Need information regarding hallucinatory diseases

I'm doing research for a novel and one of the characters is schizophrenic, or whichever form of disorder would best suit the plot. A have a few questions regarding the nature of schizophrenia, and wikipedia can only help so much:

What are the main causes of schizophrenia? Is it possible to be brought on by trauma or through nurture? Or is it mainly genetic?

Just how realistic are such hallucinations? What is the level of interactivity between the person and hallucination? I.e. Would it be possible for a schizophrenic to imagine an entire person (like an imaginary friend, only much more real)? And if it's possible to hallucinate an entire being, could they, say, carry out a conversation?

How difficult is it for an average schizophrenic to differentiate hallucination and reality? If someone has a recurring hallucination, will they eventually realize it is a hallucination and not reality?

What is the probability that only one type of hallucination would be present (like, going along with the imaginary friend bit, that the person would only see the friend and wouldn't have any other hallucinations)?


Please realize that this is a work of fiction and a bit of artistic license may be applied. I thank you greatly for any light you can shed on this matter.

-Y


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I've studied psychology for a long time, and I'll tell you right now that the answer to each question is a book in it's own right.  Please forgive me for summarizing, you'll need to do some further research on your own.

1)  What are the main causes of schizophrenia? Is it possible to be brought on by trauma or through nurture? Or is it mainly genetic? 

   -Schizophrenia is not as much a disease as it is a symptom.  It's a broad term covering possibly hundreds of conditions that are similar.  There can be many causes including inheritance (genetic), substance abuse, trauma, brain damage, etc.  There is a classic and fairly typical form of schizophrenia that is a basic set of symptoms and there are often patterns that you can expect such a person to follow throughout their life, but almost nobody diagnosed with schizophrenia fits the mould exactly. 


2) Just how realistic are such hallucinations? What is the level of interactivity between the person and hallucination? I.e. Would it be possible for a schizophrenic to imagine an entire person (like an imaginary friend, only much more real)? And if it's possible to hallucinate an entire being, could they, say, carry out a conversation?

  -There are as many degrees of severity as there are people who have schizophrenia.  There are also many, many different types of schizophrenia as well as a whole spectrum of similar and related disorders.  There are probably as many different types of psychoses as there have been people living on this planet, past and present. 

  -For most persons, even some of the most severe cases, hallucinations are extremely brief and distorted and often entirely incomprehensible.  There is often no form or meaning to their visions, and auditory hallucinations are usually at clearest a random jumble of words.  They CAN be realistic visions for people in extremely rare cases. 

  -People tend to try and assemble some meaning to everything they experience, so they may develop a narrative when they tell the story of their hallucinations.  It's similar to when you try to remember a dream, you'll often assemble some linear sort of story, but the reality is that your dream was likely quite random and non-linear.

  -Yes, it's possible for them to imagine a friend, and I would be inclined to suggest you'll see this more often when a person's disorder is in part due to severe psychological trauma. 


3) How difficult is it for an average schizophrenic to differentiate hallucination and reality? If someone has a recurring hallucination, will they eventually realize it is a hallucination and not reality?

  -A schizophrenic's view of the world can be quite oddly distorted, but almost all will be able to recognize a hallucination for what it is.  It's only in the very worst cases and or the very worst episodes that differentiating between reality and a hallucination becomes difficult.  That said, even mild hallucinations could greatly disturb a person.   Other characteristics of their particular condition will affect how they react.  Will they take suggestions from the voices that they hear?  Rarely they do, but very often they do not and are simply bothered by them.


4) What is the probability that only one type of hallucination would be present (like, going along with the imaginary friend bit, that the person would only see the friend and wouldn't have any other hallucinations)?

  -Very, very slim.  Given the incredibly wide variety of documented mental conditions out there, I wouldn't doubt for a minute that this is possible...  but it'd be one-in-a-billion.  There are traumatic situations where a person might create an imaginary friend and retain it for many years into adulthood, but there are typically other symptoms that may be difficult to detect but very much present in their lives and affecting their development greatly nonetheless.




I honestly wish I had more time to help you, but the best I can suggest is to study.  Start with a high-school or entry-level college textbook on psychology and read it.  It'll probably be horribly outdated, but it'll be good enough to get you the basics.  Then start looking for consumer-level books and films on psychology-related topics, like perhaps biographies of those who have experienced such conditions.  A Beautiful Mind comes immediately into my own mind, but there are many many more such stories.

