I live in Sydney, Australia and I’ve been diagnosed with schizophrenia. I don’t believe I really have such an illness, but now I’m stuck in the mental health system and not sure how to get out. It all began with an experiment.
During my teenage years, I was on the fence about whether “mental illness” was real. I used to have fluctuating moods, but nothing out of the ordinary; they all seemed a part of life. It seemed possible that some extreme emotions could be classified as mental illness. But due to my comfortable youth, I couldn’t imagine what could possibly trigger people into such debilitating thoughts.
At university, I developed an interest in the concept of mental illnesses. I didn’t understand what was meant by “normal” and how mental health professionals defined this term. At the time, I was studying engineering, and in STEM, all critical terms are well-defined. Yet in psychology, there was no formal definition of “normal.” I soon started to spend more time researching mental illnesses than doing my homework. At the same time (2008), I started to smoke a lot of weed. Smoking weed would fixate my concentration on mental illness. After about two semesters of researching mental illness and smoking weed, my grades slumped; I failed a lot of classes. My weed-smoking became even more frequent, and I knew I had a problem.
At first, I thought about giving myself a semester off to gather myself and then finish my degree. But by that point, I was also starting to get depressive symptoms. The feeling started with one random negative thought. Then these thoughts became more frequent. It got to the point where I was sad most of the time. I knew I had to stop smoking weed and take a time-out to get myself together. But I didn’t. Instead, I wanted to explore how deep my sadness could go. The formal accounts of depression and mental illnesses I’d read were too vague, and I wanted more detail. So, I decided to keep smoking weed and keep reading up on mental illnesses to see if I could briefly trigger the more severe symptoms of mental illness so I could better understand it. To my way of thinking at the time, I might someday use this knowledge to help people, so it seemed worth the risk.
Depression, then Psychosis
The first step into depression was changing my perspective on my past. Weed allows users to rationalize different points of view. In high school, I was frequently called a loser. I used to tell myself I was just learning, and it was OK not to fit in. With weed, I was now able to understand the bullies’ perspective. At first, this POV was interesting because it was new to me. I’d keep smoking weed to find other insights I might have missed. But then the negative thoughts became obsessive, and I stopped working out. This is when my mood started to drop.
As my mood dropped lower, the usual “high” and interesting perspectives from weed became fewer and the negative thoughts became more frequent. As my weed smoking became more compulsive, I cut down on eating to be able to afford to keep buying the drug. This is when withdrawal symptoms started to manifest. The anxiety they caused was debilitating because it heightened whatever emotions I felt. My negative thoughts became more negative still. It didn’t take too long before I was engulfed in negative interpretations of everything, past and future. I was now convinced that depression is real. I finally understood how sadness could become disabling.
As negative thoughts were now the only thoughts I had, I couldn’t seem to form opinions anymore. I thought, “What’s the point? I’m going to be wrong anyway.” I then became cognitively sluggish. And as weed-smoking became an all-day, everyday habit, my memory was no longer what it used to be. There was a point where I couldn’t tell the difference between objective material I read and my interpretation of it. I had to constantly pause to gather myself because of my mental confusion.
Was this psychosis? It depends on which psychiatrist you ask. Confusion is one criterion, but it’s on a spectrum. At what point does confusion become psychosis? The boundaries of sanity and insanity aren’t so clear. This was shown in the 1970s by the Rosenhan experiment.
For those unfamiliar, David Rosenhan was an American psychologist who conducted an experiment to test whether psychiatrists could tell the difference between “normal” and “abnormal” people. The researchers sent pseudo-patients with no record of mental illness into mental wards and told them to say they heard voices. Most of the participants were diagnosed with schizophrenia. The researchers’ report highlighted the fact that the hospital’s nurses framed their observations of the pseudo-patients’ normal behavior as symptoms, and that other patients were able to spot some of these pseudo-patients as fakes.
Early Psychosis Intervention (2009)
During this period of self-doubt, I voluntarily started to see a psychiatrist because I was engulfed in negative thoughts, and I just couldn’t find a direction in life. The slightest joys came only when I was high, and this made me feel “normal.” By this point, I had forgotten that my weed addiction was likely causing all of my mental and emotional symptoms.
My psychiatrist’s response was to put me on antipsychotic medication. They offered drug counseling, but I declined. They offered therapy but I declined it as well. I made no effort to place myself in any other form of treatment because while they did offer it, they did the bare minimum to explain the benefits. I was very lethargic from my depression and lacked motivation. You would think the mental health profession would consider the apathy of depressed patients and make a better effort to communicate their options.
