't psychotic and almost (but not quite) diagnostic of an illness like schizophrenia. The hallucinations in a psychotic illness can be as wierd as you like.

Visual hallucinations do happen in psychosis, but are much more common in organic illness such as brain tumours, head injury, delirium or alcohol withdrawal (delirium tremens). Drugs are another major cause.

Mood disorders, if they become psychotic, tend to create hallucinations and delusions consistant with the mood. A depressed person may have illness, death, etc as themes. A manic person is more likely to hear some sort of meaningful message telling them how great they are.

Final pointer is that apart from confusion and delirium, most hallucinations limit themselves to one sense. The first thing i think when someone tells me there is a person in the room that they can clearly see and who is talking to them is that they are delirious or making it up. If they add in the smell of his cigarette and say they can feel him touching them then I'm pretty certain it's their imagination. The different senses are mapped out to different parts of the brain and they do odd things independently of each other, not usually in synch.

Craig

Maryn
04-07-2010, 04:36 PM
Lewy Body Dementia also causes vivid hallucinations. Its other symptoms include physical trembling and hesitant gait virtually identical to Parkinson's (although not in the illness's early stages), memory loss, inability to make decisions, and (most frustrating), the in-and-out nature of the mental loss, so that some days the person is his/her normal self, other days hallucinatory and more.

Maryn, reminded of Lewy by an article in today's paper

shaldna
04-07-2010, 05:12 PM
Final pointer is that apart from confusion and delirium, most hallucinations limit themselves to one sense. The first thing i think when someone tells me there is a person in the room that they can clearly see and who is talking to them is that they are delirious or making it up. If they add in the smell of his cigarette and say they can feel him touching them then I'm pretty certain it's their imagination. The different senses are mapped out to different parts of the brain and they do odd things independently of each other, not usually in synch.


This is exactly what I needed. So, just so I get this right, someone should only have an hallucination of one sense? Either see something, or hear it, or feel it, but not all of them, assuming it's not delirium.?

So if I had a character who was experiencing hallucinations of a person that they could see and talk to and touch it would, under normal circumstances, most likely be considered to be making it up? Would that still be considered the case if this person has a history of an illness like schizophrenia?

Wiskel
04-07-2010, 08:04 PM
This is exactly what I needed. So, just so I get this right, someone should only have an hallucination of one sense? Either see something, or hear it, or feel it, but not all of them, assuming it's not delirium.?

So if I had a character who was experiencing hallucinations of a person that they could see and talk to and touch it would, under normal circumstances, most likely be considered to be making it up? Would that still be considered the case if this person has a history of an illness like schizophrenia?

People are still people. They still have their own agendas and someone with schizophrenia can still lie to me...either to make me think they're well or, sometimes to make me think they're ill.

Hallucinations that cross senses don't make logical sense if you think about the neurology. Delirium basically equates to confusion. A confused person will not be able to make sense of their experience to describe it accurately. They confabulate (meaning make it up as they go along) and so something that is part true gets embelished or just plain jumbled up.

My thought process if someone told me that they had an all singing, all dancing hallucination they could see, hear and touch would make me instantly suspicious. If they had no history of mental illness I'd suspect a confusional state or a drug high and run blood tests to check for both. I'd also want to book an MRI. If the tests were fine, I might admit them to a ward for observation. I'd be cautious enough to think they might be ill, but extremely suspicious and probably wouldn't give them any medication. I'd have the nurses watch them very closely.

If they had a history of mentla illness then I'd start thinking they might be ill but also wonder what they had to gain by making me think they were more ill than they actually were. Same blood tests would happen. Might do an MRI but might leave it a couple of days. I'd wonder if they owed someone money and wanted to be admitted to hospital to hide from them (seen that happen before), or suspect they might have committed a crime and be looking for a doctor to tell the police how ill they were. (seen that too). I'd probably admit them to hospital for observation, but be looking for signs of what they had to gain from it.

These situations work on the principle that delirium is dangerous so exclude that first. Drug high is very likely so check for that. Malingering or something to gain are also likely but having them on a ward is safest so probably admit, wait, watch and try to solve the puzzle.

