David Baxter PhD
Late Founder
Understanding Voices
By Peggy Thompson, NAMI
Reprinted with permission from Schizophrenia Digest, Winter 2009
When Faye Herrick first heard the voices, she broke down. “I was shattered,” she says. “That my son had to go through that was unbearable for me. As a mom it was more than I could handle.”
Herrick, director of health service initiatives for the Schizophrenia Society of Alberta, Calgary Chapter (SSACC), is more than familiar with the auditory hallucinations (voices) heard by those who have been diagnosed with schizophrenia. She’s watched her son, diagnosed when he was 18, as he listened to the voices in his head; observing his expressions and reactions.
But she’d never actually heard them herself until she experienced Mindstorm—A Virtual Hallucination. Through a 3D virtual simulator, Mindstorm presents to the viewer a genuine feeling of what it’s like to suffer from the powerful symptoms of the debilitating illness known as schizophrenia.
Although there is no typical case of schizophrenia, Mindstorm centers on what would be a typical morning, first through the eyes of someone who does not have schizophrenia and then from the view of someone who does.
In the first scenario, you’ve wakened on a beautiful morning: The sun is shining, a breeze wafts through an open window, the house is bright and welcoming, hot coffee is ready in the kitchen and, best of all, there’s good news in the morning paper.
The circumstances are different in the second scenario. While it’s the same house, and the same day, the house is dark and slightly foreboding. From the moment you wake up you hear a running commentary of voices—a male and a female. They tell you that you are “stupid, so stupid,” and that they hate you. They alert you not to eat or drink the coffee because it’s poisoned. They warn you not to take your medication. They never stop—on and on they go— calling you worthless, a waste of space, berating you for being lazy and ungrateful. And, the headline in the newspaper says “DON’T LEAVE THE HOUSE.” The voices are not just internal; they’re coming from the television, too. The weatherman is asking you if all you’re going to do is sit around with “your stupid mouth open?” And, before telling you to stop staring at him, he reminds you, once again, that you are lazy, sleep too much, and pretty well everything is “all your fault.”
Created by Janssen, a Division of Ortho-McNeil- Janssen Pharmaceuticals, Inc., Mindstorm was developed with the help of people with schizophrenia and an expert panel of psychiatrists. It produces visual hallucinations and distortions, voices, wind effects, and smells, all endemic to the life of a person with schizophrenia. A 2D video/audio only program can be viewed online. However, viewing Mindstorm may be disturbing to some people. If you anticipate being disturbed by it you should consider not participating.
To live with schizophrenia is to live with a chronic, severe, and disabling brain disorder that seriously impairs one’s ability to think clearly, relate to others, and function in society. People with schizophrenia have trouble distinguishing between what is real and what is imaginary and, as a result, they may become withdrawn or have difficulty in everyday situations. Janssen research estimates that worldwide, one person in every 100 develops schizophrenia. Although the cause of schizophrenia remains unknown, the illness is believed to result from a combination of environmental and genetic factors.
Yet, Joseph M. Palumbo, MD, franchise medical leader, psychiatry, Johnson & Johnson Pharmaceutical Research and Development, LLC, Titusville, New Jersey, can confirm what the medical profession does know. “The human brain is a remarkable machine, added on to over time as we mature, with most brains reaching maturation around the age of 25,” he says. “But it doesn’t have a fail-safe.” Palumbo, who has developed novel agents for the treatment of depression and psychosis as a clinical leader in psychiatry, says there are “many, many thoughts” about what causes schizophrenia.
Genetic dispositions, infections, germs in the environment, seasonal viruses that can affect babies in utero, and the possibility of a number of them happening at once are among them, as each has the ability to disturb the way the brain develops. An overtaxed brain may be doing its best, but “isn’t able to give accurate information and can misfire,” he explains.
Psychotic symptoms, such as hallucinations and delusions, usually emerge in men in their late teens and early 20s and in women in their mid-20s to early 30s. They seldom occur after age 45 and only rarely before puberty. Research conducted by The National Institute of Mental Health has shown that schizophrenia affects men and women equally and occurs at similar rates in all ethnic groups around the world.
