I talk on the phone with a 9-1-1 operator. Someone is trying to kill me. I argue that it's not my illness making me think these things, but I have no evidence. At the end of a 30 minute conversation, the operator tells me that the best thing I can do is call up my family and tell them that I love them.
In the middle of the night, I awake. My CPAP mask has been knocked off my face. I can't shake the feeling that something is wrong. Someone in this house is planning to kill me. If they haven't already. My bedtime medications could have been poisoned. I sneak out the back door and go to the nearest public place, a Petro-Canada. I call 9-1-1 and tell them I might have been poisoned. An ambulance arrives promptly and takes me to the hospital.
I'm introduced to a room that I'll be spending the next 2 days in. There's no electrical outlets, and there's stains on the walls. These two facts keep me occupied. First, the lack of electricity makes it impossible for me to plug in my CPAP machine, so when a doctor gives me some sedatives I spend a night struggling to stay awake. The stains on the walls become my lifeline to everyone who has been in here before. They are a reminder of the ghosts that once ate in this room.
This time, I am in the hospital voluntarily. It is not because I think I am ill, but because I think I am in mortal danger. A few months, I thought, would convince my would-be assassin that I am crazy, and thus not worth pursuing. It feels like I am under Witness Protection. All I have to do is blend in, which is fine because I know how crazy people act.
This time, I am in the hospital for three months. Like every other time I am hospitalized, I pick up smoking. I become highly religious. I believe the fantastical stories of the people around me. Here's the leader of Illuminati. There's a Star Ship captain training for his mission.
I feel a tinge of sorrow for those who think they are religious icons, like Jesus the Messiah or Lucifer. This sorrow comes from a deep well of subconscious experience, like the super-ego chastising the id, that these familiar faces lead to pain. Being a Messiah means suffering under the yoke of the hospital complex. No one would treat a real Messiah that flippantly. I learned, therefore, not to be Jesus. Every new time I go to the hospital, it is under a different guise.
There are four times so far, each for 3 months or more. In the last 12 years, 10% of my life was in some institution of mental health. I watched hospitals remove the smoking rooms. Stress, basic everyday levels of stress, is no longer an option. I have tried to go back to university several times, but this always leads down dark and dangerous paths.
But where did this start?
Like so many things, it's partially coded into my genes. My paternal grandmother committed suicide when I was four years old, a victim of bouts of depression and paranoid delusions.
But, it's also environmental. I started to act out against my upbringing when I was in high school. For the first two years, it was alcohol. But alcohol was expensive, and difficult to obtain without a proper ID. So, I graduated to pot. Although pot is not deadly, and for most people not dangerous at all, for roughly 1% of the population, it can trigger latent psychosis.
I exploded in slow motion. I read everything I could get my hands on about drugs. I took chemistry incredibly seriously, and got a perfect grade in Chemistry 30. When I did choose to use a drug, it was informed by more research than used in the propaganda of the drug war. This is not to say that drugs are good by any means, but they can be revelatory in small doses.
I miscalculated how much I could handle and still be safe. I overdosed on a combination of crystal meth and ecstasy. For a week, I talked in a croak. I coughed up blood. My muscles spasmed uncontrollably. It was actually pretty easy to quit, compared to cigarettes.
But the damage had been done. Eight months later, I was trying to turn my house into a perpetual motion machine, by having it do as much stuff as possible. I opened all the windows, turned on all the lights, turned on every faucet, and moved all the things around. When my mom came home, she yelled at me, so I vanished and tried to think of a safe place to go. The bus driver wouldn't let me on without money or shoes.
I eventually ended up at the University. I was kicked out of a class for being disruptive, and someone told me to go see security. From there, I was brought home. I talked to a nice couple of nurses, and got in their car. I played with my cornea the whole way out of the city to Alberta Hospital.
Everything was taken out of my hands. It's hard to write about complete surrender. I was powerless, led from one doctor to another, and then into a long hallway filled with people just like me. There was excitement at first. I flipped out after a few hours and got wrestled to the ground, injected with a muscle relaxant, and locked in a room for nearly 2 weeks while I was gradually sedated to some level of coherence. Meanwhile, I rubbed feces on the wall. It's prison, and prison is boring.
