4.8 The distorted mind

In contrast to depression, anxiety, and even addictive behaviors which somehow fit within the spectrum of experiences most of us can relate to, reality-distorting conditions seem bizarre, disturbing, and intimidating. 

Psychotic disorders are characterized by a disturbance of perceptions and by an impairment of reality testing. Hallucinations are sensory perceptions without an actual stimulus. Most often, they are auditory and involve hearing voices (e.g. instinct chatter, hearing one’s name name called, commenting voices, or imperative voices). Delusional thought may range from overvalued ideas (e.g. “Google is a huge spying scheme that tracks every step we take”) to outright delusions (e.g. “The government is using satellites to implant thoughts into my brain.”) Delusions can involve ideas of reference, persecutory thoughts, grandiose ideas, erotomanic ideas, or jealous thoughts. 

Psychotic symptoms sometimes occur as part of medical conditions (i.e. delirium) or during periods of extreme emotional stress. They can also occur as part of severe depressive or manic episodes.  Hallucinations, delusional ideas, and other bizarre behaviors are part of a paranoid schizophrenia. Certain forms of schizophrenia involve flat affect and disorganized thoughts (disorganized schizophrenia) or immobility/hypermobility, negativism, and parroting of other peoples’ speech and behaviors (catatonic schizophrenia).  

Schizophrenia is primarily a structural disease of the brain and has a strong genetic component. Research suggests that a flu virus infection of the mother during the 2nd trimester of the pregnancy as well as other environmental stressors during childhood influence the expression of the genes. Symptoms may occur very rapidly or insiuously over a longer period of time. Treatment consists of long-term antipsychotic medication and supportive counseling to provide education and stress management strategies.

Religious people with schizophrenia often find it difficult to discern genuine spiritual experiences from delusional ideas. They are prone to losing touch with reality and may struggle to adhere to medication consistently because they become convinced that God has healed them. On the other hand, competent and sensitive spiritual mentoring, a supportive faith community, and the reassurance of God’s grace may be instrumental in helping psychotic believers find stability.