Probing Psychoses

Courtney Humphries in Harvard Magazine:

Feature_JAAndrew LeClerc knew something was wrong when he heard voices when no one else was around. Some were those of people he knew, others were unfamiliar, but all had the authentic mannerisms of real people, not his imagination. He was in his early twenties, unsure of his direction in life, and had been taking synthetic marijuana to ease stress from past traumas. Disturbed by the voices, he sought help in an emergency room and voluntarily admitted himself to a psychiatric hospital, not realizing he would be kept there for six days. He was diagnosed with psychosis, but had little interaction with a therapist. “You mostly sit around with coloring books,” he says. It felt like a punishment, when all he wanted was help. Afterward, he contacted therapists, but many were booked. An online search led him to a research study at Beth Israel Deaconess Medical Center in Boston for people newly diagnosed with psychotic disorders. In January 2014, he entered a two-year study that compared two approaches to psychotherapy to help manage cognitive impairments and other symptoms. He was also prescribed an antipsychotic medication.

Eventually he was diagnosed with schizophrenia. Now, about four years later, at 26, LeClerc is learning to live with the condition. “It’s hard for a person who’s diagnosed with schizophrenia to be told something’s not real when they think it’s real,” he says. He continues to take antipsychotic medications that help control his hallucinations and lives in an apartment below his parents in Middleton, Massachusetts. He’s hoping to start a small business, putting his love of gardening to work as a landscaper. But more importantly, he’s learned to make peace with his mind. He likes to say: “I don’t hear voices, I hear my own brain.” When voices do appear, he recognizes them as a product of an aberrant auditory cortex, and he thinks about engaging his prefrontal cortex—the decision-making part of the brain—to help him distinguish fact from fiction. “I have tools to pull myself back to the moment,” he says. Not everyone who struggles with schizophrenia is able to find such stability. The illness takes many forms; symptoms may include hallucinations and delusions, lack of motivation, and cognitive problems similar to dementia. It tends to strike in the late teens and early twenties, robbing young people of their mental stability just as they’re entering adulthood, beginning careers, or pursuing a college degree. Some improve, while others experience a long mental decline.

More here.