Tag Archive | Hallucination

PTSD and Schizophrenia May Be in the Same Spectrum

PTSD and Schizophrenia may be related as varying degrees of a similar malfunction.

I was describing a recent flashback to my therapist, and I finally got brave and actually described it without watering it down. I told her how it seemed so real, and that I could see, hear, feel, smell – everything- my past superimposing and flickering over my present – leaving me unsure for moments which age I actually was.  I told her I was afraid to say that before, afraid I would get taken away and locked up. She smiled her sad smile at me, knowing what I meant. I asked her if any of her other clients describe flashbacks as powerful hallucinations – and she said yes.

So that got me thinking – woah – what if my brother’s schizophrenia is similar to my PTSD flashbacks? What if all hallucinations work on the same mechanism, the same spectrum of disorder, but that schizophrenia is much more severe?

What if schizophrenia is a flashback that doesn’t end with a safe return to reality?  I shudder at the thought. 

Turns out some recent studies have been thinking along the same lines. Check out this article: http://healingattention.org/documents/doc_litreviewpsychosis.pdf

Excerpts from that article:

“Paranoid delusions: faulty attempts to explain traumabased hallucinations? Some people, when faced
with negative, emotionally loaded, or unusual or anomalous experiences quickly jump to the
suspicion of external threat, i.e. they become paranoid. Hearing voices when there is nobody
there is often (but not always) a negative experience, and is often experienced as unusual

or anomalous. Paranoid delusions are sometimes, therefore, understandable attempts to make sense
of hallucinations (in various sense modalities) (106, 146–148, 155–157).
Paranoid delusions can, of course, develop in the absence of hallucinations. Is there a difference
between the hypervigilance to threat acknowledged in PTSD patients to be the outcome of
trauma and the belief that people are out to get you which is labelled delusional in traumatized
people diagnosed psychotic? (30, 33). Having been severely or repeatedly abused as a child is
likely to render other people a serious potential threat, a threat that can easily be generalized to
anyone or anything that is reminiscent of the perpetrator or the circumstances surrounding the
abuse. The processes by which hypervigilance develops into fixed paranoid delusions would
appear to be a fruitful research avenue. Again, Nadel and Jacob’s (159) work on the impact of
trauma on the brain is salient. Whether we label this PTSD, DID or schizophrenia, the resulting
fear, distortions and impoverishment of lives remain. Heightened sensitivity to stressors: the Traumagenic
Neurodevelopmental (TN) model Many of the theories attempting to explain trauma’s relationships with hallucinations and
delusions, such as high levels of distress in the face of anomalous experiences and hypervigilance
to threat, are consistent with a heightened sensitivity to stress in general. A study of 271 severely ill
in-patients found that the two subscales of the Brief Symptom Inventory most strongly related to
sexual and physical abuse were psychoticism and interpersonal sensitivity (164).
Heightened reactivity to stressors is a cardinal feature of schizophrenia (165) and is considered
the core of the constitutional vulnerability that forms the diathesis in the stress-diathesis model.”

A good day for someone with schizophrenia

Once in a while, I get to talk to my brother without the schizophrenia getting in the way. I had a talk like this recently, and my heart is still warmed from it.

The part that made it truly great, was that he answered the phone. On bad days he won’t even pick it up. On average days he will answer the phone, but get rid of me quite quickly. But once in  a while, I get not just a glimpse of my amazing brother, but I get to see that he still completely exists.

Treating his symptoms of auditory and visual hallucinations requires 2 meds. Treating his anxiety requires 1 med. Treating his blood sugar fluctuations caused by antihallucination meds requires 1 med. Treating his sleep disorder requires 2 meds, 1 for sleeping and 1 for waking. Treating his stomach troubles caused by the sugar meds needed to balance the antihallucination meds requires 1 med. Treating the migraines requires 2 meds, 1 med daily, and 1 at onset. Treating the mood swings requires 1 med and causes overeating and weight gain. I may have missed some, but luckily my mom keeps track of all of that for him. Each med is adjusted each month, some up, some down, based on his tolerance and symptoms.

So, to have him answer the phone at 9am while mom was out, was shocking and pleasing.

Me:Good Morning. How are you?

Him: I don’t know yet, just woke up.

Me: Oh, did you sleep well? Are you back on the sleeping pills? (He has to take breaks once in a while to rest the liver and make them still be effective as he builds up tolerance)

Him: Yes, I’m back on the sleeping pills, it is working better now. But I had insomnia and did not sleep for the 4 days I was off them, so doc put me back on. That first night back on was such great sleep. I love that. I actually sleep all night when I get back on after a break. And I fall asleep right away, the voices just all shut up and I can sleep. (apparently the dreadful voices he hears never sleep – so he has to tune them to fall asleep each night. He has special sleeping music to help drown them out too)

Me: That’s good, you need your sleep. I don’t hear your coffee pot yet.

Him: No. I got a diet coke – too tired to make the coffee yet.

Me: I understand. Mornings are rough for me too. Hey is that your guitar I hear? Did you get it fixed?

Him: Yes, got it back yesterday. All new frets, it sounds brand new again.

Me: Wow, you play it so much you wore out the frets?

Him: Yes, frets are like car tires, need replaced once in a while. They might not look bad until you look real close. The frets are soft metal so you can push on them, and they start out a bit rounded. After you play, they get flat. Which is funny, because it makes the notes sharp. (he laughs at his joke)

Me: (I laugh too.) Good one! I’m so glad you got it fixed the way you like. I bet you’ll play it all day long today, right?

Him: Yup. I have a new mix I’ve been playing in my head waiting to get it back. Think Mom’ll mind if I eat one of her chocolates?

Me: No, I think she’ll be happy you saved her some calories. She’ll be happy to share.

Him: MMmorkay (mouth full of chocolate) but if she gets upset I’m telling her you said it was okay.

Me: Deal! Enjoy your day – good talking to you, I’m off to work.

Him: MMMoooodguy (Goodbye still full of chocolate) Thanks for taking time to talk to me. (Awww – he feels like we’re all too busy with real lives to waste our time on him sometimes)

The Cmaj chord in guitar, with bass in G

Image via Wikipedia