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What is your worst nightmare? What if the entire human population thought of you as defective and criticized you harshly? How about having several voices screaming at you for any little thing that you did wrong? What would life be like if you couldn't decipher reality from imagination? These are common scenarios that schizophrenics deal with every hour of the day -- they can't wake up from their nightmare. A living hell. A torture chamber devoid of walls. Like a schizophrenic poet wrote, "I live in a closet. Unlike most closets, mine is invisible. No one else can see it or touch it or even come inside to keep me company. Nevertheless, its imprisoning walls and terrifying darkness are very real," (3). The loneliness that this poet, Pamela Wagner, feels is excruciating, yet what is it about schizophrenia that makes the victim so alone? What makes the disease so isolating and detrimental to one's existence? These questions are answered here by the voices of those who have first-hand experience as paranoid schizophrenics. Not only are some symptoms of schizophrenia discussed, but also the turmoil one goes through with medication as well.
Albeit that their have been many case studies performed by psychologists, the words of a schizophrenic give new meaning to the disease. For paranoid schizophrenia, an increase in recent literature reveals the point of view of the ill person. No two cases are exactly the same, so what follows is a conglomeration of experiences of paranoid schizophrenia survivors. As one schizophrenic has stated: "The schizophrenic experience can be a terrifying journey through a world of madness no one can understand, particularly the person traveling through it. It is a journey through a world that is deranged, empty and devoid of anchors to reality. You feel very much alone. You find it easier to withdraw than cope with a reality that is incongruent with your fantasy world. You feel tormented by distorted perceptions. You cannot distinguish what is real from what is unreal. Schizophrenia affects all aspects of your life. Your thoughts race and you feel fragmented and so very alone with your 'craziness,'" (6). Paranoid schizophrenia is a very debilitating disease -- it takes over one's life and creates a downward spiral into one's own surreal world. No longer can one communicate or relate to other people. Reality is distorted to fit the pattern of paranoia inside one's mind.
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"I know all the negatives: schizophrenia is painful, and its craziness when I hear voices, when I believe that people are following me, wanting to snatch my very soul. I am frightened too when they whisper, every laugh is about me; when newspapers suddenly contain cures, four-letter words shouting at me; when sparkles of light are demon eyes. Schizophrenia is frustrating when I can't hold onto thoughts; when conversation is projected on my mind, but won't come out of my mouth; when I can't write sentences but only senseless rhymes; when my eyes and ears drown in a flood of sights and sounds ... and on and on ... always more ..." (1). Schizophrenia heightens one's sensitivity to emotions, stress, sound, and other stimuli while inflating the ego of the schizophrenic to believe that the world in fact revolves around him. As a schizophrenic, suddenly it seems that the spotlight is on you alone. One is at once extremely important, yet persecuted. People are talking about you. People are conspiring against you. You are the chosen one. The schizophrenic's world is full of turmoil and distress, which is also, at the same time, very isolating.
Auditory hallucinations are often experienced by schizophrenics, whereby, usually, voices are criticizing the patient or are telling that individual to hurt themself. It seems that the feelings and thoughts of the schizophrenic take on an identity or some times several identities, each of which attempts to interpret the environment. "Emotions that would normally be comfortably catalogued as unacceptable take on a life of their own as voices that seem more real than the real world outside" (2). New characters are created by the imagination that distracts the schizophrenic from reality. The voices seem like they are coming from somewhere outside of the self; they are very real for the person experiencing them. "I heard them coming at me from the outside, as real as the sound of the telephone ringing... Occasionally they were friendly, but mostly they reviled me, shouting in their hoarse, harsh tones: 'You must die, you bitch,' they shrieked. 'Die! Die! Die!'" (2). Everyone feels at one point in his life that he is not performing as well as he would like. In the prior passage, Lori's perfectionism and eagerness to please her family turned into self-hatred. The slight awkwardness or embarrassment of a situation turned into a barrage of criticism from within. Not only did the voices chastise her for her mistakes, they eventually demanded that Lori hurt herself. They became so strong that Lori's own identity was becoming intertwined with the voices. "The Voices were twisting themselves around me. It was hard to tell where they left off and I began. They threatened me, and I believed them. If I squealed on the Voices, they might kill me. If I ratted on them, the person I told would have to die," (2). The voices inside the schizophrenic's head become so dominating and frightening that, in the mind of the schizophrenic, the voices are in control. Once that has happened, the situation becomes more tragic, for the free will of the patient has been lost. The schizophrenic often times withdraws from the community because the voices are so strong. He starts behaving as if he was afraid of people in general, when really what scares him is the voices. He does not trust himself to engage with others, because the voices are usually telling him that other people are dangerous or that they are making fun of him. There is also fear that other people might define themm as crazy and not understand. "It got to the point where I couldn't decipher reality from what the Controller was screaming. So I withdrew from society and reality. I couldn't tell anyone what was happening because I was afraid of being labeled as 'crazy.' I didn't understand what was going on in my head. I really thought that other 'normal' people had Controllers too," (1). This schizophrenic was so fearful of what was going on inside his head that he could not express it to anyone. He assumed that other people had "controllers" also. Assumptions like this can get schizophrenics into a pit of fear, because they are essentially lost in their own worlds without any basis of reality.
