Cognitive Behavioral Therapy Session | Thursday, October 8, 2015 [Enhanced]
I was diagnosed with Tourette’s at the age of 12, although, according to my mother, I had shown symptoms since I was two. I sometimes wonder whether I was even then showing signs of the psychosis that has plagued me for my entire adult life.
I was 18 when I had my first psychotic episode. It was Christmas Day, 1994. I was living in New York City and was admitted to Beth Israel, where I was given a number of tests—medical and psychological.
My toxicology report came up 100% clean, a clear indication that my psychosis was not drug-induced. My intake report by the ER doctor shows that I had a “loosening of association” and “pressured speech,” both of which can indicate schizophrenia, schizoaffective disorder, or bipolar disorder with psychotic features. No wonder it took so long for me to get the right diagnosis; so many of the symptoms overlap.
However, I want to bring this back to delusion and truth, and how people so frequently label your truths as delusional as soon as you’ve been diagnosed with a psychotic disorder. I will also discuss my condition’s genesis and prognosis—and then move onto those accomplishments for which I’ve never been truly recognized.
I often wonder if other people, like me, have trouble being believed.
As I may have mentioned already, serious mental illness, such as schizoaffective disorder, is believed to be caused first by a genetic predisposition to develop mental illness and second by environmental factors. In my family, I have a grandfather who seems to have been diagnosed with schizophrenia, according to old medical records that I recently found. In addition, I have two second cousins, both of whom have been publicly diagnosed with mental illness. So, I would definitely seem to be genetically predisposed to becoming mentally ill.
However, having this predisposition isn’t enough. You also need certain environmental factors. What I’ve read in some of the literature is that mental illness can be compared to diabetes. A person may be genetically predisposed to develop diabetes, but if that person gets enough exercise and watches their sugar intake, then the diabetes may never take hold—it’s the same with mental illness.
In my case, I had the predisposition, but I also underwent enough traumas (sexual, physical, and emotional abuse) and upheavals (such as my parents’ divorce when I was young) for the illness to take hold. Boy, did it take hold.
Sometimes, though, people like my sister, who has a genetic predisposition plus environmental factors (my sister comes from the same family and has had the same kind of upheavals), do not become mentally ill. Nobody knows why.
Maybe, as my wife says, it’s just the luck of the draw. She’s kidding. At least about the luck part, because having mental illness isn’t lucky, although we do have to keep laughing about it. Keep positive. You’re never alone if you can laugh with someone about it.
As I’ve mentioned, I have schizoaffective disorder. Originally, though, I was diagnosed with depression. That was back in 1994, when I was 18.
Over the next 10 years or so, I saw doctor after doctor, moving here and there, trying to find my place in the world. I made seven suicide attempts and had years of alcohol and drug abuse issues. My last suicide attempt was in 2001, and I was freed from my drug and alcohol addictions in early 2003. More than 11 years ago.
As I was getting off the drugs, I saw a doctor who diagnosed me with schizoaffective disorder, which basically means schizophrenia with a mood disorder thrown in, and, in my case, that mood disorder is bipolar with manic features. However, in 2005 and 2006 I saw a doctor who said that I did not have schizoaffective disorder. Instead, I had a personality disorder. The point is that getting the right diagnosis can be time-consuming and frustrating, but it is also necessary, as once I was “re- diagnosed” with schizoaffective disorder, I was able to get on the right medication. But that’s a different story altogether.
I’m focusing here on being diagnosed with any type of mental illness that includes psychotic features that then make it almost impossible for people around you to believe your truths. However, not only do I have the double whammy of a thought disorder coupled with a mood disorder, I also have Tourette’s syndrome, which is considered severe since this usually tapers off in one’s 20s but mine did not. I’m 39 now, so, along with the confusion I suffer and the mood fluctuations, I also tic and sometimes engage in coprolalia, which is involuntary swearing or yelling out racial epithets.
Added to that mix, I also seem to have aspects of obsessive compulsive disorder—I have to keep my computer arranged ‘just so’; Post-traumatic Stress Disorder (PTSD)—I frequently relive earlier traumas; attention deficit disorder—I can’t focus on anything for any period of time; autism or Asperger’s—like Temple Grandin, I may be smart, but I can’t read social cues at all. Makes it difficult to hang out and just be “one of the guys.”
My current psychiatrist, Dr. C, who—unlike others—never hesitated to diagnose me, saw me when I was at my worst. I was in the middle of a psychotic episode. I was in the process of a divorce (my wife and I have since reconciled), and I had no money, as my family had cut me off from my trust income. In the past, too many doctors had seen me when I did have money and was able to hire people to do what I could not—for example shopping, driving, and cleaning. Because these doctors saw me when I could hire people, they all considered me to be “too high functioning” to have any form of schizophrenia.
As a result of being considered “high functioning,” I was diagnosed for years as having a personality disorder. Some doctors thought I had borderline personality disorder (BPD); others thought I had a personality disorder not otherwise specified (NOS). Let me tell you, having the right diagnosis has turned things around at last. I’m now on the right medication. My wife and caregivers understand the nature of the illness and know some excellent ways of dealing with it and with me.
Although the illness will never go away, I do have hope that I’ll continue to get the right treatment and that my life will continue to get better.