The shadow of schizophrenia casts its gloom over news reports with alarming regularity. It seems that only too frequently a schizophrenic slips through the net of Care in the Community, letting loose Furies of personal and social tragedy in their wake. Who are these people? If further attacks are precipitated by their refusal to continue with their prescribed medication, why do they stop taking it? Why are we failing to address the needs of this alarmingly large percentage (one person in a hundred) of the population?
Sadie is a fairly text-book example of a schizophrenic. She jumped at the chance to tell her side of the story.
"There's a lot about schizophrenia in the papers and on the news, but it always seems to be from the family's point of view. It's very different when you're actually living it yourself."
Sadie had graduated from a leading university not long before first falling prey to schizophrenia. The condition often strikes academically intelligent individuals, usually between the ages of 17 and 25. She was 24.
"I could say that it happened overnight, that I suddenly found myself in an intensely strange, terrifying yet beautiful place; but it would also be true that it had been coming to a head for some time. I'd had a strange sense that it was going to happen for many years, and had read fairly widely on the subject, but as it turned out, nothing really could have prepared me for it when it did finally come. I was more lost than I ever would have thought it possible to be."
Friends and family were disturbed by the change that came over her, and within two months she was admitted to a psychiatric hospital on a section.
"The last thing I wanted was to go there. The way I felt at the time, I felt it would destroy me to go in there, but I was powerless to resist. I'd lost the ability to express myself - words held too much meaning. I would listen to something as banal as a football match commentary, and to me it would be the story of the last battle of the gods. Everything was so vast, so deeply mythological. I'd see the arcane history of the world in everything, every little detail would hold another clue, and I was trying to hold all this information together, launched upon a mythic quest that terrified and excited me in ways far more real, far more vivid, than my life ever had up to that point."
When prompted that this account sounds not unlike what is experienced whilst under the influence of psychoactive drugs, Sadie readily agreed.
"Yes, if I had to compare it to anything, it would be that. The intensity certainly, and the sense of an other-worldly dimension which is accessible from this one."
Current medical opinion sees schizophrenia as often being triggered by the use of controlled chemicals. Indeed, a schizophrenic attack can often be indistinguishable from a drug-induced psychosis. The psychiatric definition of drugs in this context is very loose, covering substances as diverse as LSD, which is taken for its mystical effects, and amphetamines such as speed, which are taken for the frantic mental and physical energy they can impart. Did Sadie think that use of such substances could have caused her schizophrenia?
"Well, that's a difficult question. I'd be a fool to say that the two are entirely unrelated. I've never been into amphetamines, which are generally considered the most dangerous from the point of view of psychosis, but I was smoking quite a lot of pot around the time when it first happened, and yes, I suppose it may have moved things along a bit. I think it's certainly wise to be aware of the dangers, as use of marijuana and LSD is increasingly widespread, and isn't going to go away. Yet as a direct result of my experiences, I've been able to pull my friends out of psychoses which otherwise would have held them fast."
Chris, another young schizophrenic, has his own ideas about the relationship of drugs with schizophrenia.
"In some societies psychedelic drugs are used to help induce visions that will help the individual to understand his place within that society. This is how my friends and I use drugs. Among the people that use drugs in this way are some who are especially affected by them, and are ever after always touched by the worlds that they have seen, in a way they can't ignore, not even for a minute. These people, who in our culture would be called schizophrenics, are the apprentice shamans or medicine men of their own, and have a vital social function. They are able to make it through the confusion because there are older shamans who have been there themselves, and can help them. I have a few friends who are diagnosed with schizophrenia, and we all feel this way."
The vital difference here is how the individual is treated when he is suddenly assailed of a vastly different perspective, possibly complete with concomitant aural and visual hallucinations. Medicine man or madman? Yet I put it to Chris that in the West we have our spiritual mediums, who are permitted to see and hear whatever they like, without fear of being incarcerated in an institution to "rectify their perceptions".
"My doctor would say the same thing to me, that it isn't a question so much of what we see, and what our personal belief systems are, but how we can cope with what we see. In other words, how we cope with the world around us, how we fit in. Many mediums, though, have had all the nightmares, and at some time probably gone off the rails a bit as a result, but they have learned to cope with it. But it isn't just a matter of seeing or not seeing strange things. It's the whole way the world's made up that comes into question, and you need time and space to deal with such a crucial change. I think that everyone at this stage would benefit far more from being somewhere where they have time to understand what's happening to them than being forcibly locked up, in places that aren't going to be in any way restful."
But if there are medications that will help the schizophrenic to function again, why don't they want to take them? Why are they so distrustful of the medical profession?
