This personal narrative of a time with schizophrenia will cover one patient’s descent into madness and ultimate recovery from a period that felt like a sentence in a prison of hell and irrationality. Following a breakdown that led to the patient’s withdrawal from graduate school, this narrative covers the experience of madness that led to delusions and hallucinations which tyrannized the patient’s world. The narrative not only follows the breakdown of humanity that cursed the patient’s understanding but also provides for the highlights of recovery that brought about a return to intellectual activities and a full comprehension of experience in the world. Though this patient’s life was destroyed by schizophrenia, including the loss of all worldly goods and a career in academia, her experience of caring psychiatrists and a loving family redeemed her life and brought about solace and renewal at last.
The scientific basis of benefits in autobiographical recall in psychosis is suggested in some recent research and review papers [1, 2, 3]. It may also be noted that some books on autobiographical issues in psychosis indicate how important personal memories are in self-help and in explaining the subjective sense of the illness [4, 5, 6]. To this end, I offer a narrative of my time in insanity. I hope that it may be illustrative of one person’s experience with schizophrenia and thus useful to psychiatrists and others who study not only the neurological changes in the brain but also the subjective experience of an altered reality and its consequences on outlook and behavior.
In the spring of 1993, I came down with schizoaffective disorder. At the time, I was a graduate student in history at a West Coast University in the United States. This disorder took me by the neck, shook out my life and utterly destroyed my career along with my hopes and dreams. To be honest, it shook up my humanity most of all and reduced me to what I now feel was a state of less than an animal. I would say I felt like a cornered beast, alienated from my friends and family and wholly cut off from the human race.
I interacted solely with dreams and created a whole world of delusions that determined how I spent my time and what I understood of reality, such as it presented itself to me. Because I had money to pay for my next year of graduate study, I was able to live off the proceeds and disappear into a large city leaving the real world and my relationships behind as I struggled to understand what I felt was the real truth of the world revealed to me at last.
What I remember most of my time alone with psychosis was how harrowing it was. I lived my days in what I considered a war zone, terrorized by an enemy I believed to be an Adolf Hitler or Saddam Hussein of dictators bent on world domination. In my opinion, I was a spy, modeled on the French Resistance. I thought I was working with a shadowy organization to undermine the growing influence and power of a madman who would surely destroy the world.
In this capacity, fear was my constant companion, my warm blanket in a dark forest of the unknown, helping to manage my response against the biting cold of evil. I regarded it as a necessary implement, useful as wool against a blizzard of pure, unadulterated madness that consumed my days. Though I was insane, I believed I was only now in possession of the real truth of the world. You could not have argued me out of my beliefs. I would have considered you pernicious and in league with the devil. In some ways, it was like being brain-washed.
In reality, I already considered most people in league with the Evil Dictator as I thought of him. Therefore, I avoided people as if they were indeed devils and only interacted with them when absolutely necessary. I lived in a world accentuated with horror as if some SS Storm Troopers followed close behind me threatening torture and medical experiments if I were caught. Because that is how I interpreted the new data of the world, represented to me in terms of code placed in newspapers and the radio that spoke to me alone of all the millions of people in the world. It never occurred to me to question this data that suddenly presented itself to me. It seemed only reasonable that truth should be given to me alone. It seemed as clear to me that the world might be flat when all along I had information that it is round. I was as certain of this new information as if I were Ptolemy mistakenly describing the circuits of the planets and stars.
In my opinion, madness came on me suddenly. Although I had early symptoms that friends began to observe, to me the break between sanity and insanity came as a matter of a moment. I can pinpoint that minute to the very instant. I was crying. Something had upset me. Something I would have coped with in my right mind. But now my emotions had become so labile. I cried and cried and cried some more. Even I wondered why I was crying so hard. It was as though I was engaged in an inebriated crying binge. And then I had a thought, a brief weird and poignant thought “This person has hurt me so much that I will go insane over it.” I would strike at this individual for upsetting me, though in reality, it was at myself I unknowingly struck. And so it began: in that moment of unwarranted grief, I went completely and clinically insane. In effect, I announced the beginning of a psychotic episode to myself.