Craig

waylander
04-07-2010, 10:14 PM
I have been with a member of my family who is schizophrenic when she was hallucinating.

StephanieFox
04-08-2010, 01:26 AM
Severe mania, as part of manic-depressive episode, can cause hallucinations.

backslashbaby
04-08-2010, 05:25 AM
So interesting :) Remember that schizophrenia usually has at least a handful of other noticeable symptoms; those differ based on the type of schizophrenia it is. Depression or bipolar can also coexist with schizophrenia; in fact, it's relatively common.

I don't recall if schizoaffective disorder usually has full-blown hallucinations? I'm leaning toward not, but that's just a heads up...

Mr Flibble
04-08-2010, 10:38 AM
Severe mania, as part of manic-depressive episode, can cause hallucinations.


So can the depressive phase if it's severe


Mostly auditory for me, either way.

shaldna
04-08-2010, 12:27 PM
Thanks for the help guys. Your all brilliant. Especially Wiskel.


Also, can I ask a couple more questions.

1. as a bystander what would you experience or notice about someone having an hallucination - of any type, but specifically a visual or auditory

2. is it possible for someone to hide their illness from family and friends? other than a few odd moments/incidents of the sort that can be written off as stress or similar?

Mr Flibble
04-08-2010, 04:30 PM
1 - not necessarily anything. Unless I answer back :D Though it can be obvious, that's not a given

2 - Absolutely though it would depend on a) the severity of the symptoms and b) if the sufferer is either ashamed of what the hallucinations are showing / telling him and / or knows something isn't quite right


I was the only one who knew I had them until last year when I 'fessed all to my doc ( I Knew something wasn't right, wasn't sure what. We soon found out) I'd had these things for years and because I knew other people didn't experience these things, I didn't want to appear even odder than I was, in fact, being during those times.

shaldna
04-08-2010, 04:55 PM
So it's fair to assume that someone could hide their condition from a close family member for a prolonged period of time.

Mayfield
04-08-2010, 06:01 PM
Does it need to be a mental illness? Some of the sleep disorders can cause very vivid hypnopompic and hypnagocic hallucinations. They can mix senses since it's basically dreaming while awake (not psychosis). When combined with sleep paralysis, these are very unpleasant experiences. They're a common symptom in narcolepsy.

shaldna
04-08-2010, 06:22 PM
Does it need to be a mental illness?

Yes, it needs to be a mental disorder. I need no one to believe this character because of their history.other factors that will reduce the credability of a witness other than just hallucinations.

Wiskel
04-08-2010, 06:31 PM
Also, can I ask a couple more questions.

1. as a bystander what would you experience or notice about someone having an hallucination - of any type, but specifically a visual or auditory

2. is it possible for someone to hide their illness from family and friends? other than a few odd moments/incidents of the sort that can be written off as stress or similar?

Glad to help.

1. The hallucination seems real to the person. The reaction depends on the emotion it generates. Just describe what you'd do.

If it's auditory and I was alone in a room, I'd start looking around to see where the sound came from. When i couldn't see anything I might answer it and ask who was there. I might walk over to the part the the room the sound was coming from and look around carefully. I might look out of the wondow and poke my head out of the door to see if anyone was playing a trick on me. I'd react differently to a voice calming saying my name than I would to a voice screaming at me that I was about to die.

If I was sitting and talking to you when i heard something, it would distract me. You'd notice that you didn't have my full attention. My gaze might keep flicking to something that you couldn't see. I might have to ask you to repeat what you said as at times I'd be listening to the voice more than I was listening to you. I might even ask you if you could hear it. if it was a scary hallucination i might look, anxious, scared, uncomfortable.

A visual hallucination is going to going to be similar. Without sound it won't be as distracting during a conversation but the temptation to look at it is greater. If I'm alone I might talk to it, if it's a person ask who they are. Maybe walk across to it and try to touch it (my hand would go through a hallucination) Again, different reaction if I see a nice friendly old lady in the corner of the room than if I see a clown holding a knife and a human head.

The key is to recognise that the hallucination is as real as anything else in the room to the sufferer. The way they react to a hallucination of a clown holding a human head will be the same as how they'd react to a clown holding a human head......but if it's happened before. If they've already investigated it....if they've recognised that it's not real then they may try to hide their reaction.

