Insight from a Schizophrenia Patient with Depression
Schizophrenia Bulletin, Vol. 21, No. 4, 1995
National Institute of Mental Health
Nearly every person I've talked with who has a mental illness can come up with a date that it began. What they really meant was, the date when it got so bad they could no longer function. Around July of 1987 I was doing a lot of self-examination. I became obsessed with the Bible, particularly the book of Revelation. Up to that point I had not really studied much of the Bible. But it seemed as though my life was coming to an end, so what better book to read than Revelation? At that time I was working on an entirely new reality, one with mysticism in it, one with emotional gratification beyond any reasonable comprehension. In fact, I experienced it, but I also experienced terror and hell. This was all due to my illness.
It was during this time of reading the Bible and fasting that I had my first emotional trauma coupled with a hallucination. At the time I thought it was evil. I thought people could transfer themselves, their thoughts and minds, from one body to the next but it was more complex than that. In fact when this transfer occurred you would actually "see" the person from whom the transfer had been taken. For example, you imagine person A transferring his or her mind to person B. Although in "reality" person B is the physical entity before you, person A is the one you actually "see." I could actually see both (hence the hallucination). Deception thus existed because of this mind switch. In reality I was looking at a co-worker and nothing more.
I think it was later in the week when I began to have more serious delusions. I was responsible for loading copies of programs for the online system programmers. This authority was given to one person to consolidate the process and avoid costly errors. It was usually quite stressful on Fridays because the online transfer would happen Thursday night. This meant the freshly changed program might develop problems the following morning, thus requiring a "dynamic load" to change the erroneous copy to a working copy. So one Friday, I imagined that the end of the world was coming and those programmers who wanted their names in "the book of life" (Rev. 20:12) would have to go through me to save their lives, or was it the end of their lives? I didn't know. It was so real. I felt as though I was a demon and a savior, holding the key to all these people's lives, and that the computer was actually determining their fate via every key I punched. I imagined the file cabinets (full of microfiche) were in fact transcripts of every thought and every statement anybody had ever made -- the necessary "goods" by which to judge each individual's salvation. Instead of a merciful judgment, it was a financial enterprise in which corruption pervaded every corner. The "higher-ups" would have the power to manipulate records that would incriminate or discredit them.
I dealt with the concept of killing the people (via the dynamic load process) by denying it was actually happening and being totally unaware of the killing. I was imagining myself a pawn in a giant game of deception against humanity. I lived all this as if it were reality. It was terrifying. However, now I know this was all due to my then undiagnosed mental disorder.
Back then my delusions caused tearfulness at times and consequently my boss suggested I see a psychiatrist. I did go and see one, but I was too sick by then to be able to realize all this was in my imagination. I was certain the therapist did not have my best interest in mind and in fact considered him a part of the corrupt system of knowledge/judgment that I referred to earlier. Trusting your therapist is essential in getting on the road to mental health.
These thoughts and others caused my breakdown and finally my decision to quit the company I was working for. Unfortunately, I lost my disability benefits when I made that poor decision. I decided to go back to school to get a bachelor's degree. I struggled further with my mental illness at Wichita State University and could not complete the first semester. Finally my parents came from Oklahoma and picked me up. I went to a clinic and had my second experience with the mental health profession. The clinic first gave me talk therapy from a psychologist. Next I'd be ushered into a room where the doctor prescribed medication; my first was Mellaril. Later, a "friend" of mine curious about my problems, called and I told him I was taking the Mellaril. He, being a pot smoker, just laughed and thought I was doing it for kicks. I have since discontinued my friendship with him. Disassociation with friends that use drugs is highly advisable.
The problems I have are not easily understood. They have pretty much rendered me unemployable for any length of time. In some cases, I think my illness aided me in dealing with abstract programming applications. But I would gladly give up the abstract thoughts and creativity for emotional receptiveness, stability, and energy.
My brother said the other day, "You are very creative." He went on to say I should write a book about my illness so people could try to understand. In fact, it is true that this illness enriches my imagination, but it can be very frightening and at times debilitating. It seems my mental illness will not just go away. It is a chronic situation in which the complications are mental and not physical. With the body, when an organ fails, sometimes complications develop in another part of the body. With the mind, it is a thought or thoughts pervading the conscious and/or subconscious that build up, yielding false beliefs.
