Hallucinations and Delusions: When to Seek Help for Mental Health Issues

Auditory hallucinations, visual hallucinations, and self-talk?

Hello Dr.
Wu: My daughter is 34 years old.
In 2018, she believed that her family had transferred the family deities onto her and suspected that they intended to harm her, which led her to refuse contact with them.
She also reported experiencing auditory hallucinations in 2018, hearing a girl repeatedly calling her "sister, sister." When she looked in the direction of the voice, she saw a headless woman dressed in a blue kimono, adorned with accessories, sitting at the foot of her bed while laughing.
She also claimed to have seen her roommate sitting in the corner of the room singing.
She repeatedly called her roommate's name, but her roommate did not respond and kept her head down.
A few days later, her roommate told her that she had seen my daughter sitting on the bed, staring at the wall and singing, unable to respond no matter how much she called.
She has no insight into her condition and currently does not exhibit self-harming or violent behavior; she has simply become unable to communicate with her family.
Could this indicate a mental disorder? Is it urgent for her to see a doctor?

zhama, 60~69 year old female. Ask Date: 2022/08/28

Dr. Wu Enliang reply Psychiatry

It is indeed possible that the individual is experiencing issues.
It is recommended to seek treatment at a nearby mental health facility, especially as the treatment outcomes are generally better for those with first-onset conditions.
Dr.
Wu Enliang.

Reply Date: 2022/08/28

More Info

It sounds like your daughter is experiencing some serious mental health issues that could be indicative of a psychotic disorder, such as schizophrenia or a severe mood disorder with psychotic features. The symptoms you describe, including hallucinations (hearing voices and seeing things that are not there) and delusions (believing that family members are trying to harm her), are concerning and warrant immediate attention from a mental health professional.

Hallucinations can manifest in various forms, including auditory (hearing voices), visual (seeing things), or even tactile (feeling sensations that aren't there). Delusions are false beliefs that are strongly held despite evidence to the contrary. In your daughter's case, her belief that family members have transferred a deity to her and her refusal to communicate with them are signs of a significant disconnect from reality.

Given that she has been experiencing these symptoms since 2018, it is crucial to seek professional help as soon as possible. Early intervention can significantly improve outcomes in mental health conditions. A psychiatrist can conduct a thorough evaluation, which may include a physical examination, psychological testing, and a review of her medical history. This assessment will help determine the appropriate diagnosis and treatment plan.

Treatment for psychotic disorders often includes a combination of medication and therapy. Antipsychotic medications can help manage symptoms of hallucinations and delusions, while therapy can provide support and coping strategies. Cognitive Behavioral Therapy (CBT) is particularly effective in helping individuals understand and manage their thoughts and behaviors.

It's also important to consider the impact of her condition on family dynamics. The refusal to communicate with family members can create a sense of isolation and distress for both her and her loved ones. Family therapy may be beneficial in helping everyone understand the situation better and learn how to support her effectively.

In the meantime, it is essential to approach your daughter with compassion and understanding. Avoid confrontation about her beliefs, as this may lead to further withdrawal or agitation. Instead, express your concern for her well-being and encourage her to seek help. You might say something like, "I care about you and want to help you feel better. It might be a good idea to talk to someone who can help."
If she is resistant to the idea of seeing a doctor, you could suggest starting with a general practitioner who can provide a referral to a mental health specialist. Sometimes, individuals may be more open to seeing a doctor if they perceive it as a general health check rather than a mental health issue.

In conclusion, your daughter's symptoms are serious and require professional evaluation and treatment. Encourage her to seek help and offer your support throughout the process. Remember, mental health issues are medical conditions that can be treated, and with the right support, individuals can lead fulfilling lives.

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