Schizophrenia Basics: Delusions, Hallucinations & Onset
One of the most obvious kinds of impairment caused by schizophrenia involves how a person thinks. The individual can lose much of the ability to rationally evaluate his or her surroundings and interactions with others. They often believe things that are untrue, and may have difficulty accepting what they see as “true” reality.
Schizophrenia most often includes hallucinations and/or delusions, which reflect distortions in the perception and interpretation of reality. The resulting behaviors may seem bizarre to the casual observer, even though they may be consistent with the schizophrenic’s abnormal perceptions and beliefs.
The Differences Between a Delusion & a Hallucination
Delusions are an unshakable theory or belief in something false and impossible, despite evidence to the contrary. Examples of some of the most common types of delusions are:
- Delusions of persecution or paranoia – Belief that others — often a vague “they” — are out to get him or her. These persecutory delusions often involve bizarre ideas and plots (e.g. “Russians are trying to poison me with radioactive particles delivered through my tap water”). Click here to learn more about paranoid delusions, or here to learn more about persecutory delusions.
- Delusions of reference – A neutral event is believed to have a special and personal meaning. For example, a person with schizophrenia might believe a billboard or a celebrity is sending a message meant specifically for them. Click here to learn more about delusions of reference.
- Delusions of grandeur – Belief that one is a famous or important figure, such as Jesus Christ or Napolean. Alternately, delusions of grandeur may involve the belief that one has unusual powers that no one else has (e.g. the ability to fly). Click here to learn more about delusions of grandeur.
- Delusions of control – Belief that one’s thoughts or actions are being controlled by outside, alien forces. Common delusions of control include thought broadcasting (“My private thoughts are being transmitted to others”), thought insertion (“Someone is planting thoughts in my head”), and thought withdrawal (“The CIA is robbing me of my thoughts”). Click here to learn more about delusions of control.
A hallucination is a sensation or sensory perception that a person experiences in the absence of a relevant external stimulus. That is, a person experiences something that doesn’t really exist (except in their mind). A hallucination can occur in any sensory modality — visual, auditory, olfactory, gustatory, tactile, etc.
Auditory hallucinations (e.g. hearing voices or some other sound) are most common type of hallucination in schizophrenia. Visual hallucinations are also relatively common. Research suggests that auditory hallucinations occur when people misinterpret their own inner self-talk as coming from an outside source.
Hallucinations can often be meaningful to the person experiencing them. Many times, the voices are those of someone they know. Most commonly, the voices are critical, vulgar, or abusive. Hallucinations also tend to be worse when the person is alone.
More Schizophrenia Basics
Someone with schizophrenia may act in an extremely paranoid manner — purchasing multiple locks for their doors, always checking behind them as they walk in public, refusing to talk on the phone. Without context, these behaviors may seem irrational or illogical. But to someone with schizophrenia, these behaviors may reflect a reasonable reaction their false beliefs that others are out to get them or lock them up.
Nearly one-third of those diagnosed with schizophrenia will attempt suicide. About 10 percent of those with the diagnosis will commit suicide within 20 years of the beginning of the disorder.