I would like to describe the few delusions I've had in the past to help others understand how frightening and real these thoughts can be. They are a thumbs up from President Clinton on TV, a nip on the thumb from a dog, a smile from my mother while my nephew had difficulty swallowing a piece of potato. I now recognize all these past delusions as false, caused mainly by my condition stabilizing with the medications I take.
The sign from Clinton stems from my uncertainty about whether to vote for the Governor. I was wavering between Clinton and Perot. On the morning of the vote, as I drove to the polls, I decided to vote for Clinton. (Most of the time I felt that I would vote for him anyway.) When I went to the polls, voting was not by machine but rather by ballot. After receiving instructions on how to fill out the ballot I thought I heard the registrar say to initial it in the lower right-hand corner. I wondered why I would have to initial a ballot. It is supposed to be a secret ballot. Immediately I suspected that my vote and my vote alone would determine the destiny of the presidency for election year 1992. (In fact there were initials on the form itself, which needed to appear through the ballot holder so the ballot would go into the ballot box face down.) Later thoughts of my "sentencing" those individuals at work to death (the computer incident) crept in. I thought Clinton was the power boss who controlled everything including this "evil empire." So later, while watching TV, I saw what I perceived to be a rather sheepish, maybe slightly devilish glance from Clinton and a thumbs up (presumably at me) for having cast my vote the way I did. You see I had an additional delusion that while watching TV the subject being televised can peer right into your living room (which, by the way, is not far down the road technologically). In my deluded mind, the thumbs up was for me personally for voting as I did. I thus made myself responsible for voting in somebody who at the time I felt participated in the knowledge/judgment system of corruption I described earlier. The Clinton delusion stemmed from the "voice" that said to initial the ballot.
The nip on the thumb was my mother's thumb, not my own, but it caused me mental pain just as well. I was having a rather open discussion about God with my sister and Mom, and my mind had been wandering. I had just told my sister how God operates in my life. I had been attending a support group, which has helped quite a bit. At times it seems as though God works through the people there. Anyway, I was beginning to tell her this when my sister's dog nipped my mom. Immediately, I thought it was a sign from God that my going to the support group was wrong. It was further reinforced by the blood that was coming out of her finger, analogous to Christ's crucifixion. This was a delusion. I was distraught, and it didn't end there. My sister said innocently, "God doesn't give signs that often." I thought to myself, "True. I haven't seen a sign in a long time, and there it was -- the dog bite -- so I'd better pay heed." Then I said, "Maybe it was a sign from the devil." My sister said, "He wouldn't bother." What she meant was that the devil would not bother with such a trivial sign as a little nip on the thumb, but what I perceived was that the devil wouldn't bother with me because I was too sinful to worry about. This only furthered the self-destructive paranoid delusion.
The last delusion I mentioned stemmed from when I was in Wichita. There was a job service called "Man Power," a name that can take on additional connotations if taken into an ill mind. The incident with my nephew occurred during a rather stress-filled day. My sister and her husband's mom and dad were here for a visit and dinner. I occasionally suffer from paranoia regarding food; for example, it is evil to eat food and barbaric to eat meat. My Mom had fixed a large meal and everybody had helped themselves to some of the meat. My cute little nephew Sam sat in his highchair next to my mom, and my sister watched as mom fed him a few potatoes. He was having difficulty swallowing the potatoes, and my sister was concerned. She wasn't yelling or anything, just a little nervous about him being able to swallow what he had in his little mouth.
Just then I looked up at my mom and she smiled at me. I thought it was an evil smile and that she purposely fed him too much so he would choke and die. She had been changing his diapers all day long, caring for him the way grandmothers do, and I thought she was doing harm to him. I was certain of it then, but now I am certain it was a delusion brought about by my mental illness. My paranoia sometimes tells me that children are born to provide a vessel for a future inhabitant who is aging. This was reinforced by the delusion I had about the "Man Power" company. In my mind I thought that a child is not his own person, but rather a "pawn" in this corrupt company. The corruption in my mind extended all the way up to the President of the United States. My nephew Sam was going to be a vessel for me. It was terrifying! As I write this I wonder whether this thought will extend to God being corrupt too! Writing this enables me to detect this line of thinking and understand it as fiction, a wild imagination coupled with mental illness.
Nevertheless, the story about my nephew is very disturbing. I believed it and even acted on it. I got up out of my chair, walked out, and hitched a ride to the Psychiatric Crisis Center. I even accused my mother of child abuse. It was a few hours before I realized that the whole thing was in my mind. I called my brother in Seattle and he talked me through it. I came home to a worried family and my snoozing nephew.
