Psychotic experiences, such as hearing voices, are surprisingly common, but can lead to diagnoses such as schizophrenia or bipolar disorder.
WHAT ARE PSYCHOTIC EXPERIENCES?
Also referred to as psychosis – a psychiatric term that describes experiences such as hearing voices seeing things or holding unusual beliefs, which other people don't hear/see or share. The psychotic episodes that a person experiences usually consist of hallucinations (seeing, hearing or feeling things that aren't there) and delusions (holding unusual/unfounded beliefs such as paranoia or feelings of importance). Some delusional ideas can be extremely frightening; for example, someone might believe that other beings are placing thoughts in their head, or trying to control or kill them. These ideas are called paranoid delusions.
These symptoms can be very distressing for sufferers and can lead them to become withdrawn, depressed and suicidal so it is vital that sufferers of psychosis get help. Psychiatrists regard these types of experiences as symptoms, and, depending on other factors, they will base a diagnosis on them. The diagnosis could be severe depression, schizophrenia, bipolar disorder, paranoia, psychotic illness, schizoaffective disorder, or puerperal psychosis (a very severe form of postnatal depression). These diagnoses are not clear-cut, and people may receive different diagnoses at different times.
Everyone’s experiences are unique. The majority hear voices, which may be recognizable or unfamiliar. There may be one or many of them talking to, or about, an individual. They might be present occasionally, or all the time, interfering with ordinary life, making concentration and conversation difficult. The voices may be benign and helpful, or hostile and nasty. Some people hear only positive voices, and may not regard them as a problem, others hear only negative ones, which causes great distress. The sufferers may feel the voices are in control of their body and can hurt them or punish them if they don’t do as they’re told. This may cause them to cut themselves or carry out other harmful types of behaviour.
Other psychotic experiences can take form of non-verbal thoughts, images and visions, tastes, smells and sensations, which have no apparent cause. For example, feeling as if insects were crawling under your skin, having a sensation like an electric shock, or smelling something that other people around you can’t.
WHAT CAUSES PSYCHOTIC EXPERIENCES?
Almost anyone can have a brief psychotic episode resulting from a lack of sleep, through illnesses and high fevers, or abusing alcohol or drugs. There is considerable evidence that psychotic experiences are connected to using cannabis in some vulnerable people. Experiences of this kind can also be a result of damage to the brain or dementia, of lead and mercury poisoning, or changes in blood sugar levels. There are different ideas about why psychotic experiences develop. But it’s generally thought that some people are more vulnerable to them, and that very stressful or traumatic events make them more likely to occur. A person's own attitude to their experience, as well as the attitude of those around them, also plays a part.
The experiences may involve biological changes in brain structure or brain chemistry, but its not clear whether these are the cause or the effect of the psychotic experience. Research into whether there’s an inherited vulnerability is inconclusive. If one member of a family is diagnosed with schizophrenia or bipolar disorder, then there seems to be more chance of another family member being similarly diagnosed, but no single gene has been found to be responsible. Early experiences in life may be important in helping to prevent, or contributing to, problems. One theory suggests that overcritical or over-protective families make people more vulnerable.
Psychosis can be treated in a number of ways once it has been diagnosed: anti-psychotic drugs, psychological therapies, hospitalisation and self-help.