Descending into Madness

I have been reading books on mental health. Either written by people who have suffered from mental illness or on the subject of.

All have been fascinating. For a start I have read three books by Carrie Fisher (yes, Princess Leia) – who is the ‘poster girl’ for Bi-polar and sharp, dry and witty to boot. Wishful Drinking and Shockaholic are more memoir-y – she is writing her memories down before the ECT she has wipes them all forever – but Postcards from the Edge offers some quite interesting insights into mental health, and even drug dependency, in a light way that was enough to get me into the subject and thinking more deeply.

On top of this there was an excellent Sky Arts programme from the 2012 Hay Sessions where Stephen Fry interviewed Kay Redfield Jamison to discuss her work on bipolarity. And Channel 4 had a ‘Mad’ season where Ruby Wax (the UK’s depression ‘poster girl’) looked into her own journey with depression “Ruby Wax’s Mad Confessions” and the “World’s Maddest Job Interview” which aims to challenge employers and the public’s perception of suffering from poor mental health.

I am reading “Touched with Fire: Manic-depressive Illness and the Artistic Temperament” by Kay Redfield Jamison (as above) as I have long believed that there is a strong link between creatives (of all types) and depression/mental illness.

I am only 9% into the book and already it is inspiring me and flooding me with ideas. This is mostly because it contains quotes and text from many literary greats (so far) about their own experiences of bipolar. Now, I’m not bipolar – just depressive – but the mania part of the illness seems just as bad as the depressed part, but can also lead to periods of extended (and exhausting) work periods for many creatives, who often feel ‘lost’ if it is medicated to make them ‘better’. Reading the descriptions they provide – and the fact that depression can often lead to preoccupation with religious themes (sin etc.) – has made me intrigued by the drawings and paintings of William Blake. His paintings on Dante’s Inferno in particular – despite them being of hellish themes – have often reminded me of madness. The crazed eyes of many of the subject probably cause this, as well as the confused lines and objects and the claustrophobic, oppressive feel of the whole.

I would like to look at translating some of the text I am finding in Jamison’s book into pieces. Probably by drawing with the sewing machine – there is something demented about the frenetic stitches caused by the machine when it is slightly out of control that add to the desired feeling in a way that you just can’t do with paper and pen. Loose threads that are unpredictable and can move and change shape are perfect at conveying the uncertainty of trusting your own mind.

Channel 4 also have some excellent text attached to the Job Interview programme (above) under their Mad World section – which I am including in full here, lest the pages disappear in the future.

http://www.channel4.com/programmes/worlds-maddest-job-interview/articles/mad-world-text-version

Mad World Text Version

Ever wondered what it’s like to hear voices? Or maybe you reckon you’re just ‘a little bit OCD’? Mad World explores three of the most misunderstood mental health conditions: schizophrenia, OCD and bipolar disorder.

Mad World
Population: 1.75 Billion

Schizophrenia

Over a lifetime, just under 1 in 100 of us will experience schizophrenia.
(Thats the ‘lifetime prevalence rate’ – the number of people who experience schizophrenia at some point in their lives.)

Over the course of a year, 5 in every 1000 people will experience schizophrenia.

Can you imagine not being able to tell the ‘real world’ from your own thoughts and perceptions?

Schizophrenia: try a new brain for size

There is no standard experience of schizophrenia, but symptoms that doctors will look for to make a diagnosis can include any of the changes in behaviour below.

‘Hi, I’m Sandeep. This is my experience of schizophrenia.’

Click here to take a trip inside Sandeep’s brain.

Hallucinations
(like hearing voices)
Sometimes the voices you hear can seem friendly, but more often they are critical, abusive or frightening.

Disordered Thoughts
(confused and jumbled thinking)
Thoughts may seem hazy, disorganised and unpredictable. You may feel your thoughts are disappearing and find it really difficult to communicate with other people.
Delusions
(strongly held false beliefs, paranoia)
Often these are unusual or extreme – you may believe you’re being followed, watched or plotted against by the people around you.

Like other mental health problems, schizophrenia is an episodic condition – people will be well or unwell at different points in their lives.

Other symptoms that are usually present in schizophrenia include&

Speech Problems
Jumbled thoughts can lead to confused speech – making conversation hard for other people to understand.

