My delusions, as out there as they were, are actually common to many people with schizophrenia. I find it strange that two people, as different as they might be, might have the same delusions, but this is how it seems to be.
The first theme that my delusions took was that people I knew were aliens, and that they were reading my mind. I thought that I was being integrated into alien culture, and that the T.V., radio and newspapers had hidden messages in them that were specifically for me. The second theme was that I was the second coming of Jesus Christ. I thought that all of my college friends were angels preparing me for my mission to somehow bring peace to the world. A third theme was that the world of astrology was completely true. Everyone’s personality was completely based on the signs of the zodiac, and your birth chart said everything there was to know about you. It was the age of Aquarius, which to me meant that everyone was metaphorically underwater, and the signs that had a water element to them were comfortable in society, while everyone else felt more socially awkward (strange I know).
I would say that with the exception of the last theme, my delusions were quite typical of people with schizophrenia. The paranoia that comes with the belief that aliens are reading your mind and the grandiosity that comes with the thought that you are Jesus are central to the schizophrenic experience. Although different individuals may not have the exact same themes to their delusions, things like paranoia and grandiosity are what their delusions are often based on.
My insight into my own illness came when I learned of this similarity. I was reading articles online and came across an article describing experiences similar to mine. The author of the article had schizophrenia, and at that moment I knew that I had schizophrenia as well. I finally had some confirmation that my thoughts were actually delusions and not reality, and this is what snapped me back into taking medication and getting help.
Stress and caffeine–these are the things that trigger my psychosis. All it takes is an extra cup of coffee and I become paranoid and I may even start hearing voices. On the day I realized this, I had followed an iced coffee with a bottle of caffeinated soda, and then sat for four hours in a bar with a group of people thinking every word that was said had a magical symbolism that pertained only to me.
After this incident I wizened up. I began limiting my coffee drinking to one or one and a half cups, then waiting about six hours until I drank any more. This seemed to work in controlling caffeine-related symptoms, but I still had the big monster to tackle: stress.
For me, stress at work is dealing with the person that I don’t like, and who probably doesn’t like me either. My symptoms come out when the person is around, and I have delusions that they are doing things to hurt me or my reputation. It gets that much harder to avoid being stressed out. To deal with this, I usually give the person the benefit of the doubt if the situation is ambiguous, telling myself “I probably took it the wrong way.” Other times, when it is perfectly clear they are saying something wrong, I try to fire back with something like “What do you mean?” to put them on the spot and to make them back off. It is with these tools that I can stay somewhat calm and avoid being swallowed into the world of delusional thinking, while maintaining my standing in the workplace.
If at some point I am devoured by delusions, I go to my last resort–basically I tell myself the opposite of whatever delusional thoughts come into my head. They usually come quickly, one after the other, so it can be hard to keep up, but eventually they fade and I am back to my old self again. It helps to also tell myself that the thoughts will be gone in just a little while so I am not consumed by the moment.
So, in any case, the caffeine can stay–in moderate amounts, and well, the stress I just take one moment at a time.
I was in the psychiatric ward for twenty-eight days. On day number twenty-eight I had not yet recovered, but I wanted to go home and my doctor could not force me to stay. At this point I still believed some of my closest friends were actually aliens from another planet, but I suppose I was not a danger to myself or others.
I guess that I believe in involuntary confinement, but it is hard to tell when it is necessary. I had not done anything to make it seem like I might hurt someone, but does being floridly psychotic mean that it is possible? I do not know. I do know that it is much harder to get the services you need when you are out of the hospital, so in this way it helps to be inside.
After I was out of the hospital, my family realized that I would need services in the long term. At the time I could not hold a job to support myself and so I needed Medicaid to assure that I would be covered for those services. The problem with Medicaid is that it requires you to make several appointments and then wait months for the decision. Without some kind of support, in my case my family, there is no way a person could ever recover in this system. They would need a place to stay, and help in getting to the appointments. They would be out of the hospital before they had recovered, and then not be able to get the services they need to fully recover.
