Tag: psychosis

Haunting ‘Demon Faces’ Show What It’s Like to Have Rare Distorted Face Syndrome

A 58-year-old man with a rare medical condition sees faces normally on screens and paper, but in person, they take on a demonic quality. The patient has a unique case of prosopometamorphopsia (PMO), a condition that causes peoples’ faces to appear distorted, reptilian, or otherwise inhuman.

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A new study published in The Lancet describes the case, which is unique in that, to the man, the faces only appear demonic when the individuals are physically present. The patient has been perceiving faces as distorted for 31 months; at first, it was distressing to him, but now, he has “become habituated to them,” the paper states.

Because faces appear ordinary to him on screens and in person, the research team had a unique opportunity to probe how the distortions manifest and create accurate visualizations of the “demonic” countenances.

“In other studies of the condition, patients with PMO are unable to assess how accurately a visualization of their distortions represents what they see because the visualization itself also depicts a face, so the patients will perceive distortions on it too,” said Antônio Mello, a researcher at Dartmouth College and lead author of the study, in a university release. “Through the process, we were able to visualize the patient’s real-time perception of the face distortions.”

For the patient, faces in person are unsettlingly distorted. Eyes are stretched and angular, nostrils flare out and lips stretch outwards to comprise the entire width of the face. Grooves appear in the forehead, and ears warp into an elvish shape, ending in sharp points. In milder cases, facial features merely droop, appear out of position, or are smaller or larger than they are in real life.

In another case, published in The Lancet in 2014, a 52-year-old woman in The Netherlands reported:

A life-long history of seeing people’s faces change into dragon-like faces and hallucinating similar faces many times a day. She could perceive and recognise actual faces, but after several minutes they turned black, grew long, pointy ears and a protruding snout, and displayed a reptiloid skin and huge eyes in bright yellow, green, blue, or red. She saw similar dragon-like faces drifting towards her many times a day from the walls, electrical sockets, or the computer screen, in both the presence and absence of face-like patterns, and at night she saw many dragon-like faces in the dark.

According to Brad Duchaine, senior author on the study and principal investigator of Dartmouth’s Social Perception Lab, people suffering from PMO are often diagnosed with other disorders, like schizophrenia, and prescribed anti-psychotics.

“It’s not uncommon for people who have PMO to not tell others about their problem with face perception because they fear others will think the distortions are a sign of a psychiatric disorder,” Duchaine said. “It’s a problem that people often don’t understand.”

The 58-year-old patient had a history of bipolar affective disorder and post-traumatic stress disorder (PTSD), the research team noted, as well as a head injury when he was 43 years old. The patient had no impairments to eyesight and a small round lesion on his left hippocampus, which the team concluded was a cyst. Other individuals suffering from an Alice in Wonderland syndrome (a catch-all term for perceptual distortions) also were reported to have brain lesions; encephalitis, migraines, and psychoactive drug use are also linked with the syndrome, though none were observed in the recent patient’s case.

To characterize the facial distortions, the researchers had the man describe perceived differences between the face of a person in the room with him and a photo of that person. Due to his PMO, the in-person face was distorted, and the on-screen face looked like an ordinary face.

PMO can last just days for some, and years for others. Only 75 case reports of PMO have been published, according to the researchers. It’s certainly one of the rare—and more disturbing—perceptual disorders, but knowing how it manifests means that fewer patients will be misdiagnosed in the future.

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Isaac Schultz

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March 21, 2024
Study: Canadian MJ Legalization Has No Association with Increasing Psychosis Rates | High Times

Amidst the growing cannabis reform across the West, there have been growing conversations surrounding cannabis-induced psychosis, suggesting that regular cannabis use and highly concentrated products may exacerbate mental health symptoms as access increases.

However, a recent study published in the International Journal of Drug Policy took a closer look at shifting cannabis policy following Canada’s cannabis legalization in October 2018, ultimately finding no association with legalization and increasing rates of cannabis-related psychosis.

The research suggests that, at least so far, changing cannabis legislation is not related to increasing cases of psychotic disorders, though researchers also cautioned that “a longer post-legalization observation period … is needed to fully understand the population-level impacts of non-medical cannabis legalization.”

No Association Between Psychotic Disorders and Cannabis Reform

The research highlights the concern that has made waves in recent years, with cannabis as a “risk factor in the onset and persistence of psychotic disorders” and the notion that recreational cannabis legalization could elevate these risks.