These “positive” symptoms, so named by the medical profession, include abnormal or exaggerated behaviors or patterns of thought that are added to an individual’s way of interacting with the world. Along with voices, they include visual or tactile hallucinations (seeing and feeling things that don’t exist), persistent delusions (false beliefs that aren’t changed by reason or evidence), paranoid delusions, and disorganized or unusual thought processes and speech.
Voices are very real to those diagnosed with schizophrenia. “They (voices) sound just like a person would when talking to you,” explains Michelle Misurelli, 45, of Calgary, Alberta. “They’re very real; they sound just like you and me.” Misurelli was diagnosed with schizophrenia when she was 25 but went undiagnosed from the age of 18. During those seven years she experienced a great deal of fear as a plethora of voices invaded her brain. “I was living in an apartment at the time and I could hear people on the other side of the wall, screaming at me, putting me down,” she recalls. “They told me that I was ugly, stupid and fat and that the Communists were coming to get me.” She had no idea what was happening and truly believed that there were people yelling at her from the other side of the wall. “I was afraid; I believed they were putting gas under my door. And I was angry, wondering why they were shouting at me. They even said they were going to stick a pick in my ear and pull out my brain.” Why Communists and the threat of gas? At the time Misurelli was studying political science, focusing on capitalism and communism. She believes, that the auditory delusions concentrated on what she was surrounding her life with at the time. Terrified for her life, she became home-bound until she turned to her mother for help and was eventually admitted to hospital where she was diagnosed with schizophrenia.
If you do not have schizophrenia, those who do want you to know that this illness was not invited into their lives and they are managing the best they can, striving for productive, fulfilling lives.
If you do have schizophrenia, rest assured, you are not alone. Lori Rochat, 38, of Garfi eld Heights, Ohio, was diagnosed with schizophrenia in 1990 and believes the general public doesn’t understand the illness and its voices. At one time she didn’t either. Hospitalized but undiagnosed at the age of 20 due to her erratic behavior, she met another patient who told her he had schizophrenia. “I was so afraid of him,” she recalls. “I wouldn’t even go near him.”
Today, she hopes others will not stereotype the way she did at that point in her life. “When we are on the right meds and they’re working, we don’t do crazy things.” Rochat did do some ill-considered things prior to her diagnosis and eventual management of her illness. But she has chosen to share so that others will understand why, for the most part, people with schizophrenia behave the way they do when they’re not taking their medication. “The classic symptom of schizophrenia is hearing voices telling you weird things, she explains. “Almost all people with schizophrenia get similar symptoms: The radio, TV, and newspapers are talking about them. For example, I heard voices telling me that I was psychic.” Paranoia plagued Rochat constantly, but in one case her voices came to the rescue. “One time I wanted to strangle my grandmother because I thought in my mind that she ruined an imaginary relationship that was in my head, but something in my mind said don’t strangle her, so I never did.”
While paranoia affects her to this day, Rochat’s life has improved tremendously, thanks to medication. “Without the medication I’m on, my life would be worthless,” she says. “I always say to myself that schizophrenia is the curse and the medication is the blessing.” Misurelli, now the coordinator of the SSACC group peer support program, Unsung Heroes, is also healthy and free of voices. “Medication worked for me,” she says. “Schizophrenia doesn’t have to be hopeless or a death sentence. Today there are better meds; more hope. You can go to school or work and lead a relatively good life.” Antipsychotic medications can help people with schizophrenia function better. In conjunction with counseling programs designed to help manage and cope with behavioral symptoms, medications have been proven to significantly alleviate psychotic symptoms and reduce the chances they will return.
Nevertheless, medication does not always alleviate auditory hallucinations. Glen Moore, 45, of Calgary, Alberta has lived with the voice of Elwood in his head for the past 16 years. Moore, an outreach worker and public speaker, by his own account, descended into mental illness rapidly at the age of 26. Studying physics in university, he heard a voice that called itself God. Among its many directives, the voice told him that in order to become one of God’s creatures, he must die and go into a plastic body. “At first I believed him,” he remembers. “But soon I wanted him gone. He said he would leave, but he didn’t.” Ultimately, Moore’s mother hospitalized him against his will and he was soon diagnosed. And once he acknowledge his illness and complied with medication, it “removed a huge weight” off his shoulders.
