All along the aisles of the grocery store, the faces stare. Some are benign, others malevolent. Or so it seems. Their lips don't move, but their voices and derisive laughter fill the air. It is a relentless cacophony.
"Who let him out?"
The inside of a schizophrenic's mind is a very scary place.
While only someone afflicted with the mental illness can know what it's like to be at the mercy of delusions, an interactive computer technology called Virtual Hallucinations is allowing others to experience a snapshot approximation.
Wearing earphones and viewing goggles, a person can step into the schizophrenic's shoes and see the world through his eyes and ears as he makes his way through a supermarket to the in-store pharmacy counter.
"I lost my medication a couple of weeks ago and I need to get my refill," the pseudo-schizophrenic is told to say.
Behind the counter, the pharmacist seems to go at warp speed from one spot to another as she checks on the customer's insurance coverage, then says she must call his doctor. She laughs with a co-worker, but it turns into a cackling whisper: "Why did they let him out of the hospital?"
Voices, male and female, barrage the mind. "Don't take that, they're trying to poison you."
Delusions, paranoia and the attendant anxiety, depression and rage -- these are the common hallmarks of schizophrenia, a disease that affects about 300,000 Canadians, said Dr. Joel Jeffries, a psychiatrist at the Centre for Addiction and Mental Health in Toronto.
The seven-minute Virtual Hallucinations tour cannot fully replicate what a schizophrenic goes through, especially putting "into your mind the idea that somebody is controlling you," said Dr. Jeffries. "It's just a fragment of the experience, but at least it's an attempt to create [it]for people who would have no idea otherwise what psychosis is really like."
The computer tool, developed by Janssen Pharmaceutica and Elan Communications, can be used by mental-health professionals, police, hospital personnel and others who have daily contact with schizophrenics, so they can better understand the disorder, he said.
The exact cause of schizophrenia is unknown, but it seems to be rooted in an excess of the brain chemical dopamine. Doctors believe some people have a genetic predisposition for the disease, and research is focused on finding the specific gene. As well, a small proportion of cases arise in children born to mothers infected with a virus around the fourth month of pregnancy.
Symptoms -- starting with anxiety, depression and withdrawal -- usually begin in the late teens or early 20s, Dr. Jeffries said. "That turns into a more flagrant psychosis, where there are hallucinations, hearing voices, misinterpretation of what's going on around you, thinking people . . . know your thoughts, that they're putting thoughts into your mind, they're controlling you."
For young adults who become prisoners of their own minds, the future can seem bleak.
"It's an illness which affects almost every aspect of somebody's being," said Ursula Lipski, a spokesperson for the Schizophrenia Society of Ontario, part of a national charitable organization that supports families and victims of the disease.
"It's the time of their lives when they're starting to move forward in their education, maybe building their career, and they're stricken with an illness that really impairs their judgment," Ms. Lipski said. "They may lose contact with reality and virtually their entire life is turned upside-down, as is the life of their family and people around them."
If left undiagnosed and untreated, most schizophrenics are unable to concentrate well enough to work or go to school. Although there is no cure, anti-psychotic drugs can control delusions and hallucinations, said Dr. Jeffries, who uses psychotherapy to help patients "grieve about the loss of their mind, the loss of their expectations, the loss of relationships and the loss of vocational and educational goals."
Some who don't receive treatment or are unable to keep on a drug regimen end up homeless. Unable to afford housing, they either rely on group homes or live on the streets.
"They may develop a kind of vagabond lifestyle or behave in ways that make them unacceptable to even be in hostels occasionally," said Dr. Jeffries.
Schizophrenia is estimated to cost Canada's economy more than $4-billion each year in lost productivity and health-care and medication costs, said Ms. Lipski.
In October, Schizophrenia Awareness Month, Ms. Lipski's organization puts on a special push for donations to fund research and runs public education campaigns to dispel the myths and misunderstandings about the illness.
"What we need to do as a society is to begin to understand mental illness, the impact of it on individuals and on the broader society . . . and to integrate people with mental illness into society."