2. Definately. Many people hide hallucinations very successfully for ages. Whether you can hide an illness depends on the illness. If it's psychosis, you can more successfully hide a delusion that aliens want to eat your brain than a belief that your wife wants to eat your brain. If you believe that, you won't want to sleep next to her anymore and you'll start checking your meals for posion. It's hard to hide the low mood and low energy that goes with depression, people will notice you're not yourself even if they don't know why....it's also hard to hide the general elation that goes with mania from someone who knows you well.

Craig

shaldna
04-08-2010, 06:43 PM
So while people might notice something was off, they wouldn't necessarily know what?

shadowwalker
04-08-2010, 07:04 PM
It's hard to hide the low mood and low energy that goes with depression, people will notice you're not yourself even if they don't know why....

Just a quick comment - from experience, it's very easy to hide even deep depression from family and friends. Look at all the suicides where no one realized they were at all depressed. But that's for another thread, another time. ;)

Wiskel
04-08-2010, 07:47 PM
So while people might notice something was off, they wouldn't necessarily know what?

They might notice nothing more than the person looking distracted or uncomfortable. They might notice nothing.

There have been times when it's taken weeks for doctors and nurses to realise someone was hallucinating while under observation on a psychiatric ward. There are probably some people who have masked ther symptoms so completely that professionals still don't know they have them. There are also some people who I can tell are hallucinating with absolute certainity after meeting them for 5 minutes even if they deny it. Most people are somewhere in the middle.


Shadowwalker...totally take your point. Anything except frank thought disorder can be masked with enough effort, although the better someone knows you, the more likely they are to see through the mask.

Craig

backslashbaby
04-08-2010, 08:57 PM
Schizophrenics usually seem odd in other ways (if unmedicated), but someone could just think they were odd. Their language can be strange (a symptom), they can take things very literally (a symptom), and I've found they ask strange questions. In other words, they tend to have a bit of a world of their own, although they try to seem normal, of course.

But it has levels of severity too. You might think they were just behaving a little strangely if it's not severe.

Bipolars are harder to spot, imho. The mania can be very fun for folks around them, and they don't have as much odd stuff, frankly: big plans, maybe lots of sex ;) Things that sound more relatable, if that makes sense. The bipolars I know who hallucinated also didn't let on about that part, and I wouldn't have known.

I'm generalizing a lot here, btw. There are levels of severity that make a huge difference!

shaldna
04-09-2010, 02:30 PM
Again, that you guys. This is exactly what I needed. Thank you all for sharing experiences and for the input on this. I'd have never gotten this from research papers.

KTC
04-09-2010, 02:45 PM
Severe mania, as part of manic-depressive episode, can cause hallucinations.

Yes.

DrummerGirl
04-10-2010, 06:09 AM
Hey, I dont mind sharing a bit, but I'm not sure how helpful it will be :)

I have bipolar and OCPD. I have had it since late teens, but was formally diagnosed two years ago. I have had various paranoid ideas at different stages, but only once have I had hallucinations and that was last year.

I was on the verge of a major depressive/manic episode (I was in a bit of a mixed state).

I was very jumpy and on edge and not sleeping, anxious, etc. At this point, I also became paranoid: Our fridge was having problems -- the seal thing wasnt working, as a result, the carrots kept going slimy. Anyway, I became convinced that the carrots going funny was a sign, proof that they "saw through me" and it was also an omen that bad things were going to happen to me. I am including this so you can get a feel for my state of mind. (I dont know what they were seeing through me, they just were and I knew I was going to be exposed. As what or for what, I have no idea, but it was very real).

Then, I started "seeing" dead mice around. I would just suddenly see a dead mouse on the floor of the lounge room out of the corner of my eye and then when I looked again, it would be gone. For a period of about a week, I would see about three or four a day in random spots. On the lawn, the road, the floor of the car. Everytime after seeing them though, I would look back and they wouldnt be there.