Losing Motivation You may lose interest in life and relationships, not want to leave the house, and find it difficult to concentrate or communicate.

Unpredictable Behaviour
All of these symptoms can lead to behaviour other people may find strange, such as becoming agitated easily, shouting or swearing for no reason.

Schizophrenia: open your mind

Schizophrenia is probably the most misunderstood mental health condition, but you almost certainly know someone who will be affected by it in their lifetime.

Let’s put the stats in context. In the UK population&

1.5% are wheelchair users
3% are twins
1-2% have green eyes
1% have a PhD
1% will experience schizophrenia (lifetime prevalence)

You probably know one of these guys.
Still think you don’t know anyone with schizophrenia?

Schizophrenia: it gets better

With the right treatment and support, most people who experience schizophrenia are able to improve and manage their symptoms. It’s a lifelong condition, but it’s not a life sentence.

For every five people with schizophrenia:

One will get better within five years of their first symptoms
Three will get better, but will have time when they get worse
On will have troublesome symptoms for long periods of time

Adding support from family and friends to medication can cut schizophrenia relapse rates in half.

There is no standard experience of schizophrenia. Each person will have a different set of symptoms, and a unique account of their condition.

Talking to your friends, family or colleagues about your mental health problem can be a big step in the recovery process and offering support to a friend makes a huge difference.

Click here to read Sandeep’s story.

OCD
(Obsessive-Compulsive Disorder)

Just over 1 in 100 of us have OCD at any one time.

And some studies suggest that 3 in 100 of us will experience obsessive-compulsive disorder at some point in our lives.

Maybe you think you’re ‘a little bit OCD.’, but its not just about keeping your sock drawer ordered by colour… What if your obsessions and compulsions ruled your every waking moment?

OCD: Try a new brain for size

OCD has two main features: obsessions and compulsions. Obsessive thoughts and urges can often be overwhelming and frightening. Here are a few common examples…

‘Hi, I’m Julia. I have OCD.’

Click here to take a trip inside Julia’s brain.

Obsessions

Intrusive sexual impulses
e.g. such as worrying that you will expose yourself at work

Fearing contamination
e.g. from dirt and germs in a toilet

Imagining doing harm
e.g. imagining you’re going to push someone in front of a train

Compulsions

Compulsions are repetitive actions or rituals that people feel compelled to do in order to relieve anxiety or stop obsessive thoughts.

Ordering or Arranging
e.g. keeping food organised by colour in the fridge

Washing
e.g. washing your hands six times with soap and six times without every time you wash your hands

Repeating actions
e.g. touching every light switch in the house five times before you go out

OCD: open your mind

Minor obsessions and compulsions are common. But if youre diagnosed with OCD, it’s usually when unwanted thoughts or actions start to disrupt your life.

There’s more to OCD than liking things neat and tidy. At its worst, being stuck in a seemingly endless cycle of obsessions that lead to compulsions can take over your life.

OCD is sometimes associated with above-average intelligence (as the nature of the condition involves complex thinking patterns).

Some people historians believe these guys had OCD:
Dr. Samuel Johnson, Beethoven and Charles Darwin

The average age for the onset of OCD symptoms is 19.

Both men and women are equally affected by OCD although, in children, OCD seems to be more prevalent in boys.

OCD: it gets better

While there’s no instant cure, there are plenty of different treatment options and self-help strategies available if you feel OCD is having a negative impact on your life.

After the age of 40, OCD usually fades away.
It’s rare over 50 (about 3 in 1000 people over 55).

For some people, it is possible to achieve complete recovery from OCD. Cognitive Behavioural Therapy (CBT) is one of the most effective treatments for OCD. It’s a form of talking therapy that focuses on connections between thoughts, feelings and behaviour.

Every person with OCD will experience a different set of symptoms and have their own story to tell.

Talking to your friends, family or colleagues about your mental health problem can be a big step in the recovery process and offering support to a friend makes a huge difference.

Click here to read Julia’s story.

Bipolar Disorder
(Formerly known as Manic Depression)

About 1 in 100 of us experience bipolar disorder in the course of a lifetime. But in any year, hospital admissions will be much higher than 1 in 100, due to the recurrent nature of bipolar disorder.

How much do you know about the reality of the highs and the lows?

