Mental illness & substance abuse: When delusions and hallucinations occur

Janie awoke suddenly with the voices in her head. “Why are you bothering me so early?” she thought,

“Why don’t you just go away and leave me alone?” “Just one day I would like to not be bothered by you…

Just one day,” she thought, as arising and preparing for her day. She then glanced over to the

Corner of her bedroom and saw the old lady standing there. “And you! You come and go as you

Please…who are you and what do you want from me?” She continued dressing and doing her

Bathroom chores; thinking, “When are the voices and the lady going to go away for good and leave me in peace?”

Janie, age 34, a person with Schizophrenia.

Some of the hallmarks of the person with Schizophrenia are the person’s inability to sort, interpret and appropriately respond to stimuli. They really have a rough time making sense of incoming stimuli, making it impossible to focus on seemingly simple activities, regardless of their intelligence, educational level, culture, or social standing.

The person with Schizophrenia is really out of touch with reality; most well known by the person having delusions, hallucinations, and disorganized speech. A key sign that one is suffering from Schizophrenia is a pervasive thought disturbance; he/she doesn’t “think straight:” can’t maintain one unified thought, but rather skips from one idea to the next; besides having hallucinations and/or deluded thinking.

I remember quite vividly an incident involving a patient while I was serving at a State Residential mental health facility. The facility had two wings, separated by a courtyard/patio. On one morning, following the patient’s breakfast, they were all sitting in the courtyard.

One of our patients, with diagnosed Schizophrenia, explained with much excitement, “Wow! Look at that 747 aircraft parked here!” He went on and on with his fellow patients about the sight he was looking at in his minds-eye. For those of you who are unaware, the Boeing 747 passenger jet is a huge aircraft, and the “irony” of that is there is no way that it could have landed or parked in the space of the patio. Yet there it was for the patient to visualize…a visual hallucination.

But do you know that delusions and hallucinations not only may plague one who has a mental illness, they may also occur with those who have other types of mental illness, and those whom use and abuse illicit chemical substances?

George was a Vietnam veteran. He was a soldier engaged in many battles during the war. During one battle he watched as most of his buddies were killed or critically wounded. He was plagued for many years by flashbacks to those battles, and had terrifying nightmares of those events.

On occasions, when it was raining, he found himself in the middle of a rice paddy in Vietnam, fighting with the enemy. At times, when a helicopter came overhead, he would relive the events of those battles. His delusions and hallucinations were very real to him. George suffered from acute, chronic Post Traumatic Stress Disorder (PTSD).

During my last 4 years in the Air Force I was assigned as a Drug and Alcohol Counselor and program administrator. Those were very difficult times in the service, when the abuse of alcohol and other drug substances were rampant among the military as it was within our entire society. Our job was to “clean it up,” to help those with alcohol problems to recover, and to transition those with illicit substance abuse to discharge. I shall never forget my first case of working with an individual who suffered psychosis related to the use of Marijuana.

Fred, at least let’s call him Fred, drove onto the base one very early morning. As he entered the main gate, and was stopped by the Security Police, he jumped out of the car; stating, “Please help me get this naked woman out of the car!” There was no woman in the Car. He further shouted, “Who turned my car orange?” His car was blue. Fred had been with others and was suffering from the ill effects of a continuous evening of smoking large amounts of Cannabis Sativa, Marijuana, and was in a psychotic state…out of touch with reality.

When one thinks of delusions and hallucinations related to illicit substance use, one thinks of the use of a hallucination type drug, such as Lysergic Acid Diethylamide (LSD), or another drug in the hallucinatory category. Yet, the above example is evident that the use of many other substances can lead to psychosis. Those that use and abuse illicit substances are also quite engaged in delusional thinking as well. I vividly remember the large transition groups I had in counseling during those days in the Air Force; at one time I had a group of 54 in group; a rather large group for counseling I might add.

Among the group were five airmen who were constantly challenging the Air Force regulations concerning substance abuse, blaming everyone and everything outside their selves for their predicaments. On one occasion they were stating, “This base is against us!” I took these 5 airmen out into a field, in the middle of the base, and stated, “Here we are in the middle of the base. Look at all of the buildings and trees and the people walking around.

I want each one of you to address the base…shout out to the base how it is against you!” They fell silent, and then one of them stated, “This is silly!” I stated, “Isn’t it though.” They were brought back to reality from their deluded state.

Yes my friends, delusional thinking and hallucinations are most real to the person experiencing them; whether brought on by a mental illness or a substance abuse disorder. We only need look at our community to follow the deluded thinking of those engaged in illicit substance use…the arrests made…the deluded challenging of laws and authority when it comes to illicit substances; or hear the stories of those who have had hallucinations, whether it be from Mental Illness or illicit Substance Use. Those suffering from the effects of mental illness may be treated for their illness with medication and appropriate counseling therapies.

Those who are experiencing a substance abuse disorder are in need of detoxification and appropriate therapies for their condition. Delusions and hallucinations are treatable symptoms, and there is always hope that the individual may be brought back to reality and go on to live fruitful lives. What if you began your day as Janie did? What if you experienced the same symptoms as George or Fred? Well, millions of individuals in our society do. We must remain optimistic; we must dwell on the positive side…remain realistic. Until Next Time, Stay Healthy My Friends!