Like any good horror movie, it all starts with relative normalcy. Warm sun rays filter through a kitchen window, coffee is brewing, and a fresh newspaper is resting on a counter; a television news anchor smiles as he reads the latest headlines.
Then the rosy scenario starts twisting, deforming and ultimately veering into the eerie and surreal. The coffee looks like boiling lava, and the scent goes from full and familiar to chemical. The television host grimaces and spews meanness.
Then there are the malevolent contradictory voices, the ones that tell the protagonist he's stupid, worthless and should trust no one. Not even the coffee. It's poison.
The delivered pizza? Eat it. Don't eat it. The warring impulses and voices result in mental chaos and physical erraticism.
Only thing is, this is no horror movie. It's a "normal" day for a schizophrenic patient as showcased by "Mindstorm," a six-minute 4-D experience that produces visual hallucinations and distortions for all senses.
"For us, it's like a movie because we can leave," says Portuguese psychiatrist Nuno Cunha after seeing "Mindstorm" on a recent morning during the American Psychiatric Association's annual meeting at the Walter E. Washington Convention Center. "But imagine for patients. they can't leave. It is their reality."
"Mindstorm" was created by Janssen, a division of Ortho-McNeil-Janssen Pharmaceuticals Inc.; Joseph Palumbo, one of the company's psychiatrists, helped develop the 4-D experience.
"What we're trying to get across is what's going on inside their minds - give people an idea of why they're so frightened," Dr. Palumbo says. "We hope it will help make people more compassionate."
At the convention center, the 4-D movie, which features a composite of what schizophrenics can experience, was shown in a minitheater. However, the company also has two dozen mobile units (goggles attached to a computer) that are taken to such sites as police academies and the meeting places of mental health advocacy groups.
Dr. Palumbo previously has used the device in teaching police officers about the condition. "[When an officer] encounters someone who is acting in an erratic manner," he explains, "this will help them figure out what it is they're dealing with."
"It's a teaching device," adds Ambre Morley, a spokesperson for Janssen. "It helps people recognize the symptoms and - for law enforcement - makes them think before they pull their gun."
Schizophrenia is often diagnosed when patients are in their late teens or early 20s. It is a condition that makes it impossible for the patient to integrate information. Essentially, schizophrenics - whose minds are in constant high gear (their brains actually work harder than the rest of ours) - feel as if they can't trust their senses.
Most of us, Dr. Palumbo says, have experienced these sorts of horror-movie-like moments, times when we wake up in the middle of the night and have a hard time distinguishing what's real and what belongs in the dream world.
"Most of us are able to talk ourselves down by relying on our senses," he says, "but people with schizophrenia can't do that. To them, it's more like, 'I can't trust what I'm hearing and seeing. And the voices are belittling me, and my sense is that people are out to hurt me.'"
The condition affects more than 2 million Americans.
Along with being a useful tool for law enforcement, the 4-D device also might be helpful for families, says Dr. Heather Rowe, a psychiatrist in private practice from Auburn, Ala., after experiencing "Mindstorm" at the annual meeting.
"I think it's very good," Dr. Rowe says. "It's very realistic, very similar to how patients describe it to me. It can help families understand why [their loved one] is scared all the time."
Dr. Rowe says the only thing missing in the six-minute segment is the constant mumbling of voices patients report; the warring voices in the movie are all clear and take intermittent breaks.
The condition, though, doesn't take breaks, and there is no cure for schizophrenia. Medications help dull the sensory overload, but they don't make the experiences go away.
"Medications can turn the volume down," Dr. Palumbo says. "It's like taking a Tylenol. It dulls the pain, but it doesn't take it away completely."
Medicines are completely ineffective, however, for as many as 30 percent of patients. For them and for those not yet diagnosed, Dr. Palumbo says, more effective treatment and earlier diagnoses, including possibly pinpointing the genetic marker for schizophrenia, are on the horizon.
Until then, the horror of sensory distortion continues.