| BackgroundAnupama (name changed for anonymity) 27 year old unmarried female, working as a helper in an office was brought to the clinic by her family members for evaluation of abnormal behavior that they had been noticing in her over the past few months.
Symptoms
Off late Anupama had stopped talking much to her family (parents and sister) and seemed to be lost in her own world. She stayed awake in the night because she believed the neighbors were plotting against her family and were keeping a watch on their moves so she stayed up at night in the fear that they’d break into the house. She kept windows locked and always suspected that she was being watched and reacted with tremendous fear and apprehension.
Loss of reality
Anupama could constantly hear the voices of neighbors as a running commentary 24 hours a day. (This was not real, the neighbors were not talking to her; it was imagined.) She also believed there were invisible video cameras installed in her house with which they kept constant vigilance over her family. At one instance she also tried to hammer the wall to break the imaginary camera that had been installed within it by the neighbors (so she suspected)
Effect on her life overall
She refused to eat food, as she believed these persecutors (neighbors) had poisoned it. She survived on biscuit and wafer packs which she would open by herself, to make sure that it was not tampered with, or poisoned by her perceived tormentors, of whom she was extremely fearful. Anupama received a memo from her workplace since she couldn’t take orders or instructions well. She was always sitting by herself and gesticulating as if she was talking continuously to some unknown invisible person around her. When questioned by someone, she would invariably look away and pretend as if nothing had happened.
Management
Anupama had frank delusions and hallucinations. Her suspiciousness was coloring her functioning and performance in all areas. She was diagnosed with paranoid schizophrenia and started on medication. Cognitive techniques were used a while after some suspiciousness had gone down. This was targeted at breaking her false belief about the neighbors. The family and friends were getting very worked up, hence they were given psycho-education that this was not pretense or a supernatural force; it was a mental illness which could be treated.
Progress and recovery
Anupama took her medication regularly. She showed some improvement within a month’s time and the hallucinatory behavior stopped. She stopped suspecting the neighbors although the thought crossed her mind sometimes. She resumed work and is now on regular medication. She does get stressed at times but it is within her logical control and she is in touch with reality now. |