In addition to the hallucinations, one other symptom - delusions - also plays a major role in dissociating the schizophrenic from the world. There are many different types of delusions. The thought pattern of a delusional person is itself very unique. One wonders how such grandiose conspiracies develop in the schizophrenic mind. Dr. Frese, who is also schizophrenic, has a theory as to how delusions are capable of occurring: "When our rational processes break, our cognitions become dominated by the activities of the paleocortex... We begin to lose our confidence in rational processing and begin to see truth in nonlinear relationships," (4). Dr. Frese suggests that the neocortex stops functioning correctly so that the delusional person relies on more primitive manners of thinking. These more primal manners of thinking do not incorporate information into a rational pattern, but instead take bits and pieces of inconsequential material and string them together to fit the already paranoid thought pattern. When one is paranoid, he begins to look for signs that fit into his perception of reality. The delusions get more surreal as new information is incorporated. Some times, the delusions involve that person having a special mission in life, for example, Maurizio wrote: "I began to have delusions about the state of the world around me. Suddenly the noises made by cars and planes going by outside my house took on secret and deliberate meanings. I became convinced that I was involved in the start of a nuclear war and the only way for me to survive was to find the answer to a difficult riddle," (5). Maurizio's delusions were kept aflame by the hallucinations that he heard in the noise that the traffic made outside his house. He does not explain why he thought that a nuclear war was about to occur, but he does state that he was the one destined to be in control of the war. Another common delusion that schizophrenics have is thought broadcasting -- where everything that goes through a schizophrenic's mind is thought to be heard by the people around him. "I thought perhaps I had a special calling in life, something beyond normal... It progressed to where I thought the world could read my mind and that everything I imagined was being broadcast to the entire world," (6). Thought broadcasting is especially interesting for it is so common among paranoid schizophrenics, yet there really is no reasonable foundation for the delusion. What could make one believe that other people could hear their thoughts? Maybe there were coincidences that caused the schizophrenic to feel that another person knew how he felt about something. The delusions that are created make the illness especially difficult to treat, for the ill person must come to trust another and believe him over one's own irrational thinking.
Hope for the schizophrenic comes in the form of antipsychotic medication, which can alleviate some of the symptoms. However, these same medications can wreack havoc on the body and cause disorientation. One is never the same on antipsychotics as he was before the illness struck. Emotions often become flattened. As an anonymous schizophrenic has said: "Medication upon medication made my thoughts return to reality, but my body seemed suspended in time and space. There was no laughter; there were no tears; there was only existence," (1). What kind of life can one lead without emotion? It is as if a zombie has taken over the life of a once active person. The meaning has been stripped from these medicated patients. Antipsychotics do not work for everyone. As Lori, who was resistant to most medications, put it: "I felt like I was getting worse and worse with each trial of new medication. I felt like a tree being cut down. The more the doctors and medications hacked away at me, the closer I was to falling," (2). Finding a medication that works is extremely frustrating. The patient clings to the hope that this new drug will "cure" him, all the while suffering from the horrible side-effects of each drug. There is no method to figure out which medication will work for that individual. Psychiatric medications mostly work by trial and error with some consideration for the seriousness of the side-effects. This shopping period for antipsychotics can be tortuous in itself. Often, one has to take other medications to offset the side-effects of another. Some people, like Lori, have to take several different kinds of medication four times a day. Lori was at one time on so much medication that she did not know what to do with herself. "Because the medications made me at once lethargic and restless, I often just stood in one spot, moving my weight back and forth from one foot to another. I was taking so much medicine that I found it difficult to even smile. I walked around the house sluggishly, doing what I had to like a robot," (2). Lori, at that instance, was clinging to life out of the love for her family. For her, life was unbearable without motivation or feeling. Eventually, Lori found that she could offset the side-effects of the antipsychotics by taking illegal drugs. This is a trap that many schizophrenics fall into, for it gives their life a superficial meaning. One lives just to get high so that they can feel "normal" again. Illegal drugs make the case more difficult, because the drugs, along with the delusions, create an ever more surreal world for the schizophrenic.
Although paranoid schizophrenia is a deadly spiral that can be very difficult to escape from, there are many who have survived to retell their incredulous stories. Those who have spoken throughout this paper are survivors that have managed to get the help they need through psychiatric medicine and counseling. As Maurizio had put it, "my experiences with schizophrenia were initially very devastating, derailing my career and almost destroying my future" (5). The illness for him was a great obstacle to hurdle, but his life progressed once he learned how to cope with schizophrenia. For M.E. McGrath, schizophrenia has altered her life so much that she still feels the repercussions. "The illness has certainly stripped me of any pretense now, leaving me, instead, feeling hollow, yet hurting. I twist and turn, hoping to find a comfortable position in which just to be me," (1). Each schizophrenic's illness is different. Some are not cured by antipsychotics. Others are still in denial believing that there is nothing wrong with them. Unfortunately, with psychiatric care focusing on medication instead of housing the schizophrenics, many ill people are forced to live on the street. Pamela's picture of how schizophrenics are treated is glim. "Schizophrenia is, for most people, an uncharted and terrifying shadowland that they seek to avoid along with the sufferer whose torments, pain and oddness scare them. In the past, such people were put behind locked doors of asylums. Today they are simply consigned to the anonymity and powerlessness of poverty, and are forgotten," (3). It is true that there are many schizophrenic individuals that are homeless because the disease itself is so hindering to one's existence. If one is so poor that one cannot afford antipsychotic medication, then there is a very slim chance that he will be able to get a job. Schizophrenics need to be taken care of while they are in the depths of their illness. Unfortunately, people do not want to spend the money on those individuals in society that cannot fend for themselves. One wonders whether the reformation in psychiatric care really helped the nation or hindered it. Certainly, in the case of paranoid schizophrenia, a change needs to be made to help those that suffer. Empathy is a great place to start helping those with schizophrenia. Hopefully, this paper has helped to bring the schizophrenic's perspective into focus.
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