Without warning I began to believe the disc jockey on the radio was speaking to me. It shocked me. Could this be true? Something like this had never happened before. But now it seemed quite reasonable that it might. I never thought to question how in the world it was happening or even that it occurred. It never struck me that anything was wrong with my perspective beyond the fact that I had been wronged and now here was information confirming it.
The disc jockey seemed to relate my opinion right back at me. He played a song, “Breaking the Girl,” from the rock group the Red Hot Chili Peppers. I felt vindicated. Someone else agreed that I was wronged and showed it by playing a song that spoke to that effect. So it was that the radio corroborated my feelings. A sort of coincidence became substantiated fact in the whirling insanity in my head. Of course representatives spoke to you from the radio. Can you see how tentative this relation was? But this supposed point held for me the very height of plausibility. I wondered to myself why had I never listened carefully to the radio before. In that moment of consideration, I was lost. I, as I knew myself, was gone. Long gone.
And yet many of my memories of this time remain vivid. I try to forget them as they are embarrassing and the terror of insanity is as frightening now as when it began. The memories worry me. Like epileptic fits, I worry the insanity will reoccur as if no time had passed, as if 20 years had not intervened to distance me from the consequences of irrationality. I know some people romanticize mental illness . A removal of the veil of rational thought they think imprisons us in the world. This is frankly absurd. Only someone who is not a responsible psychiatrist could make such a damaging assessment.
In reality, irrationality is an invitation to hell where nothing is as it seems. There is no freedom in irrational thinking. When you cannot care for yourself or even brush your teeth regularly, when you are incredibly vulnerable to all sorts of real evil such as theft, rape or murder, the free workings of the imagination unencumbered by rational structures threaten your daily existence. Without rationality, we are unable to examine and make sense of world, of the myriad bits of data that we experience and act upon without conscious thought. Irrationality alone is as dangerous and destructive to the mind as a tornado that tears across an urban landscape. You are forced to ask, like the poet, Sylvia Plath in Poppies in October, “Oh my God, what am I/That these late mouths should cry open/In a forest of frosts, in a dawn of cornflowers”? .
Once ruptured by such an earthquake in your mind, you are forever imprisoned by the knowledge that it continues to exist underground ready to tear open a gaping hole in your existence again. I am unable to forget the cracked hermeneutical system that governed my days. Secret codes became my life. Found in all kinds of media from television, radio, to newspapers, I felt that only I (and a special Illuminati-like few) could decode their meaning. I lived for seven long months alone with only my delusions to guide me. How I paid rent on a small, dingy room and managed to appear at least semi-normal amazes me to this day. I spent my time engaged in what I thought was deep cover as a master spy decoding messages from the shadowy organization that would alert me to secret operations and strategy against the Evil Dictator. Naturally I was a highly valued employee and most in demand. Insanity is nothing if not grandiose and vainglorious. I even went on a countrywide road trip to break down defenses that the Evil Dictator and his minions had placed in otherwise unsuspecting communities. In some respects, I felt I was successful.
See how I slip into first-person narration of the events as if they really happened? It was all so real to me that in my memory, it is not what supposedly happened but what really did. The psychotic episode lasted so long (and in a later episode continued unabated for almost a year) and was of such heightened experience, like a visit to a circus, that it feels as real to me as if it was true. I did fight against an unimaginable horror and evil that threatened my country. I was engaged in clandestine activities that led me to withdraw from my PhD program and break from all my family and friends. I feel as if the line between reality and insanity is blurred in my head. It felt so true. And that feeling remains if not the thoughts that promoted it.
For that reason, I am leery of these memories. When I approach them in depth again, the delusions make an entrance. They wander into my mind as if they had been gone only a little while and not for whole decades. Perhaps as I watch the evening news tonight, it will come to me that there is a hidden message within the supposedly objective presentation of the day’s events? Perhaps I will wonder if there is a code written as if in invisible ink that I need to decipher and respond to? Maybe I will take notes again on words that strike me as important in the anchor’s speech? Maybe I will search out the hidden meaning in the segments they choose to present on the news? Because I became so habituated and accustomed to this line of thought it comes back as naturally as riding a bike. What took 7 months to develop into a full-fledged world view seems to threaten me again like a destabilizing virus.
