Hearing Voices and Paranoid Delusions: Inside a Schizophrenic Brain
Now and then we've all thought we heard someone calling our name, or noticed a strange coincidence. But for people with schizophrenia, these can take on a much more nefarious quality. Dr. Vikaas Sohal walks us through what it feels like to be inside a schizophrenic brain.
Dr. Vikaas Sohal is Assistant Professor of Psychiatry at UC San Francisco. His research has focused for years on cognition and functioning. He has written extensively on aging in schizophrenia, functional impairments in severe mental illness, the cognitive effects of typical and atypical antipsychotics, as well as studying the effects of cognitive enhancing agents in various conditions, including schizophrenia, dementia, affective disorders, and traumatic brain injury. Dr. Sohal is also a board certified psychiatrist and continues to see outpatients approximately one half day each week. He directs an annual conference on cognition that is an official satellite of the International Congress on Schizophrenia Research and the Schizophrenia International Research Society.
Dr. Sohal earned his A.B. in Applied Mathematics from Harvard University, his M.A.St. in Mathematics from Cambridge, and his MD, PhD from Stanford University. He completed his graduate work in the lab of John Huguenard, then stayed at Stanford to complete his psychiatry residency and a postdoctoral fellowship in the lab of Karl Deisseroth.
Vikaas Sohal: Many of us often have the experience of thinking we heard someone calling our name and then realizing that wasn't really the case, and we just move on, and we forget about it. Sometimes we notice coincidences, like, "Oh, there were a couple of cars on the street," and again, we pay no attention to it. But for someone with schizophrenia, these experiences take on a vastly different kind of feeling. So you might notice, "Oh, there were three red cars on the street," and instead of just forgetting about it, you start thinking, "Well, why were there three red cars on the street? Maybe it has something to do with me. Maybe these people are actually coming to monitor me or do something that would harm me," and you start working through some kind of plot or conspiracy related to that coincidence that you noticed.
The symptoms that people are most familiar with in schizophrenia are often hearing voices or having paranoid delusions and paranoid thoughts. We now know that, in addition to those kinds of symptoms, many people with schizophrenia have trouble focusing, paying attention, and remembering things. Many people talk about hearing voices and mean different things. Sometimes people will say, "Oh, yeah, when I'm thinking about what to do, I hear a voice in my head that tells me this would be the right thing to do, or this would be the wrong thing to do, or that gives me an idea." And when individuals with schizophrenia talk about hearing voices, they describe it very, very differently. It's really a voice, that they can't tell the difference between that voice and a voice coming from a person sitting right next to them in a room. And it sounds absolutely real. It sounds loud. Sometimes it's so loud that they can't stop paying attention to it. And sometimes the voices are just calling their name, but sometimes the voices are saying much more complicated things. Sometimes they're giving them commands, telling them what to do. Sometimes they're commenting on what they're doing, often in a negative or derogatory way.
It comes as no surprise that the brain is a complicated place. There's information flying all over the brain, and the brain has to get that information to the right place and decide what to do with it. We think that, perhaps, in schizophrenia some of the problems come because information isn't getting to the right place, or, sometimes when information does get to the right place, the brain doesn't know what it should pay attention to and what it should ignore. This is really important. In our everyday lives, we might hear a car alarm in the background, and we have to know not to pay attention to that, but we might also hear a baby crying in the background, and that probably is something that we need to pay attention to. And so, if your brain's not able to act as an executive and say, "This is what's important and this is what's not important," it becomes very difficult to sort through those everyday situations in ways that are really important for living and holding down a job or managing your life.
Seeing things — visual hallucinations, are more uncommon in schizophrenia. They do sometimes happen, and sometimes they take the form of people seeing ghosts or seeing people who aren't really in the room. Sometimes they look at a picture and they see something more than what the picture shows, often something with nefarious intent. Those are the kinds of experiences that individuals with schizophrenia will sometimes describe. Some people have them; some people don't. Even for people who have them, they can come and go at times. But these other symptoms that we now understand better and are starting to recognize more, they're much more fundamental to the disease, and they're much harder to deal with. And those are the symptoms like having trouble paying attention, having trouble remembering information, and having trouble being able to organize your activities and switch from one activity to another activity. These are things which individuals with schizophrenia start to find are harder than they were before they became ill. So, all of a sudden, they have trouble paying attention in class. They have trouble focusing on what they're reading. They have trouble doing jobs that require them to switch between one kind of thing and another kind of thing quickly. And that obviously stands in the way of people being able to live their lives to the fullest, being able to work, being able to manage their household, being able to manage their families and family relationships. And so those symptoms, what we often call "cognitive" symptoms, symptoms related to attention, and memory, and concentration, and focus. They're really one of our biggest challenges right now in schizophrenia.
Now and then, we've all thought we heard someone calling our name, or noticed a strange coincidence. But for people with schizophrenia, these can take on a much more nefarious quality. Dr. Vikaas Sohal walks us through what it feels like to be inside a schizophrenic brain.
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If you want to know what makes a Canadian lynx a Canadian lynx a team of DNA sequencers has figured that out.
- A team at UMass Amherst recently sequenced the genome of the Canadian lynx.
- It's part of a project intending to sequence the genome of every vertebrate in the world.
- Conservationists interested in the Canadian lynx have a new tool to work with.
If you want to know what makes a Canadian lynx a Canadian lynx, I can now—as of this month—point you directly to the DNA of a Canadian lynx, and say, "That's what makes a lynx a lynx." The genome was sequenced by a team at UMass Amherst, and it's one of 15 animals whose genomes have been sequenced by the Vertebrate Genomes Project, whose stated goal is to sequence the genome of all 66,000 vertebrate species in the world.
Sequencing the genome of a particular species of an animal is important in terms of preserving genetic diversity. Future generations don't necessarily have to worry about our memory of the Canadian Lynx warping the way hearsay warped perception a long time ago.
Artwork: Guillaume le Clerc / Wikimedia Commons
13th-century fantastical depiction of an elephant.
It is easy to see how one can look at 66,000 genomic sequences stored away as being the analogous equivalent of the Svalbard Global Seed Vault. It is a potential tool for future conservationists.
But what are the practicalities of sequencing the genome of a lynx beyond engaging with broad bioethical questions? As the animal's habitat shrinks and Earth warms, the Canadian lynx is demonstrating less genetic diversity. Cross-breeding with bobcats in some portions of the lynx's habitat also represents a challenge to the lynx's genetic makeup. The two themselves are also linked: warming climates could drive Canadian lynxes to cross-breed with bobcats.
John Organ, chief of the U.S. Geological Survey's Cooperative Fish and Wildlife units, said to MassLive that the results of the sequencing "can help us look at land conservation strategies to help maintain lynx on the landscape."
What does DNA have to do with land conservation strategies? Consider the fact that the food found in a landscape, the toxins found in a landscape, or the exposure to drugs can have an impact on genetic activity. That potential change can be transmitted down the generative line. If you know exactly how a lynx's DNA is impacted by something, then the environment they occupy can be fine-tuned to meet the needs of the lynx and any other creature that happens to inhabit that particular portion of the earth.
Given that the Trump administration is considering withdrawing protection for the Canadian lynx, a move that caught scientists by surprise, it is worth having as much information on hand as possible for those who have an interest in preserving the health of this creature—all the way down to the building blocks of a lynx's life.
The exploding popularity of the keto diet puts a less used veggie into the spotlight.
- The cauliflower is a vegetable of choice if you're on the keto diet.
- The plant is low in carbs and can replace potatoes, rice and pasta.
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