At this time, I believed what I saw, and knew it meant bad things were going to happen. I also knew deep down that no one else was aware of the dead mice, so I didnt say anything. It's hard to explain, knowing something is real, and yet knowing I shouldnt talk about it as it was only a sign for me or something.

incidentally, I also saw a dead mouse while in my psychaitrists office :D but I wasnt' saying a word about it, as i didnt want to alert anyone that I was getting unwell. On this occasion (my mice hallucinations), I didnt end up having a full episode of mania or major depressive episode. I ended up using my Stay well Plan and managed to stave off a full blown incident. I only spoke of the mice and carrots to my husband a few months after, when I was able to see the incidents for what it was: my bipolar state and not real life.

now to your questions.

1. No one knew about the dead mice. I didnt talk about it and I was mostly by myself when I saw them. I think my reaction would have been noticable in my facial expressions only -- and even then, I didnt have a theatrical reaction, more a muted response (not that I wasnt unnerved). Although I was particularly jumpy anyway, in the weeks up to this. (whenever someone said my name, walked into a room, I'd be startled.)

2. Yes, I got to a full state of mania before anyone really knew I was sick. Although my parents were thinking I had post-natal depression, and then I was having anxiety/panic attacks/insomnia, etc and was diagnosed with Grave's disease, which I think masked a lot of my bi-polarness (or explained some of it away) so maybe i am not a good example of this? Anyway, everyone just thought I was stressed :)


I have only incuded the one story about my hallucinations, but I did some odd/unusual things in my late teens and masked it all. It was like I was living a secret life and now I realise I had minor episodes and no one really noticed apart from thinking I was a moody teenager, hyperactive teenager, etc. When my diagnosis came out, my family were able to look back and see that, yes, I suffered with bipolar as a late teen (from around 16yrs) but at the time they didnt pick up on it.

In other words, I hid my mental state from my family and friends for a long period of time :) If you have any specific questions for me, I'm happy for you to PM me :)

shaldna
04-13-2010, 03:59 PM
Ok, so I get the sense that there are certain hallucinations that will repeat themselves, is that right?

Would I be fair to say that for some people they could keep seeing the same thing?

OneWriter
04-13-2010, 05:35 PM
Sorry, this goes back to earlier questions of yours, but have you checked this wiki page:

http://en.wikipedia.org/wiki/Psychotic_depression

It spells nicely the difference between schizofrenia and maniac depression.
I've used it for my current WIP, although I confess that hallucinations in a story are SO much better when they encompass all senses!!! I understand it doesn't happen this way, I had the revelation from a psychiatric friend of mine when he commented on how "Hollywood" the hallucinations in a Beautiful Mind were, though that's what makes the movie so intriguing...

backslashbaby
04-13-2010, 08:04 PM
Someone I know saw werewolves at night (bipolar, up for days). She saw them again and again, yes. She only hallucinated alone, usually when she was trying to sleep but couldn't due to mania.

I know from my studies that folks hear things like, "Kill your children" over and over. Or they believe that the CIA can see them from their TV, etc (which recurrs). There are delusions that can include hallucinations, and delusions are pretty recurrent by definition.

Wiskel
04-14-2010, 10:28 AM
Ok, so I get the sense that there are certain hallucinations that will repeat themselves, is that right?

Would I be fair to say that for some people they could keep seeing the same thing?

Yes

Seeing something entirely different every time would actually be very unusual unless the cause was drugs or delirium.

Seeing the same thing over and over, although perhaps in different contexts or in slightly different ways would be common. Seeing things that at least share a theme, like "faces" is also common.

Craig

swansongunsung
04-14-2010, 11:03 AM
Hey, I dont mind sharing a bit, but I'm not sure how helpful it will be :)
I'm sure it is very helpful. It take a lot of guts to share something like that. If lurkers on this site have had the same symptoms as yourself, I am sure they take comfort from knowing that they are not alone. Thank you.

shaldna
04-14-2010, 12:13 PM
Thanks guys. I've had hallucinations linked to my insomnia in the past, the sort of blink and you'll miss it, out of the corner of your eye, might just be a trick of the light kind of hallucinations which I gather is very common in sleep related disorders.