A team of Canadian researchers examined regional changes in health services use and incidences of psychotic disorders over the months immediately following cannabis legalization through a cross-sectional interrupted time-series analysis from January 2014 to March 2020.

Researchers examined psychosis-related outpatient visits, emergency department visits, hospitalizations and inpatient length of stay along with incident cases of psychotic disorders among people aged 14 to 60 years.

Ultimately, researchers did not find evidence of increase in health service use or incident cases of psychotic disorders over the short-term period, 17 months, following cannabis legalization. However, they noted “clear increasing trends in health service use and incident cases of substance-induced psychotic disorders” throughout the 2014-2020 observation window as a whole.

“Our findings suggest that the initial period of tight market restriction following legalization of non-medical cannabis was not associated with an increase in health service use or frequency of psychotic disorders,” authors concluded, stressing the need for a longer, post-legalization observation period to fully understand the population-level impacts of legalization and reform.

“Thus, it would be premature to conclude that the legalization of non-medical cannabis did not lead to increases in health service use and incident cases of psychotic disorder,” they state.

Further Proof That Legalization Does Not Increase Psychosis Instances

The study adds to a growing body of research similarly affirming that cannabis reform is not associated with significant changes surrounding cannabis-induced psychosis.

Another 2022 study looking at Canada’s cannabis legalization framework in relation to cannabis-induced psychosis and schizophrenia emergency department presentations also found that reform was not associated with these cases. Researchers still noted that there is a need for further research on the topic.

Looking at the United States and recent reform trends, recent research has also suggested that states with legal cannabis programs do not have elevated rates of psychosis. A 2023 study looked at the relationship between adult-use cannabis legalization and psychosocial functioning among a cohort of 240 pairs of identical twins, with one residing in a state where adult-use cannabis was permitted and the other where it was criminally prohibited.

While researchers noted a slight uptick in the frequency subjects reported cannabis use, they found that legalization was not positively correlated with increased psychotic or substance abuse disorder instances, along with other adverse outcomes. The research also found that those in legal cannabis states were less likely to engage with problematic alcohol use behaviors.

Additionally, 2022 data examining a cohort of 233,000 European cannabis consumers found that cannabis consumption rarely triggers episodes of acute psychosis among those without a pre-existing psychiatric disorder. Authors reported that less than one-half of 1% of subjects reported ever having “cannabis-associated psychotic symptoms,” with those at higher risk being younger subjects and those with a prior diagnosis of bipolar, anxiety, or depressive disorder, or psychosis.

Cannabis and Psychosis Messaging: Modern Resurgence of ‘Reefer Madness?’

While further research on the topic is still needed, many cannabis professionals, experts and advocates have deemed the new trend of associating legal cannabis with newly onset psychosis symptoms as a modern-day form of “reefer madness.”

Many have drawn comparisons of these modern-day conversations, associating legal cannabis with psychosis symptoms and mental health concerns, as mirroring the conversations had in the 1900s, when cannabis use became more prominent and broader messaging suggested that cannabis use and access innately carries greater mental health risks across populations.

While research has found a correlation between schizophrenia and heavy cannabis use, and psychiatrists have also long known that substance abuse disorders carry psychiatric comorbidities, there is limited evidence showing how this relationship translates to the general population. There is also limited information surrounding how much substance use disorders are driven by such comorbidities.

Studies have shown that heavy alcohol use can be shown to cause organic psychosis and dementia, though these potential risks typically don’t promote the idea of avoiding alcohol use entirely, especially among those who don’t already have associated risk factors.

Paul Armentano, deputy director of pro-cannabis advocacy organization NORML, wrote about this topic last year, noting that those with certain psychiatric disorders or predispositions may carry additional risks of increased mental health symptoms when it comes to cannabis consumption, “but sensationalizing the potential risks of cannabis will do little to protect them.”

“Calling for the re-criminalization of cannabis in state-legal markets won’t either,” Armentano writes. “Rather, the establishment of a regulated market designed to keep cannabis products away from young people, and that provides clear warnings to those specific populations who may be more vulnerable to its effects — coupled with a policy of consumer education — is the best way to protect public health and mitigate consumers’ risks.”

