What do my friend's hallucinations indicate?

September 8, 2016 7:25 PM

My friend (a 35 year old woman) has experienced two weird hallucinatory experiences in the past two weeks right when awakening from sleep. She described it to me as a "fisheye lens effect" where she doesn't recognize her own fingers, everything in the room looks "off" and is too bright. More details inside.

The experiences both lasted about 15 minutes. During one of them she was nursing her infant and the sensation of milk coming out even felt unusual. Her body feels weird and she hears sounds differently -- she said it felt like being on drugs. I asked about if she's ever taken hallucinogens (flashbacks were the first thing that came to mind) but she said it was 15 years since she had done anything like that. She's not on any new medications and barely goes to the doctor because she doesn't have insurance. Possibly significant: she did tell me she had started purging food a couple months ago. I wasn't able to find any resources for her for that at the time so it might still be going on.

Does this sound like anything in particular to anyone? Thanks!

posted by Locative to Health & Fitness (25 answers total)

Postpartum psychosis is a thing..
posted by aetg at 7:35 PM on September 8, 2016 [8 favorites]

Her life sounds very stressful and she seems to have few resources. It is great she is confiding in you, can you find out what insurance options/low cost health care is available to her and offer to take care of the infant while she gets professional help? Can you offer babysitting on a regular basis to reduce her stress? A friend did have hallucinations and psychosis during her postpartum depression but that may not be the case here - only a professional can evaluate her.
posted by saucysault at 7:37 PM on September 8, 2016

Can she go to the doctor? Since there is an infant involved, I'd vote doctor. This seems like a potentially serious situation since it only takes a moment to accidentally terribly harm your newborn when you don't have all your senses working for you. Doctor.
posted by Kalmya at 7:39 PM on September 8, 2016 [7 favorites]

Response by poster: She doesn't have a car and her husband drives out of state to work every day. She does have severe postpartum anxiety, and lifelong anxiety. I met her because she was so nervous about attending the parent-related group I volunteer for and I told her I would stay with her the whole meeting to assuage her fears. She did great, she's gorgeous and clever and we became good friends. She has gained about 100lbs in the last couple years and has extreme shame associated with it that makes her incredibly uneasy and fearful in public. She's off Xanax because of the breastfeeding. I think her son is about 8 months old now. Could postpartum psychosis start that late, or morph from PPD/PPA? She dotes on her son. I would be able to help her get to a doctor, of course.
posted by Locative at 7:48 PM on September 8, 2016

If she's nursing, is it possible she's extremely sleep deprived? That coupled with purging has got to be taking a huge toll on her body, that could absolutely be indicating she needs to listen to her physical needs of getting enough rest and food.

Regardless of the cause, I agree with the above re doctor.
posted by A hidden well at 7:49 PM on September 8, 2016 [10 favorites]

Is she eating potatoes or other foods with resistant starch? This video is funny, but this happened to me when I went on the potato hack diet. Resistant starch feeds good bacteria in your large intestine, and those bacteria produce lots of serotonin and GABA. I had lucid epic dreams that were pretty intense and fortunately really wonderful.
posted by waving at 7:52 PM on September 8, 2016 [5 favorites]

Also possibly a contributing factor is benzo withdrawal, which can persist for a startlingly long time.

I think your help here in getting her to the doctor and supporting her in securing treatment would be a great kindness to her and her child.
posted by praemunire at 7:52 PM on September 8, 2016 [3 favorites]

I don't think this has anything to with hiw awesome she is. She may have PPD or hormonal imbalance or another issue. The weight gain is concerning because it means she's emotionallu or physically really struggeling with something. A doctor can help with those issues. We agree she's awesome and we want her to get medical care for whatever potentially serious thing this is.
posted by Kalmya at 7:53 PM on September 8, 2016 [1 favorite]

Hormones are a much much more likely explanation for this than any drugs she did 15 years ago. While this is likely the chemical maelstrom of post-childbirth/breastfeeding + sleep dep, given all the other factors if you could get her to a doctor (preferably her doctor, but urgent care would do) just to see someone so that if it (or something else worrisome) happens again she can see the same person/facility again, you would be doing her a kindness.
posted by Lyn Never at 7:58 PM on September 8, 2016 [1 favorite]

When I was post partum I was so sleep deprived that I hallucinated babies. No joke. How is her sleep?
posted by St. Peepsburg at 8:06 PM on September 8, 2016 [3 favorites]