Thoughts like these remain under the surface of my conscious life like tiny ants nesting in the timber of a house. It is incumbent on me now to live with this now as there is no amount of talk or medicine that will rid me of a decay that threatens the very pillars of my mind. Yet, despite the remaining embers of irrationality, I have made so much progress. For this reason, I worry insanity will return and devastate the otherwise full plains of my mind. Memories will start the tapes running all over again. I live with this uneasiness, with the apprehension that I will lose years of back-breaking work to regain my life. I worry I will begin to attend to conversations again looking to find that nugget of information to organize my thoughts and actions on any given day. In my mind, I cringe from the idea that there is a full world of meaning hidden beneath the daily patterns of our everyday speech and concerns that occupy so much of our time. I remember too well where that deceptively interesting consideration leads.
That is why I am fully compliant with medication. Though my antipsychotic makes me feel as if my head has a bucket of concrete in its cavity rather than a brain, I endure it. Though I am cognitively impaired by more medication than a cancer patient takes, I put up with it being almost impossible to read nonfiction and with it being difficult to engage in social activities. Because in my first years of illness I often refused to take enough medication to mediate the insanity, I had to learn through bitter experience that the crippling sedation of antipsychotics is the most logical choice to be made in this predicament. Agonizing boredom is preferred over insanity. Loneliness is better than a whole host of delusions. I would rather be severely disabled than to be insane where the truth is never to be found and peace is not offered for any price. In fact, in my experience, the difficulties of psychotropic medications are well worth the trade-off in sanity. If you can accept the diminishment in your life of all you once held dear you can begin to build another world that may present its own joys, its own wonder in the end. It took me a while to learn this. But, fortunately, in time I learned it well.
It seems to me that one of the most difficult aspects of insanity was how upside down my world appeared to me at first. It was like being thrown into a lake and learning to swim or sink beneath fiery waters. I had never heard of nor had any experience with the symptoms of psychosis so when they presented I was unable to recognize them. Out of nowhere, I began to believe my phone was tapped. Soon, I thought someone or some persons were watching me. Can you imagine how disconcerting and alarming such concerns might be? These ideas seemed as legitimate to me as knowing who the president of my United States was, facts that sustained the essential background of my reality.
I even believed I fact checked them to determine their legitimacy. Did graffiti on a wall seem to have a message that spoke directly to me? Did flyers on a bulletin board acknowledge some truth about my reality? I related all this to my burgeoning belief system, and it seemed to synchronize with my concern that unknown persons were trying to communicate with me. Despite the obviously loose correlation of reference, why these people never spoke to me outright was a question I never thought to pursue. It was just a given of the situation, like rain comes from clouds—a fact you learn and expect to occur with some regularity.
Although flyers and graffiti might be twisted into any kind of significance, it seemed obvious to me that the meaning related directly to myself alone. The abbreviation for the World Wide Web (the “www” introducing any email address on a flyer) held a special significance for me. It seemed to have a connotation that lay in what seemed to be a simple play on letters and words: “www” spoke to me obscurely of World War III. I thought it contained a reference to the oncoming of a new and terrible worldwide war. To say that I was stunned and horrified, is to understate the obvious. I was in a panic. It began to dawn on me that war was on the brink of happening in what I had otherwise believed was a promising horizon and future as a history professor. All I knew about the world was wrong, and I thought if I only looked carefully enough, there was proof of what was true right beneath my nose.
The repetition of email addresses that appeared with the public unveiling of the Internet in the early 1990s alarmed me and caused me to rethink my position on what was really and even factually accurate. As it dawned on me that evil was about to enter my existence, and that of my fellow citizens, I was distraught. What was going on and how did it relate to my life, I thought? Although my understanding of the connotation of “www” was hardly reasonable or comprehensible, I was certain of its legitimacy. What do you do when you think world war is coming? Do you continue to pursue the studies you love or do you join in the offensive? Obviously, you do your duty by humanity like any other soldier in any other conflict. You pursue the defense of those you love and those in your country whom you value.