"To be honest, I don't think your average psychiatrist really has a clue," said Chris, a little guardedly. "My psychiatrist has never even read any Jung. It's impossible for me to respect that, and dangerous for me to allow him to administer drugs that affect my mind. It is, after all, my mind. My medication makes me very lethargic, but I'm bullied into taking it, and my appeals to reduce it, gradually, aren't considered. People are horrified at the thought of Medieval tooth-pullers, and I think as we learn more about the mind, in years to come people will feel much the same way about our psychiatrists. My doctor kept trying to make me believe that the things I was seeing and hearing and feeling were delusions, whatever he thought he meant by that. But what I was experiencing was real, in the truest sense of the word. The experiences of schizophrenics are incredibly similar to each other."
Sadie's thoughts ran along similar lines.
"The doctors are just on the look-out for symptoms that match what it says in their medication manuals. I was horrified when I found out that a lot of people who died in the Chicago heat-wave were on anti-psychotic drugs. My psychiatrist wasn't even aware of that. My medication made me sluggish. I wasn't myself. I was existing, but not living. Whilst in hospital, I suffered totally debilitating and agonising side-effects, such as having very little control over my muscles, and painful spasms, and no-one would believe that this was happening to me. I felt very angry, but couldn't vent any of the anger. If I complained, or questioned the way I was being treated, my behaviour became, in the eyes of the doctors and nurses, symptomatic of the schizophrenia. There was no way I could win. I made a decision to gradually phase myself off the medication that had been forced on me, although I was very afraid to do so."
The only benefit that Sadie felt she had received from her medication was that it slowed her mind down and enabled her to block out the fear and paranoia that haunted her twenty-four hours a day. So what happened when she stopped taking it?
"Well, I started to feel so much more alive. I found new enthusiasm and creative ability. But then one night it happened again. I was back in the nightmare world. To try and describe it, it was as if I'd been alive hundreds of years ago, and the world felt very familiar in some ways, but there was a lot that had changed, that I had to learn to adapt to. It was very animistic - I felt as if a spirit pervaded everything, that I was sensitive to, to the degree that I would identify totally with whatever was in my mind, what I was looking at or thinking about, at the time. I was determined to evade incarceration this time, and moved up to Scotland to work in the forests.
It was very difficult. I couldn't relate well to people - they seemed so chaotic, so cut off. I had been used to defining myself by the way I interacted with other people, so it was very hard for me to be a loner. But a change of scene, where no-one expected anything of me, was so refreshing, so strengthening. It's very difficult, living in these over-crowded islands, to truly be alone, but I do think that it is vital to be able to do this, in a positive way, to understand the changes that are happening, and to find a degree of perspective.
"I began to look very closely, as objectively as I was able to, at the way my mind worked, almost as if it were a machine I was working on, and managed to kind of re-wire it to perform the tasks I needed it to do. I had stopped feeling like a victim, and regained a little control."
The method seems to be working for Sadie, who hasn't been readmitted to hospital since recovering from her first attack, and is currently studying full-time. She only wishes that the medical profession were brave enough to try different kinds of help for schizophrenics.
Of those who are diagnosed as suffering from schizophrenia at some time in their lives, roughly a third make no apparent recovery, a third will suffer sporadically for the rest of their lives, and another third will have no relapse. Sadie says that it is a Catch 22 situation - anyone who succeeds in pulling themselves out of the mire just slots neatly into the accepted statistics of those that have recovered, and psychiatry is no wiser.
"I still see and hear things though. In fact, it is largely through characters I have met in my dreams that I have been able to work out how to help myself. In other words, by immersion in what I have been experiencing, rather than trying to block it out."
Indeed, many diagnosed schizophrenics will deny that their their condition even is an illness.
"It certainly feels more like an initiation of some kind," expands Chris. "For all the pain it has brought me, I wouldn't be without it, as it has made me so much more aware of a lot of things. I have become very interested in alternative medicine, and wouldn't hesitate to recommend it to anyone. I've received an awful lot of benefit from reflexology, and am now thinking about studying psychology at university, so that I'm in a position to be able to put my experience to good use."
With a condition that is still so little understood, perhaps it does make sense to try a more bold approach, since the medications available are somehow unsatisfactory to those that are prescribed them.
What keeps Sadie topped up and healthy is dancing to trance music.
"I think it's the beat, the rhythm. It does wonderful things to your mind. Since I started dancing in this way, I haven't felt the need to take any kind of drug. I'd love to get a group of people together to visit schizophrenics and all sit round in a circle somewhere playing hand drums, bongos and whatever. Methods like this have been used for thousands of years to pull people out of psychoses. I think we need to try more ways of helping these people to get their lives back. I know it can work - I have my life back, better than ever. And it's all the more precious for having been away."
Sam Malone