Today, Moore shares his past and current experiences amid auditory hallucinations with those he mentors. When it comes to life with Elwood, he manages. “I am a very logical guy. I like things that make sense,” he says. “Elwood deliberately says things that don’t make sense.” On the surface, he says its okay, and tries not to talk back. He used to, but he stopped after watching the movie, A Beautiful Mind, where he learned that if he talks back, he “just feeds them.”
In order to focus, Moore has developed some coping skills. “The best one is reading—that shuts them down. I exercise, don’t over-schedule, and if they bother me when I’m walking, I sing a hymn.” A devout Christian, Moore puts his life in God’s hands and finds empowerment through public speaking. “Now I’m not so afraid to have schizophrenia,” he says.
Not everyone diagnosed with schizophrenia hears voices, but for those who do, medication may provide a welcome respite. “Medication works for some and not for others,” Palumbo explains. “50 to 60 percent get better.”
To complicate matters, Palumbo says that many people with schizophrenia have depression. And, it’s important to be aware that they are struggling daily to make sense of the world. “Their brain is working enormously hard to figure out what’s going on. They didn’t ask for this, it’s an awful,awful illness.”
To compare the brain of someone who has schizophrenia to that of a person who does not have the illness, Palumbo draws on clouds in a blue sky for illustration. “If you do not have schizophrenia and look up at the clouds and see one that looks like a rabbit, you know that’s what it looks most like. But if your brain is broken it is a rabbit because your brain can not normally filter what’s real and what’s not.” Further, individuals with schizophrenia do not always hear the song of a beautiful bird; instead it may be the sound of a menacing hawk. A glorious day can look like a dark, miserable one, or a friendly face can be someone out to get you.
Darryl (whose last name has not been used at his request) understands this world all too well. In recovery today, he knows his illness is not his fault. But, even though it was not his fault, he suffered. There were times when he was homeless, dredging for food in dumpsters, roaming wooded areas in search of places to hide, cold and scared.
“The voices are inside your head, but they are so real you think someone is really there. My voices have been all kinds. At first the female voice was nice. She would say she loved me and things like that. Then the voice changed. It was still a woman’s voice but it was mean and told me to cut myself. I had no choice but to listen to the voice. Most of the time the voices are bad and are telling you to do bad things, one told me to break into a trailer and so I did.”
As soon as Darryl got on the right medication the voices left him alone. “I don’t want to ever hear them again,” he says. “That’s why I’ll stay on the medications. Now at times I hear music, but that’s okay. I hear Pink Floyd.”
Gahan J. Pandina, PhD, clinical leader, psychiatry, Johnson & Johnson Pharmaceutical Research and Development, LLC, confi rms that people with schizophrenia are “absolutely” subjected to the voices they hear. “It’s a very terrifying inner experience.” Pandina, also an adjunct clinical assistant professor at Robert Wood Johnson Medical School, New Brunswick, New Jersey, teaching psychology internship and psychiatry residency programs, relates that three-quarters of individuals with schizophrenia have
auditory hallucinations and one quarter have visual hallucinations. While scientists don’t know their source, one theory is that there are various brain chemicals at play, most particularly an excess of dopamine, creating a “not so perfect storm.”
Listening to constant commentary in their heads, usually critical, people with schizophrenia often react to what they’re told internally and get in trouble. They are often observed by others talking to themselves or inanimate objects in an agitated state; their expressions can be scary and their personal hygiene not the best.
Pandina reminds us that people with schizophrenia don’t ask for this. “It’s an awful, awful world, passed on to them while the real world passes them by.” He hopes people will “understand without judgment. It’s not their fault; they’re treading water and doing the best they can through their interpretation of reality.”
Professionally, Herrick takes such insight to the public stage through the SSACC Partnership Education Program. Providing educational presentations to high schools, colleges, and universities, society members illustrate auditory hallucinations through role play. The presentation involves three people, representing three voices with varying messages, at amplifying volume levels. An ordinary voice at a normal level will ask, for example, “how are you doing?” The neutral voice, a little louder, will ask, “is there something that I can help you with?” But the negative voice is very loud, shouting things like, “you’re stupid!” All three speak at the same time, demonstrating to the audience just how difficult it is to listen only to the ordinary or neutral voice saying pleasant things when the negative, loud voice is doing whatever it can to take over. “It’s an excellent way for people to experience what those with schizophrenia do,” Herrick says.
Herrick has a great deal of respect for the people she works with. “All of them are so courageous. They keep going and keep smiles on their faces. I do not have that kind of courage.”
