Schizophrenia and Other Psychotic Conditions
First of all, we come to the more serious types of mental illness, encompassing schizophrenia and other psychotic conditions. In these cases the individuals are not in contact with reality, in that they have lost the ability to tell the difference between what is real and what is imaginary. Psychotic illnesses are characterized by severely disordered behavior and speech, with delusions and hallucinations (such as hearing voices and seeing nonexistent things). Occasionally psychotic episodes can occur in other mental disturbances such as mood disorders. Similar symptoms can also be caused by substance abuse, side effects of medication, and general medical conditions. Autism probably should also be included in this category, a disorder characterized by language problems, repetitive behaviors, and difficulty with social interaction. Schizophrenia, however, is always characterized by psychosis. These people are often so disturbed in their ability to think and judge clearly that they may not realize that they are mentally ill. The following is a description of a typical paranoid schizophrenic:
“A. B., a physician, 38 years of age, was admitted in 1937 to a public hospital for mental disease following his arrest for disturbing the peace. Specifically, he had frightened his neighbors by hurling objects at imaginary people who, he said, were tormenting him, by beating the air with ropes, and by breaking glass in the apartment that he and his wife occupied.
“Upon his commitment to the hospital, his wife described his personality traits as follows: ‘He has always been a deep thinker. Lately, however, he cannot concentrate. He is rather aggressive and is the type who insists upon imposing his own ideas on everyone else. He thinks that people have to agree with him. He is stubborn and argumentative. This trait was even referred to in his college yearbook. He is an independent thinker and is very bright. He had big plans for the future. He was formerly quite extrovertive until the last few years, when he refused to go out and mingle with people.’
“As the patient’s mental disorder progressed, he developed a great wealth of delusions. He stated that he was ‘the link between the living and dead,’ that he was a ‘universal medium,’ that a certain physician called on him by mental telepathy for added strength and skill in surgical operations. He believed that someone was hiding in a trunk in his house and so he fired several bullets into the trunk. He accused his brother of spraying him with chloral hydrate from the third floor of his house. He therefore sat behind a closed door waiting for his brother, and upon hearing a noise, shot through the door. He grew a beard because his face, he said, was being changed in subtle ways by outside influences, adding that if he wore a beard, his true identity would be known. Following his admission to the hospital, he often spent long hours in his room where he could be heard pacing the floor, moaning, or making a noise like a dog, striking his head with his fist, or pounding the wall. When asked the reason for his behavior, he explained that he was suffering tortures because people abused their powers of mental telepathy and were directing those powers toward him. He spent nearly all the day in his room where, during the fourth and fifth years of his hospital residence, he would frequently be heard shouting, screaming, and uttering noises that the attendants described as resembling the howling of a wolf.”