Nothing to fear but fear itself? For a schizophrenic, that’s plenty.
I could have told Moira Blum, the girl in my dorm who believed in astral projection and traveled to other planets on weekends, but she would have just congratulated me. I thought of telling Candy Weiland, who always said “Hey” to me, the girl who let me know on day one of college: “This here Kentucky—it’s God’s country.” She was the size of a jockey and swore she’d own a horse farm some day. “My granpappy’s got some land and a passel of horses,” she’d say, twirling her mane of hair into a bun. But how do you explain to anyone that something wispy and curling is crawling beneath your skin?
Or that I could not understand my clock anymore. Little arrows pointed to numbers, but I had no idea what they meant. To get to class I had to go down the stairs, and the stairs were revolving the way they do in spy flicks after the hero gets poisoned. I groped for the floor with my foot and clung to the handrail. Everywhere I went a ruckus throbbed in my head. Shadowy images of helpless victims in guillotines snapped in my mind. And my spring term papers were due.
After a phone call home, after my mother groaned, “Oh God, where have we gone wrong?” I shuffled to the university health clinic. I had no specific fears or expectations about the outcome, only the same fierce anxiety that had settled in me back in the fall.
The psychiatrist summed up my entire future within minutes. After tapping her finger down the page of symptoms, she began to write. “You’ll have to take pills the rest of your life,” she said, without looking up, “and you’ll spend a lot of time here.” What did she mean by here? Kentucky?
“Um, what’s the matter with me?”
“Well.” She placed my chart on her knees and leaned forward. “It’s as if your body . . . is making its own LSD, which means . . . ”
Which meant, I can tell you now, that I hovered over a fault line cracked open by some unseen stress. That vaulting abyss you see in movies where trees and dinosaurs fall in and ricochet off the walls or foolish humans hurtle down with hands reaching for the sweet, blue sky. But I did not know this as I stared at the black ringlets on the doctor’s head. I only knew that I wanted to call home. Florida, where juicy navels dangled from trees.
I had walked out of my dorm like I did every day and then disappeared into a psychiatric ward, past two sets of locked steel doors. Red bandanna pulled snug over my ash-brown hair, tan desert boots on my feet. Gone from campus, vanished, vamoosed.
“It’s better if you don’t talk to anyone at first,” said the third-floor nurse as she took away my fringed leather pouch and checked my jeans pockets. “For 72 hours. It helps you to get adjusted to being here.”
I turned to look down the hall, lit with caged overhead lights. The nurse insinuated that I had found a new home here, where I would live a life with slightly different rules. Like the difference between magnetic north, which you have to compensate for all the time, and true north, firmly established on every traveler’s map. Geographers call this variance “declination,” and if you do not compensate for it, you’ll get lost. A body making its own LSD gets lost, or at least stuck on the stairwell. An aide led me to my new room, where a small woman lay on a bed, face toward the ceiling with eyes open, bandages on her neck. She neither moved nor glanced my way. Swirling flecks of dust drifted in the light from a window partitioned by iron bars. I sensed desolation ahead, maybe like the first time a Jew discovered a swastika on a synagogue wall.
I had known fear as a child, experienced its sudden grasps, as on the day I found myself far from shore on a fast-diminishing sandbar, watching water churn in around me. That fear taught me to use caution, which comes in handy around forests, bodies of water, and spirited friends. I knew fear again when my mother had open-heart surgery. A throbbing, persistent fear that stayed until she went into recovery, and then rejoined me whenever I saw the bulging seam down her chest. This fear reminded me of mortality, which comes in handy around bodies of water and spirited friends. I knew fear when my brother physically fought with my father and my mother, which caused nausea and a surge of panic in me. Fear of such skirmishes taught me to seek peace, a wise strategy in a testy world. And around spirited friends.
The fear that seeped in during the spring in Kentucky, though, differed from all others in my life. They made sense, mostly, but this one blew the doors off my tidy soul, barged in, and became a resident.
From what I can figure, illness came before the fear settled in. A psychiatrist might disagree and tell you instead about family-of-origin issues and all sorts of childhood psychological dysfunctions, but you also have to know this: Somewhere along the panhandle of Florida, between Pensacola and Yulee, my cortex thinned. The sheath of membrane protecting my brain function got skimpy somehow, and left me wide open for deranged thinking. At least that’s one of the latest theories about what happened to brains like mine.
I’m pretty sure the thinning began the year I got sent home from school for wearing culottes. Well before I left for college to major in philosophy. Well before my synapses twitched with paranoid schizophrenia, manic depression, and psychosis. I could give you all the defining characteristics of this gumbo of diagnoses, the “if you have seven or more of these symptoms, see a doctor immediately” lists, but you only need to know this: My frontal lobe punk’d me.