Other incidents made me question the wisdom of psychiatry. Once I was in a mall, and I thought I heard my mom call my name. I looked around and didn’t see her. I knew that I must have heard something else; it was a very windy day. Wanting to know what psychiatrists write in their note pads, I told the psychiatrist I heard voices. So she wrote it down. But I knew I had actually misheard something, and at the next session, I corrected myself. But she didn’t write anything then. I concluded that they only write down information that can be used for a diagnosis. They don’t try to understand the context of their patients’ experiences.
First Involuntary Admission (2015)
I never did stop smoking weed and finally, my psychiatrist just ended the “psychosis intervention.” One day, my dealer cut me off and I also lost my job. So I started drinking alcohol. My habit got worse. I stopped eating because I thought I could fit more alcohol in my stomach that way. About a week later, my mom confronted me about the drinking, but I continued. Then she pulled a knife on me. I threw her off her wheelchair, took the knife from her, and called the police. I was shaken and drunk, acting in an “odd” manner. A few days later, I was still drinking but I told myself I was going to stop and came up with a plan to do something with my life. Then the police showed up with a medical crew. They told me I must go with them. I asked where they were taking me, but they didn’t answer.
I got stuck in a mental ward, with no explanation of what was going on and without their knowing I was withdrawing from alcohol and weed. Days later, they handed me a contract. The lady told me to trust her and just sign it. They locked me up against my will with no reason given; why would I trust her? Then, when I asked for more information, she told me she didn’t have time to tell me about my rights. I insisted and got my rights in writing. I read them and signed the document. Turns out I was supposed to see a doctor within 24 hours of arriving on the ward. It took a few more days before I did.
I also had a right to a hearing, but this tribunal was biased by design, involving one psychiatrist convincing another psychiatrist that I was mentally ill. That’s like a policeman trying to convince another police officer the accused is guilty; they both have the same incentive: to prosecute. A few days before the hearing, I was assigned a lawyer. He didn’t have time for me and barely made my case. Of course, they don’t give patients their files to help them defend themselves because of stigma. Basically, there’s no defense; these lawyers have about half a dozen or so patients to look after per day, while each patient’s files would take days to read.
They also medicated me before I had seen a doctor. How did they make the decision to medicate, and which drug to prescribe? All along there was still no explanation of what was happening to me. My suspicion of “mental health professionals” was growing. After a few days, the medications had taken full effect. And I started to feel zoned out. Then, they took me to the sub-acute (less severe) section of the mental ward. There I met other patients and befriended a few of them to track their situations alongside my own.
I was assigned the same doctor I’d seen at my earlier psychosis intervention. Just before I was discharged six weeks later, she told me the medications were working because I looked better, like the times I’d said I’d felt better during the psychosis intervention. This was bullshit! I’d been stoned all the way through my sessions with her. Sometimes I got stoned just outside the building and walked in baked. What she meant by “better” or normal was the stoned version of me she’d come to know.
Just before my admission, I’d been feeling optimistic about my plans and felt more energetic. I just had a drinking problem. After I got discharged, I was trying to implement the same plan I was going to pursue before admission. But I felt sluggish because of the medication. Medications lower serotonin; what do you expect? I tried to get some type of service job, but failed. I could get a tryout, but I just couldn’t keep my energy levels up. It took four cups of coffee within an hour to wake up every day and a cup every 45 to 60 minutes to stay alert. And I still got less done than before. I couldn’t read more than a chapter of a book a time.
The Schizophrenia Diagnosis (2015)
I kept drinking because I got no enjoyment out of life. When I completed a task towards my goal (financial trading), I didn’t feel good because the drugs I was on block dopamine receptors. When I could string together some sort of progress in spite of my low motivation, I didn’t feel anything. My heart felt like it was jamming, my body felt weak, and my mind was numb. I was still trying to find a real job. Back then, I was required to work to get welfare payments. Then one day, I was asked to come in and see a doctor, so I couldn’t make it to my welfare job. There I was handed a medical certificate by my psychiatrist. The note read: “SCHIZOPHRENIA.” This is how I found out about my diagnosis. There was no formal meeting to sit down and discuss my symptoms and diagnosis. By this point, it had become clear to me that the level of professionalism expected from most doctors is not required in psychiatry.