Bipolar: try a new brain for sizeE

Bipolar disorder is characterised by swings in mood: from times of extreme highs (mania) to extreme lows (depression). In between these can be periods of stability.

‘Hi, I’m Tom. I have bipolar disorder.’

Click here to take a trip inside Tom’s brain.

Manic Episodes

Feeling ‘high’
(overly happy, outgoing or elated)
Mania often causes an abnormally euphoric mood with increased energy and activity.

High-risk behaviour
(like impulsive sex or spending sprees)
Rash decisions and risky adventures – often with disastrous consequences.

Unrealistic beliefs
(grandiose thoughts, distorted judgement)
You might have grand ideas of your own self-importance, and be full of outlandish plans.

Depressive Episodes

While the manic phase of bipolar is often a time of high energy and over-excitement, the low episodes of deep depression can be just as extreme.

Feeling hopeless
(sad, lethargic, despondent)
You might feel empty, pessimistic or worried. Feelings of guilt or despair can seem overwhelming.

Losing interest in activities
(like sex)
You could lose interest in the kind of activities you used to find pleasurable.

Self-doubt
(like feeling worthless)
You might experience a major drop in confidence and self-esteem.

Bipolar: open your mind

There are two main types of bipolar disorder – Bipolar I and Bipolar II – as well as some less common variations of the disorder.

The four most common types of bipolar disorder:

Bipolar I
The classic form. Recurrent episodes of mania and depression, mainly characterised by manic episodes.

Bipolar II
Longer periods of depression, with less disruptive symptoms of mania.

Rapid cycling
Rapid fluctuations between mania and depression, with little or no stable periods.

Cyclothymia
Frequent short periods of less severe mania and depression, separated by periods of stability.

The connection between bipolar and the arts is often discussed. Some people experience an increase in creativity and productivity during the manic phase of bipolar disorder.

Bipolar symptoms are often first experienced by people in their teens and early twenties.

A study has found that teenagers who excelled at school were four times more likely to develop bipolar disorder – particularly if they excelled in music or literature.

It’s often described as an ‘occupational hazard’ for celebrities, with famous faces of the disorder including Jean Claude Van Damme, Vincent Van Gogh and Catherine Zeta Jones.

Bipolar: it gets better

Bipolar disorder is not necessarily a chronic condition – there is a growing recovery movement among survivors. Seeking help and support in managing your symptoms can be an important first step.

[On Average:] Some research claims people with bipolar wait four-and-a-half years before seeking help.

[On Average:] People are misdiagnosed an average of three times before they discover they have bipolar disorder.

[On Average:] It takes 10.5 years for a correct diagnosis of bipolar disorder.

So, the average person with bipolar disorder spends 15 years without proper treatment or support.

Every person with bipolar disorder will experience a different set of manic and depressive symptoms, and respond to different treatments.

Talking to your friends, family or colleagues about your mental health problem can be a big step in the recovery process and offering support to a friend makes a huge difference.

Click here to read Tom’s story.

On Bipolar http://www.channel4.com/programmes/worlds-maddest-job-interview/articles/mad-world-text-version-bipolar

Mad World Text Version: Bipolar

This is a text version of the binaural audio experience in Mad World

You are in a car, the engine humming rhythmically. The window must be down because you can hear the sounds of a highway – cars whizzing past, the rush of wind.

You hear a man’s thoughts, your thoughts, rapidly flowing – he’s excited, wired.

You think: This is it. Today. This is it. Why didn’t I think of this before? I wonder if I should go faster, they’ll all get out of my way anyway. They can feel me. I know they can. God, look at the sky. Does anyone actually even look at the sky? Blue, blue, blue. I dont think I’ve ever looked at it properly before. Maybe I should pull over and walk the rest of the way. Take my shoes off, feel the earth under my feet. That’s what it’s supposed to be like. Everybody’s forgotten, but that’s it, isn’t it – earth, mud. Yes. Wow, look at the sky.

You suddenly notice that your mobile is ringing in your pocket – you fumble around and take it out, holding it up to your ear (the car swerves slightly).