She has hope that the close to 300 members she serves will benefit from the improved medications that are emerging today. And, she hopes that the stigma associated with mental illness—schizophrenia in particular—through awareness programs, will subside, even a little. “We are coming close, but not near close enough,” she says. “We’ve barely scratched the surface of stigma.”
Dedicated to all aspects of good mental health, Palumbo and Pandina agree: They hope to change the lives of people diagnosed with schizophrenia. They aim for lives where voices are silenced, hallucinations faded, social skills improved, and the ability to earn a living becomes more than a dream. “We’re working on it,” Palumbo says. “Hope is at least as important as medication.”
But, as a cure for schizophrenia has yet to be found, medication is the response to those dreams. The National Alliance on Mental Illness (NAMI), reports that antipsychotic medications can help people with schizophrenia function better. In conjunction with counseling programs designed to help people manage and cope with their behavioral symptoms, medication has been proved to significantly alleviate psychotic symptoms and reduce the chances that symptoms will return. The organization’s Web site states that primary medications, antipsychotics, help relieve the positive symptoms of schizophrenia by helping to correct an imbalance in the chemicals that enable brain cells to communicate with each other.
As with drug treatments for other physical illnesses, many patients with severe mental illnesses may need to try several different antipsychotic medications before they find the one, or the combination, that works best for them.
“We’re making great progress,” Pandina says. “But we have a long way to go as we need to provide as many options and types of treatment as we possibly can for our patients.”
Darryl has lived through psychosis that led to life on the streets and in the woods. Once diagnosed and treated with medication, he moved on and was welcomed by Catholic Charities who provided him with shelter, security, and hope. After graduation to a group home he was finally discharged. “No more hospital!”
The road to recovery has been a long one for Darryl but his is a success story. Today he is working in his community with ever-increasing career responsibilities and an increasing sense of pride and self-esteem. “I wish good luck and good fortune to others who will follow me on this journey of recovery,” he says. “Hold tight to the faith in yourself and don’t give up.”
Peggy Thompson, a freelance writer based in Fort Erie, Ontario, is also the Associate Editor for Magpie Media, Inc.
By Peggy Thompson, NAMI
Reprinted with permission from Schizophrenia Digest, Winter 2009
When Faye Herrick first heard the voices, she broke down. “I was shattered,” she says. “That my son had to go through that was unbearable for me. As a mom it was more than I could handle.”
Herrick, director of health service initiatives for the Schizophrenia Society of Alberta, Calgary Chapter (SSACC), is more than familiar with the auditory hallucinations (voices) heard by those who have been diagnosed with schizophrenia. She’s watched her son, diagnosed when he was 18, as he listened to the voices in his head; observing his expressions and reactions.
But she’d never actually heard them herself until she experienced Mindstorm—A Virtual Hallucination. Through a 3D virtual simulator, Mindstorm presents to the viewer a genuine feeling of what it’s like to suffer from the powerful symptoms of the debilitating illness known as schizophrenia.
Although there is no typical case of schizophrenia, Mindstorm centers on what would be a typical morning, first through the eyes of someone who does not have schizophrenia and then from the view of someone who does.
In the first scenario, you’ve wakened on a beautiful morning: The sun is shining, a breeze wafts through an open window, the house is bright and welcoming, hot coffee is ready in the kitchen and, best of all, there’s good news in the morning paper.
The circumstances are different in the second scenario. While it’s the same house, and the same day, the house is dark and slightly foreboding. From the moment you wake up you hear a running commentary of voices—a male and a female. They tell you that you are “stupid, so stupid,” and that they hate you. They alert you not to eat or drink the coffee because it’s poisoned. They warn you not to take your medication. They never stop—on and on they go— calling you worthless, a waste of space, berating you for being lazy and ungrateful. And, the headline in the newspaper says “DON’T LEAVE THE HOUSE.” The voices are not just internal; they’re coming from the television, too. The weatherman is asking you if all you’re going to do is sit around with “your stupid mouth open?” And, before telling you to stop staring at him, he reminds you, once again, that you are lazy, sleep too much, and pretty well everything is “all your fault.”
