Rakesh, 21 years old, had appeared preoccupied, scared and distressed over the previous two months. He then reported to his mother that he had been hearing voices – and these voices were coming from the adjacent building. He clearly felt that these voices were from a group of people - two men and one woman – who worked for the secret service and they were talking about him. These voices, he reported, were real and threatening. He said they were out to create evidence to arrest and torture him and experienced intense fear and lost his sleep. He refused to leave his home and stopped going to college.
This experience of hearing voices is an ‘auditory hallucination’. Rakesh felt it coming from the next building – this is, from outside his mind, but sometimes it is experienced as coming from within one’s mind. These voices can give commands, may comment on one’s actions, or may talk to one another. Sometimes they could be sounds – for example, of people walking or musical sounds, and not voices like Rakesh heard.
As his condition worsened, Rakesh felt that he was able to see the face of his late grandfather on the wall. It looked very real and was scary. He could even see the expression change on his grandfather’s face. He also told his mother that he saw a procession walk outside his house – and they were playing loud music with large musical instruments.
This experience of seeing non-existent things is called a ‘visual hallucination’. Hallucinations can affect any modality – smells can be experienced (called an olfactory hallucination); similarly taste (gustatory hallucination) and touch (tactile hallucination) can also be experienced.
Often these hallucinations are an occasional experience in a single modality, but sometimes it is a detailed experience in more than one sense modality – that transports the individual into a hallucinatory world that feels almost real.
Hallucinations can be seen in many diseases, for example, schizophrenia, dementia , bipolar disorder, epilepsy, brain tumour – and it is important to make an early diagnosis and start treatment as soon as possible to get the best outcome for all these conditions. Detailed history, mental state, neurological and medical evaluation usually provides the diagnosis. Treatment appropriate to the diagnosis must be started at the earliest.
Rakesh was taken to a Psychiatrist by his mother. A diagnosis of Schizophrenia was made after a detailed evaluation and he was started on appropriate medications. Two weeks into treatment Rakesh was much better and restarted college. All his hallucinations vanished. When last seen, he has been symptom free on regular medications for the preceding 6 months and is leading a normal life.
Please note that the information in this case study should not be considered as medical advice for an individual’s condition. If anyone shows or feel symptoms of a possible medical condition, we strongly encourage you to seek advice from your primary physician or a mental health professional for an evaluation as soon as possible.
The names been changed to protect the privacy of individuals.