How to Handle a Neighbor with Severe Auditory Hallucinations

How to deal with a neighbor who has severe symptoms of soliloquy?

Hello Doctor, two months ago my family moved to our current residence, and since then we have noticed that the elderly woman living upstairs often talks loudly by the window at all hours.
It sounds like she is having a conversation with someone, complete with pauses.
Her voice is very loud, and our entire family can hear the content of her conversations clearly, which consists of various curses directed at family members, people she encounters during her cleaning job, and colleagues, among others.
The elderly woman continues to "talk on the phone" for very long periods, lasting two to three hours, and she resumes her cursing in the middle of the night.
Over the past two to three months, we have observed that she has three distinct periods of outbursts: she curses for two to three hours in the evening, then again for one to two hours in the middle of the night, and once more around six in the morning.
At this point, we realized she seems to be conversing with a non-existent person! We also noticed that the lighting appears to trigger her behavior; if she sees lights on downstairs at night, she will start talking loudly "to someone." If we turn off the lights first, she immediately quiets down.
However, if she sees that we have the lights on, she seems to engage more vigorously in this "conversation" with the non-existent person.
One night, someone downstairs yelled at her to be quieter, but it seemed she didn't hear and continued talking for several hours, only stopping immediately when the lights were turned off.

I would like to ask the doctor if this elderly woman has a mental health issue.
What could it be? Is it schizophrenia or another condition? Additionally, how should we handle this neighbor? She seems to live alone.
A colleague warned us not to approach or communicate with her, as it could lead to unwanted entanglement.
I would appreciate your professional opinion on this matter, as it is quite concerning.
Thank you, and I wish you all the best.

You Shui De Yu, 30~39 year old female. Ask Date: 2023/09/26

Dr. Li Guanying reply Psychiatry

Thank you for your letter.
Regarding the situation mentioned above, it is recommended to call the "Suspected Mental Illness Reporting Hotline" of the health bureau in your county or city.
Professional personnel will assess the situation on-site.
If the elderly woman exhibits any abnormal mental conditions, early treatment can be provided, which will also help maintain community safety.

Reply Date: 2023/09/26

More Info

Dealing with a neighbor exhibiting severe auditory hallucinations can be a challenging and sensitive situation. Based on your description, it appears that the elderly woman upstairs is experiencing symptoms consistent with a mental health disorder, possibly schizophrenia or another psychotic disorder. These conditions can manifest as auditory hallucinations, where individuals hear voices or conversations that are not present in reality. The fact that she seems to respond to stimuli, such as lights, suggests that her condition may be exacerbated by environmental factors.

Understanding the Situation
1. Auditory Hallucinations: These are perceptions of sound that occur without an external stimulus. They can be benign or distressing, depending on the content of the hallucinations. In this case, the woman seems to be engaging in a dialogue with an imaginary person, often expressing anger or frustration.

2. Possible Causes: The underlying causes of auditory hallucinations can vary widely. They may stem from psychiatric conditions such as schizophrenia, severe depression, or bipolar disorder. Additionally, neurological conditions, substance abuse, or even severe stress can contribute to such symptoms. Given her age, it is also possible that she may be experiencing cognitive decline or dementia, which can sometimes lead to hallucinations.

3. Impact on Surroundings: The behavior you describe—loudly talking to an imaginary person for extended periods—can be distressing for neighbors. It is important to approach the situation with empathy, recognizing that the woman may not be aware of how her actions affect others.

Recommended Actions
1. Avoid Direct Confrontation: While it might be tempting to address her directly about the noise, this could lead to further distress for both you and her. People experiencing hallucinations may not respond rationally to confrontation, and it could escalate the situation.

2. Document the Behavior: Keep a record of the times and nature of her outbursts. This documentation can be helpful if you need to involve authorities or mental health professionals later.

3. Reach Out for Help: If her behavior continues to disrupt your household, consider contacting local mental health services or social services. They may be able to conduct a welfare check or provide resources for her care. If she is indeed living alone and struggling with her mental health, she may need assistance that she is not currently receiving.

4. Community Resources: If you feel comfortable, you might also consider reaching out to community organizations that focus on mental health. They often have programs in place to assist individuals in crisis and can provide guidance on how to approach the situation.

5. Consider Safety: If you ever feel threatened or unsafe due to her behavior, do not hesitate to contact local authorities. Your safety and the safety of your family should always be the priority.

Conclusion
In summary, the elderly woman upstairs likely exhibits signs of a serious mental health condition that requires professional intervention. While it is natural to feel concerned and even frustrated by her behavior, approaching the situation with compassion and caution is essential. Engaging with mental health professionals or community resources can provide the necessary support for both her and your household. Remember, mental health issues can be complex, and those affected often need understanding and assistance rather than judgment.

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