Life radically changed for me at age 20 due to emerging schizophrenia. I experienced delusional thinking, paranoia, and hallucinations.
Before schizophrenia interrupted my life, I was a biochemistry student at the University of Southern California. My first psychotic break happened during the fall semester of my senior year when I went from a student in good standing to failing all my classes. I never told anyone, but I believed it didn’t matter because I was about to become a prophet.
Looking back, I ask myself what opportunities for intervention were missed during this difficult time of my life.
Family and friends
One of my first symptoms of schizophrenia was paranoia of friends, family, professors I had known, and most of all, my parents. My parents would have done anything to get me to a doctor, find the best treatment for my erratic behavior, and support me in any way possible, but I was afraid of them. They would have welcomed me to live with them while I was getting back on my feet. Instead, I found myself living outside.
Looking back, had my parents managed to see me while I was ill (which I continually refused), I probably would have thought they were the crazy ones, not me, believing that nothing was wrong with me at all. Furthermore, I probably would have believed that the reason they were getting me psychiatric help was that they wanted “revenge” because I had not finished my college degree. This was wrong, as they never would have wanted to hurt me, but I would have imagined it. I wish they had had legal authority to get me into treatment. But looking back, I really needed someone other than family to tell me I was mentally ill.
Educational system
Almost every university or college in the United States offers counseling for students who are struggling. The problem is, those of us who are the sickest often have no idea that we need help. So how do we help a student who used to be in great standing and is now doing poorly (specifically, without bad decisions like drug use or partying)?
As I was failing my classes, I felt lost. I wanted help from the university, but had no idea how to ask for it. Deep down, I realized I had a problem, but I still didn’t think it was an illness. I was lost in confusion.
I believe that the university should have had more influence than they did in an effort to help me recover. The problem was that a person must be a danger to self or others, or gravely disabled, for an involuntary hospitalization. I eventually became that person, but it took time.
If a counselor had approached me and told me they deeply cared, they knew something was wrong, and they wanted to help, would it have made a difference? I do not know, but I wish it had been tried.
I also wish, at the very least, that I had known more about schizophrenia. I thought schizophrenia was a sign of weakness or associated with a low IQ. I did not know it is a treatable brain disorder that anyone can develop.
Community
In January of 2006, after I had been homeless for nearly three years, I began spending every night outside in a churchyard near the university. I felt forgotten by society, and sometimes felt as though the community around me just wanted me to disappear.
I wish that the first night I did this, I had been approached by a social worker or other professional (ideally not a police officer) who offered me help immediately. In the last couple of years, California has initiated a program called the CARE Act (Community Assistance, Recovery and Empowerment Act) where they do approach people living outside and ask what services they need, such as housing, food, and medicine.
I don’t know if the CARE team would have helped me while I was so desperate for help and sleeping outside. I think that I probably would have accepted their help. However, I do not know how long it would have lasted. CARE programs do not require participants to take their prescribed medication or treatment. Without medication, I would have soon been screaming back at the voices, paranoid of the staff, and probably delusional, leading to disruptive behavior. I would probably have been evicted from whatever housing they arranged for me.
Law enforcement
After I had been looking for garbage to eat on the USC campus for a number of years, someone finally did call the police on me. This was an ideal opportunity for me to be evaluated and sent to a facility for treatment. Instead, I was left alone, feeling wrongly accused and misunderstood.
I was incarcerated for two days in October 2006 and again briefly over Thanksgiving of 2006. While I was in jail, no one evaluated me.
It is remarkably common for people with psychosis to end up in jail or prison. We must do a better job of getting them appropriate care at this phase in their lives when they are vulnerable and dependent on the justice system.
What actually happened
On March 3, 2007, I woke up in the churchyard where I was living, screaming back at the voices in my head, and began walking and running in strange patterns. That was when a police officer snuck up on me, and I found myself in handcuffs. This was a terrible day, but a day I am very grateful for, as it led to treatment.
I was one of the lucky ones. I responded to an antipsychotic medication called clozapine (though it took a year to find it) and reclaimed my life, returning to school and working again. But I hope and pray that, for others, these opportunities for intervention will be explored much sooner to avoid so much wasted time.