At first, I was furious with my friends and family who I sometimes thought understood everything that was happening long before I did. Why had no one informed me of the real state of being in the world? Instead I had been allowed to live in ignorance of a terrifying massacre that loomed in the near future. It was like some dystopian nightmare. Because no one spoke to me in what I felt was an honest and direct way about the real truth of the world, it occurred to me I was being asked to be a special operative who could work in cognito to help save my country from the jaws of sheer evil. Again, paranoid delusions lead to big dreams. You are never just a cog in the wheel. You are the main spoke around which the rest of the world looms. A Hitler of a dictator pursued me of all the people in the world (who might or might not know they were threatened with imminent destruction).
My undergraduate degree was in English Literature. I think the critical analysis of works you learn most was my undoing in psychosis. I began to believe that structures of meaning were layered into reality as they were in a book. Deep meanings took on the most important aspect of my time trying to understand the world. In this case, I had to learn to read beneath the obvious denotation of any statement or sentence. This was exhausting. Everything I heard, everything I read, everything I saw had to be decoded for its ultimate implication. What was it trying to say to me? What was the message hidden in the puzzle for me to learn and act on in my day?
I took notes. I studied advertisements, even cosmetic banners in department stores. I actually drove around and regarded numbers and letters on license plates. And even though it seems ridiculous now, everything held meaning that I had to decode. At night, I sat home and put together the layers that had been offered to me on any particular day. From this I learned (or believed I learned) about the malevolent force bent on world conquest and that I faced horrifying dangers that included the very real threat of torture and execution. I was shocked and even horror-struck. Why had I had remained innocent to the very present dangers of this world before? I came up with a complicated answer to that question, but it only frightened me more and convinced me that my series of delusions were deeply and absolutely authentic. I never shared my belief system with others though. What kind of spy would give away their intelligence I reasoned?
I even determined that my father and sister were trying to sell me to the Saudis for medical experiments. I was pretty upset with them. In general, I was pretty upset most of the time. I felt I was pursued by evil and if it won the world would come to pieces. Really, it was like one of those video games your children play. Ironically, it would have been exciting if it were not so real, I thought. None of it seemed crazy to me. It appeared all too rational and real. Despite my education, I had absolutely no insight into my disease at all.
How else did I construct these seemingly random theories about reality as I knew it? Here is an example. In 1993, a movie came out in the United States called The Net, starring Sandra Bullock. She and I had shared some similar traits. We both had moderately long brown hair. We both had brown eyes and were of similar height. Can you see where this is going? Based on a few corresponding features I began to identify with her. I felt she represented me in this movie. Movie advertisements on bus stop billboards called out to me and tugged at the recesses of my mind. I decided to go see the film. Perhaps I should have been working on a paper that was dwindling in importance to me? Instead, I paid my movie money, drank the poison, and fully submitted to the full force of insanity that was to follow.
In The Net, Sandra Bullock’s character was stripped of civilization and the accoutrements of middle-class life. Her identity was stolen from her as well as her career, home and friends. In this thriller movie, she was made to live and act underground to save her life and that of the freedom of her country which was threatened by an evil CEO of a large corporation. Can you see the parallels between some of my own hard-won beliefs and that of the fate of Sandra Bullock in the movie?
After sitting through the film, I realized I was being asked to give up my comfortable life to battle evil where it showed itself in my country. Because I resembled Sandra Bullock (in my mind), it was clear I was supposed to divest myself of attachments, including family, friends and even furniture and clothing. This would allow me to be mobile like the character in the film. It was necessary to conduct guerilla warfare with no goods to tie me to a place or family relations to threaten my commitment to being a spy. I resisted for a while but finally I gave in. I made a tearful break with my relations and the university where I was so happy. Then, I gave away most of my household items and jewelry to a charity organization. It was an awful time for me. I disappeared from my life as a graduate student into the big city where I lived. No one knew where I had gone or how I was. Imagine the distress my parents experienced. I was gone for 7 months. Who knew if I was ever coming back?