Created by Janssen, a Division of Ortho-McNeil- Janssen Pharmaceuticals, Inc., Mindstorm was developed with the help of people with schizophrenia and an expert panel of psychiatrists. It produces visual hallucinations and distortions, voices, wind effects, and smells, all endemic to the life of a person with schizophrenia. A 2D video/audio only program can be viewed online. However, viewing Mindstorm may be disturbing to some people. If you anticipate being disturbed by it you should consider not participating.
To live with schizophrenia is to live with a chronic, severe, and disabling brain disorder that seriously impairs one’s ability to think clearly, relate to others, and function in society. People with schizophrenia have trouble distinguishing between what is real and what is imaginary and, as a result, they may become withdrawn or have difficulty in everyday situations. Janssen research estimates that worldwide, one person in every 100 develops schizophrenia. Although the cause of schizophrenia remains unknown, the illness is believed to result from a combination of environmental and genetic factors.
Yet, Joseph M. Palumbo, MD, franchise medical leader, psychiatry, Johnson & Johnson Pharmaceutical Research and Development, LLC, Titusville, New Jersey, can confirm what the medical profession does know. “The human brain is a remarkable machine, added on to over time as we mature, with most brains reaching maturation around the age of 25,” he says. “But it doesn’t have a fail-safe.” Palumbo, who has developed novel agents for the treatment of depression and psychosis as a clinical leader in psychiatry, says there are “many, many thoughts” about what causes schizophrenia.
Genetic dispositions, infections, germs in the environment, seasonal viruses that can affect babies in utero, and the possibility of a number of them happening at once are among them, as each has the ability to disturb the way the brain develops. An overtaxed brain may be doing its best, but “isn’t able to give accurate information and can misfire,” he explains.
Psychotic symptoms, such as hallucinations and delusions, usually emerge in men in their late teens and early 20s and in women in their mid-20s to early 30s. They seldom occur after age 45 and only rarely before puberty. Research conducted by The National Institute of Mental Health has shown that schizophrenia affects men and women equally and occurs at similar rates in all ethnic groups around the world.
These “positive” symptoms, so named by the medical profession, include abnormal or exaggerated behaviors or patterns of thought that are added to an individual’s way of interacting with the world. Along with voices, they include visual or tactile hallucinations (seeing and feeling things that don’t exist), persistent delusions (false beliefs that aren’t changed by reason or evidence), paranoid delusions, and disorganized or unusual thought processes and speech.
Voices are very real to those diagnosed with schizophrenia. “They (voices) sound just like a person would when talking to you,” explains Michelle Misurelli, 45, of Calgary, Alberta. “They’re very real; they sound just like you and me.” Misurelli was diagnosed with schizophrenia when she was 25 but went undiagnosed from the age of 18. During those seven years she experienced a great deal of fear as a plethora of voices invaded her brain. “I was living in an apartment at the time and I could hear people on the other side of the wall, screaming at me, putting me down,” she recalls. “They told me that I was ugly, stupid and fat and that the Communists were coming to get me.” She had no idea what was happening and truly believed that there were people yelling at her from the other side of the wall. “I was afraid; I believed they were putting gas under my door. And I was angry, wondering why they were shouting at me. They even said they were going to stick a pick in my ear and pull out my brain.” Why Communists and the threat of gas? At the time Misurelli was studying political science, focusing on capitalism and communism. She believes, that the auditory delusions concentrated on what she was surrounding her life with at the time. Terrified for her life, she became home-bound until she turned to her mother for help and was eventually admitted to hospital where she was diagnosed with schizophrenia.
If you do not have schizophrenia, those who do want you to know that this illness was not invited into their lives and they are managing the best they can, striving for productive, fulfilling lives.
If you do have schizophrenia, rest assured, you are not alone. Lori Rochat, 38, of Garfi eld Heights, Ohio, was diagnosed with schizophrenia in 1990 and believes the general public doesn’t understand the illness and its voices. At one time she didn’t either. Hospitalized but undiagnosed at the age of 20 due to her erratic behavior, she met another patient who told her he had schizophrenia. “I was so afraid of him,” she recalls. “I wouldn’t even go near him.”
