Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality and experience hallucinations, delusions, disorganized thinking and speech, and impaired cognitive function. Schizophrenia is often described as involving a “split mind”, where a person’s thoughts, emotions, and behaviors are disconnected. About 1% of the population has schizophrenia. Let’s explore in more detail what schizophrenic people may see, hear, or believe.
Hallucinations
Hallucinations are one of the most well-known symptoms of schizophrenia. A hallucination is defined as seeing, hearing, smelling, tasting, or feeling things that don’t exist outside the mind. Hallucinations feel very real to the person experiencing them and are often accompanied by delusions which reinforce the hallucination.
Visual Hallucinations
Visual hallucinations are the most common type of hallucination in schizophrenia. About 70% of people with schizophrenia experience visual hallucinations. Some examples of what schizophrenic people may see include:
– Seeing patterns, flashes of light, or colors
– Seeing people or objects that aren’t really there. These can range from simple shapes to fully formed humans or animals.
– Distortions in perceptions – for example, a wall may appear to be bending or breathing.
– Alterations in the appearance of people’s faces – their features may appear distorted.
The visual hallucinations in schizophrenia are often recurrent and have a real sense of meaning for the individual. For example, they may repeatedly see a loved one who has passed away. The hallucinations are typically related to the person’s delusional beliefs.
Auditory Hallucinations
Auditory hallucinations, or hearing voices, sounds, and noises that aren’t real, occur in about 60% of people with schizophrenia. Some examples of what schizophrenic people may hear include:
– Hearing voices talking to or about the person. The voices may be familiar or unfamiliar, friendly or critical.
– Hearing noises like banging, clicking, hissing, or ringing.
– Hearing music or mechanical sounds like a radio playing.
– Hearing words or phrases being repeated.
The voices and sounds heard in auditory hallucinations are oftenthreatening or derogatory. However, sometimes the voices provide a running commentary on the person’s behavior and surroundings. The person has no control over when the voices occur or what they say.
Other Hallucinations
While visual and auditory hallucinations are most common in schizophrenia, people may also experience:
– Olfactory hallucinations – smelling odors that aren’t really present, like smoke, decay, or chemicals.
– Gustatory hallucinations – tasting flavors that don’t exist, like poison or rotten food.
– Tactile hallucinations – feeling sensations on or under the skin, such as insects crawling.
These types of hallucinations are less common but can feel extremely real and distressing for the person experiencing them. The themes are often unpleasant, involving dirt, disease, or danger.
Delusions
Delusions are fixed, false beliefs that are firmly held despite contradictory evidence. About 90% of people with schizophrenia experience some form of delusion. Common themes include:
Persecutory Delusions
These involve beliefs that others are plotting harm or planning to hurt the person in some way. For example, the person may believe the government is spying on them, strangers want to poison them, or co-workers are sabotaging their work.
Referential Delusions
Referential delusions involve believing that certain gestures, comments, passages from books, song lyrics, or other environmental cues have personal meaning or significance. For example, a person may believe a news anchor on TV is sending secret signals or messages directly to them.
Grandiose Delusions
A person with grandiose delusions believes they have special powers, talents, or identities. For example, they may believe they are famous, have supernatural abilities, are a prophet or God, or that they have uncovered a major scientific breakthrough.
Erotomanic Delusions
Someone experiencing erotomanic delusions believes another person, often someone famous or of higher status, is in love with them. They may believe they are married to or in a relationship with this person.
Nihilistic Delusions
Nihilistic delusions involve the belief that a major catastrophe will occur, such as the world ending. The person may believe they are the cause of this impending disaster.
Somatic Delusions
Somatic delusions relate to preoccupations about health and body image. For example, believing that something foreign is inside or on them, like parasites or aliens. Or that a body part is diseased, abnormal, or missing.
Disorganized Thinking
In addition to hallucinations and delusions, schizophrenia also impacts thinking. Disorganized thinking refers to confused and fragmented thoughts and speech patterns. Signs include:
– Switching abruptly from one topic to another at random
– Giving answers unrelated to the question
– Making up words or using made-up meanings for real words
– Rhyming or repeating words or phrases out of context
Disorganized thinking can make conversations very difficult. The person may be difficult to follow as their ideas seem jumbled or don’t make logical sense.
Cognitive Difficulties
Schizophrenia also affects basic cognitive functions like memory, concentration, and executive functioning skills. This includes difficulties with:
– Attention – trouble focusing and ignoring distractions
– Processing speed – taking more time to understand or respond to information
– Working memory – problems holding info in mind and using it to complete tasks
– Verbal learning – struggling to remember words, stories, or lists
– Executive functioning – issues with planning, flexibility, and abstract thinking
These cognitive deficits make it challenging for people with schizophrenia to remember instructions, have organized thinking, problem-solve, and manage daily responsibilities.
Negative Symptoms
In additional to hallucinations, delusions, and disorganized thinking, schizophrenia also involves negative symptoms or losses of normal function. Common negative symptoms include:
– Reduced emotional expression – lack of facial expressions, vocal inflection, or gestures
– Apathy and loss of motivation – feeling withdrawn or disinterested in activities and relationships
– Anhedonia – inability to feel pleasure from normally enjoyable activities
– Asociality – preferring isolation, reduced interactions with others
– Alogia – diminished speech output, short responses, lack of conversation
– Avolition – inability to begin or persist in goal-directed activities
Negative symptoms often appear before positive symptoms and can be mistaken for depression or other conditions. They greatly impact daily functioning.
Conclusion
Schizophrenia has a wide range of psychotic symptoms that fall into categories like hallucinations, delusions, disorganized thinking, cognitive deficits, and negative symptoms. Hallucinations involve perceiving things that are not real – most often hearing voices but also seeing vivid visions, smelling odors, or feeling sensations. Delusions are fixed false beliefs like paranoia, grandiosity, or strange bodily preoccupations. Disorganized thinking affects the ability to have coherent conversations. Cognitive deficits impact memory, concentration and problem-solving. Negative symptoms lead to reduced speech, expression, and motivation. These symptoms disrupt a person’s reality and make it very challenging to function without treatment. However, many people with schizophrenia can find relief through antipsychotic medication and social support. Increased understanding by society may help reduce stigma and support those suffering from this difficult disorder.