However, I thought a break was necessary to prosecute war against the worst viciousness America had seen since Hitler. Following my introduction to texts within texts, I went to a lot of movies and drew similar conclusions about how to fight an under-the-table war that might damage the standing of a rising dictator. Such conclusions reminded me of Elie Wiesel in Auschwitz who said, “Could this just be a nightmare? An unimaginable nightmare … We must do something. We can’t let them kill us like that, like cattle in the slaughterhouse. We must revolt.” . Although Jews in concentration camps were unable to revolt, I felt it was incumbent on me to fight back, to fight against the madness in the deepest of nights in my head that I only assumed was real.
To be honest, I engaged in a lot of magical thinking and ritual actions. I would say I was essentially engaged in casting spells that I thought would safeguard my well-being and threaten wickedness as it loomed. If I said a ritual incantation correctly, it would bar the Evil Dictator from acting. I spent a lot of time interpreting the code I found in newspapers and daily life, such as advertisements on display cases in stores. From this code, I extracted pieces of information that told me what words and in what order to recite them to counter the evil perpetuated by those who would oppress my nation and its vulnerable and innocent civilians. As far as I knew, I was engaged in my duty to my country for those 7 months until in the real world I was finally caught and hospitalized by the police. The only threat I presented to anyone was to myself. Violence against others was against my code of conduct.
In my altered state, I believed danger threatened me from all sides. Perhaps it is easy to see how frightened and disoriented I felt and became. Sheer panic and anxiety became my closest friends. What was left of my world was shattered with the development of the disease. As time went on, madness became more of a tyrant and ruled my hours and days like an emperor controlling his court. It was not only perceived physical danger that threatened me. There was also the severe mortification of my humanity as the disease preyed upon and destroyed my mind.
At a certain point, I decided that anyone and everyone could read my mind. Though I could not see into anyone else’s head, I believed my thoughts were as visible as if seen through clear glass. Truly, this belief was daunting and disturbing. Many of our thoughts are not fit for public consumption. It is the nature of consciousness. We are torn by drives, aggressions and feelings we barely understand. Should they become public knowledge we might well be considered anathema. So the disease also ripped away at my humanity. It felt as if I was beset by devils: one day, racial epithets became engaged in my brain and from that day forward they never stopped. I was appalled. I had not heard words like this unless delivered by ignorant, bellicose morons. And I believed that everyone could hear them as I passed by. It was as true for Italians or Middle Eastern peoples. No gender was safe from the viciousness I hurled at people as I passed by. On streets I called women whores and worse. I tore into Eastern Europeans as Pollacks. I was completely unable to repress these thoughts in my head. And I thought that everyone heard them. I was mortified and distraught. I used the utmost of my energy to repress these ideas and to kill them off but it was of no avail. They occurred and recurred like hiccups, rising to the surface and bubbling forth with no help for them but to apologize profusely in their wake.
One day I took a cab ride. I decided the cab driver looked like a child molester. In my head I told him so. Naturally, I believed he heard this judgment as loud and clear as if I spoke through a megaphone. Fortunately, I was unable to register how he replied in his own brain. Notwithstanding I apologized in my head. Over and over again, I begged him to forgive me for thinking such an awful thing about a stranger who had done me no harm. Once the thought had come, it repeated itself as if on a loop. I had no control over it. I believed the thought was offered as loudly as if in spoken word. In essence, I insulted this poor man repeatedly and violently. He continued to be polite despite my repeated denigration of his looks. I was not fooled. I knew he heard me and that he was as strictly offended as I was desirous of not causing offense. This happened to me every day, and it came without warning. I found it terribly hard to bear. Essentially, I believed I was hurling damaging racial vulgarities and insults to anyone at any time on the street. I have left out the worst of these experiences as they remain unprintable. This was another reason I began to avoid people like the plague.
