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Forum Name: Psychiatric Topics

Question: hallucinations and anxiety


 kylune23 - Sun Apr 06, 2008 7:16 am

Nightmares 4/7 nights since age approx 2
Increased in severity as puberty arrived age approx 13
Increased in severity into adulthood current age 28
duo gravida
Nightmares were always detailed, often in colour, rarely with a feelng of being able to smell something within the dream (blood, feces, a dog) always wake confused, frightened, elevated heart rate, sometimes combative.

creative. Writer, poet since age approx 5

2 months ago (feb 2008) began having "visions" or hallucinations of .....a train toppling and killing my family. me falling from a moving car. severed heads. faceless people in ...elemental terror for a reason i could never see. rarely have olfactory hallucinations (blood, feces, vomit, sweat) these day time visions last one-five seconds and fill me with numb terror. I have had as many as 40 flases in a day, as few as 3. Always know that what I am seeing is not real. Completely lucid once hallucnation has passed (have been told that during a hallucination, I seem very still and detached)

I feel nothing but terror during these hallucinations. there is no pleasure of any kind. I have no feelings of hopelessness, suicide or harming anyone or anything.

i began to lose sleep. I began to lose pleasure in sex, spending time with family and my usual hobbies in fear of a hallucination. I began to be fearful to leave the house (I always managed to leave the house, but it was frightening).

My doctor is adamant; I have a psychosis and need anti-psychotics.

I have this deep feeling (i know, intuition is not a medical metric) that there may be some sort of physical *reason* for the hallucinations. Are there any physical reasons for hallucinations that I can ask my doctor to look for? Or am I just trying to find some other excuse becuase I just don't want a "psychosis"?

Thank you

~Ky
 Dr. E. Seigle - Mon Apr 07, 2008 6:40 pm

Dear kylune23,

Your hallucinations are quite unusual for a psychiatric disorder. Typically, hallucinations due to a primary psychiatric psychosis are auditory, last longer than yours, and do not occur in so many discrete episodes. What kind of evaluation have you had? Have you had a psychiatric or psychological evaluation in which your family and life experiences have been discussed in detail, over several sessions? A period of psychotherapy might help you yp understand the sources of the hallucinations. If you haven't had a thorough psychiatric evaluation over several sessions, you might consider that. One would wonder if you have possibly had some very adverse or traumatic experience that might cause hallucinations in a picture of Post-Traumatic Stress Disorder and its spectrum. Your symptoms of anxiety, not wanting to leave the home, and nightmares are suggestive of this.

It is possible, while not probably, that your hallucinations represent symptoms of an unusual seizure disorder. To look at this, you would want to be evaluated by a neurologist.

So, above are a few things to think about and consider. While you may choose not to take an antipsyhotic medication, a low dose anti-psychotic might be helpful, more for treating what may be anxiety or trauma-based hallucinations rather than a "functional" psychiatric psychosis due to mental illness.

Good luck!

-Eliot Seigle MD
 kylune23 - Mon Apr 07, 2008 10:09 pm

I am seeing someone at mental health. she took a complete history then, asking about trauma (none) guilt (none) minor stress. We talked about family, my profession, my marriage. we will go more in depth, back further, see if there is a possible trauma.
We will be meeting weekly for a while, I'm quite sure. I like her and feel i can be totally open with her about anything. this is a very good thing.

Between her, my own research, and your post, I have some ideas to suggest to my doctor, like seizure disorders, auto-immune disorders, etc. In the meantime, I'll take the anti psychotics Risperidone 1mg daily. my doctor also suggested low dose clonazepam 0.5mg am and pm to help with the anxiety and fearfulness.

i thank you, Doctor, for your input.

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