A solution to this would be an intermediate step between hospital and home in which a doctor and caseworker could work together in making sure the person got services. The doctor could provide the caseworker with a diagnosis, and the caseworker could file the paperwork necessary for Medicaid. Services would be extended under this intermediary step until a decision on Medicaid is made.
The media has untruthfully portrayed psychiatric illness. In movie after movie, psychiatric patients are shown either to be sedated, to be homeless, to be violent, or to be funny and eccentric characters. The viewpoint is always based on an outsider looking in, and it misses the real point of what mental illness is about.
Most recently, we have the movie “It’s Kind of a Funny Story.” While I have not seen the movie, the preview makes me think about the media’s depiction of psychiatric patients as people with eccentric personalities. In reality, while some psychiatric patients may have eccentric personalities, it is illness that makes the vast majority of them eccentric. The movie also makes me think about how depression is portrayed as a “normal” illness while other illnesses, like schizophrenia, are portrayed as abnormal. While depression may be more common in the general population, this is not a reason why it should be validated in our culture while other mental illnesses are segregated.
In another movie, “The Soloist,” schizophrenia is portrayed as a crippling and violent condition with little hope for recovery. The protagonist eventually decides to help the schizophrenic person because he has a talent for playing the violin. It makes me think about a common misperception of mental illness, namely that it is impossible to control. It also makes me think a disturbing thought: that others may view a schizophrenic person as not worth saving if he or she is not extraordinarily talented. If someone had this mindset, they would be much less likely to help a person with mental illness.
We have had enough stereotyping and misrepresentation of mentally ill individuals in the media. What really needs to be addressed is the normality of psychiatric disorders so as to demystify them. We need to inform the general population of the realities of psychiatric disorders: that they are experienced by “normal” people and that they can be managed.
Risperdal made me restless, Zyprexa made me gain weight, and Abilify gave me acid reflux. These are my conclusions after years of medication management.
I remember the first time I started taking medication in the hospital, or at least the first time I felt its side effects. I was on Risperdal, bumped up to 6 milligrams per day, a maximum permitted dose of the drug. I couldn’t sit still, couldn’t read, and found myself pacing up and down the floor hundreds of times daily. This is due to a condition called akathisia, a common side effect of many anti-psychotic drugs, in which one feels a sense of inner restlessness.
When I got out of the hospital I was taking three medications, a couple of which I took multiple times daily. Risperdal was the only drug I actually needed to control my symptoms. The other two, Cognentin and Inderal, were to control side effects like blurred vision and the restlessness that I constantly felt, but they did not seem to have any effect. It was at this point in my life that I felt I had hit bottom. I couldn’t go to school, couldn’t work and I never felt good. I had to get my blood drawn every couple of weeks to test my body’s reaction to the medication, which I detested.
I don’t know why I did all of these things while I continued to be psychotic. I guess I did them because people told me to. Without that critical support I may have just abandoned my treatment because of the terrible ways the drugs made me feel.
The next doctor I saw put me on Zyprexa. I felt like it controlled my symptoms well, and it did not cause terrible side effects, except for one: I would eat like my stomach was a bottomless pit. I never felt full and would eat second and third and fourth breakfasts, lunches and dinners. I ate an insane amount of food because no matter what I ate, I would never feel satisfied. I gained weight and begged my doctor to switch my medication.
Currently, I am taking Abilify for my symptoms, and Cogentin and Omeprazole for side effects. The Cogentin handles tremors that I get in my face and hands, and the Omeprazole handles the acid reflux and acid indigestion that I experience daily. As of right now, I believe that this combination of medications is the best for me. I no longer gain weight, I am not restless, and I have medications that actually work on my side effects. After years of trying different combinations of medications, I have finally found something that is agreeable to me, something that is not that terrible after all.
I feel like I used to be a different person. I was outgoing, confident, and eager to meet new friends. When my illness began I became isolated. I rarely saw my old college friends. I was anxious when I was around new people and I felt like I didn’t have anything to say.