At once I was being asked to exist on two planes. On one level I spoke out loud to people. “Will you show me that camera in the case,” I might ask? And then, since the clerk could read my mind, another thought came to me which I only believed was heard out loud. “Are you being sold as a slave to an overlord,” I might conclude in my head? Whatever reply the clerk gave in spoken language would be my clue as to what I was supposed to learn from the shadowy resistance organization I worked for. This kept up month after month. After some time, the dual nature of the labor left me completely exhausted and broken down. However, although I believe I asked for it, I found no recourse, no relief; I had to run to keep up and never stop running. Also, I was no longer sleeping much. I felt on the verge of a breakdown. As I recount these memories, I remember just how painful they were and yet how absurd and outlandish they may appear today. Yet, imagine this is your very reality. You sincerely believe you have just called someone an unforgivable name. Right to their face. How do you cope with that and still feel human? I sincerely believed my humanity was being undermined and deposed. I fought vainly to retain my decency in the face of the inner violence that surrounded me at all times.
I felt keenly the breakdown in my humanity that is involved in psychosis. Not only was I besieged by a fear of physical danger in my external world, but I was overwhelmed by the changes in my mind that invaded my inner world and left me no place of safety or peace. Coming near on 7 months of uninterrupted insanity, I began to understand I was being pursued by the Evil Dictator so I could be transformed into a monster-like, zombie serial killer. This sounds like an advertisement for the year’s most frightening horror flick. Instead, it was a belief that terrorized me and caused me to become frantic and desperate. I was in great danger of harming myself as I tried to avoid a fate that I thought ran me down like a shadow.
After about 5 or 6 months of psychosis, I developed anhedonia. I remember when it came on quite vividly. I was engaged on my road trip to try to save the United States from booby traps set like land mines by the Evil Dictator and his ruthless, unorthodox government. I drove from state to state across the country intent on and invested in my magical thinking where I had only to speak to dismantle snares set for an innocent population. I never knew exactly what sort of traps these might be. It never occurred to me to wonder. It was only my duty to proceed according to the information I thought accrued from codes left in the media or in spoken word by various informants (from hotel clerks to cashiers in gas stations and grocery stores). The whole world was involved in my madness and that seemed quite logical to me. I can only imagine how I presented myself to various people with whom I interacted. In essence, I was on a giant treasure hunt with a return to the status quo of the country as my golden statue.
I was driving through Utah when I first noticed the anhedonia. As I wound my way through canyons, there were picturesque or scenic pullovers on the shoulder of the freeway. I drove into one and walked out onto a cliff to view the beautiful striations of color that curved their way in rippling stripes along the canyon beyond me. I had seen pictures of Utah ravines and chasms. Now, I found myself with an opportunity to really observe them in their glory. I anticipated the joy I would find in taking a moment for myself in a day I regarded as full of hard and intense work (remember, license plates absorbed my attention at all times, I took notes on them as I drove).
Only nothing happened. I could see the mineral deposits in the side of the cliff were gorgeous. I could see the various colors that stippled the rock before me. Yet I encountered no emotional reaction in response to this view. I felt no pleasure or joy in seeing the beauty I knew was there but to which I could no longer respond to or even feel. I was astonished and sick at heart. I really began to feel my humanity was being stolen from me piece by piece. As in truth it was, but by the breakdown in my own brain not through the machinations of another. I attributed the anhedonia (a condition I had never heard of before) to plans for my utter destruction. What could I do but continue the morning along with my significant work? Although I felt like others before and after who might say, “It was like I was no longer a person,” . I was attuned to duty and felt its claim on me.
There were other times I experienced hallucinations that terrified me. I understood they were not real but the experience was painful nonetheless. In fact, I believed I was being tortured but I did not know how to stop it. For a while when I closed my eyes, cartoon characters appeared in the black darkness before my eyes. These characters were bright as neon strobe lights and in all colors of a crayon box. They streamed before me back and forth like ghosts on a Halloween string. They were so bright it actually hurt my eyes. The only way I could modify or impede them was by keeping my eyes wide open no matter how fatigued I felt. Of course, this made sleep particularly difficult. And I was so afraid. I was afraid I would go blind from the intensity of the figures before me. For some time at night, I kept my eyes open until I could fall asleep from sheer and utter exhaustion.