‘Hello?’
‘Tom?’
‘Hey Louise, Lou-lou, how are you?’
‘Tom – where the hell are you? I’ve just had your boss on the phone – he says he’s been trying to reach you all morning. Why aren’t you at work?’ ‘Lou, it’s ok. It’s ok. I don’t need to go to work – I mean, you don’t need to either. I’ve had – what do you call it? I’ve had an epiphany. That’s it. Isn’t that a brilliant word? E-iph-any. Sounds like music.’

You think: I need some music. I should put the radio on.

‘Do you want to hear some music Lou?’
‘Are you driving?’
‘Yes – the open road Lou, the road to nowhere, on the road again!’

You think: ‘I wonder if I’ll see a hitchhiker. Maybe I should get out and hitchhike – I could meet anyone.’

‘You shouldn’t use your phone, you idiot. Put me on speaker at least.’
‘Ok ok ok, wait a minute.’

The car swerves a bit more. You press a couple of buttons and put the phone down beside you.

‘Hello? Lou?’
‘I’m here. Tom, why the hell are you driving? Whose car is it?’
‘It’s a surprise – it’s mine, ours I mean. Surprise! Wait till you see it Lou, it’s a beaut – best in the showroom. Nought to sixty in – um, I don’t remember. But it’s fast! You’ll love it. Wait till you see.’

You think: You know, I think the car’s part of me, really. I put my foot down, it speeds up, if I concentrate I bet I can do it without putting my foot down. I know I can.

‘Oh God, Tom. We can’t afford this, you know we can’t. I can’t believe this. You need to come home now – you’re really starting to scare me. Where were you last night? Did you even sleep?’
‘Lou Lou Lou, I’m fine – I’m fine. I feel amazing. It’s all amazing, Lou. I want you to feel this too. You need to stop worrying about everything. Have you seen the sky? I want you to go outside and look up right now, Lou – I mean really look. It’s incredible, you just have to let yourself see it. It’s really something.
‘Tom. Tom, listen to me. I want you to come home now – where do you think youre going anyway?’
‘Anywhere, Lou. The world! Why are we all sitting behind desks everyday Lou, do you ever ask yourself that? We dont even look up – we don’t even look out the bloody window. There’s so much to see out there, you just have to go. Just go. Dont you see?’

You think: Go, go, go. I wonder how fast it can really go?

‘Tom, you’re seriously scaring me. I don’t think you should be driving like this, please – listen to me.’
‘It’s all going to be ok. If something’s meant to happen, it will happen. I’m meant to do this, Louise. I just need to keep going. I need to hang up now, I need to concentrate. Bye Lou!’
‘Tom – wait!’

You hang up and turn the radio on – fiddling until you get to a channel you want.

‘You think: Poor Lou, she doesn’t understand. She just doesn’t understand what I really am. What I can really do. You know, I actually think, no, I know it – I can make those lights up ahead turn green – I know I can. I just need to concentrate. Concentrate… Concentrate… Yes! Yes, I knew it. I knew it.

The car speeds up – the wind whistles in your ears.

Tom’s Story – Bipolar disorder

This is a text version of Tom’s story in Mad World.

It actually took me a really long time to get a bipolar diagnosis – I think because, to be honest, I didn’t think I needed any help – not when I was manic anyway. When you are manic why would you go to the doctor’s when you feel absolutely incredible and youre just flying? A manic episode for me would start with hypomania, and for me, that always just feels really good. I would just be so full of energy and just wanting to do everything – I’d be going out every night, my mates couldn’t keep up. You just have so many thoughts whizzing around your head, you don’t want to sleep, or you can’t sleep. I’d stay up for three, four nights easily.

When I first started having manic episodes I was working in a job I really loved, in the media. And it’s really high energy anyway – you have to be ‘on’ all the time. And that suited me when I was manic – and I think people are sort of drawn to you more when youre like that, for a while anyway, they think you’re having lots of fun, they think that’s who you are. You know, I’d walk down the street and start talking to everyone I met, I’d walk into bars and be buying everyone drinks. But it’s not really your normal self.

When you get into full-blown mania, it feels good at first. It’s hard to describe, but I’ve had times when I just felt almost like I had special powers, or that I was ‘chosen’, or invincible. I thought I could do anything. And at that point it’s like hypomania, but amped up a bit more, but then you get to the point where you’re so amped up that you just get incredibly agitated and panicked. And you start doing stupid things – for me it was buying ridiculous stuff, taking all kinds of drugs, just being out of control really. And you have so many thoughts racing around your head and you just want it all to stop. It crosses over into this totally different experience.