After I was released from solitary confinement, I was allowed visitors. Most patients are not so lucky. Many have long lost or never had the sort of confidantes who will visit. I learned, instead, to relish having company, and to have as much as possible.
Other than family, there is also spirituality. I was normally an atheist, but desperation leads to religion. Says Friedrich Nietzsche: "a casual stroll through the lunatic asylum shows that faith does not prove anything." Maintaining faith after the asylum is difficult, because of the intense self-critical doubt that fills the mind during recovery.
The medicine that they give me has side-effects. One caused hypothyroidism which caused me to gain 70 pounds in 3 months. I take a different medicine for that. Another can lead to diabetes, and another constipation. So I take medicines to counter that. My evening pills fill the palm of my hand. Every month I need to do blood work, and I get an injection. Because of the volatility of one of my drugs, I can only withdraw one week of medication at a time. It's all an inconvenience, and there's no room for error. I used to do stuff like not take my evening medicine so I could stay up later. This landed me in the hospital. On top of this, individual body chemistry means that two people meeting the exact same diagnostic criteria may take radically different treatments. As well, a single person will, in their lifetime, have several different medicine cocktails. If I recall correctly, the average magic number is 3.
How does it feel to be manic? Ironically, it feels freeing. There are overwhelming, mystical, beautiful, destructive, and dangerous emotions with nothing to place them to. The brain demands order, and ties these emotions to the world around you, and sometimes to a world of pure imagination. It's a bit like dreaming, except with better retention. These wild emotions bring to mind the electronic monk of the Douglas Adams story, a being that believes the entire world is a uniform shade of pink, despite all evidence to the contrary.
When I feel like a predator is hunting me, I am overcome with a fight-or-flight instinct. When there is no predator in fact, I suspect everything of being mortally dangerous. The world is pink. I flee to the safest place I know: the hospital. And because hospitals are for the insane, and I'm not insane, everyone implicitly knows -- in collusion with my private madness -- that they should treat me as any other patient to keep up the necessary facade. In case one of the hospital staff plans to poison me, I refuse to eat anything not labelled on the little slip that comes with my meals. I fly into a fit when someone thinks I should eat an apple. The paranoia is boundless and intensely creative. I have never had the same delusion twice, although I have had the same delusion for sleepless weeks on end.
I would like to finish on a hypothesis, brought up by the anti-psychiatry movement. The premise of the movement is that doctors do more damage by their treatments than that done by what is being corrected. We call the mad "patients" to fit it into the cozy box of medicine, when really what we have are "survivors" doped into something that, from the outside, vaguely resembles normalcy. They are survivors not only of mental illness, but of the labels that come with it, and the drugs that come with those labels. If that is a bit too harsh, perhaps the label "student" would be more useful.
However, sometimes abnormal is a third eye. In shamanic cultures, madness plays a strong role in the psychological health of the group. One after another, generation to generation, madmen serve as a conduit to another world, psychopomps. The 1-in-100 schizophrenics is normal, a Darwinian imperative to assist the larger group dynamic. Doctors are trying to treat with phamaceuticals what madmen have treated in themselves by experience. The shaman is the mad scientist of theology.
I believe that the normal world of a schizophrenic is healthy. We live in a society; the premise that we live in an individualist world is fiction. Shamans bring out the best of the group, often at considerable cost. Mental hospitals, especially in countries with free health care, are proof of communal compassion. The problem is that we don't give mental patients time to do anything more than become cured; we don't transform them from students into teachers.
If we ignore all psychiatric uses of antipsychotics, what we are left with is a handful of sedatives that over time cause all manner of metabolic problems.
Thomas Szasz described psychiatry as the Science of Lying; Michel Foucault as a power struggle, here between doctors and patients. An innately powerful group restricts the movements of confused and directionless people who are having trouble fitting in. In this state, we are most vulnerable to labels; unfortunately, the labels doctors prescribe say nothing as to what the lived experience is like.
From a phenomenological perspective, what is it like to suffer a delusion? I hope that my description of my own delusions helps clear up confusion in a way that outright calling myself a schizophrenic would be meaningless. Everyone knows what panic fear feels like when danger is present; it doesn't take a huge step to figure out terror when there is no immediate threat.