He couldn’t have been the one who’d made that diagnosis. At no point in my life could I not distinguish reality from fantasy. Proving someone has delusions based on their behavior ultimately requires mind reading. Plus, the diagnostic criteria for schizophrenia specify that I can’t be under the influence of drugs nor having withdrawal symptoms. Meanwhile, I was hungover every time I saw him, just as I’d been stoned all the way through my psychosis intervention. The psychiatrist I saw specializes in mood and anxiety disorders, psychosis, and bipolar disorder. He didn’t specialize in substance abuse; expertise in this area is required to diagnose any kind of substance-related psychosis.
I am convinced that I’ve been misdiagnosed with schizophrenia for all the reasons I’ve just described. In doing further research on mental illness I’ve learned that this preventable mistake is all too common. A recent report by Johns Hopkins Schizophrenia Center noted that over 50% of recently diagnosed schizophrenics were found not to have the disorder. Of those, over 40% didn’t have a “mental illness” at all. The researchers blamed faulty electronic medical records for these misdiagnoses, calling it “checklist psychiatry.” Apparently, this problem was never fixed after the Rosenhan experiment. But now that I have that label, I am treated as if that diagnosis is true.
Second Involuntary Admission
At my tribunal during my second involuntary admission, the reasons my psychiatrist listed for admitting me were that I had:
- Thought disorder. What did this mean? I argued against my psychiatrist. He argued in favor of the neurotransmitter hypothesis of mental illness and he called it a theory. All I said to him was that he needed proof for such claims, or the idea remained just a hypothesis rather than a verified scientific theory. Apparently, disagreement with a psychiatrist about one’s treatment plan or psychiatric thinking is a delusion or a form of abnormal thought, because it is psychiatrists who get to define “normal.”
- Grandiose delusions. At the time, I was writing a book. They asked me about my book, and I told them it was going to be “revolutionary.” Was I serious? No, I just gave them a hyperbolic statement, because I thought that might help me to get my hands on my medical records to see what they were writing in their notes. I got them, but there was nothing in there but blood tests and useless reports and nothing about my symptoms. Afterward, the psychiatrist asked to see a draft of my book, but I declined. Without evidence, they decided my hyperbolic statement was a delusional symptom.
- Paranoia. I did say “Nurses are drugging the food to make patients drowsy.” But, here’s the context: the day before I made this comment, I was talking to another patient and he told me he thought the nurses were putting something in the food because it made him drowsy. I told him it’s probably the gravy because it contains refined carbohydrates which can affect blood sugar levels. The next day, I also felt tired after eating. I saw him in the common area and just started a conversation about the food, which led me to the comment about the food being drugged. A nurse walked by as I was saying it. The psychiatrists took my comment out of context as paranoia.
- Rejection of diagnosis. Misdiagnosis cases are littered throughout history. But psychiatrists note a patient’s concerns about their diagnosis as a symptom, not as something to investigate.
After what I’ve experienced and witnessed, I consider the so-called symptoms of schizophrenia highly questionable. For example, to measure the severity of a patient’s symptoms, psychiatrists use the positive, agitation, and negative symptom scale (PANSS). The DSM characterizes the positive symptoms of schizophrenia as delusions, hallucinations, and disorganized speech. “Agitation” is aggressive behavior, and “negative symptoms” refers to apathy.
The World Health Organization’s International Classification of Diseases (ICD) system characterizes positive symptoms as distortions in thinking and perception. How do they measure distortions in perception? There’s no objective method. A man spent 20 years in a psych hospital because psychiatrists wouldn’t believe his version of events regarding a crime which turned out to be true. Post-traumatic stress reactions are also sometimes misdiagnosed as schizophrenia, because psychiatrists don’t want to believe the patients’ stories of trauma, claiming they are delusions. Delusions are disagreements. But as psychiatrist R.E. Kendell once wrote, “Disagreement is not an illness.”
Observations from the Mental Ward
It doesn’t require a professional evaluation to be declared mad. Patients are involuntarily institutionalized on the claims of others. These claims aren’t investigated. Psychiatry has no due process and mental health workers often don’t explain their reasons for locking patients up.
Unlike what the public imagines, questioning reality isn’t needed to prove someone’s insanity; the assessment is all based on behaviors. Psychiatrists do ask questions, but even if patients are aware of where they are and what’s happening, they can still be locked up. I observed this happening in intensive care; as patients came in, they showed a clear pattern of behaviors. It’s just the grief process that occurs when they realize they’ve been involuntarily admitted. They go through most of the phases: denial, anger, bargaining, depression and acceptance. These behaviors are taken to be the symptoms of schizophrenia.