I have realized that I felt this way because of the negative symptoms of my illness, things like social isolation, poverty of speech, and diminished emotional affect. When I came to this realization, I sought therapy as an answer. Now I must put in the work.
In therapy I go over my anxieties and practice things like eye contact and expressing emotions. I sometimes get comments that I have a poker face, a face without emotion, and so I must work to express my feelings through facial expression and gesture. Things that used to come naturally to me take concentration and effort.
I think something that drove my isolation was the fear of rejection. I did not want people to see this change that had taken place inside of me. It was just easier to not see people than to make a huge effort in order to interact with them. My fears also extended to expressing emotions. I felt vulnerable when people could read my feelings on my face and so I began to wear a poker face as a mask. I hid behind this mask and it became second nature to me.
My social skills are now coming back to me and my confidence is returning. I still feel anxious around new people but I feel like my fear has become more manageable, and that it is not a reason to isolate myself.
Everyone gets paranoid sometimes, but for a schizophrenic person, paranoia can easily get out of control. Every day I overhear snippets of conversations and wonder if people are saying malicious things about me. My gut feeling is always that people are being mean or don’t like me, and I must tell myself repeatedly “No, it is just my illness,” but the feeling often persists.
My paranoia used to be much worse than it is now. I had a belief common to many schizophrenic people that aliens from outer space had taken over earth and that they were able to manipulate my thoughts. This belief, however bizarre, was how paranoia presented itself in my personal experience. (I did, however, stop short of wearing a tin foil hat.)
With therapy, my paranoia has become much more toned down. I have recognized the role my insecurities and moods play in influencing my paranoid thoughts. If I think I don’t look good one day, I might think people are talking about my appearance. If I am feeling lonely I might think people are saying they don’t like me as a person. I have to be cautious with what I say in these situations and keep my emotions to myself because many times my gut feelings are not justified.
I often need to discuss an ambiguous situation with someone to obtain a clearer view and figure out if my instincts are right or wrong. For example, when I think someone has said something negative about me I will usually discuss it with my girlfriend. We go over the situation together and more often than not I find that I have taken an innocent remark the wrong way.
One thing that bothers me is that when I am in a situation where someone is saying negative things about me, I cannot answer back right away because I am afraid I may have misinterpreted them. This makes me appear as if I am weak and cannot defend myself. I do not like the feeling of taking abuse and allowing people to walk all over me, but I figure that as long as it does not bother me too much, this is what I must do for now.
I must accept that for the time being I have trouble with paranoia, but I do not expect it to last forever. As I have stated in previous posts, I believe that with medication and therapy I can completely heal from my illness and free my mind from paranoia.
The first and hardest step in my recovery was accepting that I had an illness. After my first hospitalization I was still half convinced that people I knew were aliens (yes, the “take me to your leader” type of aliens). Despite this belief, I continued my life with school, friends, and everything else. I took my medication because my doctor ordered it, but all the while I considered my stint in the hospital to be a single episode and not part of a larger illness.
When I was away at college, I stopped taking my medication and stopped seeing my doctor, and there was no one to encourage me to do these things. Sure enough, I became increasingly psychotic within a few months and I was back in the hospital again. This time I thoroughly believed in my delusions, and when I was asked questions about my condition I gave all the right answers: “No, I am not experiencing hallucinations” (the voices were real) and “No, I am not experiencing delusions” (my psychotic beliefs were based on reality).
The hospital discharged me after just a few days, while I was still acutely psychotic, and I remained that way for months afterward. I never took medication. One day, I was online, reading articles, when I stumbled across a person’s account of their own illness. While reading this account I had a revelation: this person had the same thoughts as I did and they had a very real disease called schizophrenia. I slowly began to admit to myself that we shared this chronic illness and it soon came to me that I needed to do something about it. I needed the medication the doctor had prescribed but I was hesitant to start taking it. It was hard to accept that I needed to take responsibility for attending to my condition. It wasn’t until my on again off again girlfriend gave me an ultimatum–either I took my medication or she would stop seeing me–that I eventually gave in and took it.