WriteKnight
04-14-2010, 08:35 PM
Hope this isn't a hijack - but I'd like to ask about PTSD and hallucinations. Again, Hollywood likes to have 'full blown' hallucinations with sight, sound and smell as a reaction to stimuli based on Past Stress events. Is this a factual representation? I'm thinking particularly about Combat related PTSD. Sure, a car backfires, and for a brief instant, there is a moment of panic - completely believable - but I'm working with the concept of seeing the street become a street scene from combat - seeing a person you're talking to become the face of the enemy - that sort of thing.

Any one care to comment?

shadowwalker
04-14-2010, 09:59 PM
Hope this isn't a hijack - but I'd like to ask about PTSD and hallucinations. Again, Hollywood likes to have 'full blown' hallucinations with sight, sound and smell as a reaction to stimuli based on Past Stress events. Is this a factual representation? I'm thinking particularly about Combat related PTSD. Sure, a car backfires, and for a brief instant, there is a moment of panic - completely believable - but I'm working with the concept of seeing the street become a street scene from combat - seeing a person you're talking to become the face of the enemy - that sort of thing.

Any one care to comment?

An excellent source (IMHO) is here:

http://www.mnwelldir.org/docs/mental_health/ptsd.htm

Wiskel
04-14-2010, 10:04 PM
Hope this isn't a hijack - but I'd like to ask about PTSD and hallucinations. Again, Hollywood likes to have 'full blown' hallucinations with sight, sound and smell as a reaction to stimuli based on Past Stress events. Is this a factual representation? I'm thinking particularly about Combat related PTSD. Sure, a car backfires, and for a brief instant, there is a moment of panic - completely believable - but I'm working with the concept of seeing the street become a street scene from combat - seeing a person you're talking to become the face of the enemy - that sort of thing.

Any one care to comment?

You need to seperate "flashbacks" from hallucinations. Flashbacks are a part of PTSD, hallucinations aren't. I have to clarify that a little by saying that anything can happen in any condition, especially as there is no rule saying you can only have one condition at a time.

It's a little harder for me to describe the experience of a flashback than for me to describe a hallucination. First hand accounts from someone who has had them will give a better description then I can.

To help understand the difference.

A hallucination is the perception of a stimulus that isn't there. You see something that isn't there, or hear it, or smell it etc.

A flashback is the vivid reliving of an experience or memory.

A second clarification. No memory is 100% and there is room for a little difference in the experience each time it is relived, and sometimes it might merge with a daydream and change a little, but flashbacks are generally true to what happened. They would never be fantastic, ie a soldier would never flashback to a memory and suddenly find a demon there. Someone who'd spent time in a warzone might have a lot of different traumatic experiences and so have flashbacks to a number of different events.

You see or hear a hallucination in addition to whatever else you're experiencing. A flashback might be partial, ie a soldier might hear the sounds of guns and explosions but not get the visuals sometimes and that experience might be very similar to a hallucination. At other times it will be a full blown experience almost as real as being there....at that point everything else around you may seem to fade into the background and seem unimportant next to the flashback. The person may look as though they're either daydreaming or preoccupied.

The neurolgy of a flashback and a hallucination is different. Hallucinations usually effect one sense in isolation. A flashback can include all of them in synch. Scans of brain activity done during flashbacks show that the sensory areas of the brain light up in much the same way as they would during a real experience.

Someone experiencing a flashback would usually know exactly what had just happened to them and know it wasn't actually real (even though it felt real). It is usually traumatic and distressing.

Craig

WriteKnight
04-14-2010, 10:28 PM
Craig - excellent post - thank you for the info. This is along the lines of what I'm working with. I sent you a more detailed message to your inbox.

Xelebes
04-16-2010, 02:37 AM
Asperger's and Autism sometimes have hallucinations of sensitivity (psychotic episodes) which often lead to meltdowns.

backslashbaby
04-16-2010, 03:24 AM
I had hallucinations (or vivid, short delusions) when I had PTSD and had blocked the precipatating event. I was terrified to look at my friend's face one night, for instance (afraid she'd be a monster). I was afraid that ceiling fans would chop my head off if I sat up in beds they were under.

Long story short, they were hints, so to speak. They were like symbolism for the two events that caused my PTSD (my best friend was the cause of one event).

I don't know if that adds anything, or what that would be called, but there ya go :)