There were also periods where I experienced strange auditory hallucinations. I knew these sounds were just as unreal as the cartoon images that plagued me. And yet in their own way, they too were frightening. I heard murmurings in back rooms that sounded like low voices on the radio. Murmur, murmur, murmur they went like a broken record, like a recording or stimulus designed to drive you insane. Many rumbling voices muttering words just below my range of hearing. I also attributed this hallucination to a form of torture. I believed the Evil Dictator was threatening me with what I might encounter next if I continued to oppose his reign and to work actively to resist him. Ironically, I believed he was threatening me with insanity. At that time, though I was sure I was sane, I was concerned that evil might undermine my grasp of reality. I continued to feel that my grip on sanity was good though in reality I was disintegrating beneath the unimpeded development of madness.
It was late into the development of schizoaffective disorder that my experience of anhedonia and these series of hallucinations led me to reason that my soul, my very humanity was under attack by the evil enemy. Over time I concluded that I was being transformed into the zombie serial killer who would roam the streets and assassinate individuals according to the will of the Evil Dictator. It seems a little bit like a Star Wars plot to me. In this case, good was being ravaged by a terrible, spreading evil. Already I could not experience beauty anymore. An afternoon breeze on my cheek left me feeling nothing. I no longer took pleasure in its soft touch through my hair. I could feel the light wind, but I did not have a reaction to it in my own heart anymore.
To be transformed into a zombie serial killer is a conclusion that sounds almost laughable when put into print. Yet, I believe it shows the propensity toward magical thinking that pervades our unconscious when no one is looking. From these experiences, I drew conclusions that led me to believe the loss of humanity I experienced was due to an external force bent on my destruction. One experience led to another until I felt that I was being threatened with becoming an inhuman creature. So that one night when I looked out a window on the ground floor of a hotel and saw a ragged drug addict or alcoholic stumbling through the street I believed he was one of those killers searching for me through darkened streets. To me he was the walking dead. It seemed a horrible confirmation of accumulated fears in which I believed I was marked for death. Some zombie assassin would savagely murder me, and then, like a vampire, my transformation into one among a vast serial killer army would be complete. I would be as devoted to the Evil Dictator as any SS officer in Hitler’s army. You can see the fairy tale-like thinking that pervaded my conclusions. The good versus evil duality that defined my days. And especially the externalization of cause and effect of symptoms that were really creating havoc in my own brain.
And then one day, to my great surprise, I was what you can call sane. It happened that I was finally cornered and apprehended by the police and sometime later, fell under the care of a wonderful, caring psychiatrist who attended to my diagnosis with what was the newest and most radical psychotropic medication of the time, Risperidone. Suddenly, I could understand, I felt, I could reason again. I might end my story here but it would be the wrong position from which to close my account. It took many years and several extended periods of delusions for me to recover from mental illness. As much as one might say they are able to recover. I want to point out, however, the crucial role psychiatrists play in the recovery of sanity and humanity again after long stretches of madness. I have had two devoted psychiatrists for over 20 long years now. In this, I know I am blessed. Their long experience and strength of character have been instrumental in my recovery from delusions and return to a life beyond that of solipsistic ideas dreamt up in nightmares. I believe both of them helped me to become a better person than I was going in to psychosis.
I think my psychiatrists focused their efforts on the recovery of humanity whose loss was so traumatic for me when I was ill. Both have consistently treated me with dignity, charity and compassion. They behaved toward me as if my delusions were never an irritant or imposition. They worked as the people do who love me, with a concern for my state of mind, my happiness and my overall well-being. When I could not reason, they were the voice of reality. When I considered myself an aberration and a monster on the very edge of society, they reminded me of what I had accomplished and perhaps could achieve again in small measure. They stood by me just as a parent will and supported my dreams. They never discouraged me from being able to function at any level. They saw me through every struggle, every failure, and every time I felt lost and adrift in my world. In conclusion, they behaved toward me as if I were as important to them as a loved one is to a family member. They insisted on my humanity and sought to save my soul even when I was as torn and shredded as a sick animal.