Keegan Williams

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January 8, 2024
Science Weighs In On Marijuana And Being Psychotic

There are a number of myths about marijuana. For the canna-curious, you have to look at what data says to the real answer

But one of the biggest fears from those with little experience—will I have an adverse reaction to smoking pot? For the canna-newbie and the canna-curious, it might be a wee bit worrying. Science weighs in on marijuana and being psychotic. Ignore the myths and look at the data so you consume without a concern.

Canadian scientists tried to answer that question by determining if an individual’s genetic makeup could determine how they’d respond to THC, the cannabinoid responsible for inducing psychoactive sensations. What genetic technology expert John Lem of Lobos Genetics discovered was that genes could predict several key factors: your body’s metabolization of the drug, whether cannabis was more likely to induce paranoia into your systems, as well as the possibilities of memory loss and developing schizophrenia.

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All scientists would have to do, Lem attests, is a simple cheek swab that would test three different genes that could answer all those questions.

“Looking into the science, we came to the conclusion that there is actually a genetic basis for someone’s reaction to THC,” Lem told CBC. “”If people understand how their body reacts to cannabis, that’s a good thing,” he added.

However, another expert cautioned that such a genetic test could provide all the answers with 100% accuracy. Dr. Bernard Le Foll, a team member with the Centre of Addiction and Mental Health that created recommendations around cannabis usage, was quick to remind everyone that “there has been limited research done on cannabis.” He urged the need for tests with a larger number of participants before drawing any substantive conclusions.

In addition, Le Foll said more factors are at play when understanding the body’s reactions to a type of drug like cannabis. Maybe in the future we’ll be better at accurately predicting someone’s response to marijuana, though “we’re not there just yet.”

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“The type of environment, the type of previous drug exposure, the dose — that is all very important, possibly more important than genetics,” added Le Foll.

While we can’t fully know how cannabis will affect each individual, Lem added his test is only to help consumers make better decisions. As edible products hit stores this fall in Canada, it’s important people know not to take more than they need. But I’m not sure we needed a genetics test to help consumers understand not to be gluttons when using marijuana.

Brendan Bures

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December 4, 2023
I Kept My Schizophrenia A Secret For 20 Years. Everything Changed When I Told A Friend.

On a Thursday this past July, my husband and I drove to our county’s police academy training facility. A uniformed officer let us in. We were escorted through several hallways and into a conference room, where I was scheduled to speak representing our local National Alliance on Mental Illness office.

Standing at the front of the room, I introduced myself first with all my accomplishments ― my recent graduation from a certificate program at Columbia University, the classes and workshops I teach, and a 25-year marriage. Then I added: “And I live with chronic paranoid schizophrenia, which is why I’m here to talk to you today.”

I spoke for nearly an hour about the five types of hallucinations, the time the voices I heard identified themselves as God, Jesus and the Holy Spirit, and how I frequently thought my food was poisonous due to paranoia. I also touched on delusions I’ve had while psychotic.

It’s important for officers to hear the information of someone with lived experience of a severe mental illness, because they so often encounter people who are in a mental health crisis in the course of their duties. I want them to understand that psychosis can make people act erratically, but that in many cases, these people can be treated successfully.

To the best of my ability, I answered the officers’ questions about all aspects of living with schizophrenia. Many thanked me for coming, and for my vulnerability about a diagnosis that still has a great deal of misinformation and stigma associated with it.

I kept my mental illness a secret from friends, in-laws and employers for almost 20 years. Since 2015, I’ve been making part of my income by telling the details of what it’s like to live with schizophrenia. I talk to law enforcement, nursing students and people studying marriage and family therapy, and at treatment facilities for those who are living with a similar diagnosis.

Sharing my story helps certain groups understand mental illness better, and helps those living with it to feel less alone in their journey. The details I share can help professionals better understand what it’s like to have a break from reality.

In my late 20s, I started to have thoughts that people were out to get me. As the paranoia increased, I stopped eating and sleeping. My relatives brought me to a hospital, but it was several days before I agreed to inpatient treatment. My hospital stay led to a diagnosis of bipolar disorder with psychotic features. At the time, I had a lot of denial and shame about the labels that became a part of my identity.

Telling people I had a mental illness ― especially the men I was dating ― almost always ended with them disappearing from my life. I remember one man saying “I simply can’t handle this” when he ended things that very day, although I had never shown symptoms around him. I learned early on that mental illness was a deal breaker for many relationships.