I believe the anger phase of grief is the origin of the stereotype of the violent schizophrenic. Turns out most people diagnosed as schizophrenic are more likely to be the victims of violent crimes. Psychiatrists are working to reduce this violence stigma. But who started this stereotype? Psychiatrists! They have had exclusive access to mental asylums since the late 19th century. All cases of schizophrenia in early modern psychiatry were involuntarily hospitalized, and so are most cases today. As there are no reasons given to take away an individuals’ rights and lock them up indefinitely, such patients tend to get confrontational. I believe psychiatrists created this ‘violent’ stereotype by manipulating the patients’ environment to trigger their agitation and justify their incarceration. Schizophrenic and schizoaffective patients in the hospitals I’ve stayed in who were classified as violent weren’t confrontational to me — only to psychiatrists.
The bargaining phase of grief is interpreted as delusion, which psychiatry proves using a logic that’s the opposite of a police interrogation. In police interrogations, they question the suspect to see if they can get a specific answer that links the accused to the crime. What psychiatrists do is to make patients look clueless by not giving them any information about why they are locked up. The mental health professionals assume that they’re trying to help the person, but patients don’t understand this. This set-up creates two different interpretations of what is happening. Patients then try to bargain their way out of mental wards, guessing the reasons for their involuntary admission. In the process, patients list many possible different reasons and are unlikely to guess the psychiatrist’s reasoning. The process is constructed to confirm delusionality in anyone.
The depression phase is what psychiatrists call the negative symptoms of schizophrenia. After a while, involuntary patients give up hope for change and just sit there and watch television. Schizophrenia is only described as a lifelong illness because psychiatrists created an alienating ward environment that triggers the symptoms they are looking for, and once the symptoms are diagnosed, can’t help their patients because they are treating them for unproven biological causes.
While on the wards, it became obvious to me who was actually experiencing psychosis and who had been misdiagnosed. Obviously psychotic patients don’t go through the grief process, because they have nothing to grieve — some don’t even know where they are. Classically “schizophrenic” patients have no direction in life, thus they’re indifferent about their involuntary admission. To not recognize that their dignity has been taken away is, for me, the true sign of insanity.
As for patients who do go through the grief process, they know where they are and they’re not agreeing with their treatment. Generally, they have some vectors to their lives, and they have reasons to want to get out of the ward. These patients have been misdiagnosed. This is the critical problem of clinical psychiatry: the context behind patients’ behavior is too often disguised. In front of psychiatrists, everyone shows disagreeableness, which is seen as a behavioral trait of schizophrenics. But their reasons for disagreeing differ, which can only be found by engaging in real, personal conversations.
But psychiatrists have only superficial, mechanical conversations with patients, and these discussions plus the manipulative environment produce disagreeableness. Most importantly, there is no benefit of the doubt given! If a patient doesn’t know a topic, and psychiatrists do know, the patient is said to have a cognitive deficit. If a patient knows a topic and psychiatrists don’t, the patient’s knowledge is a delusion. In this way, clinical settings create false-positive symptoms.
Concluding My Experiment
Through experimenting with my own mental health, I found that depression is very real. Treatment for depression, however, needs to change to a therapy-first model. I found that the loss of an objective in my life was the biggest trigger of my downward spiral. Giving myself tangible goals has enhanced my mental state the most. By setting goals, following a healthy diet and exercising, I saw my mood improved. I still had negative interpretations. But after doing cognitive exercises such as reading, these interpretations disappeared. I’ve taken antidepressants and antipsychotics, but all they do is numb me out. I believe helping patients set a tangible goal and hitting milestones is the key to beating depression.
So, am I actually crazy? Possibly. But just as in the Rosenhan experiment, long-term mental hospital patients recognize that I’m not like them. They have a better idea of who is “sick” or not because they have a more holistic view of other patients — the only thing to do in mental wards is to socialize.
I have tried getting a second opinion on my diagnosis, but I recognize that these are not really independent judgments. I can’t choose to see whatever psychiatrist I want to; I can only select one they’ve approved. Of course, they’ll come to the same conclusion because they collude. I’ve learned not to argue with psychiatrists because they see disagreements as delusions. So I must comply with their treatment or I’ll get sent to a mental ward again.
Schizophrenia is not like it’s conceived in the popular imagination. As Dutch psychiatrist Jim Van Os has claimed, an entity called schizophrenia does not exist. There are too many variations for it to be a single illness. There are only hallucinating, detached from reality, disagreeable, or misdiagnosed patients. Only a small minority of “schizophrenics” hallucinate and have distressing experiences. Antipsychotics seem to work for these individuals. For most of the rest of us, the treatments are worse than no intervention. The authoritarian tendencies of psychiatry must stop if any of us are to be well.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.