They are used in movie plots, crime and medical TV series and psychological best-sellers to shock and awe viewers and readers. We list some unusual psychological disorders that make us wonder about the intricacies of the human mind and shudder at the range of disturbances possible. According to Thomas M.J., consultant and coordinator in psychiatry, Sagar Hospital, Bangalore, such syndromes are indicative of some form of abnormality in thinking and there can’t be uniformity in treatment even for two people suffering from the same syndrome. Psychotherapy, gaining insight into the thinking process of the suffering person and precisely tailoring a treatment to match his problem, is what works.

Alice in Wonderland/Todd’s syndrome

Named after the Lewis Carroll masterpiece, this disorder causes a person to imagine objects to be much larger or smaller than they are actually. This distorted perception seems to be a temporary condition, caused by migraines, hallucinogenic drugs and brain tumours.

This condition could also be an early sign of infectious mononucleosis, a disease caused by a type of herpes virus.

Treatment: Treatment for the temporary or acute condition is similar to that for migraine. If it’s a chronic condition, there is no permanent treatment.

Capgras delusion

Joseph Capgras, a French psychiatrist, first described this disorder in which a person has a delusion that the spouse, a friend or any other close family member has been replaced by another identical-looking impostor. This leads to the person refusing to have anything to do with the person, treating her/him with complete distrust. Earlier, the disorder was associated only with women. Now it is proven to exist in both men and women, as a part of paranoid schizophrenia, and in patients suffering from brain injuries and degenerative disorders.

Treatment: Antipsychotic drugs and personalized psychotherapy are the mode of treatment advocated.

Trichotillomania

This term was coined by French dermatologist François Henri Hallopeau. In Greek, trich means hair; till to pull; and mania is frenzy. A person suffering from this disorder has a compulsive urge to pull out her/his own hair (scalp, eyelashes, eyebrows or other body hair) and sometimes even eat her/his hair, leading to patchy hair loss and semi-baldness. Usually originating between nine and 13 years of age, trichotillomania is said to be caused by anxiety or depression, or is seen as a symptom of obsessive compulsive disorder.

It often involves a feeling of increasing stress before pulling one’s hair and a sense of relief after pulling it out. People suffering from this disorder often pull out one hair at a time; each episode could go on for a few hours. They can go into a relapse, which can last from days to years, where they lose the urge to pull out their hair. Where the hair pulling is accompanied by ingestion of the hair, it leads to a condition called trichobezoar, where the hair, being indigestible, accumulates in the stomach to form a hair ball.

Treatment: Current treatment modalities for this disorder include psychotherapy and antidepressant medication.

Munchausen’s syndrome

Most people want to avoid falling sick or going to a hospital. Those suffering from Munchausen’s syndrome are quite the opposite. They invent and play out illnesses, going to doctors, getting investigated and even going through surgeries just to gain attention and empathy. They turn into experts at inventing, causing fainting spells, taking pills to induce symptoms like diarrhoea, cutting themselves, burning or exaggerating disease symptoms that can convince the best of doctors that something is wrong with them. People suffering from Munchausen’s know they are healthy, whereas hypochondriacs believe that they are unwell. This is seen more often in young and middle-aged men.

The triggers for Munchausen’s could be a history of abuse, serious illness during childhood, the death of a close relative after a serious illness, or the desire to work as a healthcare professional. People with this syndrome have a baffling knowledge of medical terminologies and a history of seeking consultations and treatments at a string of hospitals and doctors.

Treatment: It depends on the underlying psychiatric disorder, whether anxiety, depression or personality disorder. The prognosis too depends on this.

Munchausen’s syndrome by proxy

Unlike Munchausen’s syndrome, where the person wants to make people believe that s/he is unwell, in this case the person (usually a caregiver) knowingly falsifies information or inflicts harm on the person they care for, to get sympathy. The most common situation is a mother pretending her child is sick or making her child sick to gain attention and sympathy. It is baffling to hear of the extent to which an affected person can go to convince people that the person under her/his care (usually the child) is unwell, such as changing test results (by contaminating urine/blood samples), starving the child, or inducing vomiting, etc., after which the caregiver (usually the mother) will insist that the child should undergo numerous investigations to diagnose the problem. When the mother is suffering from this disorder, and inflicts damage on the child, this becomes a form of severe child abuse.

Treatment: This disorder is difficult to treat and requires intensive, long-running therapy.

Stendhal syndrome

This psychosomatic disorder gets its name from the famous 19th century French author Marie-Henri Beyle, better known by his pen name Stendhal, who described his experience when he visited Florence in 1817 in his book Naples And Florence: A Journey From Milan to Reggio. It is also called Florence syndrome or hyperkulturemia. A person suffering from this syndrome reacts after being exposed to stunning natural beauty, breathtaking works of famous art, etc., in a short span of time and has symptoms such as palpitation, dizziness, vomiting, even hallucinations. It could affect any age group. The symptoms are known to resolve gradually when the person comes back to his normal surroundings.

Treatment: It is advisable for people with pre-existing mental illnesses to undergo counselling before visiting places of high emotional and personal significance.

Foreign accent syndrome

This is a rare condition in which a person suddenly develops a foreign accent. It usually occurs after a head injury or a stroke, and is believed to be caused by damage to the part of the brain responsible for linguistic functions, resulting in mispronounced syllables or a changed pitch that makes the speech sound like the person has acquired a new accent.

Treatment: There could be some benefit from speech therapy and counselling.

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