Another vote for extreme sleep deprivation. She may not have even been awake at all.
posted by BlahLaLa at 8:37 PM on September 8, 2016 [3 favorites]

although it could be anything already mentioned, it also sounds like one of the ways people get migraine aura without the headache. There's lots of variation in how people experience them, but hard-to-describe visual disturbances, narrowing of visual field, the feeling that your hands or other parts aren't connected to your body the way they usually are, those are all familiar things. The purging doesn't sound connected to these episodes but if she's experiencing nausea, that also goes along with it for some.

but I don't think it would be much help to her to have anybody but a doctor suggest this possibility to her, unless having it as a potential explanation would help her decide to go to a doctor. If by some weird chance this is what it is, migraine/aura is often set off by sleep deprivation, stress, hormonal issues, etcetera, so she'd still need to do whatever can be done about those things.
posted by queenofbithynia at 8:50 PM on September 8, 2016 [5 favorites]

These are hypnopompic sleep hallucinations. In diagnosing psychoses, these are specifically excluded as criteria meeting hallucinations. So many circumstances can cause them (including nothing in particular) but with a newborn + anxiety I would agree with all above: Doctor, now please.
posted by The Noble Goofy Elk at 8:57 PM on September 8, 2016 [3 favorites]

SHE'S NURSING.

I could go on. Nothing feels weirder than being a new mom, I swear I used to hear the air vibrating. Like, I could swear I heard moth's wings flapping and frequencies usually dogs can hear ;))

Sleep deprivation, vitamin deficiency, just how taxing it is to make another person within your own body. Hormones. Anyway, I most likely could not hear moths wings or ultrasonic frequencies. But it seemed real for a moment there. Heh.
posted by jbenben at 9:12 PM on September 8, 2016

I also hope the family looks into ACA-related health plans, and other lower-cost healthcare options. Please remind her too that many med offices allow installment payments. (You say she dotes on the child so I hope that means baby is already getting regular dr. visits.)

IANA doc or nurse. But I do wonder if there is something common-ish at play like hypoglycemia or low potassium. *Purging* while also breastfeeding and possibly sleep deprived? She's taking a lot out of her body.

You're a good friend. Keep encouraging her to visit a doc. Assure her there's No Judgement there, they just want her and baby to be healthy.
posted by NorthernLite at 10:12 PM on September 8, 2016 [1 favorite]

That sounds almost the way I describe ocular migraines - visual disturbance, lasts about 20 minutes, too bright, a funked spot in the middle of my range of vision and the migraines occur in groups (so I might get one every few days for a few weeks and then not again for a few years). I never get the headache or pain, just the 20 minutes of vision problems. Before I knew what was happening, I found the ocular migraines to be incredibly disturbing and terrifying.

Of course, your friend needs to see a doctor. I share my little migraine anecdote only so she knows that there are lots of possibilities that are minor and manageable.
posted by 26.2 at 12:53 AM on September 9, 2016 [2 favorites]

Another vote for migraines. Among other symptoms, I get very severe visual disturbances and parts of my body go numb as if I'm having a stroke. I think dehydration and/or vitamin deficiencies can be associated with migraines as well--mine actually stopped when I started taking some supplements that my doctor recommended.
posted by _cave at 3:58 AM on September 9, 2016

For a while during the first year of my kid's life - after the newborn stage but while I was still breastfeeding and not quite fully rested - I would sometimes see a shadow of my cat in my peripheral vision, when she wasn't even in the room. I also had an ocular migraine during that year (which I'd had before); for me it resembles a slowly growing oval with jagged edges, transparent and rippling and shimmering, a lot like looking through a lens with drops of water on it. A google image search for "migraine aura" brings up renditions that come pretty close to what I experience.

If she's purging in addition to nursing and caring for an infant, she's probably running on empty. Is she the full-time caretaker? Is there anyone who can care for the baby for more than a couple hours while she takes a break? She needs to recharge every now and then. If she doesn't have anyone, possibly you could help her find a sitter to take care of the baby while she rests in the other room and you hang out with her. That way she gets a break and you can do periodic checks to reassure her that, yeah, the baby's fine and the sitter's doing a good job. But she needs support, and rest, and regular medical care, both physical and mental, if at all possible.
posted by Metroid Baby at 4:40 AM on September 9, 2016 [1 favorite]

She's in the US and doesn't have health insurance? Her husband drives long distances every day and doesn't get health insurance from his job? Doesn't sound right.

Does she have access to public transportation? Is there a Planned Parenthood clinic nearby? Or a local medical school with clinics? I don't think she needs to mention having taken psychedelics a very long time ago. That flashback stuff was overblown.