An example may suffice. Today, my current psychiatrist is sensitive to the fact that I still feel overwhelmed by irrational fears. I believe at least some of these fears are a side effect of the dose of Risperidone. They increase or decrease with the level of the antipsychotic medication. But because of these irrational fears, cold winter snow days and icy stretches of road terrify me. I am consumed with fear of some conflagration of an accident on slick, ice-covered pavement. Although such fears have little basis in reality, my psychiatrist remains flexible if I ask to change an appointment away from a date that calls for snow. She has always reacted with kindness and sympathy if I would like to change an appointment according to the images of death and violence that crowd in on my imagination. These fears are not amenable to reason and continue to haunt me year after year.
Honestly, her response has been a great relief to me and has helped me to function better than if she ignored my plea or were uncompromising in her reaction to my very pressing fears. My psychiatrist cares for me. It shows and is significant in how I approach other people as I aspire to pick up the pieces of my life. I know she does not think of me as a freak she studies or is saddled with. This has a great impact on my confidence in reaching out to other people. It is also a balm for my heart that has been ravaged by illness. I am fragile now. Both of my psychiatrists have never questioned this fact or challenged me to rise before I could stand. Instead they have held out a hand. It is the very dignity they offer that has reached into my heart and touched my soul. In conjunction with pharmaceuticals, I believe this has laid the foundation for my return to health.
In addition, I will never forget, nor cease to be grateful for, my first psychiatrist . When I first met him, I believed he was a covert member of the CIA who intended to inflict painful, Dr. Mengele-like, medical experiments on me. Of course, I was alarmed, and I hated and distrusted him on the spot. I held every grudge against him that could be imposed by a paranoid mind. In the interests of self-preservation, I meant to deceive him at every turn and to mislead him both of my intentions (at that time to harm myself) and as to how I hoped to escape what I thought were his dangerous clutches. Yet, his attitude of decency and kindness seeped into my conscious mind. He treated me with patience and kindness. He asked me questions about what I believed. He spoke quietly and reassuringly about what was going to happen to me now and how he wanted to treat me for illness. Although I was sure I was sane and that my psychiatrist was a genuine, threatening representation of evil, I made note of his apparent unconditional support. Despite myself he was soothing to me, and when medical experiments did not materialize I began to trust him.
My first psychiatrist switched my antipsychotic from Haldol (prescribed for me in a hospital) to Risperidone. The only effect Haldol had on me was to make me feel sick. But use of the Risperidone immediately had an effect and right away I began to understand something was desperately wrong with my world view. You cannot imagine how grateful I was at this turn of events. At the time, I was petrified that the end of the world was at hand. The calm manner of my psychiatrist emboldened me, and I was able to take what seemed a tremendous chance to talk to him about what I really believed was happening in the world. My psychiatrist was so quiet and unassuming. He never made a fuss or tried to force me into understanding that my belief system was illegitimate. Instead, he simply told me that what I believed to be true was a fantasy. Within a week of being on this new medication, I could see what he said was true. So I began my back breaking climb away from the valley of hell.
The point I want to make is that I haven’t made that climb alone. In conjunction with my parents and psychiatrists I have forced myself to take one step after another. They were the hands that steadied me. So one leaves perdition behind, on the faith of others that you can rise. With the faith that the devil’s playground is not your ultimate resting place. Without them I believe I would be less myself, less the human being I was before and who I became. It is with gratitude for kindnesses and love that I have stood up once again and planned for the refoundation of a home on fertile plains.
I write this account not to gain sympathy but in solidarity with those who remain ill, with those who find themselves on the street, who do not know the helping hand of compassion. Without a cure for the delusions I too might have become homeless and in and out of penal institutions. In my case, the police rescued me. My doctors brought about salvation and protection. Medication worked effectively for me and revived me. My parents made possible this life we have constructed together in the wake of destruction. So, I am always mindful of those who refuse treatment and remain hopelessly insane. May we remember them when we vote for politicians or city councils who support mental health treatment and outreach to those who remain in their own private corner of hell.
Conflict of interest
The authors declare that there is no conflict of interest.