It probably isn't comforting hearing these things but it is possible to find relief. The key is to be able to detect these false beliefs and reinforce them as fiction at a later time. Unfortunately, these thoughts snowball. I can't control the snowball effect (cause) but I can control the snowball affect (influence).
If I could control the cause, I would be able to help a lot of people suffering from schizophrenia. I'll leave that up to researchers who are studying schizophrenia and related disorders.
What I can do is give information about the current mental state of a person diagnosed with schizophrenia. I can also give some tips on how to help yourself if you suffer from schizophrenia.
While not an extremely common aspect of mental disorders, it is a problem nonetheless. Judgment and decision-making are greatly affected by your emotions. If you lack emotion people might consider you cruel or insensitive. Cruel is definitely not the case. In the most literal sense, insensitive basically hits the nail on the head -- insensitive in the sense that the emotional sense is defective. This is not by choice, however. The minds of individuals with schizophrenia simply do not respond to feelings on the level that a normal mind does. I cannot imagine quite what it would be like to have good emotions the majority of the time. I do know what it is like to have a low mood or a high mood. However, emotions have a great influence on the normal person's life and ultimately what they do from day to day. As a psychiatrist aptly put it, "It is difficult to feel."
Here is a dilemma. I do not know if it is possible to build up emotional sensitivity with my mental illness. I know that the medications can have a rather large impact on how one feels. So it is important, perhaps, to continue with research on better drugs for mental disorders. Flat emotions are an apparent trade-off for reduced psychotic symptoms. It has been my experience that flat emotions make one feel emotions to a lesser degree than a normal person.
In the meantime, is there anything you can do to help yourself? One main method is to reach out to others for support. Sometimes this is very difficult for people to do. Maybe they don't feel comfortable socially with the situation. Sometimes, it is not possible to meet with people and discuss problems for fear of being shunned.
The solution to the above-mentioned problems is trained mental health professionals. They can help if you will let them.
"Bad" or troubling thoughts contribute to a person's state of mind. The majority of the time the thoughts evoke shame, guilt, and anxiety. It is curious that we have these thoughts at all. My mother once told me, "Thoughts are free." It is true. They don't cost you a thing, so they shouldn't affect you in a negative way when they are troubling or bad. I've learned that the source of these thoughts is unimportant. Everybody has them from time to time. What you can do is treat them as a learning experience and learn to identify an aspect of your personality that perhaps the thoughts can be made analogous to. Then draw a positive picture from those thoughts. You may ask, how can you draw a positive picture from a negative thought? Well, you have to learn to accept that you are not perfect and those imperfections make up part of you anyhow. In many cases, those negative thoughts don't manifest themselves in your personality to any real degree, so why give them any more credence than a mere passing thought. These thoughts are a mechanism by which you can learn to grow by accepting your shortcomings.
I can't emphasize enough how destructive negative thoughts can be. It is no more comforting either, for somebody simply to say "Don't think that way," because after all, "thoughts are free." Without thoughts, what would we be? With all "good" thoughts, would our life not be rather mundane? I'm not advocating seeking out bad thoughts to enrich one's life. On the contrary, what I see is that these discomforting thoughts are instead a bit of anger surfacing, anger about not being willing to accept one's own faults or constructive criticism. Sometimes criticism is not constructive, and the same is true of some thoughts. Hence, some "bad" thoughts are present. The trick is to let these negative thoughts enrich your life, rather than destroy or control your life. It is possible to grow from negative thoughts.
The best part of all about life is that there are good thoughts to reflect on and to experience. On that note, I would like to say some positive things. The mentally ill, despite having to deal with stigma issues, have it better than they ever have. There are psychiatrists and trained counselors to help us. There are medications that lessen suffering. There are social programs to help the mentally ill. The public is slowly being educated. We need to keep all this going strong! I am very lucky because my parents and family are very supportive of me. Also, I have a support group and the people there to help me get well. The computer groups that I lead help my self-esteem. I set socialization goals in my first review and achieved them by the second. I am determined to continue to grow as a person and educate myself as much as I can about my condition. I am giving myself credit for my happiness, but a large part of this happiness is due to the people and case workers at the support group. Also, the psychiatrists I've had over the years have played a major role in improving my mental health.