Today, she hopes others will not stereotype the way she did at that point in her life. “When we are on the right meds and they’re working, we don’t do crazy things.” Rochat did do some ill-considered things prior to her diagnosis and eventual management of her illness. But she has chosen to share so that others will understand why, for the most part, people with schizophrenia behave the way they do when they’re not taking their medication. “The classic symptom of schizophrenia is hearing voices telling you weird things, she explains. “Almost all people with schizophrenia get similar symptoms: The radio, TV, and newspapers are talking about them. For example, I heard voices telling me that I was psychic.” Paranoia plagued Rochat constantly, but in one case her voices came to the rescue. “One time I wanted to strangle my grandmother because I thought in my mind that she ruined an imaginary relationship that was in my head, but something in my mind said don’t strangle her, so I never did.”
While paranoia affects her to this day, Rochat’s life has improved tremendously, thanks to medication. “Without the medication I’m on, my life would be worthless,” she says. “I always say to myself that schizophrenia is the curse and the medication is the blessing.” Misurelli, now the coordinator of the SSACC group peer support program, Unsung Heroes, is also healthy and free of voices. “Medication worked for me,” she says. “Schizophrenia doesn’t have to be hopeless or a death sentence. Today there are better meds; more hope. You can go to school or work and lead a relatively good life.” Antipsychotic medications can help people with schizophrenia function better. In conjunction with counseling programs designed to help manage and cope with behavioral symptoms, medications have been proven to significantly alleviate psychotic symptoms and reduce the chances they will return.
Nevertheless, medication does not always alleviate auditory hallucinations. Glen Moore, 45, of Calgary, Alberta has lived with the voice of Elwood in his head for the past 16 years. Moore, an outreach worker and public speaker, by his own account, descended into mental illness rapidly at the age of 26. Studying physics in university, he heard a voice that called itself God. Among its many directives, the voice told him that in order to become one of God’s creatures, he must die and go into a plastic body. “At first I believed him,” he remembers. “But soon I wanted him gone. He said he would leave, but he didn’t.” Ultimately, Moore’s mother hospitalized him against his will and he was soon diagnosed. And once he acknowledge his illness and complied with medication, it “removed a huge weight” off his shoulders.
Today, Moore shares his past and current experiences amid auditory hallucinations with those he mentors. When it comes to life with Elwood, he manages. “I am a very logical guy. I like things that make sense,” he says. “Elwood deliberately says things that don’t make sense.” On the surface, he says its okay, and tries not to talk back. He used to, but he stopped after watching the movie, A Beautiful Mind, where he learned that if he talks back, he “just feeds them.”
In order to focus, Moore has developed some coping skills. “The best one is reading—that shuts them down. I exercise, don’t over-schedule, and if they bother me when I’m walking, I sing a hymn.” A devout Christian, Moore puts his life in God’s hands and finds empowerment through public speaking. “Now I’m not so afraid to have schizophrenia,” he says.
Not everyone diagnosed with schizophrenia hears voices, but for those who do, medication may provide a welcome respite. “Medication works for some and not for others,” Palumbo explains. “50 to 60 percent get better.”
To complicate matters, Palumbo says that many people with schizophrenia have depression. And, it’s important to be aware that they are struggling daily to make sense of the world. “Their brain is working enormously hard to figure out what’s going on. They didn’t ask for this, it’s an awful,awful illness.”
To compare the brain of someone who has schizophrenia to that of a person who does not have the illness, Palumbo draws on clouds in a blue sky for illustration. “If you do not have schizophrenia and look up at the clouds and see one that looks like a rabbit, you know that’s what it looks most like. But if your brain is broken it is a rabbit because your brain can not normally filter what’s real and what’s not.” Further, individuals with schizophrenia do not always hear the song of a beautiful bird; instead it may be the sound of a menacing hawk. A glorious day can look like a dark, miserable one, or a friendly face can be someone out to get you.
Darryl (whose last name has not been used at his request) understands this world all too well. In recovery today, he knows his illness is not his fault. But, even though it was not his fault, he suffered. There were times when he was homeless, dredging for food in dumpsters, roaming wooded areas in search of places to hide, cold and scared.
“The voices are inside your head, but they are so real you think someone is really there. My voices have been all kinds. At first the female voice was nice. She would say she loved me and things like that. Then the voice changed. It was still a woman’s voice but it was mean and told me to cut myself. I had no choice but to listen to the voice. Most of the time the voices are bad and are telling you to do bad things, one told me to break into a trailer and so I did.”
