Imagine A Cacophony Of Voices In Your Head

Imagine sitting in a place like this with a crowd like this and thinking every single word being said and thought by everyone is about you. So how do the experts go about it? Like pretty much every other psychological phenomenon, low mood exists on a spectrum. Imagine a line marked 0 at one end and 100 at the other. Now consider numbers 1–99, each point a gradually changing degree of mood, from very happy to desperately sad. At which number would you say someone is experiencing a symptom of depression, rather than just an everyday low mood? Is a low mood of 64/100 meaningfully different from a 65/100? As we will see below, a diagnosis of depression is never reached on the basis of low mood alone, so this illustration is somewhat academic. In reality, depression involves many symptoms, and a certain number of them must be present before a diagnosis of depression will be considered. It is intuitively understandable that a common symptom like low mood exists on a continuum, but what about symptoms of psychosis? Psychotic symptoms can be triggered by certain drugs, medical conditions, or extreme stress, but they also appear in several mental disorders, most notably schizophrenia and bipolar disorder. To answer this question, we will need to be more specific in our definitions. Such delusions and hallucinations can be brought about temporarily by a fever or after taking psychedelic drugs, but if they become chronic, they are cornerstone symptoms of a psychotic disorder. The workings of your mind become separated from the reality around you. And it can be terrifying. Imagine a cacophony of voices in your head, screaming, telling you to do things you normally know you shouldn’t.

Straight Down The Middle

Then imagine plugs, sockets and light switches, road signs and shop signs talking to you. And then imagine snakes coming out of the floor and wild cats charging through the walls and ceilings. Hyde, but that’s not what it means at all. It is possible for someone to display several apparently different personalities in this way, but this is instead referred to as dissociative identity disorder. Besides revealing how scary it must be to experience a psychotic episode like this, the above passage may make it hard to believe that delusions and hallucinations exist on a continuum. In fact, these symptoms exist on continua just like everything else. Take the example of auditory verbal hallucinations. These inner voices may appear to come from one or many people, and are typically negative, often saying distressing and frightening things. In other words, these people are on the lower end of a continuum of auditory verbal hallucinations. In this respect, the culture and time in which someone lives are relevant in determining whether a belief is pathological. Paranormal or unscientific beliefs are only considered delusions if they aren’t widely sanctioned by the person’s culture or society. Delusions might on the face of it seem like an obvious psychiatric symptom, but the line between them and normal, healthy beliefs is blurred.

The Sky is Crying

The point at which a belief usefully becomes a delusion is subtle, a matter of degree. Delusions, in other words, are on a continuum. Symptoms of many physical health conditions also exist on continua with no definitive point at which they become an illness or a disease. The threshold at which suboptimal kidney function becomes chronic kidney disease does not exist in nature. The same is true of osteoarthritis, hypertension, obesity, gout, chronic obstructive pulmonary disease, and many more. Just as in psychiatry, the threshold has to be artificially created, determined by experts. As I said above, no diagnosis for a mental disorder is made based on one symptom alone. So, how does clinical anxiety differ from the common anxiety that everyone experiences? But it is a useful starting point for understanding how mental illness is currently classified. Anxiety takes two forms, panic and worry. Panic is the physical side of anxiety, the physiological way that your body reacts when you’re afraid. The other component of anxiety, worry, resides in the mind. Worries essentially revolve around bad things happening, disaster striking.

If There Was Any Other Way

So far, so familiar. Feeling fear in your body and having worries in your mind are entirely normal experiences, part and parcel of being alive. An entire absence of anxiety would get us into all kinds of trouble. But anxiety disorders occur when these common processes get completely out of control. When panic reaches its extreme state, it becomes a panic attack. Like many terms relating to mental illness, this phrase has a colloquial meaning that bears very little relation to the clinical one. At the time of writing, someone recently tweeted that they had a panic attack looking at James Corden in the trailer for the new film Cats. I’ve watched the trailer and it’s not a pretty sight, granted, but I’d bet good money that this person didn’t actually have a panic attack. In everyday parlance, panic attack has become shorthand for being suddenly stressed or shocked. The reality of panic attacks is quite different and specific. During a panic attack, people often feel like they are going into cardiac arrest or dying, and sometimes call emergency services. They can be triggered in the face of sudden danger or overwhelmingly stressful life circumstances, or they can be triggered by very little. A panic attack alone is not a mental illness. Sadly, just as panic attacks themselves are vicious cycles, the experience of having a panic attack can set up an intense fear of having another one, which in itself can trigger the very event that is feared. In theory, people could be diagnosed with this disorder even if the panic seems to be quite a logical response to a stressful situation. The thinking side of anxiety is worry. We are all probably familiar with the idea that some people tend to worry more often than others, irrespective of what is going on in their lives, envisaging things going wrong frequently and devising all kinds of potential problems in their head.