Hallucinations: Is It a Delusional Disorder?

Q: Hallucinations: Is It a Delusional Disorder?

Dear friend： You are a very caring sister, and it's truly touching! Your sister's condition could be due to several possibilities： it might be epilepsy, as an EEG may not always reveal abnormalities. <br>It could also be a brain lesion (has she experienced sudden headaches? Is th

Delusional disorder?

Dear Doctor Tang,
A few months ago, my sister suddenly fainted while at work.
She underwent an EEG at the hospital, which came back normal.
Since then, she has fainted two more times, but all tests have shown no issues.
Recently, she has been saying that she often hears someone screaming next to her, and sometimes she sees a woman in a yellow dress with red eyes, her right eye covered by hair, who threatens her and says she will harm her.
At times, she sees not just one person but also three other men nearby.
Every time they get close, she feels dizzy and very distressed.
Only my sister can see this; people around her cannot hear or see anything unusual.

Could this be a case of a delusional disorder? Would medication help? Are there any potential side effects from the medication? Would she need to take medication long-term? If this continues, could she lose her sanity? Thank you for your response!
A worried sister

doodoo, 30~39 year old female. Ask Date: 2001/03/24

Dr. Tang Xinbei reply Psychiatry

Dear friend: You are a very caring sister, and it's truly touching! Your sister's condition could be due to several possibilities: it might be epilepsy, as an EEG may not always reveal abnormalities.
It could also be a brain lesion (has she experienced sudden headaches? Is there any coordination or weakness on one side of her body?).
This requires further evaluation by a neurologist.
If the neurologist's examination and assessment do not indicate any neurological disorders, we should consider whether your sister has been using drugs (such as amphetamines, ecstasy, marijuana, or inhalants), which would typically present with other abnormal phenomena for assessment.
Psychiatry may consider whether your sister's condition is a form of mental illness, but this requires additional information for further evaluation, such as her behavior, work performance, living situation, and interpersonal relationships, along with a diagnosis from a psychiatrist.
If it is confirmed to be a mental illness, medication treatment can be quite effective, but it requires long-term management and evaluation.
Given that the information you provided is still limited and I have not personally examined the patient, I cannot provide a definitive answer.
I recommend that you accompany your sister to a nearby general hospital's psychiatric department for evaluation and treatment as soon as possible to avoid any delay in her condition.
Wishing you peace and joy.

Reply Date: 2001/03/24

More Info

Dear Concerned Sister,
Thank you for reaching out regarding your sister's troubling experiences. It sounds like she is going through a very challenging time, and I commend you for seeking help on her behalf. Based on the symptoms you described—specifically, auditory hallucinations (hearing voices) and visual hallucinations (seeing a woman in yellow with red eyes)—it is crucial to approach this situation with care and a thorough understanding of potential mental health issues.

Firstly, the experiences your sister is having do not necessarily indicate a delusional disorder. Delusional disorder is characterized by the presence of one or more delusions that persist for at least one month. Delusions are fixed beliefs that are not based in reality, such as believing that one is being persecuted or that one has extraordinary abilities. In contrast, hallucinations involve perceiving things that are not present, such as hearing voices or seeing figures that others cannot. Given that your sister is experiencing both auditory and visual hallucinations, it may suggest a different underlying condition, such as a psychotic disorder or a severe mood disorder with psychotic features.

It is essential for your sister to undergo a comprehensive psychiatric evaluation. This evaluation typically includes a detailed history of her symptoms, any potential triggers (such as stress or trauma), and a review of her medical history. The fact that her brain scans and EEGs have returned normal is a positive sign, but it does not rule out psychiatric conditions. Conditions such as schizophrenia, schizoaffective disorder, or severe depression with psychotic features could still be possibilities.

Regarding treatment, antipsychotic medications are often prescribed to help manage hallucinations. These medications can significantly reduce or eliminate the symptoms for many individuals. However, it is important to note that the response to medication can vary widely from person to person. Some may experience side effects, which can range from mild to severe, including weight gain, sedation, or movement disorders. Long-term use of antipsychotic medications may be necessary for some individuals, especially if their symptoms are chronic or recurrent. Regular follow-ups with a psychiatrist are essential to monitor her condition, adjust medications as needed, and manage any side effects.

Your concern about whether she might "go crazy" is understandable, but it is important to remember that many individuals with similar symptoms can lead fulfilling lives with appropriate treatment and support. Early intervention is key. The longer symptoms persist without treatment, the more challenging they may become to manage. Therefore, it is crucial to encourage your sister to seek professional help as soon as possible.

In summary, your sister's experiences warrant a thorough psychiatric evaluation to determine the underlying cause and appropriate treatment. Antipsychotic medications may help alleviate her symptoms, but they should be prescribed and monitored by a qualified psychiatrist. With the right support and treatment, there is hope for improvement in her condition.

Please take care of yourself as well during this time, as supporting a loved one with mental health challenges can be emotionally taxing. I wish you and your sister the best in navigating this difficult journey.

Warm regards,
Doctor Q&A Teams

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