If she's nursing several times during the night she may be both sleep-deprived and totally dehydrated when she wakes up in the morning. That combination can make you feel all kinds of weird.
posted by mareli at 5:37 AM on September 9, 2016

I was going to recommend Planned Parenthood too. This is definitely the kind of thing they deal with, and they provide low-and-no cost care.
Sleep deprivation can absolutely distort your visual senses--I sometimes get what I call "Alice-in-Wonderland-vision" when I half-wake-up in the middle of the night, where the walls and ceiling look like they're meeting at weird angles. The first couple of times freaked me out, but now I know what it is and don't worry too much.
She might also be experiencing pernicious anemia (vitamin B deficiency) or regular anemia, especially if she's purging or dieting, or was vegan through her pregnancy. Nursing really takes it out of your body (many nursing mothers lose weight just from that) and it's not a good time to restrict calories. They can test for this at PP or another clinic.
It sounds like things are pretty hard for her right now, and if you can help with a bit of childcare, or rides to the clinic, that would be great. She might be too anxious for the gym, but maybe she could get outside for a walk or a bike ride while you watch the baby? Exercise is good for anxiety and is a healthier way to address weight gain.
posted by Nibbly Fang at 6:49 AM on September 9, 2016

Another person with migraines reporting that it sounds like it could be migraines. The fisheye-lens she reports sounds like Alice in Wonderland syndrome (common in migraines). Perceptual disturbances are also not unusual. (I woke up once during a migraine with transient hyperacusis. Seriously weird, definitely like being on drugs, and totally the result of having a migraine. Migraines will do that to you.)

That all being said: I agree with everyone above that she needs a doctor, and she needs support. If it is migraines, then she needs support to get proper sleep (and hopefully to identify the triggers so she can avoid them -- note that stress and poor sleep are both migraine triggers!). If it's not migraines, well, good to figure that out as well.
posted by pie ninja at 6:55 AM on September 9, 2016

Migraines are exactly what I thought of too (though I did not respond when I first read this because I was, guess what, just at the start of a migraine!) This sounds a lot like the visual symptoms I experience, and I find them really disorienting and nauseating. I have heard of other people feeling hyper-sensitive in their other senses as well. It really messes with your brain.

My migraines are definitely triggered by irregular sleep patterns, and oh boy do newborns give you that. But I've also had them triggered by hormones -- when I was a teenager I'd get one monthly as a PMS symptom, and while I was pregnant I got them every couple of weeks in my last trimester accompanied by new and exciting numbness in my left hand that would travel from my thumb to my pinky over the course of twenty minutes. I've had them mess up my speech patterns and make me incapable of using the correct word or forming a sentence correctly. I know of people who have them triggered by vitamin deficiencies, things they do eat, things they don't eat, or even, in my brother's case, of walking from a dark building into sunlight. So this is all to say that your friend is sort of in a perfect storm of sleep deprivation and irregularity, a hormonal rollercoaster, nutritional issues, and stress, so there is every chance that even if she's never had a migraine before, that this is what's happening right now.

But she should see a doctor to rule out any other possibilities, and to see if there are ways to help manage the symptoms that are safe while breastfeeding (I need to double dose on Excedrin and drink a cup of very caffeinated tea the moment I notice the visual symptoms, but even then I'm "hungover" for a good 6-8 hours afterward and basically useless). Since I have, for various reasons, been solo parenting a LOT throughout my daughter's first two years, I can confirm how fucking hard this can make migraine recovery and coping when there is a small child involved -- no more locking myself in a cool dark room and sleeping it off, like I used to do. So even if it is confirmed to be "just" migraines, having medical advice on how to manage them, some good and safe drugs to do so, and the support of any available family and friends to come take the baby off her hands if she needs to sleep (preventatively) or sleep (to recover).
posted by olinerd at 8:55 AM on September 9, 2016

If she's purging and breastfeeding, and this is upon waking, after not eating all night...could it be low blood sugar? I've had some really loopy feelings when I had crashes.

She really does need to see a doctor to rule out other things, especially if this is more psychosis or anxiety related. Remind her the baby needs a healthy, strong momma and that her family and friends love her and want her to be well. Good luck.
posted by jhope71 at 9:31 AM on September 9, 2016

Magnesium deficiency causes me to have weird auditory stuff and to generally feel weird. Some people take magnesium to try to prevent migraines. Purging plus nursing sounds like a great way to end up seriously deficient in something, possibly multiple somethings.

She should try to improve her nutritional status. And possibly get blood work done.
posted by Michele in California at 9:41 AM on September 9, 2016 [1 favorite]

It sounds like it could be low blood sugar, I've definitely felt like that before.

But, gently and respectfully, it sounds like it would be very helpful for her to go back on the Xanax even if it means weaning earlier than she planned. PPD, anxiety, absent spouse, eating disorder, and now this? She needs to get back on the meds and start taking care of herself, too.
posted by lydhre at 11:46 AM on September 9, 2016