When I met my current husband, he also had reservations about my diagnosis. When we first dated, I wasn’t compliant with my medication, so I moved in and out of severe episodes. I attempted suicide twice, and had many episodes of hearing voices, paranoia and delusions.

We stuck together, though, and even after he witnessed my symptoms, he kept supporting me. Not too long after we got together, I began to take my treatment more seriously, and we were able to focus on building a foundation for our soon-to-be marriage.

By this time, I had learned not to mention my illness to people, so it became a secret between my husband and me. My family knew, but we didn’t tell my husband’s family. We didn’t tell any of his co-workers, or the friends we started to make after we bought a condo near the Los Angeles city limits.

It wasn’t just the stigma and rejection I’d experienced that kept me silent about my struggles. It was also the internalization of the messages society had fed me about my condition and the people who live with it. I thought I was less lovable and likable, and that people who knew would view me as “crazy.”

“Telling people I had a mental illness ― especially the men I was dating ― almost always ended with them disappearing from my life.”

I had a stable period lasting almost 10 years, where I worked full-time, took classes and sat on committees for our city council. I had friends I worked with, hiked with and played racquetball with, and my husband and I regularly took trips overseas.

My psychiatrist then decided there was something amiss with my diagnosis, and took me off all medication. Within a year, I was hallucinating 24/7, not sleeping, and having a total break from reality. I remained psychotic for six months before doctors could stabilize me again.

These new doctors diagnosed me with chronic paranoid schizophrenia. It hit me and my husband like a punch. The day I got the news, we barely spoke. I remember my husband finally saying: “Well, there is nothing new about you today from yesterday.” That statement reassured me that he wasn’t going anywhere, even with this new information.

We doubled down on the secret, though, and became even more protective of our personal life and the realities of my illness. I imagined that if people had rejected me when I told them I had bipolar disorder, it would be even worse if I told them I had schizophrenia.

We’d kept this new secret between us and my family members for almost 10 years when my psychiatrist gave me a homework assignment to tell just one of my friends about my diagnosis. My psychiatrist recognized that if I was keeping a secret about something that affected my life so much, it would hold me back from being truly close to other people. She knew that hiding was isolating me from others.

My husband and I talked about it for weeks. We went back and forth on whether we even wanted to disclose my illness to anyone, after living with it undercover for so long. We talked about losing friends. We talked about the fact that once we told one friend, more would find out.

We finally decided to tell a social worker I had worked with closely at a YWCA.

Over brunch, my voice shaking, I said: “I have schizophrenia.” At first, he was a little taken aback and had some questions, but the conversation did not take over our brunch date. That night, I wrote an essay about my experience with mental illness for an online magazine. When it was published, I posted a link to it on Facebook ― and that was how my in-laws, our co-workers, and even friends who’d known me since high school found out that I was living with a mental illness.

We lost a few friends. I’m not sure if they thought “I can’t handle this,” like those early boyfriends, or if they were upset that we’d kept such a significant part of our lives from them. I often wonder if it hurt some people’s feelings to know that they were never as close to us as they may have thought because we were not living an authentic and fully open life.

I felt vulnerable and scared about finally disclosing my secret, but there was also a massive relief. For the first time since my early 30s, I could talk about myself without hiding big chunks of my reality and who I am.

I’ve been writing about life with schizophrenia ever since, and telling my story led to the position at NAMI that had me standing in front of dozens of police officers and explaining what it’s like to be in the middle of a mental health crisis.

My secret has become my tool, and I no longer hide it. I talk about it each time someone asks me to, or any time mental health is the topic. I feel like I am using a difficult situation to make a difference in other people’s lives, which gives meaning to my experience of having schizophrenia, and turns it into something that isn’t entirely negative.

I run into less stigma and more curiosity in 2023 than in all those years I lived splintered and cut off from true intimacy with relatives and friends. I am boldly myself ― my authentic self ― and I’m using that once tightly held secret to hopefully make the reality of mental illness less difficult for others like me.

If you or someone you know needs help, call or text 988 or chat 988lifeline.org for mental health support. Additionally, you can find local mental health and crisis resources at dontcallthepolice.com. Outside of the U.S., please visit the International Association for Suicide Prevention.

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September 14, 2023