The depression side, for me, is the complete opposite. It’s just like life has no colour – and I’m just completely drained and hopeless. Literally hopeless, you can’t see anything getting better. I’s actually the depression that made me go and see a doctor in the end. These days I’m on anti-depressants and a mood stabilizer, and it’s really helped keep me more stable. It’s genuinely changed my life.

On OCD (and we’re all a little bit OCD aren’t we?) http://www.channel4.com/programmes/worlds-maddest-job-interview/articles/mad-world-text-version-ocd

In fact, comedian John Richardson did an excellent investigation to his own OCD (is he/isn’t he?) as part of the Mad World series, but there is no further information available on it – John Richardson: A Little Bit OCD.

Mad World Text Version: OCD

This is a text version of the OCD binaural audio experience in Mad World

You’re in the bathroom of a restaurant. A couple of women are chatting next to you – ‘can I borrow your lip balm?’ etc – The sound of water in a sink. Faint scrubbing. You are short of breath. You turn the tap off and try to breath deeply. You think to yourself: ‘You can do this. You look fine You’re clean. Hair, teeth, nails. Hair, teeth, nails. All ok. Hair, teeth, nails.”

Your mobile phone rings in your pocket, you take it out and answer.
‘Hi, Helen.’
‘Julia, I’ve got seven missed calls from you -‘
‘7’ – you think – ‘1 2 3 4 5 6 7’,
‘- what’s wrong?’
‘Nothing, sorry, I was just wondering if you could check I locked the front door – are you in the flat?’
‘I should have checked again. Check one, check two, check three. 1 2 3.’
‘It’s fine, it’s locked.’
‘Can you check?’
‘If Helen gets attacked in the flat it’s my fault. What if Helen dies. Don’t let Helen die, one. Don’t let Helen die, two. Don’t let Helen die, three’.
‘Ok, ok, I’ll check. Aren’t you supposed to be on that date?’
‘I am, I’m here.’
“Well, what”s he like?”
‘He’s nice – he’s really nice. I’m just trying not to freak out.’
‘You’ll be fine. You’re amazing, just have fun.’
‘Right. Fun.’
‘Call me afterwards; bye Jules!’

You turn the tap on again and start to quickly wash your hands. ‘Don’t think about the germs, don’t think about what’s contaminated. Don’t think, don”t think.’

You take a paper towel to dry your hands, breathe out, and walk out of the bathroom doors into the restaurant. You’re greeted by the sounds of a fairly classy bistro – people murmuring, laughing, waiters pouring drinks, cutlery and glasses tinkling, a piano playing softly in one corner. You walk to your table and sit down.

‘Hey, I’m so sorry I took so long – my sister called me in the bathroom.’
Your date is warm and friendly: ‘Don’t worry, I kept myself busy ordering martinis – I was feeling all James Bond. Here they come!’
“1 2 3 4 5, 17, 17 words. Oh God, what’s in a martini again?’
A waiter sashays over. ‘Two dirty martinis, for madam’ – he places a glass next to you – ‘and for sir.’
‘Wow, they look amazing – thank you.’
‘You’re welcome, sir. Your starter is on its way. Enjoy.’
Your thoughts race as your date is speaking: ‘Dirty, dirty. No. Look at the glass, is that fingerprints? No straw. Do they sterilize them? Maybe they don’t. Shouldn’t the waiter be wearing gloves? What makes it a dirty martini? I can’t drink it, I can’t I can’t I can’t.’
Your date picks up his glass. ‘Cheers!’
You take a deep breath and try to sound cheerful. ‘Cheers!’
*clink*
‘Cheers, 1. Clink, 1. I can’t drink this, can’t drink it. No straw. The glass will cut me, it’ll hit my teeth. Come on, try a sip. He’ll think you’re weird if you don’t try it. One sip. One one one.”
You take a sip and force a smile. ‘Wow, that’s strong.’
He laughs, ‘This is probably when I should do my word-famous Sean Connery impression, but, you know, I wouldn’t want to peak too soon.’
‘1 2 3 4 5 – 8 – 17 – 23’ (you’re counting each word he says.)
You laugh too, you’re managing to sound much more relaxed than you feel.
‘World famous? Go on, you can’t just leave that hanging there.’