As soon as Darryl got on the right medication the voices left him alone. “I don’t want to ever hear them again,” he says. “That’s why I’ll stay on the medications. Now at times I hear music, but that’s okay. I hear Pink Floyd.”
Gahan J. Pandina, PhD, clinical leader, psychiatry, Johnson & Johnson Pharmaceutical Research and Development, LLC, confi rms that people with schizophrenia are “absolutely” subjected to the voices they hear. “It’s a very terrifying inner experience.” Pandina, also an adjunct clinical assistant professor at Robert Wood Johnson Medical School, New Brunswick, New Jersey, teaching psychology internship and psychiatry residency programs, relates that three-quarters of individuals with schizophrenia have
auditory hallucinations and one quarter have visual hallucinations. While scientists don’t know their source, one theory is that there are various brain chemicals at play, most particularly an excess of dopamine, creating a “not so perfect storm.”
Listening to constant commentary in their heads, usually critical, people with schizophrenia often react to what they’re told internally and get in trouble. They are often observed by others talking to themselves or inanimate objects in an agitated state; their expressions can be scary and their personal hygiene not the best.
Pandina reminds us that people with schizophrenia don’t ask for this. “It’s an awful, awful world, passed on to them while the real world passes them by.” He hopes people will “understand without judgment. It’s not their fault; they’re treading water and doing the best they can through their interpretation of reality.”
Professionally, Herrick takes such insight to the public stage through the SSACC Partnership Education Program. Providing educational presentations to high schools, colleges, and universities, society members illustrate auditory hallucinations through role play. The presentation involves three people, representing three voices with varying messages, at amplifying volume levels. An ordinary voice at a normal level will ask, for example, “how are you doing?” The neutral voice, a little louder, will ask, “is there something that I can help you with?” But the negative voice is very loud, shouting things like, “you’re stupid!” All three speak at the same time, demonstrating to the audience just how difficult it is to listen only to the ordinary or neutral voice saying pleasant things when the negative, loud voice is doing whatever it can to take over. “It’s an excellent way for people to experience what those with schizophrenia do,” Herrick says.
Herrick has a great deal of respect for the people she works with. “All of them are so courageous. They keep going and keep smiles on their faces. I do not have that kind of courage.”
She has hope that the close to 300 members she serves will benefit from the improved medications that are emerging today. And, she hopes that the stigma associated with mental illness—schizophrenia in particular—through awareness programs, will subside, even a little. “We are coming close, but not near close enough,” she says. “We’ve barely scratched the surface of stigma.”
Dedicated to all aspects of good mental health, Palumbo and Pandina agree: They hope to change the lives of people diagnosed with schizophrenia. They aim for lives where voices are silenced, hallucinations faded, social skills improved, and the ability to earn a living becomes more than a dream. “We’re working on it,” Palumbo says. “Hope is at least as important as medication.”
But, as a cure for schizophrenia has yet to be found, medication is the response to those dreams. The National Alliance on Mental Illness (NAMI), reports that antipsychotic medications can help people with schizophrenia function better. In conjunction with counseling programs designed to help people manage and cope with their behavioral symptoms, medication has been proved to significantly alleviate psychotic symptoms and reduce the chances that symptoms will return. The organization’s Web site states that primary medications, antipsychotics, help relieve the positive symptoms of schizophrenia by helping to correct an imbalance in the chemicals that enable brain cells to communicate with each other.
As with drug treatments for other physical illnesses, many patients with severe mental illnesses may need to try several different antipsychotic medications before they find the one, or the combination, that works best for them.
“We’re making great progress,” Pandina says. “But we have a long way to go as we need to provide as many options and types of treatment as we possibly can for our patients.”
Darryl has lived through psychosis that led to life on the streets and in the woods. Once diagnosed and treated with medication, he moved on and was welcomed by Catholic Charities who provided him with shelter, security, and hope. After graduation to a group home he was finally discharged. “No more hospital!”
The road to recovery has been a long one for Darryl but his is a success story. Today he is working in his community with ever-increasing career responsibilities and an increasing sense of pride and self-esteem. “I wish good luck and good fortune to others who will follow me on this journey of recovery,” he says. “Hold tight to the faith in yourself and don’t give up.”
Peggy Thompson, a freelance writer based in Fort Erie, Ontario, is also the Associate Editor for Magpie Media, Inc.