Finally, as a writer myself, I would suggest that you try not to worry too much about realistically portraying all the details of a psychological condition and that you try to focus on the narrative as much as you can.  Get the basic facts right, and the rest you can leave for the reader to imagine.
lemonie7 years ago
"or whichever form of disorder would best suit the plot".
Roughly what kind of condition does the plot require? You want a reality/fiction split, but this is required to be caused by a recognised condition?

L
dungeon runner (author)  lemonie7 years ago
As you might have guessed from my question, the plot requires that the hallucinator be able to imagine an entire, high-level interactivity (can talk to it, can sense it with sound, touch, etc.), human being. This "imaginary friend" would be a recurring hallucination, follows the character throughout most of his life, and could conceivably be mistaken for a real person if sensed by anyone else.

As I said above, I will explain the plot in more detail if need be.

-Y
So they don't have to have a recognised condition? Just go with what you've got, let people think what the will of the character and make their own diagnosis.

L
dungeon runner (author)  lemonie7 years ago
That seems fair to me. I really just didn't want to get my basic facts wrong. It really ticks me off when television and movies get things way off about Aspbergers (diagnosed at age four), so I wanted to be precise.

-Y
I should not try to stick to facts in a work of fiction, unless a specific condition is necessary. People will think they're (this/that) you can leave it undefined, if the character's story is not tied to a diagnosis.
Psychiatrists like naming things, diagnose something new and you might get your name on it. Person says "what's wrong with me/my child?" they don't want "well some-sort-of..." they want "It's this.".
For the purposes of your work I don't think you need a diagnosis and you'll be creatively freer without one.

L
dungeon runner (author)  lemonie7 years ago
Thanks for the insight. I really hope this thing goes somewhere.
blkhawk7 years ago
There is a great movie, A Beautiful Mind, with actor Russel Crow and Jennifer Connely. It is based on the actual life of an university professor, although a brilliant man he suffered from schizophrenia. It has been said that it is the best movie made about the subject.
 It's all about cats.

www.schizophrenia.com/prevention/cats.html

members.forbes.com/forbes/2006/1211/048.html

www.sciencedaily.com/releases/2006/01/060125082853.htm

I can't find it at the moment but I remember reading about how cats carry a virus that affects the behaviour of mice, (they lose their fear of cats).
The drugs that we use to treat schizophrenia cured the mice and the link was made....or something like that ; but read around using the links above and maybe introduce Felix as the next character.




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T. Gondii is still being studied and it looks like it may play a factor in many cases.  Your suggestion is great for an author, because the relationship between human psychology and this microbe is not yet well understood. 

It's also interesting to note that because of this, even if nothing comes of the T. Gondii case, people will now be looking towards microbial and viral causes in researching other mental disorders... which is cool if only to realize that a few people could possibly be cured of a mental problem with a vaccine or even a good dose of penicillin!
That would be great for a work of fiction. It would be better if I were writing for science fiction, I think. Maye if I learn about it more I'll understand it better, but for now I'll keep chewing it over for a different story. I don't think it would be as necessary to say how he became schizophrenic as it would how it affects his life and what are the details of his symptoms.

-Y
That's really kind of fascinating.
Kiteman7 years ago
As a plot device, you only need to specify the condition if the story requires that the character be diagnosed or treated successfully.

Even then, the range of symptoms, and level of those symptoms, associated with mental disorders is enormous, which is why some patients end up being labelled with their symptoms rather than the name of a disease.

The causes are many and varied as well - physical and emotional traumas, viral conditions, dehydration, poisoning...

(Kitewife's grandmother spent a few weeks a whole generation out of synch with reality when she had a viral ear infection.)

Otherwise, you character can merely experience the level of hallucination required for the story without anybody having to say "uh-oh, the schizophrenia is kicking in again!".


dungeon runner (author)  Kiteman7 years ago
Thanks for the insight. I realized after writing this that I probably wouldn't have to get the exact diagnosis correct. As for treatment, the character really only got minimal treatment for his condition, maybe because of poverty, misdiagnosis, or maybe his parents had some dogma against normal medical practices, I haven't quite worked out the details. I have never been diagnosed with (had some close calls though) or known someone else diagnosed with such a disorder, so I don't know much about how it would be treated and what certain measures would be taken for certain levels of hallucination. Back to wikipedia.

(I would explain the plot in more detail, if it would help anyone.)

-Y
Re-design7 years ago
Wow, You're going down the same path I took 20 years ago.  Except my was not about hallucination.  I didn't have the internet then so I had to go to libraries etc.

You have the internet in front of you and basically have the accumulated knowledge and experience of the world at you finger tips

Use g00gle to find your answers.  Then you can pick and choose what you want to use.  I think you'll be happy with the result.

Hint, I'd answer YES to most of your questions already.  Now go out and find the rest of the story.