Your date continues to be charming and chatty as your thoughts race, layered over your conversation with him. Outwardly you seem remarkably breezy, but inside:

‘Why did I order salad? It’ll all be mixed up together. Oh God, he’ll see me rearranging everything. What if there are greens and reds together? No reds, no reds. What if a waiter hasn’t washed his hands and he picks up my plate and it’s contaminated? Why did I agree to come to a restaurant? Is that someone coughing? I feel sick, what if I am sick already, what if I get sick and I make Helen sick? What if he wants to kiss me later? What if he wants to have sex?’

The waiter is back: ‘Your starters – Greek salad for madam, and spare ribs for sir. Can I get you anything else?
‘Oh God, green and red.’
Your date answers: ‘Amazing, thanks. Just one thing, could you swap my water glass – it’s a bit dirty on the rim.’
‘1 2 3 4 5 6 7 8 9 14 18.’
‘Of course sir, very sorry about that. Just one moment.’ Glasses clink.
‘No problem!’ Your date turns back to you. ‘Sorry, I’m just a little bit OCD about things like that.’

You laugh.

Julia’s Story – OCD

My first memory of anything OCD in my life was probably things like not stepping on the cracks in the pavement when I was walking to school – and I was like, really scared about this – it would drive my mum up the wall, I’d just take so long to walk down the road! [laughs]

I’ve always been a bit of a neat freak, my teenage bedroom was definitely not typical – it was the tidiest room in the house! But I think it was when I was a teenager that I started being a bit obsessed with germs – especially around food. I got to the point where I was using disposable paper plates for every meal, and I’d never drink anything without a straw. I couldn’t go out to eat in restaurants, or if I did it was a nightmare – every time someone coughed I’d freak out. I started having all these rituals around eating – I suppose it was to make me feel like I had more control over it. I always had to eat from left to right – and I still do, actually. And I couldn’t deal with food touching – like peas next to potatoes, if something was touching I’d have to eat it really quickly, straightaway, just to get it off my plate.

It might not sound like much, but it does start to become all you can think about – you start to get anxious about everything. I would have to check I’d locked the door again and again after I’d left the house – I just wouldn’t trust my memory. I mean, I’d sometimes get off the bus on the way to work and go all the way home just to check one more time. I was always late for everything. My mates would just laugh about it though!

I do find it hard to explain what OCD has meant in my life – it can seem quite trivial sometimes, but for me it got to the point where I was just completely exhausted, and miserable really. I felt like I was trapped inside my own body, as if somebody had taken me over and was making me do all these things. I was really lucky to have had an understanding GP, when I finally did go and try and get some help. I’ve been on anti-depressants for the last year, and started a course of cognitive behavioural therapy – and I feel really positive about the future. My bedroom’s still ridiculously neat, but I’m definitely happier!

On Schizophrenia http://www.channel4.com/programmes/worlds-maddest-job-interview/articles/mad-world-text-version-schizophrenia

Mad World Text Version: Schizophrenia

This is a text version of the Schizophrenia binaural audio experience in Mad World

You begin standing on a train platform on the London Underground, you hear the ‘Ladies and gentlemen, please stand behind the yellow line for your safety’ announcement.

Someone is standing beside you, a friend: ‘Right, my train’s on the other platform. I better run.’

You answer dully: ‘Ok, see you – see you tomorrow.’

Suddenly you hear a hoarse whisper right in you ear: ‘Don’t touch the yellow line.’ The voice is joined by others whispering all around you: ‘Don’t touch it, don’t touch it, ladies and gentlemen.’

Your friend: ‘You know, you really don’t look so good. Are you sure you’re ok?’
You: ‘I’m fine. Honestly, I’ll be fine.’
Your friend: ‘Ok, I’ll see you at the lecture tomorrow morning – it’s medieval history, isn’t it? Perfect to snooze through!’
You: ‘Ha. Yes. Bye Ally.’

She pats you on the shoulder and walks off. You think you can hear her saying something as she goes, her voice harsher, slightly distorted: ‘What a loser.’

Voices seem to be all around you repeating in a sing-song: ‘You look like hell, you look like hell.’

