Charles is a poor student studying MTech second year at IIT. 23 years old Charles hails from a village near Thanjavur. He secured good marks in his plus2, studied B.Tech at Anna University and completed it with several gold medals to his credit. He passed in the entrance examinations to join MTech at IIT.

He was sent to me by his professor for counseling. He was not willing to come for psychiatric counseling. Yet he came because he was afraid that his professor may fail him otherwise. He was brought to me by his uneducated parents doing agriculture work for wages.

I asked him general questions about his age, education and economic stature at home. He replied to all questions in single words. He did not look at me face to face. His eyes were straying around the room. Even after talking to him for over thirty minutes a good rapport with him could not be achieved.

He said “I do not have any problem. Only my professor asked me to meet you. You have to tell.” I sent him out of the room and talked with his parents. Their statements are reproduced below.

“He is not well for over a year doctor. At first he did not eat well. He stopped talking even to us at home. He got angry for all of our questions. He watched TV up to two in the night. We found it very difficult to wake him up in the morning.

Always he was thoughtful. Even if he is close, we had to call him thrice and he would suddenly turn to us at the third time.

He got acquainted with a Guruji and started meditating at all times, read a lot of spiritual books and bought many books about devotion, power and world of spirits.

About six months back he suddenly complained about a 45 years old women living next door, that she was spreading lies about him everywhere and mocking whenever he crossed her. We also went unknowingly and picked up a quarrel with her.

About three months ago he started telling that all his thoughts were getting known to everyone, his fellow students insert bad thoughts in his mind and false news about him were spread in TV, internet and everything. We understood a little. We tried to reason with him a lot. Praying at Temples, prayers, chanting, whatever we asked he performed everything.

For two months he did not eat at home. He did not answer to our enquiries. One day when we encountered him angrily he accused us of poisoning his food. We were moved to tears. One day I was enraged and even gave him a sound thrashing.”

We went to his college professor. He said “He is a good student. Of late he is not talking to anyone. He is skipping his classes. We told him what we know. He took him to a psychiatrist visiting IIT.

The psychiatrist talked to him for half an hour and prescribed a tablet. We gave him a tablet every night. But there was no improvement even after a month. One day when we cleaned the house we saw all the tablets stuffed inside his pillow cover. When we asked him, he replied “It contains poison” We met his professor again. He sent us to you.

What has affected Charles is paranoid schizophrenia. Environment is not the reason for this. It is genetic in nature and is associated with excessive secretion of a chemical called dopamine in his brain. I explained this to his parents and gave them counseling.

I came to know that tablets will not be of help as the patient is known to abstain from taking. Therefore I gave an injection. It is required once in three weeks. It will be released slowly into the system.

After five injections, his parents reported that he is behaving as usual. But he has to take medicine for a few years. He has also understood the nature of his illness and takes medicine regularly. He listens to counseling. If he continues his treatment his future will be like everybody.

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