I have gone through the process of hospitalization and release enough times that I fear another episode. It took a life-or-death belief to convince myself in the last case that I needed treatment, and even then it was under the spell of a delusion. Maybe my case is life-or-death, but by this, in no way do I mean that every schizophrenic is morbid. Hopefully, in the future, psychiatry will evolve to be something that empowers the student and humanizes the shaman, rather than desensitizes the patient and dehumanizes the survivor.
As I have suggested, instead of doctor/patient is the teacher/student dynamic. From the second time I was hospitalized, I insisted that if the drugs administered to me were so safe, they better be safe enough for doctors to self-medicate on them. Never administer something to another person you are not willing to swallow yourself. Don't trust a dealer who won't sample his product in front of you. It should be a tenet of epistemic care that a psychiatrist must have first-hand experience with madness, if not with those drugs that mimic madness. Nobody cares more for his fellow man than a teacher.
What psychiatry got right is the asylum. It is healthy to lock people up together. There, they grow like bonsai.
What it got wrong is the empowerment of the doctor. It makes difference sound unhealthy, and not simply part of the growing process.
There are genuine spiritual and philosophical problems at work in the human mind, and a type of these problems are best tackled in a cage. Half the men in the painting of Scuola di Atene were likely suffering from some manner of mental illness. But what did that mean in a world without mental illness? The philosophers of old were on a ship without a destination. They were captains of humanity. Presently, philosophy in universities covers topics that are palatable: minor philosophical problems are best handled in a university. But what of the problems that get us into real trouble, that throw us back on the stormy seas? The danger is old, but the content is new. In the end, the goal of mental health (or epistemic care, a much fairer designation) is to give the proper environment to bite down on these issues and solve them completely.
There is no panacea in medicine; sometimes even medicine itself is the wrong medicine. Someone may be cured with a simple pill, but should they be?
To take the example of Major Depressive Disorder, 1-in-5 humans fit into that category. Given what we know about humans, that can't be an evolutionary accident. It could be the brain's way of slowing thinking down to deal with complex problems. Removing the depression before it has run its course might be harmful. A doctor should not do any harm.
There is still room for introspection. Let's assume that the mind is the seat of consciousness. Someone with major depressive disorder is both death-positive and suicide-positive. These are attitudes that can lead to hospitalization. Another cure is the belief in eternal life, unless that is concurrent with belief in one's immortality. Religious beliefs can have a significant role to play in recovery.
Our life is punctuated with crises. Some people with more than others. Some crises can cause mental damage.
Medication works to some degree, but we should not look to medicine to cure our humanity. It is an escape route, which is good in case holistic methods fail to resolve the crisis.
To tie schizophrenia to Socrates' illness, the human mind can only grasp a limited set of knowledge. Unrestrained intellectual greed leads to madness. There are concepts that simply cannot be comprehended. But this should not make us fear knowledge, or wisdom, or greed, or madness. We ignore epistemology at our own peril.
Back to what we called Major Depressive disorder. Perhaps it would be better treated by teachers, that is to say, people who know the ins and outs of Major Depressive Disorder from the inside. Psychiatry can offer a safety net, but enlisting the skills of those who lived inside unpleasant thoughts may be the next evolution of this science. The designation of these thoughts -- and thus the appropriate teachers for the right students -- need not be a disorder (humanity is not a disorder) but a description of which thoughts are causing the behavioural changes. Someone who is inflicted with thoughts of death and suicide may be death-positive and suicide-positive. Resolving such afflictions may require spiritual and philosophical thoughts, such as contemplation of the afterlife.
Back up farther to where we were talking about schizophrenia. In the primal stages of humanity, the shaman played a role as psychopomp and spiritual leader. By collecting all the dreams and thoughts of his or her people, the shaman organized the group consciousness. It was only with collective spirituality that we could function in larger and larger groups. Eventually, this tendency would lead to religion, where people from across the known world would agree on various vocabularies and dogmas. Soon, the pace of spiritualization outran the mental capacities of the shaman -- being as the shaman is only one person in a hundred -- inevitably leading her to have uncontrollable nervous breakdowns. Empathy for all mankind is dangerous, and the nerves need to be blunted. In smaller groups, schizophrenia is important and healthy. The tendency toward the nervous breakdown requires genuine sympathy for the schizophrenic, not a medicinal palliative. One who is overwhelmed with spiritual thoughts need to control these thoughts, not destroy them.