You’re breathing quickly now. A train arrives and comes to a halt, you hear the Mind the Gap’ announcement. As it repeats it becomes more distorted and even demonic. In the background you can hear a group of voices murmuring quietly ‘mind the gap, mind the gap’, some soft laughter.

The train doors open and you hesitate for a moment – you’re breathing heavily – the voices are telling you not to get on the train. ‘Don’t do it, don’t get on, they know what you are, look at them all, they can all SEE you.’

You take a deep breath, step into the train carriage and sit down as the doors close behind you. As the train starts to move you hear a couple chatting next to you, their conversation is innocuous at first – their plans for the evening.

Man: ‘Can’t she stay an hour later?’
Woman: ‘She’s got college tomorrow – I asked her. I can always go home first if you want to stay out later.’
Man: ‘No, don’t be silly. The whole point of getting a babysitter is so we can spend some time together, anyway. With people who don’t puke on us while we’re having dinner.’
Woman: ‘That’s true.’
Man: ‘Also you’d never let me hear the end of it if I stayed in the pub longer than you sweetheart.’
Woman [laughs]: ‘That is also true.’

The couple’s conversation fades in and out slightly as the voices get louder in your head: ‘You know you’re nothing, don’t you? NOTHING. ‘You’re disgusting, filthy, they all know how disgusting you are. They don’t want you near them. You disgust me. You disgust us.’

You tune in and out, picking up a few snatches of conversation and sound around the carriage.

‘We’ve got to change at the next station, Donna!’
‘I’m tired.’
‘ – and so I told him I don’t like being spoken to like that.’

Suddenly you realise the people next to you are talking about you:

Woman: ‘We have to keep him away from the baby.’
Man: ‘He’s disgusting, look at him.’
Woman: ‘Don’t let him touch the baby. He’s filthy.’
Man: ‘He’s pathetic, you’re pathetic. Yes, you. We’re talking to you Sandeep.’

Now everyone in the carriage is talking about you.

‘Sandeep, Sandeep, Sandeep.’
‘We can see you Sandeep. You can’t hide.’
‘We see you.’

A tannoy announcement on the train seems to be speaking directly to you: ‘The front two doors won’t open in the next station, please proceed to the middle carriage you disgusting waste of space.’

The mocking voices become gleeful and rasping: ‘They’re all looking at you. They all SEE you. You can’t hide, you know you can’t hide.’

The sound of the train gets louder and louder. Your breathing gets more rapid.

The voices shout in unison: ‘You’re so ungrateful, you’re a waste of space, a waste of our time. A WASTE.’ Hysterical laughter.

Suddenly the sound of the train dies and you hear one voice speaking clearly in your ear: ‘You know they’re going to kill you now. You know.’

Sandeep’s Story – Schizophrenia

I was at uni when my schizophrenia began, although I didn’t know what was happening at the time. I just woke up one morning and I had this radio alarm clock that woke me up – but instead of the DJ talking about the radio programme, he was talking directly to me. And that kind of went on for a while I guess – people on the TV were commenting on things I was doing, telling me they were going to find me.

I mean, to me it’s just so weird now that I just accepted it – everyone was talking about me, criticizing me. You know, everyone in the street, in my lectures at uni, in the supermarket. Every time a car went past my house I could hear the people inside talking about me, but I just thought that was normal! You know, it was as real as me talking to you now.

And I was incredibly paranoid, hearing all this stuff, it made me want to just stay at home and draw the curtains. It’s hard to explain how it felt to be in my skin then. My thoughts were like listening to 10 different radio stations all at once, but not being quite on the right channel – I couldn’t sleep, I was so tired all the time.

It took me a long while to accept what my doctor was telling me, when I finally did go see my GP. And I’d convince myself that I shouldn’t take my medication, that it was poison. I was just really scared of everything. But after ending up in hospital a couple of times, it kind of started to sink in that something’s really wrong here; you know, that I need this medication and it’s a good thing, because otherwise I can’t see things clearly. I think that’s one of the most difficult things – acceptance, and awareness I suppose, of the warning signs. It’s really important to trust your friends and your family when they start to notice that you’re acting a little differently, because often you won’t notice it yourself.

I know schizophrenia is always with me, but I always tell people that I’m kind of like a diabetic who needs to take insulin. It doesn’t define my life, but it’s still just part of who I am.

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