Psychosis

This term denotes a major disorder of the mind. A patient with this condition has poor insight into his condition and lives in a world of unreal experiences and beliefs.
I happened to see a 25 year old girl with M Sc, B Ed. She has worked as a teacher for some time. For past one and half years she has been on treatment. She started telling her mother that the local police has registered a case against her and they may arrest her. Sometimes also feared that her father might also be arrested. This idea originated after she happened to overhear conversations by people walking by the road in front of her house. She insists that she could hear these conversations frequently. Her mother and other family members have tried to cross check this, but they could never hear anything. Gradually her fear increased and she refused to go out of the house. She also became sleepless and agitated; following exacerbation they consulted a psychiatrist. Later I happened to see her. With treatment there was good improvement. 2 months ago she thought she is completely cured and discontinued the drugs. Her parents failed to convince her against this. During this time her father was hospitalized and things ended there. Recently they again came to me with relapse of the same old symptoms - hearing those voices and the same fears and suspicions.

How do people start hearing unreal voices, believe in senseless things etc ? Neither her parents nor her psychiatrists are able to convince her about the absurdity of her ideas. When I asked her questions like "If there is a case against you in the police station why are they not coming to arrest you even after one and a half years ? What are the charges against you ?Have you done anything to prevent your arrest ?" etc, she has no proper answer. She is unable to follow the normal logical sequence of thinking. She cannot develop any insight even after lengthy discussions and clarifications.
There is another angle to the story. Parents were trying to get her married off after she was 21. But an astrologer told them that this is not the right time for marriage. Now the parents are totally guilty about listening to this advice. They are now worried that her chance of marriage in future is very bleak,
This girl is suffering from Paranoid Schizophrenia, which is a type of psychotic disorder. Excess transmission of a neurotransmitter called dopamine is found in some areas of brain in this condition. Treatment is by drugs to reduce this. Anti psychotic drugs are the mainstay of drug treatment. Education of family, rehabilitation etc are also equally important.