This was my turning point–I got better and better–and while I still had the hallucinations and delusions, they became less and less pronounced. The voices slowly lowered in volume and the delusions lowered in frequency. Since then I have not looked back. I take medication every day and go to therapy. My healing seemed to be a two step process: I first had to be convinced that I had an illness and then I had to be encouraged to do something about it.
In retrospect, I feel that my experience with hallucinations and delusions is shared by many schizophrenic individuals, and if they could be exposed to others’ accounts of the illness, then they could also begin the process of healing.
Are you ready to get up and go? If you are a recovering schizophrenic, maybe you are not quite there yet. Negative symptoms like diminished motivation, socialization, emotional responsiveness, speech, and movement may accompany the better known positive symptoms of schizophrenia like hallucinations and delusions. These negative symptoms can be just as devastating to the affected person, and may even exact a larger toll over the course of the person’s lifetime.
My negative symptoms were hard for me to see. I was often told that I didn’t speak much and that events didn’t seem to affect me the way they should, but I thought “well, this is who I am now.” I did not know it at the time, but the illness had taken my identity such that I had confused the negative symptoms with who I was as a person.
Often during this time I felt like I had nothing to say to people and I stopped seeing many of my friends. Making the effort to find a job seemed impossible and so it was far from my mind. I felt like I had lost the confidence and pep that I used to have. In a way, this led me to isolate myself from people and situations that seemed to be too much for me, not knowing that these things could have helped me to heal. It wasn’t until later, when I accepted that I had negative symptoms, that I went into therapy to do something about it, and this is what brought me back to life.
In therapy I learned to interpret other people’s moods and what they might be thinking as well as how to express my own feelings through gesture and facial expression. I improved my eye contact. I also learned how to interpret ambiguous social situations and learned not to jump to conclusions easily. In every way, I learned how to better interact with others. My confidence quickly returned and brought my motivation with it.
Now people around me are surprised and delighted by the positive changes in my speech and in my actions. I feel like I have come home.
Recently, memories came to me from way before I was diagnosed. I remember being an eleven year old boy walking up to a group of friends thinking “they are talking and laughing about me” and when I asked if they were, it was always denied. I would then ponder, “why do I think this all the time?,” without ever coming to an answer. I now realize that these are classic symptoms of schizophrenia.
The earlier the onset of schizophrenia, the harsher the illness manifests itself. This itself does not comfort me in my struggle, but to hear this and then reflect on how far I have come makes me feel empowered. The illness still affects me when I am under stress, or when I have too much caffeine (caffeine undermines the effectiveness of the medication), or when all is quiet and I hear a voice not unlike the sound of a soft wind blowing through the trees. On the whole, however, I feel like I have long been victorious in my ongoing war against schizophrenia.
This may sound like a fantasy to friends and family of people with schizophrenia. They may feel a sense that the person is lost, and is no longer the person they once knew. The illness used to be looked upon as a chronic state from which one never recovers. I know this because people in my family thought this exactly, and unfortunately I suffered because of it, lacking the support I needed. I can attest, however, that this is no longer the case and with patience, medication, and therapy, the illness can be managed and under control.
Management is important from first onset to everyday maintenance. This is because with every episode of psychosis the illness becomes more difficult to treat. Most important are the people encouraging the schizophrenic person to take medication and to go to therapy. Hopefulness and patience with different combinations of medications and therapies is essential for recovery because eventually one combination will work in alleviating symptoms.
Looking back, I feel that the hardest and most significant part of recovery was accepting that the world of hallucinations and delusions is not actually real, that it is instead an illness, and that I needed help. While being supportive and encouraging treatment is beneficial, I think helping people to gain insight into their illness is the only way one can get them to independently manage it. This can be tricky, as many people in treatment may still deny that they have any illness at all. However, talking about the symptoms of the illness with the affected individual can give them a framework for comparison with their own experience.
Recovery from schizophrenia is a long road and it is important not to give up hope and support along the way. You may be surprised when you find a person returning to who they once were.