Today, not one person around me thinks I have any reason to live in fear two decades after my first hospitalization at college, but I have not told them about the years of free-floating anxiety, depersonalization, borderline personality, and dissociative disorder. I definitely have not told them about my roommate.
Eighteen months after my first hospitalization, I lived in an apartment with a quiet, plump girl who went to school with me. She paid her own way; voc rehab paid mine. I don’t remember her name, just that she had freckles, but the rest of the memory goes like this: She knows nothing about my guillotines or that my pills are not vitamins. Even though she spills Frosted Flakes on the floor every morning and does not clean them up, I still do not want to obey the voice telling me to kill her.
I have swirling, drooling sleep thanks to medication, but for some reason my eyelids pop open in the middle of the night. My body feels pumped with air. In the darkness, a voice speaks, a male voice, I think.
“Kill her. Get a knife and stab her now.”
I am schizophrenic, but I have enough sense to know something is wrong. Even while I’m medicated and dopey, I know stabbing is a point of no return. The voice sounds authoritative, though, and my body feels pushed upward, against my will.
“Do it now,” says the voice.
Out of the corner of my eye, I look at my roommate, a white-skinned fattened lamb, and hope she makes it through the night. I resist the pressure to get up, breaking into a sweat from all my effort.
“Help me,” I try to shout. Only a raspy whisper emerges. Images of police and prison and the end of the world flash and twirl in my mind. My body shudders. I can’t believe my life will end this way. I can’t believe this is me.
The pressure on my body ceases and I slump into my mattress, exhausted. I do not know how long the episode lasts, but as suddenly as it began, it ends. I stare at the ceiling and pant, scared to budge.
I am afraid. Of self-absorption. Total. Constant. I want people to like depressed people like me. I want joy. I want a career. I want normal. I want to understand. I want you to understand. I want you to fix me. I want a pill. I don’t want a pill. I want help. I don’t want help. I don’t want to go to a psychiatrist. I want to see a psychiatrist every day. I want death. I want life. I want to stop wanting. I don’t want to talk about this anymore.
I am afraid. Of the stigma. The shame. The automatic assumptions that come when someone hears the words schizophrenia, manic depression, or borderline anything. The whispers that I am merely a drama queen. The belief that I am to blame and am too weak to get a grip. The perception that I am a bad Christian because I do not mortify the sin, whichever one it is, that causes mental confusion and anguish. I dread filling out any application that questions my medical history. I fear speaking the truth.
I am afraid. Of my genes. That my great aunt died in a mental hospital. That I see depression, obsession, and alcoholism everywhere I look down the family tree. My brother, who is older, has lived a tormented life, a magnified version of mine. He has crashed his car and rammed his head through a tree, abused drugs and alcohol, strangled people, and set animals and buildings on fire. Self-medicating, he says. He has crossed the line of normal behavior and I shudder, knowing I stand only one foot away from doing the same. The doctor tells me that if I have children, they run a strong risk of developing schizophrenia. I married, between hallucinations, and had two sons after my mental health improved. Was I a fool? The idea that they could suffer like this makes my stomach churn. Every time they go through a period of sadness I wonder “Is this it?” and I can barely breathe.
I am afraid. Of the cures. I try to stay positive; the worst remedies ran their course before I became mentally ill: cutting holes in the head to let demons out, blistering the scalp with mustard powder, drowning therapy, the spinning cage (100 revolutions a minute), surgical removal of abdominal organs, and induced convulsions so severe that bones fractured and teeth fell out. No one performs lobotomies anymore or induces insulin shock, but I am not thrilled about electroconvulsive therapy. A police Taser hits a torso with .002 to .03 amps of electricity, and shock therapy hits a skull with up to 1.6 amps.
What about the pills? Aren’t they worth an extra 25 pounds of weight, relentless restlessness, grogginess, insomnia, and complete lack of motivation? What could be so bad about a pill that helps you cope, gets you smiling again, keeps you from the seductive thoughts of suicide? But part of your personality gets amputated by the drug and no matter how much better you cope, you want your self back, even if it’s morose and takes a ridiculous amount of effort to get along with. Could I have my self and feel better, please?
I am afraid. Of not trying the cures. I could hurt myself, again. I could hurt someone else. I could lose my mind. I can only see two unmedicated choices before me: I could wake up every morning in gouging misery for the rest of my life or I could “go over the edge” one day and never come back to any semblance of sane living at all. Animalia. Forever pacing. Forever begging. Forever separated from my husband and children.
The options bring me to Stage IV “find-a-cure obsession” because the alternative looks pretty bad. So I try other cures: orthomolecular psychiatry and megavitamin therapy, homeopathy, cow hormones, St. John’s wort, candida diets, sugar-free diets, anti-inflammatory diets, prostaglandins/lecithin/DHEA or whatever the health food store says will work, shots for brain allergies, acupuncture, inner healing, and counseling.
While I’m in counseling, I am afraid to give the wrong answer to the inevitable question: “On a scale of one to ten, how depressed would you say you are right now?” If I say five, am I giving the right answer? Maybe I really am a six or a four. This morning it was four, this afternoon six. Five sounds good. But five could mean a stronger pill and I can’t sleep at all with what I’m on now. Seven. But I feel too shaky for seven. My head doesn’t stop talking, and without a strong pill I might go down the tubes. Five point five. Six? I now fear making decisions in any realm of my life.
I am afraid. Of a relapse. No one uses the word cured with schizophrenia. They say recovered, the same term used with alcoholics, who live forever liable to slide into another round of clinking ice and sweaty glasses. Cancer patients use the term remission. They reach the five-year marker and shout hallelujah. Depression, murky as it is in cause and course, does not have a word of its own to finalize its suspicious, halting end. I guess depressed people get over it, or gradually get better.
I gradually recovered. At the time of my diagnosis, prospects for a restored life were dim (“you’ll spend a lot of time here”), but now, about half of schizophrenics recover when certain factors are present: early treatment, cognitive therapy, permanent housing, supportive relationships, and persistence. It just so happens I was born persistent, very persistent—ask my husband. Whether by accident or by mercy from heaven, all the other markers needed for recovery also fell into place. The most critical factor was marriage to a solid, persevering man who bravely walked down the aisle with me, though he knew that I still hallucinated.
A new theory that might open the door to an actual cure for schizophrenia bases its hope on the Neanderthals, who supposedly never suffered mental illness. Theoretically, their big brains had a short time to mature, which shortened the years needed for schizophrenia to develop. As humans evolved, brain development changed and environmental factors had plenty of time to get involved and wreak havoc. Remove the toxic, hectic environmental factors, new experts say, and you might eliminate the cause of mental illness. Live a Stone Age lifestyle.
Neanderthals might have avoided schizophrenia, but I bet they still had a chunk of fear to deal with—from thundering mammoths to sizzling tar pits to hordes of marauders with spears. Fear is inevitable, whenever you’re born, a helpful tool around danger, but disastrous when it takes up residence in your soul. It bullied its way into mine, collateral damage from a mental war.
We have nothing to fear but fear itself. Those words from a man encased in the collateral damage of polio. Terror of fear, he said, “paralyzes needed efforts to convert retreat into advance.” That’s another way of saying fear will keep you permanently stuck at home in your nightie with the curtains closed if you don’t watch out. He was right, but what’s an ex-schizophrenic to do with all that leftover fear?
I have chosen to do many things while I am very afraid. Even though my chest still tightens and I want to turn around and run home, I stand up to the resident bully and walk on by, shaky legs and all. I plan on wearing him out.
Since those crumbling days in Kentucky, I have ended up doing much more than my real or imagined limitations allowed. I’ve held jobs, done volunteer work, led women’s retreats, been a mime, a clown, a mother, and a friend. Recovered, cured, healed, in remission, wrongly diagnosed—put it any way you like—I have learned to factor in my deviations wherever I go.
Last year, I pushed past fear to fly to Costa Rica and gathered my courage to zip-glide across deep ravines. But, on the same vacation, while I was snorkeling in a rocky cove, I was pulled toward the ocean by a powerful undertow. Choking on water and sinking with exhaustion, I was sure that I was dying. Unlike my imagined fears of an unraveled mind or of tormented children, the fear of actual, conscious death jackhammered any urge to retreat. Grasping outcroppings of stone, I advanced inches at a time, pulling forward with each wave that rolled toward the beach. I clung to the stones as each wave retreated, as its undertow sucked all untethered creatures out to sea.
By a barren shimmering beach, at the heaving change of the tide, my feet finally dug into the shore. The howler monkeys sat silent in the trees as I trudged up the crest back to my car and my family on the other side. I was shaken, for sure, but as I got to the top of the crest, there, far, far from my Florida home, I knew I was in God’s country.
Inez Holger tutors high school English and composition and has been nominated for a Pushcart Prize. Excerpted from Bellevue Literary Review (Fall 2010), a journal of humanity and human experience published twice a year by the Department of Medicine at New York University’s Langone Medical Center. blr.med.nyu.edu
This article first appeared in the March-April 2011 issue of Utne Reader.